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Survey Templates Surveys K. Davies Thesis

K. Davies Thesis

Demographics
Hello:
You are invited to participate in this survey. In this survey, approximately 200 people will be asked to complete a survey that asks questions about the development of certain personality traits. It will take approximately 30 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Kyra Davies by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

ID # (on informed consent)
Gender
Age
Ethnicity
Marital Status
What is your current classification?
What is your major?
Approximately, what is your current grade point average?
Approximately, what was your grade point average in high school?
On the following questions you will find a series of statements that individuals can use to describe themselves. There are no correct or incorrect responses. All people are unique and different, and it is these differences which we are trying to learn about. Please read each statement carefully and give your best estimate of how well it describes you.


Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
1. I become easily frightened.
2. I am often late for appointments.
3. Sometimes minor events cause me to feel intense happiness.
4. I find loud noises to be very irritating.
5. It’s often hard for me to alternate between two different tasks.
6. I rarely become annoyed when I have to wait in a slow moving line.
7. I would not enjoy the sensation of listening to loud music with a laser light show.
8. I often make plans that I do not follow through with.
9. I rarely feel sad after saying goodbye to friends or relatives.
10. Barely noticeable visual details rarely catch my attention.
Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
11. Even when I feel energized, I can usually sit still without much trouble if it’s necessary.
12. Looking down at the ground from an extremely high place would make me feel uneasy.
13. When I am listening to music, I am usually aware of subtle emotional tones.
14. I would not enjoy a job that involves socializing with the public.
15. I can keep performing a task even when I would rather not do it.
16. I sometimes seem to be unable to feel pleasure from events and activities that I should enjoy.
17. I find it very annoying when a store does not stock an item that I wish to buy.
18. I tend to notice emotional aspects of paintings and pictures.
19. I usually like to talk a lot.
20. I seldom become sad when I watch a sad movie.
Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
21. I’m often aware of the sounds of birds in my vicinity.
22. When I am enclosed in small places such as an elevator, I feel uneasy.
23. When listening to music, I usually like turn up the volume more than other people.
24. I sometimes seem to understand things intuitively.
25. Sometimes minor events cause me to feel intense sadness.
26. It is easy for me to hold back my laughter in a situation when laughter wouldn't be appropriate.
27. I can make myself work on a difficult task even when I don’t feel like trying.
28. I rarely ever have days where I don’t at least experience brief moments of intense happiness.
29. When I am trying to focus my attention, I am easily distracted.
30. I would probably enjoy playing a challenging and fast paced video-game that makes lots of noise and has lots of flashing, bright lights.
Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
31. Whenever I have to sit and wait for something (e.g., a waiting room), I become agitated.
32. I'm often bothered by light that is too bright.
33. I rarely notice the color of people’s eyes.
34. I seldom become sad when I hear of an unhappy event.
35. When interrupted or distracted, I usually can easily shift my attention back to whatever I was doing before.
36. I find certain scratchy sounds very irritating.
37. I like conversations that include several people.
38. I am usually a patient person.
39. When I am resting with my eyes closed, I sometimes see visual images.
40. It is very hard for me to focus my attention when I am distressed.
Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
41. Sometimes my mind is full of a diverse array of loosely connected thoughts and images.
42. Very bright colors sometimes bother me.
43. I can easily resist talking out of turn, even when I’m excited and want to express an idea.
44. I would probably not enjoy a fast, wild carnival ride.
45. I sometimes feel sad for longer than an hour.
46. I rarely enjoy socializing with large groups of people.
47. If I think of something that needs to be done, I usually get right to work on it.
48. It doesn't take very much to make feel frustrated or irritated.
49. It doesn’t take much to evoke a happy response in me.
50. When I am happy and excited about an upcoming event, I have a hard time focusing my attention on tasks that require concentration.
Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
51. Sometimes, I feel a sense of panic or terror for no apparent reason.
52. I often notice mild odors and fragrances.
53. I often have trouble resisting my cravings for food drink, etc.
54. Colorful flashing lights bother me.
55. I usually finish doing things before they are actually due (for example, paying bills, finishing homework, etc.).
56. I often feel sad.
57. I am often aware how the color and lighting of a room affects my mood.
58. I usually remain calm without getting frustrated when things are not going smoothly for me.
59. Loud music is unpleasant to me.
60. When I'm excited about something, it's usually hard for me to resist jumping right into it before I've considered the possible consequences.
Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
61. Loud noises sometimes scare me.
62. I sometimes dream of vivid, detailed settings that are unlike anything that I have experienced when awake.
63. When I see an attractive item in a store, it’s usually very hard for me to resist buying it.
64. I would enjoy watching a laser show with lots of bright, colorful flashing lights.
65. When I hear of an unhappy event, I immediately feel sad.
66. When I watch a movie, I usually don’t notice how the setting is used to convey the mood of the characters.
67. I usually like to spend my free time with people.
68. It does not frighten me if I think that I am alone and suddenly discover someone close by.
69. I am often consciously aware of how the weather seems to affect my mood.
70. It takes a lot to make me feel truly happy.
Extremely Untrue
Quite Untrue
Slightly Untrue
Neither True Nor False
Slightly True
Quite True
Extremely True
71. I am rarely aware of the texture of things that I hold.
72. When I am afraid of how a situation might turn out, I usually avoid dealing with it.
73. I especially enjoy conversations where I am able to say things without thinking first.
74. Without applying effort, creative ideas sometimes present themselves to me.
75. When I try something new, I am rarely concerned about the possibility of failing.
76. It is easy for me to inhibit fun behavior that would be inappropriate.
77. I would not enjoy the feeling that comes from yelling as loud as I can.
The following items are designed to measure attitudes people have toward themselves,their performance, and toward others. There are no right or wrong answers. Please respond to all of the items. Use your first impression and do not spend too much time on individual items in responding.

