PrevatteSusan1988

CALIFORNIA STATE UNIVERSITY, NORTHRIDGE
DEPRESSION AS A FUNCTION OF COGNITIVE
VULNERABILITY AND JUDGEMENTS OF
NEGATIVE SOCIAL TOPICS
A thesis submitted in partial satisfaction of the
requirements for the degree of master of Arts in
Community/Clinical Psychology
by
Susan J. Prevatte
January 1988
is approved:
The
Dr. Ronald Doctor, Ph.D.
Dr. Linda Fidell, Ph.D.
Chair
California State University, Northridge
ii
ACKNOWLEDGMENTS
My sincere appreciation and gratitude to my
chair, Dr. Brennis Lucero-Wagoner, for her attention,
time and flexibility.
I extend thanks to my committee, Dr. Ronald
Doctor and Dr. Linda Fidell.
My appreciation to the faculty members who
allowed me to do my study in their classrobms.
I am most grateful to my husband, son, and
daughter for their love, support, and encouragement
throughout the work on my thesis.
iii
TABLE OF CONTENTS
page
........................
................................
Abstract
Review of Literature ...................
.................................
Hethod
Design ..............................
............................
Subjects
Acknowledgments
Subject Classification
Material
............................
...........................
................................
Results
Discussion ..............................
.............................
References
Procedure
iii
v
1
9
9
10
10
12
14
15
20
23
Appendices
A.
Beck Depression Inventory
(BDI)
B.
Dystunctional Attitude Scale
(DAS)
C.
.........................
30
Topic Appropriateness Scale
(TA)
D.
.....................
.................. ' ...... .
35
Life Experiences Survey
39
(LES)
iv
ABSTRACT
DEPRESSION AS A FUNCTION OF COGNITIVE
VULNERABILITY AND JUDGEMENTS OF
NEGATIVE SOCIAL TOPICS
by
Susan J. Prevatte
Master of Arts in Community/Clinical Psychology
A group of currently non-depressed college students (as
assessed by the Beck Depression Inventory, BDI) who are
vulnerable to depression, were given the Topic
Appropriateness Scale (TA) and the BDI on two separate
occasions to elicit both their willingness to discuss
personal problems and their depression level.
The results
showed that there was no linear relationship between
level of depression and willingness to discuss negative
topics.
!
Explanations for this lack of direct association
were explored.
In support of previous findings, subjects
who were vulnerable (high on the Dysfunctional Attitude
Scale, DAS) rated negative topics as appropriate for
discussion.
In addition, the results supported the
contention that vulnerable individuals may become
depressed over time.
This information may imply that
cognitive therapy may be effective in treating depression.
v
Depression is described in the DSM III (1980) as
a dysphoric mood or loss of interest or pleasure in
all or almost all usual activities and pastimes.
The
dysphoric mood is characterized by symptoms such as:
depressed, sad, blue, hopeless, low, down in the dumps,
and irritable.
The disturbance is prominent, relatively
persistent and associated with other symptoms including
appetite disturbance, weight change, sleep disturbance,
psychomotor agitation or retardation, energy decrease,
feelings of worthlessness or guilt, difficulty
concentrating or thinking, and thoughts of death,
suicide, or suicidal attempts.
Depression has been studied from several
perspectives.
The most influential and enduring theory
.
of depression was developed by Freud (1917).
psychoanalytic view of depression
emphasize~
t
·-
His
unconscious
conflict associated with object or ego loss . . Freud saw
the potential for depression in childhood experience.
1
2
He theorized that during the oral period the child's
needs may be insufficiently or oversufficiently
gratified.
The person would remain "stuck" at this
developmental stage and dependent on the instinctual
gratification particular to it.
Fixation at the oral
stage results in a tendency to be excessively
dependent on other people for the maintenance of
self-esteem.
Freud (1917) hypothesized that after the loss of
a loved one through death, or in an ideal sense
symbolically lost as an object of love, the mourner
incorporates or introjects this lost person and
identifies with him or her.
Freud asserted we
unconsciously have negative feelings against those
we love, and that the mourner now becomes the object
of his own hate and anger.
