1. Try to imagine that you overhear two people whom you know very well talking about someone. After a while they say something that makes you realize that they are talking about you because what they say fits pretty closely with how you think other people see you. Which of the following statements is closest to the one that you “overheard?”
a) “X” seems to be a pretty well balanced person. Nothing much bothers him/her.
b) I like “X” but I wish he/she weren’t so fussy and finicky.
c) Poor “X” always seems to have something the matter with him/her!
d) “X” is very moody‚ don’t you think? I wish he/she were a bit easier to get along with.
e) I simply don’t understand “X.” I wish I knew what made him/her tick.
2. Here’s a question about your relationships with the opposite sex. Which of the following most common corresponds to your own case?
a) I find it extremely easy to get along with members of the opposite sex‚ and my love life is smooth and untroubled.
b) I am quite unable to form a happy relationship with anyone of the opposite sex‚ and I find this very worrisome.
c) On the whole‚ I get along well with members of the opposite sex‚ and I have difficulties or upsets from time to time.
d) Occasionally‚ I get along well with men/women‚ but most times it’s not too easy.
e) I lead an active love life‚ but it’s a very troubled and uncertain one.
f) I cannot find any statement above that is anywhere near my own case.
3. Here are six statements. Indicate whether you strongly agree‚ agree‚ disagree or strongly disagree with each.
a) Politicians tend to be concerned with advancing themselves rather than helping ordinary people. _______________
b) “Spare the rod and spoil the child” may be an old-fashioned saying‚ but there is certainly a good deal of truth in it. ________________
c) Most people who suffer from neuroses could benefit from more firmness and less sympathy. ___________________
d) Homosexuality is basically wrong and is a matter for punishment rather than treatment. ______________________
e) People who become alcoholics have only themselves to blame.__________________
f) An untidy house denotes an untidy mind. _____________________
4. Indicate which of the following statements most closely agrees with your overall picture of your attitude toward life.
a) I feel full of confidence about the future most of the time.
b) I’m pretty optimistic about things on the whole.
c) Sometimes‚ I feel optimistic‚ sometimes pessimistic‚ about the way things are going to turn out.
d) Occasionally‚ I feel optimistic‚ but most I’m not too hopeful or happy about my future.
e) The future looks pretty black to me most of the time.
5. Indicate the questions to which you answer “yes.”
a. Do you have difficulty sleeping? _____
b. Do you tend to be troubled by dizzy spells or shortness of breath? ____
c. Do you dislike the idea of travel? _____
d. Do you have what you feel to be an unreasonable fear of high places or open spaces? _____
e. Do you often find yourself crying? _____
f. Do you dislike shyness in others? _____
g. Do you find that you get unusually annoyed if someone prevents you from doing something you want to do? _____
h. Are you interested in athletics? _____
6. Here are some drugs that people take to help them when under stress of one kind or another. Say honestly whether you use them never‚ occasionally or regularly.
a. Aspirin or tranquilizers: _____________________________
b. Sleeping pills of any kind: _____________________________
c. Herbal tonics or medicine: _____________________________
d. Alcohol: _____________________________
This instrument can be found at: http://www.lopdf.net/d/Coping-Skills-for-Anxiety.pdf