Respond to each of the items using the scale below to describe your degree of agreement with each item. Fill in the appropriate circle.

Strongly Disagree
Disagree
Disagree Slightly
Neutral
Slightly Agree
Agree
Strongly Agree
1. I have high standards for my performance at work or at school.
2. I am an orderly person.
3. I often feel frustrated because I can’t meet my goals.
4. Neatness is important to me.
5. If you don’t expect much out of yourself, you will never succeed.
6. My best just never seems to be good enough for me.
7. I think things should be put away in their place
8. I have high expectations for myself.
9. I rarely live up to my high standards.
10. I like to always be organized and disciplined.
Strongly Disagree
Disagree
Disagree Slightly
Neutral
Slightly Agree
Agree
Strongly Agree
11. Doing my best never seems to be enough.
12. I set very high standards for myself.
13. I am never satisfied with my accomplishments.
14. I expect the best from myself.
15. I often worry about not measuring up to my own expectations.
16. My performance rarely measures up to my standards.
17. I am not satisfied even when I know I have done my best.
18. I try to do my best at everything I do.
19. I am seldom able to meet my own high standards of performance.
20. I am hardly ever satisfied with my performance.
Strongly Disagree
Disagree
Disagree Slightly
Neutral
Slightly Agree
Agree
Strongly Agree
21. I hardly ever feel that what I’ve done is good enough.
22. I have a strong need to strive for excellence.
23. I often feel disappointment after completing a task because I know I could have done better.
The following statements concern how you feel in relationships. We are interested in how you generally experience relationships, not just in what is happening in a current relationship. Respond to each statement by indicating how much you agree or disagree with it.


1 Strongly Disagree
2
3
4 Neither Disagree Nor Agree
5
6
7 Strongly Agree
My desire to be very close sometimes scares people away.
I prefer not to be too close to romantic partners.
It's easy for me to be affectionate with others.
I do not often worry about being abandoned.
I feel comfortable depending on romantic partners.
I rarely worry about a partner leaving me.
It helps to turn to a romantic partner in times of need.
I don't feel comfortable opening up to romantic partners.
When my partner is out of sight, I worry that he or she might become interested in someone else.
I get uncomfortable when a romantic partner wants to be very close.
1 Strongly Disagree
2
3
4 Neither Disagree Nor Agree
5
6
7 Strongly Agree
I worry a lot about my relationships.
I find that my partner(s) don't want to get as close as I would like.
Others make me doubt myself.
I usually discuss my problems and concerns with a partner.
I tell my partner just about everything.
I feel comfortable sharing my private thoughts and feelings with a partner.
I often worry that a partner will not want to stay with me.
I worry that romantic partners won’t care about me as much as I care about them.
I find it relatively easy to get close to others.
I'm afraid that I will lose a partners love.
1 Strongly Disagree
2
3
4 Neither Disagree Nor Agree
5
6
7 Strongly Agree
I am nervous when partners get too close to me.
Others really understand me and my needs.
Sometimes romantic partners change their feelings about me for no apparent reason.
It makes me mad that I don't get the affection and support I need from others.
I worry that I won't measure up to other people.
I'm afraid that once a romantic partner gets to know me, he or she won't like who I really am.
I often worry that a partner doesn't really love me.
It's not difficult for me to get close to others.
I find it difficult to allow myself to depend on romantic partners.
When I show my feelings for romantic partners, I'm afraid they will not feel the same about me.
1 Strongly Disagree
2
3
4 Neither Disagree Nor Agree
5
6
7 Strongly Agree
I talk things over with my partner.
I am very comfortable being close to romantic partners.
I often wish that others feelings for me were as strong as my feelings for them.
I find it easy to depend on romantic partners.
Others only seem to notice me when I’m angry. I prefer not to show a partner how I feel deep down.
Please choose the response that best reflects your opinion.