The mourner also resents
being deserted and feels guilt for real or imagined
sins against the lost person.
The mourner works through
these feelings by recalling memories of the lost one and
separating himself from the orre who has died and
loosening the bonds that introjection has imposed.
According to Freudian theory, overly dependent
!
individuals are unable to work through their grief
I and it develops into an ongoing process of self-abuse,
lself-blame and depression.
Overly dependent individuals
3
do not loosen their emotional bonds with the lost loved
one and continue to blame themselves for faults and
shortcomings perceived in the loved one who has been
introjected.
This anger turned inward is the basis for
the psychodynamic view of depression.
Davison and Neale (1982) discuss three problems
they find with the psychodynamic view of depression.
First, since the person presumably both hates and loves
the individual he has lost, why is only the hate and
anger turned inward and not the love?
Since the
depressed person is said to have introjected the loved
one, thus directing inwardly the feelings previously
directed to the loved one, why do anger and resentment
predominate?
In an attempt to resolve this
inconsistency, Freud (1917) postulated that the loss
of a loved one is viewed as rejection or withdrawal of
affection and therefore a negative emotional state is
more likely to predominate.
However, there is no direct
evidence that depressives do interpret death as rejection
~
by the deceased.
The second problem involves the concept of fixation
at an earlier psychosexual stage of development.
If
fixation at the oral stage is a result of either too
little or too much gratification, then how much is
to prevent fixation?
The amount necessary to
fixation was not specified by Freud.
4
The third problem is the concept of symbolic loss
which Freud suggests as an explanation to account for
a diagnosis of depression only after the fact, when no
actual object loss can be specified.
This concept
would not be invoked for people who are.not depressed.
Davison and Neale (1982) suggest this involves the
diagnostician in a kind of confused reasoning.
Little research has been generated by psychoanalytic
points of view to support the theory.
Because of this
lack of supportive evidence, and due to questions
regarding this theory as stated above, there have been
investigations into other theories of depression in
recent years, particularly cognitive theories which
view cognitive processes as playing a decisive role in
emotional behavior; that is, thoughts and beliefs are
regarded as causing the emotional state.
Beck (1967)
offers perhaps the most important contemporary theory
to regard cognitions or thought processes as causative
factors in depression.
Aaron T. Beck, a psychiatrist at the University of
Pennsylvania, arrived at his cognitive theory of
depression after looking over his therapy notes.
He
found that his depressed patients tended to distort
whatever happened to them in the direction of self-blame
catastrophes by drawing illogical conclusions.
5
Thus events interpreted by nondepressed people as
irritating and inconvenient would be seen by depressed
people as another example of the hopelessness of life.
He called these errors in thinking "schemata" or
characteristic sets which color how the person perceives
the world.
Beck has found that depression and
cognitive distortions are correlated, but a specific
causal relationship or direction of causation cannot
be determined from such data; depression could cause
illogical thoughts or illogical thoughts could cause
depression, or the relationship could reflect some
third variable.
In assessing the possibility of a cognitive bias in
depression, a distorted pattern of thinking that could
be a factor in depression, Krantz and Hammen (1979) did
a study using college students, outpatients in therapy
for depression, and inpatients.
Each subject was given
the Beck Depression Inventory (BDI) and a questionnaire
to assess individual tendency to select negative response
options to brief stories.
There was a consistent relation
I
between scores on the two questionnaires across all
three groups which strengthened Beck's hypothesis of
a characteristic
cognitive bias in depression.
Research on depression has indicated that depressives
typically have social interaction problems.
Lewinson (1973) conducted
Libet and
studie~ witt college students
6
in which depressed and nondepressed subjects performed
an interpersonal interaction task.
Depressed subjects
demonstrated a lower level of social skills than
nondepressed subjects.
Gotlib (1982) conducted
a study using depressed psychiatric inpatients in
which the subjects engaged in taped interaction with a
stranger which was then rated on measures of social skills.
The depressed subjects exhibited lower levels of social
skills than did normal nondepressed controls.
These
deficits in social skills often result in isolation and
poor interpersonal relationships which may contribute
to both the etiology and maintenance of depression.
