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

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

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

4. I feel rejected by others.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

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

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

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

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

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

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

13. 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
              

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

29. I tend to feel sad.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

30. I have anxiety.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

32. I have experienced tremendous unkindness.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

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

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

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

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

39. I feel powerless.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

40. I focus mostly on myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

43. I am an impatient person.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

45. I feel guilty or ashamed.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

48. I have trouble controlling myself.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

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

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

53. I feel like giving up.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

56. Life is unkind.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

58. I compare myself to others.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

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

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

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

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

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

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

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

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

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

70. I believe miracles can happen.
                 
             Never
            
                 
            Rarely
 
               
           Sometimes
 
                 
              Usually
 
                 
             Always
              

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

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

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