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I feel bitterness towards my (father, mother, God, other).
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I do things I regret later on.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

It seems like life is hopeless.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel rejected by others.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel trapped by what is going on in my life.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

When things are going well, I always worry that something bad will happen.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

'I want what I want when I want it!'
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel rejected by myself, others, or God.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel that I'm no good and my background is shameful.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I am uncomfortable when I am not in control.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I have a low opinion of myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I try to get others to do things for me.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel there are people in my life that can't or won't forgive me for things I have done.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I overdo some actions (shopping, eating, sleeping) when I feel bad or good.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I find it hard to believe that things can change.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I am afraid to love completely.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I don't have much fun because I feel that life is not much fun.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I worry about what may happen.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I get angry or irritated with the way other people do things.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel that people are too sensitive.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

It is difficult to find things to be grateful for in my life.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I expect the worst to happen.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel that I am not as successful as I should be.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

There is a part of me that is out of control.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

If someone hurts me, I have trouble having good feelings about them again.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I do things to make myself look good to others.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel that something bad is bound to happen.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I need other people's approval to feel good about myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I tend to feel sad.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I have anxiety.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I get frustrated when things don't go the way I want them to go.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I have experienced tremendous unkindness.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

Unresolved fears negatively affect my life.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel like 'It's not fair!'
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I want people to think well of me.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel incapable of doing what's expected of me.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I have negative feelings and thoughts toward myself when I fall short.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I do things I know I shouldn't do.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel powerless.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I focus mostly on myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

Joy comes from positive results such as money, work, drugs, promotions, new things, approval, etc.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel that if I could just get more ___________ I would have peace.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I am an impatient person.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

People who should have been kind to me were not.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel guilty or ashamed.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I worry about how things will turn out.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel like I am better than others.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I have trouble controlling myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I have negative feelings and thoughts toward myself and/or others for past issues.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I use substances (food, drugs, smoking, etc.) to reduce anxiety.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

Other people cause me to be happy or unhappy.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel that I am not loved enough.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel like giving up.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel that things don't change; the future will be like the past.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

When I feel frustrated I do unhealthy things such as overeating, yelling, fighting, etc.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

Life is unkind.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel afraid that if people really knew me they would not like who I am.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I compare myself to others.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I feel I don't deserve success.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I need to feel in control.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I am at peace with things that have been done to me in the past.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I am wise enough to make good choices.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I can face whatever life has to offer.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I go out of my way to help others.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I deliberately look for things to feel grateful about each day.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

All things work together for good.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

When I feel frustrated, I pause and calm myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

Every week I help someone in need.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

My life on Earth is meaningful.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I believe miracles can happen.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I am an equal, not better or worse.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

I set reasonable standards and goals for myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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