Kuiper and McCabe (1985) examined several cognitive
factors that may be associated with depressive
interaction problems.
They compared subjects who were
presently depressed, subjects who were vulnerable to
depression but not presently depressed, and nonvulnerable
i
,nondepressed subjects.
Those classified as being
cognitively vulnerable to depression were defined as
having a dysfunctional attitude demonstrated by an
characteristic of excessively rigid and
inappropriate self-statements for guiding one's life.
~ossibility
was explored that depressives as well as
se cognitively vulnerable to depression but not
rrently depressed may consider it appropriate to
scuss their own personal problems, i.e •. negative
The
7
topics, in social interactions with others more than
nonvulnerable nondepressives.
This may result in these
persons emitting verbal behaviors that lead to social
disapproval and rejection.
Participants were told to imagine they were
interacting with a person they had just met for the
first time and to rate topics for appropriateness for
discussion.
The results of this study indicated that
both depressed subjects and subjects vulnerable to
depression but not currently depressed viewed negative
topics as more appropriate for discussion than did
nondepressed subjects.
The vulnerable individual's expression of
inappropriate topics may lead to greater rejection and
avoidance by others, thus enhancing the possibility of
an ensuing episode of depression.
Such a topic
appropriateness pattern in these individuals provides
preliminary corroborative evidence for the possibility
that these social cognitions are a factor in the etiology
as well as in the maintenance of depression.
The clinical
significance of this research is to strengthen the evidence
in favor of cognitive therapy for alleviation of
epression and prevention of its recurrence.
These
results are also important for future research.
They
indicate that vulnerable but currently nondepressed
ividuals should not be placed in "normal" nondepressed
8
categories as this may mask actual cognitive differences
between nonvulnerable nondepressed and currently
depressed groups.
The present study attempted to extend the results
of the Kuiper and McCabe (1985) study which suggested
that choice of topic appropriateness for discussion is
a possible factor in the etiology and maintenance of
depression.
A longitudinal study was conducted to
investigate further the relationships between choice
of topic appropriateness and level of depression for
subjects vulnerable to depression as determined by scores
on Beck's Dysfunctional Attitude Scale (DAS), but not
currently depressed as determined by scores on the
Beck Depression Inventory (BDI).
Because stress has
been determined to play a significant role in psychiatric
symptomatology (Dekker and Webb, 1974), including
depression (Constantine, Brown, Davis
1
& Iervolini, 1973),
the Life Experiences Survey (LES) was given to each
subject.
This
m~de I~
possibl~
to partial out
stress as a contributing factor to depression and to
clarify and evaluate the relationship between choice of
topic appropriateness and level of depression.
More specifically, the following hypotheses were
1.
If a group of subjects vulnerable to
but not currently depressed is given the
Depression Inventory (BDI) and the Topic
9
Appropriateness Scale (TA), then those who rank negative
topics higher on the TA will score higher on. the BDI.
2.
If the same group of subjects is given the BDI and
the TA six weeks later, as well as the Life Experiences
Survey (LES), then those who rank negative topics
higher on the TA at Time 1 (Tl) will rank higher on the
TA at Time 2 (T2).
3.
Those who rank negative topics
higher on the TA at Tl will score higher on
th~
BDI
at T2 in both a direct correlation and a partial
correlation partialling out the LES score.
4.
TA
scores at Tl and BDI scores at T2 will be significantly
correlated; BDI scores at Tl and TA scores at T2 will
not be significantly correlated, both in direct
correlations and partial correlations partialling out the
LES scores.
Method
Design
A cross-lagged panel analysis was conducted in
which the following direct correlations were examined:
TA scores Tl with T2, BDI scores Tl with T2, BDI Tl
with TA Tl, BDI T2 with TA T2, BDI Tl with TA T2, and
TA Tl with BDI T2.
In addition, partial correlations
LES score the partialled variable were
for TA Tl with T2, BDI Tl with TA T2, and TA
with BDI T2.
10
Subjects
A total of 213 students enrolled in psychology
courses at California State University, Northridge
participated in this study.
