Instructions: Please Answer “Yes” or “No” to the Following Statements
- Do you keep quiet to avoid arguments?
- Are you always worried about others opinions of you?
- Have you ever lived with someone with an alcohol or drug problem?
- Have you ever lived with someone who hits or belittles you?
- 5. Are the opinions of others more important than your own?
- Do you have difficulty adjusting to changes at work or home?
- Do you feel rejected when significant others spend time with friends?
- Do you doubt your ability to be who you want to be?
- Are you uncomfortable expressing your true feelings to others?
- Have you ever felt inadequate?
- Do you feel like a bad person when you make a mistake?
- Do you have difficulty taking compliments or gifts?
- Do you feel humiliation when your child or spouse makes a mistake?
- Do you think people in your life would go downhill without your constant efforts?
- Do you frequently wish someone could help you get things done?
- Do you have difficulty talking to people in authority, such as the police or your boss?
- Are you confused about who you are or where you are going with your life?
- Do you have trouble saying no when asked for help?
- Do you have trouble asking for help?
- Do you have so many things going at once that you can’t do justice to any of them?
If you answered yes to Three or more of these statements, please see a Healthcare Professional for further evaluation.