1. I usually keep track of my progress toward my goals.
2. My behavior is not that different from other people’s.
3. Others tell me that I keep on with things too long.
4. I doubt I could change even if I wanted to.
5. I have trouble making up my mind about things.
6. I get easily distracted from my plans.
7. I reward myself for progress toward my goals.
8. I don’t notice the effects of my actions until it’s too late.
9. My behavior is similar to that of my friends.
10. It’s hard for me to see anything helpful about changing my ways.
11. I am able to accomplish goals I set for myself.
12. I put off making decisions.
13. I have so many plans that it’s hard for me to focus on any one of them.
14. I change the way I do things when I see a problem with how things are going.
15. It’s hard for me to notice when I’ve Ahad enough@ (alcohol‚ food‚ sweets).
16. I think a lot about what other people think of me.
17. I am willing to consider other ways of doing things.
18. If I wanted to change‚ I am confident that I could do it.
19. When it comes to deciding about a change‚ I feel overwhelmed by the choices.
20. I have trouble following through with things once I’ve made up my mind to do something.
21. I don’t seem to learn from my mistakes.
22. I’m usually careful not to overdo it when working‚ eating‚ drinking.
23. I tend to compare myself with other people.
24. I enjoy a routine‚ and like things to stay the same.
25. I have sought out advice or information about changing.
26. I can come up with lots of ways to change‚ but it’s hard for me to decide which one to use.
27. I can stick to a plan that’s working well.
28. I usually only have to make a mistake one time in order to learn from it.
29. I don’t learn well from punishment.
30. I have personal standards‚ and try to live up to them.
31. I am set in my ways.
32. As soon as I see a problem or challenge‚ I start looking for possible solutions.
33. I have a hard time setting goals for myself.
34. I have a lot of willpower.
35. When I’m trying to change something‚ I pay a lot of attention to how I’m doing.
36. I usually judge what I’m doing by the consequences of my actions.
37. I don’t care if I’m different from most people.
38. As soon as I see things aren’t going right I want to do something about it.
39. There is usually more than one way to accomplish something.
40. I have trouble making plans to help me reach my goals.
41. I am able to resist temptation.
42. I set goals for myself and keep track of my progress.
43. Most of the time I don’t pay attention to what I’m doing.
44. I try to be like people around me.
45. I tend to keep doing the same thing‚ even when it doesn’t work.
46. I can usually find several different possibilities when I want to change something.
47. Once I have a goal‚ I can usually plan how to reach it.
48. I have rules that I stick by no matter what.
49. If I make a resolution to change something‚ I pay a lot of attention to how I’m doing.
50. Often I don’t notice what I’m doing until someone calls it to my attention.
51. I think a lot about how I’m doing.
52. Usually I see the need to change before others do.
53. I’m good at finding different ways to get what I want.
54. I usually think before I act.
55. Little problems or distractions throw me off course.
56. I feel bad when I don’t meet my goals.
57. I learn from my mistakes.
58. I know how I want to be.
59. It bothers me when things aren’t the way I want them.
60. I call in others for help when I need it.
61. Before making a decision‚ I consider what is likely to happen if I do one thing or another.
62. I give up quickly.
63. I usually decide to change and hope for the best.
1. Receiving relevant information
2. Evaluating the information and comparing it to norms
3. Triggering change
4. Searching for options
5. Formulating a plan
6. Implementing the plan
7. Assessing the plan’s effectiveness
This instrument can be found online at: http://casaa.unm.edu/inst/SelfRegulation%20Questionnaire%20(SRQ).pdf
1= Strongly disagree‚ 2= Disagree‚ 3= Uncertain or Unsure‚ 4= Agree‚ 5= Strongly Agree
Items that are to be reverse: 2‚ 3‚ 4‚ 5‚ 6‚ 8‚ 10‚ 12‚ 13‚ 15‚ 19‚ 20‚ 21‚ 24‚ 26‚ 29‚ 31‚ 33‚ 37‚ 40‚ 43‚ 45‚ 50‚ 55‚ 62‚ and 63
Receiving: 1‚ 8‚ 15‚ 22‚ 29‚ 36‚ 43‚ 50‚ and 57
Evaluating: 2‚ 9‚ 16‚ 23‚ 30‚ 37‚ 44‚ 51‚ and 58
Triggering change: 3‚ 10‚ 17‚ 24‚ 31‚ 38‚ 45‚ 52‚ and 59
Searching for options: 4‚ 11‚ 18‚ 25‚ 32‚ 39‚ 46‚ 53‚ and 60
Formulating a plan: 5‚ 12‚ 19‚ 26‚ 33‚ 40‚ 47‚ 54‚ and 61
Implementing the plan: 6‚ 13‚ 20‚ 27‚ 34‚ 41‚ 48‚ 55‚ and 62
Assessing the plan’s effectiveness: 7‚ 14‚ 21‚ 28‚ 35‚ 42‚ 49‚ 56‚ and 63
Brown‚ J. M.‚ Baumann‚ B. D.‚ Smith‚ C. D.‚ & Etheridge‚ S. L. (1997‚ July‚ 1997). Self-regulation‚ extroversion‚ and substance abuse among college students. Paper presented at the Research Society on Alcoholism‚ San Francisco‚ CA.
Brown‚ J. M. (1998). Self-regulation and the addictive behaviors. In W. R. Miller & N. Heather (Eds.)‚ Treating addictive behaviors (2nd ed.‚ pp. 61-74). New York: Plenum Press.
Brown‚ J. M.‚ Miller‚ W. R.‚ & Lawendowski‚ L. A. (1999). The Self-Regulation Questionnaire. In L. VandeCreek & T. L. Jackson (Eds.)‚ Innovations in clinical practice: A source book (Vol. 17‚ pp. 281-289). Sarasota‚ FL: Professional Resource Press.