Of the 213 subjects, 32
were lost to the study as they were rated presently
depressed at T1; another 45 were eliminated due to
attrition; and another 9 were eliminated due to improper
completion of the questionnaires.
A total of 127
subjects, who were non-depressed at T1, successfully
completed the questionnaires; 87 women and 40 men.
Of these subjects, 42 were classified as vulnerable
(see below) to depression; 27 women and 15 men.
Their
ages ranged from 19 to 47 with a mean age of 25.
It
was these 42 subjects who were of interest in this study.
Subject Classification
Two assessment instruments were used to classify
the subjects as not depressed at T1 but vulnerable
to depression.
First, each subject's depression level was measured
by using the Beck Depression Inventory (BDI; Beck,
Ward, Mendelson; Mock,
& Erbaugh, 1961).
·'
Only
currently non-depressed subjects were used; those who
the 0-13 range of the BDl.
The BDI is a 21-
. item self-report inventory designed to measure depth or
everity of depression with scores ranging from 0 to 63.
11
It has been demonstrated that the BDI is a reliable
instrument with correlation coefficients ranging from
.86 to.93 (Beck
& Beamesderfer, 1974).
For validity,
the BDI has been demonstrated to correlate significantly
with clinicians' estimates of depth of depression in
university students (r=.77; Bumberry, Oliver,
1978).
& McClure,
Hammen (1980) found the BDI valid for judgements
of severity of depression in college students in the mild
and moderate range, and Dearford
& Funabike (1985)
found the BDI defensible as a measurement of depression
when the syndrome of depression is of interest.
The second classification instrument used was the
Dysfunctional Attitude Scale (DAS; Weissman
1978).
& Beck,
This 40-item self-report survey was developed
~
in a college population.
It has reliability coefficients
in the range of .88 to .92 and concurrent validity
coefficients of .30 to .47 when compared to scores on
the BDI (Weissman, 1980).
The DAS is designed to measure
attitudinal dysfunction and not depression level per se.
Thus it is possible to score high on the DAS and still
nondepressed.
Given this pattern,
with depression scales will be only
Kuiper and McCabe (1985) found the DAS
correlated with the BDI, r=+.47.
Oliver and
gart (1985) conducted a study to assess the
metric properties of the DAS in an adult ·
12
population.
The results confirmed previous research
showing reliability and validity data for the DAS and
support its use as a measure of predisposition to
depression.
Possible scores on the DAS range from 40
to 280, with greatere scores indicating increasingly
dysfunctional attitudes.
Example DAS items are "If I
do not do well all the time, people will not respect
me" or "If I ask a question, it makes me look inferior."
Subjects were classified as attitudinally vulnerable if
they scored in the top one-third on the DAS.
In this
study the top one-third scores on the DAS ranged from
114 to 180 with a mean score of 132.
Both assessment
questionnaires are presented in the Appendix.
Haterial
The Topic Appropriateness Scale (TA), devised by
Kuiper and McCabe (1985), was used in this study.
It
consists of thirty items from Jourard and Lasakow's
(1958) 60-item scale of self-disclosure.
Five items
of the following six content areas were used:
and opinions, tastes and interest, work or
tudies, money, personality, and body.
Each of these items was rated as positive, neutral
~egative by a majority decision of four
judge making independent decisions.
judges, with
Judges were
to label an item positive if they would feel
or completely comfortable discussing that item with
f3
another individual, and if they expected a positive
social interaction in pursuing that topic.
An item
was to be labeled neutral if the judges felt it would
make them feel neither good nor bad while discussing it
with another.
An item was to be rated negative if that
topic would make the judges feel uncomfortable or
unhappy discussing it, and they felt that discussing
such topics would lead to a negative social interaction.
For example,
judges rated "The kinds of movies I like
best and the TV shows that are my favorite,s" as a
positive topic.
In contrast, "things in the past or
present that I feel ashamed or·guilty about" was rated
as a negative topic.
Next to each item on the questionnaire presented
to the subjects was a 7-point scale
which ranged
from "extremely inappropriate" (1) to "extremely
appropriate" (7).