1 Strongly Disagree
2 Disagree
3 Neither Disagree Nor Agree
4 Agree
5 Strongly Agree
1. My parents set very high standards for me.
2. Organization is very important to me.
3. As a child, I was punished for doing things less than perfectly.
4. If I do not set the highest standards for myself, I am likely to end up a second-rate person.
5. My parents never tried to understand my mistakes.
6. It is important to me that I be thoroughly competent in everything I do.
7. I am a neat person.
8. I try to be an organized person.
9. If I fail at work/school, I am a failure as a person.
10. I should be upset if I make a mistake.
1 Strongly Disagree
2 Disagree
3 Neither Disagree Nor Agree
4 Agree
5 Strongly Agree
11. My parents wanted me to be the best at everything.
12. I set higher goals for myself than most people.
13. If someone does a task at work/school better than me, then I feel like I failed the whole task.
14. If I fail partly, it is as bad as being a complete failure.
15. Only outstanding performance is good enough in my family.
16. I am very good at focusing my efforts on attaining a goal.
17. Even when I do something very carefully, I often feel that it is not quite done right.
18. I hate being less than the best at things.
19. I have extremely high goals.
20. My parents have expected excellence from me.
1 Strongly Disagree
2 Disagree
3 Neither Disagree Nor Agree
4 Agree
5 Strongly Agree
21. People will probably think less of me if I make a mistake.
22. I never felt like I could meet my parents’ expectations.
23. If I do not do as well as other people, it means I am an inferior human being.
24. Other people seem to accept lower standards from themselves than I do.
25. If I do not do well all the time, people will not respect me.
26. My parents have always had higher expectations for my future than I have.
27. I try to be a neat person.
28. I usually have doubts about the simple everyday things I do.
29. Neatness is very important to me.
30. I expect higher performance in my daily tasks than most people.
1 Strongly Disagree
2 Disagree
3 Neither Disagree Nor Agree
4 Agree
5 Strongly Agree
31. I am an organized person.
32. I tend to get behind in my work because I repeat things over and over.
33. It takes me a long time to do something “right”.
34. The fewer mistakes I make, the more people will like me.
35. I never felt like I could meet my parents’ standards.
Have you ever felt the following anxiety symptoms?


Not At All
Mildly but it didn't bother me much
Moderately - It wasn't pleasant at times
Severely - It bothered me a lot
1. Numbness or tingling
2. Feeling hot
3. Wobbliness in legs
4. Unable to relax
5. Fear of worst happening
6. Dizzy or lightheaded
7. Heart pounding/racing
8. Unsteady
9. Terrified or afraid
10. Nervous
Not At All
Mildly but it didn't bother me much
Moderately - It wasn't pleasant at times
Severely - It bothered me a lot
11. Feeling of choking
12. Hands trembling
13. Shaky / unsteady
14. Fear of losing control
15. Difficulty in breathing
16. Fear of dying
17. Scared
18. Indigestion
19. Faint / lightheaded
20. Face flushed
Not At All
Mildly but it didn't bother me much
Moderately - It wasn't pleasant at times
Severely - It bothered me a lot
21. Hot / cold sweats
The next series of questions ask about the ways that your parents responded to you when you were living at home. Read each item carefully, then using the scale below, rate how true each statement is of your mother or father. If you grew up without a mother or father, please answer the questions regarding someone in your life that you think of as a mother or father figure.

