How to use this questionnaire
This questionnaire contains questions which someone can use for self-characterize.
Before answering to this questionnaire, ask yourself: "Usually, how often is true this affirmation about me?"
1. The questionnaire has following sections:
How to use this questionnaire
Possible answers
Questionnaire
Calculate your score
Interpreting your score
2. Read carefully the How to use this questionnaire section.
3. Choose for each affirmation one of the answers below, between 1 to 6, which one fits you best.
4. Write down the question number with the corresponding answer number (1 to 6).
5. Solve the questionnaire based on Calculate your score
6. By matching your score with the interval from Interpreting your score section you will be able to interpret your scores (low values are desirable for all questionnaires except Happy child and Healthy adult).
Possible answers
Each affirmation of these questionnaire has 6 possible answers from 1 to 6. Rate each affirmation based on the way you have felt or behaved in general during your adult life. If there has been a lot of variation during different periods of your adult years, focus more on the most recent year or two in rating an item.
The answers are (every time in same order for each affirmation):
1. Never or almost never
2. Seldom
3. Time to time
4. Frequent
5. Mostly
6. Always
Questionnaire
Inborn maladaptive states of the self
The vulnerable child
4. I feel fundamentally inadequate, imperfect, with flaws.
6. I feel lost.
36. I am desperate.
50. I feel alone.
67. I feel humiliated.
71. Even if I am surrounded by people, I feel alone.
105. I often feel alone in the world.
106. I feel weak and helpless.
111. I feel left out and excluded.
119. I feel like no one loves me.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10.
Interpreting your Vulnerable child score:
1 = Very low
1 to 1.47 = Low
1.47 to 1.98 = Average
1.98 to 3.36 = High
3.36 to 4.47 = Very high
4.47 to 6 = Extremely high
The angry child
22. If I don't fight, I will be assaulted or ignored.
42. I get angry when others are trying to restrict my freedom and independence.
47. I am furious with other people.
49. I have accumulated a lot of fury inside me that I feel I have to unleash.
56. If someone is not on my side, it means they are against me.
63. I get upset when someone leaves me alone or abandons me.
76. It annoys me when someone tells me how I should feel and behave.
79. I feel the need to express my disapproval of people for the way they treated me.
103. I feel like attacking / intimidate or hurting someone for the way he treated me.
109. I was deceived and wronged.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10.
Interpreting your Angry child score:
1 = Very low
1 to 1.81 = Low
1.81 to 2.29 = Average
2.29 to 3.09 = High
3.09 to 4.03 = Very high
4.03 to 6 = Extremely high
The mad / hysterical child
14. I have outbursts of anger.
25. I physically attack people when I am angry with them.
26. If I get angry, I often can't behave and I lose control.
46. I throw objects when I'm furious.
54. When I'm anger, I often lose control and threaten those around me.
60. I was so furious that I hurt or killed someone.
92. When I get angry, I lose control so much that I could hurt someone.
98. I destroy objects when I'm furious.
101. My anger gets out of hand.
123. I can get so angry that I feel like I can kill someone.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10.
Interpreting your Angry child score:
1 = Very low
1 to 1.2 = Low
1.2 to 1.49 = Average
1.49 to 2.05 = High
2.05 to 2.97 = Very high
2.97 to 6 = Extremely high
The impulsive child
12. I have a hard time controlling my moods.
15. I behave impulsively or express emotions that create difficulties for me or hurt those around me.
35. I follow my emotions.
40. I don't think about what I say and I manage to create problems or hurt others.
66. I break the rules and later I'm sorry.
69. First I act and then I think.
78. I say what I feel and act impulsively, without thinking about the consequences.
97. It is impossible for me to control my moods.
110. If I feel the urge to do something, I simply do it.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 9.
Interpreting your Impulsive child score:
1 = Very low
1 to 2.15 = Low
2.15 to 2.68 = Average
2.68 to 3.05 = High
3.05 to 4.12 = Very high
4.12 to 6 = Extremely high
The undisciplined child
13. If I don't reach my goal, I quickly become frustrated and give up.
21. I have no patience to perform routine and boring tasks.
30. It's embarrassing to make your own plan of how to handle various situations.
65. I can't convince myself to do something that I don't like, even if it's for my own good.
70. I get bored easily and lose interest in activities.
107. I'm lazy.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 6.
Interpreting your Impulsive child score:
1 = Very low
1 to 2.27 = Low
2.27 to 2.87 = Average
2.87 to 3.47 = High
3.47 to 3.89 = Very high
3.89 to 6 = Extremely high
The happy child
2. I feel loved and accepted.
17. I feel satisfied and relaxed.
19. I feel in touch with others.
48. I feel comfortable with other people.
61. I feel that I have a lot of security and stability in life.
68. I trust most people.
95. I feel safe.
96. I feel listened to, understood, confirmed.
113. I am optimistic.
122. I'm spontaneous and I'm fun.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10. (minimum values are significant)
Interpreting your Impulsive child score:
6 = Very low
6 to 5.06 = Low
5.06 to 4.52 = Average
4.52 to 2.88 = High
2.88 to 2.11 = Very high
2.11 to 1 = Extremely high
Adaptive coping states - teaching and avoidance
The capitulating compliant
8. I try my best to please others to avoid conflict, confrontation or rejection.
18. I change my behavior according to people, so that they like me and have a good opinion of me.
37. I allow others to criticize or ridicule me.
38. In a relationship, I let my partner take the control.
55. I let others do what they want, rather than express my wishes.
100. I behave in a passive way, even if the situation does not suit me.
108. I can stand anything from people important to me.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 7.
Interpreting your Capitulating compliant score:
1 = Very low
1 to 2.51 = Low
2.51 to 3.07 = Average
3.07 to 3.63 = High
3.63 to 4.27 = Very high
4.27 to 6 = Extremely high
Detached protector
28. I am indifferent to almost anything.
33. I am cold and soulless towards others.
34. I feel disconnected (I am not in contact with myself, with my feelings or with others).
39. I feel distant from other people.
43. I feel nothing.
59. I don't want to get in touch with people.
64. I don't feel connected to other people.
75. I do not care about anything; nothing matters to me.
88. I feel dull.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 9.
Interpreting your Detached protector score:
1 = Very low
1 to 1.59 = Low
1.59 to 2.11 = Average
2.11 to 2.95 = High
2.95 to 3.89 = Very high
3.89 to 6 = Extremely high
Self-soother (The super-compensation)
41. I work and do a lot of sports, so that I don't have to think about how I ruin everything.
52. I enjoy having a captivating or calming activity to avoid my feelings (e.g., working, eating, shopping, gambling, sex, watching TV).
57. In order not to be bothered by my own annoying thoughts and feelings, I make sure to be busy all the time.
86. I want to distract myself from annoying thoughts and feelings.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 4.
Interpreting your Self-soother score:
1 = Very low
1 to 1.93 = Low
1.93 to 2.58 = Average
2.58 to 3.32 = High
3.32 to 4.3 = Very high
4.3 to 6 = Extremely high
Overcompensation schemes
Narcissistic overcompensation (infatuated)
10. I do everything to be the center of attention.
11. I get mad when people don't do what I tell them to do.
27. For me it is important to be Number One (e.g., the most popular, the most successful, the richest, the strongest).
31. I cannot be pleased to be in second place.
44. I do what I want, regardless of others needs and feelings.
74. I am special and better than the vast majority.
81. I judge others a lot.
89. I have to be the best in everything I do.
91. I am demanding of others.
114. I have the feeling I shouldn't follow the same rules as everyone else.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10.
Interpreting your Narcissistic overcompensation score:
1 = Very low
1 to 2.31 = Low
2.31 to 2.9 = Average
2.9 to 3.49 = High
3.49 to 4.08 = Very high
4.08 to 6 = Extremely high
Intimidation and attack (Intimidating aggression)
1. I demand respect, not allowing people treat me like nothing.
24. If you allow people to make fun of you or intimidate you, you are lost.
32. The attack is the best defense.
53. There is no equality, so it is better to be superior to the other.
77. If you don't dominate people, they will dominate you.
93. I am invulnerable.
99. If you dominate others, nothing can happen to you.
102. I make fun of others or intimidate them.
112. I disregard others.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10.
Interpreting your Intimidating aggression score:
1 = Very low
1 to 1.72 = Low
1.72 to 2.23 = Average
2.23 to 2.74 = High
2.74 to 3.25 = Very high
3.25 to 6 = Extremely high
Dysfunctional parent types
The punitive father
3. I refuse various pleasures, because I do not deserve them.
5. I feel like punishing myself by hurting myself (e.g., I cut myself).
9. I can't forgive myself anything.
16. It's my fault when something bad happens.
58. If I get upset by others, it means I'm a bad person.
72. I don't allow myself to have pleasant activities as other people, because I am a bad person.
84. I deserve to be punished.
87. I'm angry at myself.
94. I'm a bad person.
118. I don't deserve compassion when something bad happens to me.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10.
Interpreting your Punitive father score:
1 = Very low
1 to 1.47 = Low
1.47 to 1.86 = Average
1.86 to 2.75 = High
2.75 to 3.72 = Very high
3.72 to 6 = Extremely high
The demanding parent
7. I'm harsh with myself.
23. I have to take care of those around me.
45. I don't relax and have fun until I finish what I have to do.
51. I do take an interest in everything I do.
82. I am constantly stressed out to have achievements and to solve things.
83. I try not to make mistakes, otherwise I will pay for it!
90. I sacrifice my pleasures, my health, my happiness to keep my standards.
104. I know that there is a "right" and a "wrong" way of doing things; I try to solve them in a correct way, otherwise I start to criticize myself.
115. Right now, my life is focused on getting results and being good results.
116. I strive to be more responsible than the vast majority.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10.
Interpreting your Demanding parent score:
1 = Very low
1 to 3.6 = Low
3.6 to 3.66 = Average
3.66 to 4.26 = High
4.26 to 4.86 = Very high
4.86 to 6 = Extremely high
Healthy adult adaptive states
The healthy adult
20. When problems arise, I try to solve them myself.
29. I can solve problems rationally, without being overwhelmed by emotions.
62. I know when to express or not my feelings.
73. I am assertive (I support my ideas) when necessary, without exaggerating.
80. I can take care of myself.
85. I can learn, develop myself, change myself.
117. I fight for my rights when I am misjudged, abused or tricked.
120. I feel that I am fundamentally a good person.
121. When needed, I complete tedious and routine tasks to get important results for myself.
124. I know well who I am and what I need to be happy.
Calculate your score:
SCORING KEY
1for Never or almost never
2for Seldom
3for Time to time
4for Frequent
5for Mostly
6for Always
Choose for each affirmation the answer (1 to 6) which best fits you. Compute the total by summarize all the answers than divide it by 10. (minimum values are significant)
Interpreting your Healthy adult score:
6 = Very low
6 to 5.16 = Low
5.16 to 4.6 = Average
4.6 to 3.6 = High
3.6 to 2.77 = Very high
2.77 to 1 = Extremely high
References:
SMI questionnaire by Jeffrey Young, Ph.D.