The midpoint of the scale (4) was
labeled "moderately appropriate."
previously judged as
negativ~
Those 11 items
provided the basis for
the mean TA scores for the subjects in this
The Life Experiences Survey (LES) was given to
subject at Time 2 to assess the amount of stress
had been subjected to in the previous six weeks
Time 1.
This survey was developed by Sarason,
Seigel .(1978) to eliminate certain
i4
shortcomings of previous life stress measures by allowing
separate assessment of positive and negative experiences
as well as individualized ratings of the impact of events.
The LES is a 57-item self-report measure including
47 events common to individuals in a wide variety of
situations, plus 10 events particularly relevant to
a student population.
Subjects were asked to rate
separately the desirability and impact of events they
had experienced in the previous six weeks.
Ratings
were on a 7-point scale ranging from extremely negative
(-3) to extremely positive (+3) with a midpoint (0)
indicating no impact.
The negative impact scores
were used in this study.
The negative change scores
have been found to be reliable with correlation
coefficients ranging from .56 to .88 (Sarason, Johnson,
& Seigel
(1978).
Both surveys are presented in the
Subjects were tested in classroom sessions with
oximately 30 people particip?ting per session .
. h subject participated twice with a 6-week interval
sessions.
Subjects first filled out individual
forms ensuring confidentiality, and then began
leting the test booklets which took approximately
Subjects received a random order of the
and appropriateness rati~g scale.
In sum
.r
~
15
then, each subject completed the DAS, BDI, and the TA
on the first occasion.
On the second occasion each
subject completed the BDI, TA,and LES
Results
Scores were calculated for the 42 subjects on the
BDI and TA at Tl and T2.
These scores were then correlated
through the use of the Pearson product-moment correlation
coefficient.
The positive correlations that were predicted
betweem scores on the BDI and the TA did not occur.
There was a negative correlation of -.23 between the
scores on BDil and TAl, and a negative correlation of
-.14 between the scores on BDil and TA2.
The positive
correlation predicted between the scores on the TAl and
TA2 did occur, +.69.
There was also a
positi~e
correlation between the scores on the BDil and BDI2,
+.41.
Both of these relationships were statistically
significant, p<.Ol, two-tailed.
The strong correlation
predicted between the scores on TAl and BDI2 did not
There was a very weak correlation between the
on TAl and BDI2, +16, and TA2 and BDI2, +.11.
correlation between TAl and BDI2, nor the
rrelation between BDil and TA2 were significant.
presented in
Tabl~
1.
The
r
16
...&~
r
Table 1
Intercorrelations Between The BDI and TA at Time 1
and Time 2
BDI1
BDI1
TAl
BDI2
TA2
*p<.Ol, two-tailed.
TAl
BDI2
TA2
-.23
+. 41"~~
-.14
+.16
+.69*
+-11
17
Scores were calculated for the 42 subjects on the
LES at T2.
The scores on the BDI and TA were then
partially correlated, with the LES score as the
partialled variable, through the use of the Pearson
product-moment correlation coefficient.
When compared
to the results of the direct correlation, the results of
the partial correlations were the same for the scores on
BDI1 and BDI2, +.41, and for the scores on TA1 and TA2,
+.69.
Both of these relationships were statistically
significant, p(.01, two-tailed.
There was only a slight
difference in the results of the partial correlation for
the scores on TA1 and BDI2, +.10, and BDI1 and TA2,
-.15.
The results of the partial correlations are
presented in Table 2.
A comparison of the direct
correlations and the partial correlations controlling
for LES is presented in Figure 1.
18
Table 2
Partial Correlations Controlling for LES Between the
BDI and TA at Time 1 and
BDI2
TA2
-.15
BDI1
TAl
the BDI and TA at Time 2
.10
·*p(.Ol, two-tailed.
.69*
19
Direct Correlations
Time 1
'
I
Time 2
-·
BDI---- .41""----BDI
-....,____
----- !
--
tj
-.23
I
.16~:~
.11
i
. : . .14
i
TA::"_____ 69•'• ----"-'·TA
Partial Correlations Controlling for LES
Time 1
Time 2
BDI--------- · 41 ' " · - - - BDI
~--
'"'·"·
.......--::..
