EXAMPLE: Suppose you read the following statement:
....A..B..C..D..E......(1. I am in great physical health.
If you were not in great physical health‚ then you would circle the letter "A" to indicate that this statement is "not at all characteristic" of you. If the statement was "slightly characteristic" of you‚ then you would circle the letter "B." If the statement were "somewhat characteristic" of you‚ then you would circle the letter "C." By contrast‚ if you considered the statement to be "moderately characteristic" of you‚ then you would circle the letter "D" for that item. And finally‚ if the statement was "very characteristic" of you then you would indicate your response by circling the letter "E."
1. I feel anxious when I think about my health.
2. I have the ability to take care of any health problems that I may encounter.
3. I am very aware of how healthy my body feels.
4. I do things that keep me from becoming physically unhealthy.
5. The status of my physical health is determined mostly by chance happenings.
6. I think about my physical health all the time.
7. I’m very assertive when it comes to looking out for my own physical health.
8. I expect that my health will be excellent in the future.
9. I am to blame for those times when I become sick or don’t feel well.
10. I sometimes wonder what others think of my physical health.
11. I'm very motivated to be physically healthy.
12. When I am ill‚ I myself am in control of whether my health improves.
13. I derive a sense of self-pride from the way I handle my own physical health.
14. I am very satisfied with my own physical health.
15. The status of my physical health is determined largely by other more powerful people.
16. Not only am I in good physical health‚ but it’s quite important to me that I be in good health.
17. I am in good physical health.
18. If I am careful to avoid becoming ill‚ then I will be in good physical health-shape.
19. I am depressed about my current physical health.
20. I feel like my physical health is something that I myself am in charge of.
21. I'm worried about how healthy my body is.
22. I am competent enough to make sure that my physical health is in good shape.
23. I notice immediately when my body doesn't feel healthy.
24. I am motivated to keep myself from becoming physically unhealthy.
25. The status of my physical health is controlled by accidental happenings.
26. I think about my physical health more than anything else.
27. I’m very direct with people when it comes to my own physical health needs.
28. I believe that the future status of my physical health will be positive.
29. When I become sick or ill‚ I am the person to blame.
30. I'm very concerned with how others evaluate my physical health.
31. I'm strongly motivated to devote time and effort to my physical health.
32. During times when I am sick‚ my own behavior determines whether I get well.
33. I am proud of the way I deal with and handle my health.
34. I am very satisfied with the status of my physical health.
35. My physical health is largely controlled by people other than myself (e.g.‚ friends‚ family).
36. Not only do I take care of my physical health‚ but its very important to me that I do so.
37. My body is in good physical shape.
38. I can pretty much prevent myself from becoming ill by taking good care of myself.
39. I am disappointed about the quality of my physical health.
40. My health is something that I alone am responsible for.
41. Thinking about my physical health leaves me with an uneasy feeling.
42. I have the skills and ability to ensure good physical health for myself.
43. I'm sensitive to internal bodily cues about my physical health.
44. I try to avoid engaging in behaviors that undermine my physical health.
45. Whether (or not) I am in good physical health is just a matter of luck.
46. I tend to be preoccupied with my own physical health.
47. I am somewhat passive about getting my health needs met.
48. I do not expect to suffer health problems in the future.
49. If I were to become ill‚ then I’m to blame for not taking good care of myself.
50. I'm very aware of what others think of my physical health.
51. I have a strong desire to keep myself physically healthy.
52. If I were to become ill‚ I myself would be responsible for making myself better.
53. I am pleased with how well I handle my own physical health.
54. My present degree of physical health is personally satisfying to me.
55. My health is largely determined by the actions of powerful others (e.g.‚ health professionals).
56. Not only am I in good physical health‚ but it’s important to me that I stay physically healthy.
57. I am a well-exercised person.
58. If I look out for my health‚ then I will stay in good physical healthy and avoid illness.
59. When I think about my current physical health‚ I feel really down in the dumps.
60. The status of my physical health is determined largely by what I do (and don't do).
61. I usually worry about whether I am in good health.
62. I am able to cope with and to handle my physical health needs.
63. I know immediately when I'm not feeling physically well.
64. I really want to prevent myself from getting out of shape.
65. My physical health and shape have little or nothing to do with luck.
66. I’m constantly thinking about my physical fitness.
67. I do not hesitate to ask for what I need for my physical health.
68. I will probably experience a number of health problems in the future.
69. If I were to start feeling sick‚ then it would be my own fault for letting it happen.
70. I'm concerned about how my physical health appears to others.
71. It's really important to me that I keep myself in proper physical health.
72. Whether I recover from an illness depends in large part on what I myself do.
73. I have positive feelings about the way I approach my own physical health.
74. My current level of physical fitness is very pleasing to me.
75. In order to have good health‚ I have to act in a pleasing way to other more powerful individuals.
76. I keep myself physically healthy‚ and it’s very important to me that I stay fit and healthy.
77. My body needs a lot of work in be in excellent physical shape.
78. I will be able to avoid any illnesses‚ if I just take care of myself.
79. I feel unhappy about my physical health.
80. What happens to my physical health is my own doing.
81. I feel nervous when I think about the status of my physical health.
82. I have the capability to take care of my own physical health.
83. I'm very aware of changes in my physical health.
84. I am really motivated to avoid being in terrible physical shape.
85. I don't believe that chance or luck play any role in the status of my physical health.
86. I think about my physical health the majority of the time.
87. When it comes to my own physical health requirements‚ I ask for what I need.
88. I anticipate that my physical health will deteriorate in the future.
89. When something goes wrong with my own physical health‚ it’s my own fault.
90. I'm concerned about what other people think of my physical health.
91. I strive to keep myself in tip-top physical shape.
92. If I were ill‚ my recovery would depend on how I myself deal with the problem.
93. I feel good about the way I cope with my own physical health needs.
94. When I think about my present physical health‚ I am very satisfied.
95. My physical health is largely determined by people who have influence and control over me.
96. I try to stay in good physical condition‚ and its extremely important to me that I do so.
97. My physical health is in need of attention.
98. If I just pay attention to my health‚ I will be able to prevent myself from becoming sick.
99. I feel sad when I think about my present physical health.
100. Being in good physical health is a matter of my own ability and effort.
THIS TEST‚ OR ANY PARTS THEREOF‚ MAY NOT BE REPRODUCED IN ANY FORM WITHOUT PERMISSION OF THE AUTHORS ([email protected]).
This instrument can be found online at: http://www4.semo.edu/snell/scales/MHQ.htm
A = Not at all characteristic of me.
B = Slightly characteristic of me.
C = Somewhat characteristic of me.
D = Moderately characteristic of me.
E = Very characteristic of me.
Snell. William E.‚ Jr.‚ Johnson. Georgette.‚ 1997. The Multidimensional Health Questionnaire. American Journal of Health Behavior;Jan/Feb97‚ Vol. 21 Issue 1‚ p33