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Hello:

I, Annalise Jackson, am an undergraduate student in Dr. Darryl Dietrich’s Empirical Research course at The College of St. Scholastica. I would like to request your participation in my research project, but you are under no obligation to participate. If you do not choose to participate, just do not reply to this e-mail.

The task you will be asked to perform will be to fill out two questionnaires administered and a few quick questions about yourself. The first questionnaire will be a 20-point personality test, and the second will be a love scale consisting of 45 questions. This task will take approximately 10 minutes of your time.

Although not everything about the research project can be explained to you ahead of time, there are no physical risks involved. You may feel some slight discomfort when answering personal questions; therefore there is a minimal psychological risk. I will protect your personal identity. You will be given a random number in the study so your name will be anonymous. Therefore, I will not be able to tell you about your individual results. Only group data will be presented in my report. At the end of the project you may receive a summary of the purposes and general results of the project by e-mailing me your request. I will then e-mail the results back to you. You may discontinue participation at any time. If you have any questions or concerns about this research project please talk with me or Dr. Darryl Dietrich (723-6165).

By completing and submitting this survey, you are agreeing that I may use your responses in my research.
Please start with the survey now by clicking on the Next button below.



Just a Few Quick Questions to Begin With
How old are you?
How old are you?
Are you male or female?
Are you male or female?
What is your romantic relationship status?
What is your romantic relationship status?
In your most recent relationship, how long were you together?
In your most recent relationship, how long were you together?

Personality: Please answer these questions about yourself.

Strongly Disagree
Somewhat Disagree
Indifferent
Somewhat Agree
Strongly Agree
Am often down in the dumps.

Strongly Disagree
Somewhat Disagree
Indifferent
Somewhat Agree
Strongly Agree
Am not easily bothered by things.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Am relaxed most of the time.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Often feel blue.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Am filled with doubts about things.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Fear for the worst.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Am not easily frustrated.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Remain calm under pressure.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Feel threatened easily.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Rarely lose my composure.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Get stressed out easily.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Worry about things.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Seldom get mad.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Am very pleased with myself

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Feel comfortable with myself.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Dislike myself.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Panic easily.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Seldom feel blue.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Rarely get irritated.

Disagree
Somewhat disagree
Indifferent
Somewhat agree
Strongly Agree
Have frequent mood swings.

Love: fill in the blank spaces with the name of one person you love or care about deeply in a romantic way (currently, last relationship, or if you never have been-how you think you would feel). Then rate your agreement with each of the items by using a nine-point scale in which
1 = "not at all," 5 = "moderately," and 9 = "extremely."

Not at all
Moderately
Extremely
I have a warm relationship with _________.

Not at all
Moderately
Extremely
I am able to count on __________ in times of need.

Not at all
Moderately
Extremely
_________ is able to count on me in times of need.

Not at all
Moderately
Extremely
I am willing to share myself and my possessions with ___________.

Not at all
Moderately
Extremely
I receive considerable emotional support from ___________.

Not at all
Moderately
Extremely
I give considerable emotional support to _______.

Not at all
Moderately
Extremely
I communicate well with ___________.

Not at all
Moderately
Extremely
I value _________ greatly in my life.

Not at all
Moderately
Extremely
I feel close to ______.

Not at all
Moderately
Extremely
I have a comfortable relationship with ______.

Not at all
Moderately
Extremely
I feel that I really understand ___________.

Not at all
Moderately
Extremely
I feel that _________ really understands me.

Not at all
Moderately
Extremely
I feel that I can really trust ___________.

Not at all
Moderately
Extremely
I am actively supportive of _________'s wellbeing.

Not at all
Moderately
Extremely
Just seeing ________ excites me.

Not at all
Moderately
Extremely
I find myself thinking about __________ frequently during the day.

Not at all
Moderately
Extremely
My relationship with ___________ is very romantic.

Not at all
Moderately
Extremely
I find ________ to be very personally attractive.

Not at all
Moderately
Extremely
I idealize _________.

Not at all
Moderately
Extremely
I cannot imagine another person making me as happy as _______ does.

Not at all
Moderately
Extremely
I would rather be with _________ than with anyone else.

Not at all
Moderately
Extremely
There is nothing more important to me than my relationship with ______.

Not at all
Moderately
Extremely
I especially like physical contact with ______.

Not at all
Moderately
Extremely
There is something almost "magical" about my relationship with ______.

Not at all
Moderately
Extremely
I adore _________.

Not at all
Moderately
Extremely
I cannot imagine life without _________.

Not at all
Moderately
Extremely
My relationship with _________ is passionate.

Not at all
Moderately
Extremely
When I see romantic movies and read romantic books I think of _______.

Not at all
Moderately
Extremely
I fantasize about _______.

Not at all
Moderately
Extremely
I know that I care about _________.

Not at all
Moderately
Extremely
I am committed to maintaining my relationship with _________.

Not at all
Moderately
Extremely
Because of my commitment to ________, I would not let other people come between us.

Not at all
Moderately
Extremely
I have confidence in the stability of my relationship with ________.

Not at all
Moderately
Extremely
I could not let anything get in the way of my commitment to ________.

Not at all
Moderately
Extremely
I expect my love for ________ to last for the rest of my life.

Not at all
Moderately
Extremely
I will always feel a strong responsibility for ______.

Not at all
Moderately
Extremely
I view my commitment to ________ as a solid one.

Not at all
Moderately
Extremely
I cannot imagine ending my relationship with _________.

Not at all
Moderately
Extremely
I am certain of my love for ________.

Not at all
Moderately
Extremely
I view my relationship with _________ as permanent.

Not at all
Moderately
Extremely
I view my relationship with ________ as a good decision.

Not at all
Moderately
Extremely
I feel a sense of responsibility toward ________.

Not at all
Moderately
Extremely
I plan to continue my relationship with ______.

Not at all
Moderately
Extremely
Even when ________ is hard to deal with, I remain committed to our relationship.

Survey Demonstration Conclusion
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