/~
--
. 10 _../'"
-.15
TA/_~------. 69•'•-
~A
p<.01, two tailed
1.
~'----
Correlations between Scores on the BDI and
·., Crossed-Lagged Panel Design.
20
Discussion
The present study did not add corroborative evidence
to support the suggestion by Kuiper and McCabe (1985)
that choice of negative topics as appropriate for
conversation plays a role in the etiology and
maintenance of depression.
It may be that Kuiper and
McCabe (1985) are in error in suggesting that there is
a relationship between choice of topic appropriateness
and level of depression.
It may be the case that the
relationship is carried by other variables and that
the contribution of topic appropriateness would be
more effectively demonstrated and evaluated in a
hierarchical regression analysis.
One possible explanation for the lack of correlation
between the scores on the TA and the BDI may be the time
elapsed between the two measurements.
It is possible
that the time period between the two measurements was
,not appropriate for the true causal effect being
assessed (Neale and Liebert, 1980).
Since all th'e
rrelatLons between TA and BDI scores were slight,
~
T1, at T2, and between T1 and T2, it is suggested
at the relationship is not instantaneous, nor does it
take place at a 6-week interval.
This study did support the results of the Kuiper
(1985) study which indicated that subjects
to depression (high DAS) but not presently
21
depressed rate negative topics as appropriate for
discussion.
In that study the mean TA score was 2.64
with a standard deviation of .94.
In the present study
subjects vulnerable to depression (high DAS) but not
presently depressed had a mean TA score of 3.26 with a
standard deviation of 1.03, indicating that they found
negative topics more appropriate for discussion than did
the subjects in the previous study.
Although there are no prior reports in the literature
concerning the reliability of the Topic Appropriateness
Scale, based on the results of this study, a correlation
of +.69 between TAl and TAZ, it may be a reliable
instrument.
This study also supported the use of the
as a measure of predisposition to depression.
Of
42 subjects, 12% had a score of 14 or higher on
BDI at T2 which classified them as depressed at
This 12% had DAS scores ranging from 118 to
with a mean of 136.
The results of this study suggest that the vulnerable
willing to talk about negative topics, but that
llingness does not lead to greater levels of depression,
stresses appear to interact with vulnerability
topic appropriateness.
This willingness to discuss
ative topics with casual acquaintances may be seen
indication of vulnerability to depression.
This
may be useful in a clinical setting for
22
treatment of depression and prevention of recurrence
of depressive incidences.
23
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Association, Hartford, Connecticut.
Weissman, A. N., & Beck, A. T. (1978). Development
and validation of the Dysfunctional Attitude Scale:
A preliminary investigation. Paper presented at tfie
American Educational Research Association Annual
Convention, Toronto, Canada.
26
Appendix A
BECK DEPRESSION INVENTORY
(BDI)
~
'
-
-
---·M
-·
m •r • mw ,:tl!!!!?:!!:!rwr·· ··:: ?trwr•&&#imY';;~ \
27
BECK INVENTORY
On this questionnaire are groups of statements.
Please read each group of statements carefully. Then
pick out the one statement in each group which best
describes the way you have been feeling the PAST WEEK,
INCLUDING TODAY!
Circle the number beside the statement
you picked.
If several statements in the group seem to
apply equally well, circle each one.
Be sure to read
all the statements in each group before making your
choice.
1
0
1
2
3
I do not feel sad.
I feel sad.
I ~sad all the time and I can't snap out of it. ·
I am so sad or unhappy tr~t I can't stand it.
2
0
1
2
3
I
I
I
I
0
1
2
3
I do not feel like a failure.
I feel I have failed more than the average person.
As I look back on my life. all I can see is a lot of failures.
l.feel I am a complete !a.ilure, as a_ ;>_erson'!
0
1
2
3
I
I
I
I
get as much satisfaction out of things as I used to.
don't enjoy ·things the way I used to.
don't get real satisfaction out of anything anymore.
am dissatisfied or bored with everything.
0
1
2
3
I
I
I
I
don't feel particularly guilty.
feel guilty a good part of the time.
feel quite guilty most of the time.
feel guilty all of the time.