The first 20 questions will be answered in terms of how your MOTHER OR MOTHER FIGURE responded to you when you were living at home.

False
Mostly false
Slightly True
Mostly True
Very True
1. This parent felt that I should have my way as often as she did.
2. Even if I did not agree with this parent, she forced me to conform to what she thought was right.
3. Whenever this parent told me to do something, she expected me to do it immediately without asking any questions.
4. Once family policy had been established, this parent discussed the reasoning behind the policy with me.
5. This parent always encouraged verbal give-and-take whenever I felt that family rules and restrictions were unreasonable.
6. This parent often shouted and yelled at me when I misbehaved.
7. This parent felt I needed to be free to make up my own mind and to do what I wanted to do, even if this did not agree with what she might want.
8. This parent often threatened to punish me if I misbehaved.
9. This parent felt I never listened to her, so she did not bother to try to talk with me.
10. This parent often used verbal or physical force to make me behave myself.
False
Mostly false
Slightly True
Mostly True
Very True
11. This parent felt my problems were not her responsibility. I had to learn to take care of myself.
12. I was not especially close to this parent. I had to learn things on my own.
13. This parent often got really mad at me and made me do what she said.
14. This parent let me know what behavior she expected of me, and if I did not meet those expectations, she punished me.
15. This parent often punished me by shaming me, embarrassing me, or saying things that made me feel bad.
16. This parent took my opinions into consideration when making family decisions, but she would not decide on something simply because I wanted it.
17. This parent seldom asked me to do things because I seldom listened to her.
18. This parent had clear standards of behavior for me, but she was willing to adjust those standards to meet needs.
19. This parent allowed me to form my own point of view on family matters and she generally allowed me to decide for myself what I was going to do.
20. This parent did not communicate well with me. It just seemed to make things worse if we talked.
The next set of 20 questions are the exact same questions as above but should be answered regarding how your FATHER or FATHER FIGURE responded to you when you lived at home.



False
Mostly False
Slightly True
Mostly True
Very True
1. This parent felt that I should have my way as often as he did.
2. Even if I did not agree with this parent, he forced me to conform to what he thought was right.
3. Whenever this parent told me to do something, he expected me to do it immediately without asking any questions.
4. Once family policy had been established, this parent discussed the reasoning behind the policy with me.
5. This parent always encouraged verbal give-and-take whenever I felt that family rules and restrictions were unreasonable.
6. This parent often shouted and yelled at me when I misbehaved.
7. This parent felt I needed to be free to make up my own mind and to do what I wanted to do, even if this did not agree with what he might want.
8. This parent often threatened to punish me if I misbehaved.
9. This parent felt I never listened to him, so he did not bother to try to talk with me.
10. This parent often used verbal or physical force to make me behave myself.
False
Mostly False
Slightly True
Mostly True
Very True
11. This parent felt my problems were not his responsibility. I had to learn to take care of myself.
12. I was not especially close to this parent. I had to learn things on my own.
13. This parent often got really mad at me and made me do what he said.
14. This parent let me know what behavior he expected of me, and if I did not meet those expectations, he punished me.
15. This parent often punished me by shaming me, embarrassing me, or saying things that made me feel bad.
16. This parent took my opinions into consideration when making family decisions, but he would not decide on something simply because I wanted it.
17. This parent seldom asked me to do things because I seldom listened to him.
18. This parent had clear standards of behavior for me, but he was willing to adjust those standards to meet needs.
19. This parent allowed me to form my own point of view on family matters and he generally allowed me to decide for myself what I was going to do.
20. This parent did not communicate well with me. It just seemed to make things worse if we talked.
Below are five statements that you may agree or disagree with. Using the 1 - 7 scale below, indicate your agreement with each item by placing the appropriate number on the line preceding that item. Please be open and honest in your responding.



7-Strongly agree
6-Agree
5-Slightly agree
4-Neither agree nor disagree
3-Slightly disagree
2-Disagree
1-Strongly disagree
1. In most ways my life is close to my ideal.
2. The conditions of my life are excellent.
3. I am satisfied with my life.
4. So far I have gotten the important things I want in life.
5. If I could live my life over, I would change almost nothing.
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