0
1
2
3
I
I
I
I
don't feel I am being punished.
feel I may be punished.
expect to be punished.
feel I am being punished.
am not particularly discouraged about the future.
feel discouraged about the future.
feel I have nothing to look forward to.
feel that the future is hopeless and that things cannot improve.
0 I don't feel disappointed in myself.
1 I am disappointed in myself.
2 I am disgusted with myself.
3 I hate myself.
0 I don't feel I
am any \o'Crse than anybody else.
l I am critical of myself !or my weaknesses or mistakes.
2 I blame myself all the t~~e for my faults.
3 I blame myself for ever}~hing bad that happens.
l
28
9
10
0 I don't have any thoughts of killing myself.
1 I hc:we thoughts of killing myself, but I would not carry them out.
2 I would like tcs kill myself.
3 I would kill myself if I had the chance.
0
1
2
3
I
I
I
I
don't cry anyrr.ore than usual.
cry rnore now than I used to.
cry all the time now.
used to be able to cry, but now I can't cry even though I want
tO•
ll
0 I am no more irritated nov than I ever am.
r
get annoyed or irritated ~re easily than I used to. ·
feel irritated all the time now.
3 I don't get irritated at all by the things that used to irritate
I
2 I
12
13
mE;!.
.
0 I have not lost interest in other people.
1 I am less interested in other people than I used to be.
2 I have lost most of my interest in other people.
3 I have lost all of.my interest in other people.
0 I make decisions about as well as I ever could.
1 I ~t off making decisions more than I used to.
.. ,
•·
~I
2 I have greater difficulty in making decisions than before.
3 I can't make decisions at all anymore.
14
0 I don't feel I look any worse than I used to.
1 I am worried that I am looking old or unattractive.
2 I feel that·there are permanent changes in my appearance that make
me look unat~acti~e.
3 I believe that I look ugly.
15
0 I can work about as well as before.
1 It takes an extra effort to get started at doing some.thing.
2 I have to push myself very hard .t.o do anythinq.~
3 I can't dO any work at all.
16
0 I can sleep as well as usual.
1 I don't sleep as well as I used to.
2 I wake up 1-2 hours earlier than usual and find it hard to get
hack to sleep.
3 I wake up several hours earlier than I used to and cannot get
back to sleep.
17
0 I don't get more tired than usual.
l I get tired more easily than I used to.
2 I get tired from doing Almost anything.
3 I am too tired to do anything.
29
18
19
20
0 My appetite is no worse ~~ usual.
l'MY appetite is not as good as it used to be.
2 My appetite is much worse now.
I am purposely trying
3 I have no appetite at all aD}~re.
to lose weight
by_ eating less.
0 I haven't lost much weight, if any lately.
Yes
Ro
1 I ·have lost more than 5 pounds.
2 I have lost more than 10 pounds.
3 I have lost mor~ than 15 pounds.
0 I ~ no more worried about my health than usual.
1 I am worried about ohysical problems such as aches and pains;
or upset stomach: c:r constipation.
2 I am very worried about physical problems and it's hard to think
of IIIUCh els'!!.
3 I am so worried about my physical problems I that I cannot think
about anythir.g el.::e.
21
0
1
2
3
I
I
I
I
have not noticed any recent change in my interest in sex.
am less interested in sex than I used to be.
am much less interested in sex now.
have lost interest in sex completely.
Appendix B
DYSFUNCTIONAL ATTITUDE SCALE
(DAS)
~
~;
gj'i'
31
DAS
This inventory lists different attitudes or beliefs which people
sometimes hold. Read EACH statement carefully and decide how much you
agree or disagree with the statement.
For each of the attitudes, show your answer by placing a checkmark
under the column that BEST DESCRIBES ~ow YOU THINK. Be sure to choose
only one answer for each attitude. Because people are different, there
are no right or wrong answers to these statements.
To describe whether a given att~tude is typical of your way of
looking at things, simply keep in mind what you are like MOST OF THE
TIME.
EXAMPLE
ATTITUDE
:>..
.c:
Q)
Q)
"'b'>
f:J;
:>..
..-(
..-(
ca
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u
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rl
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01
CJ)
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Ul
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a "' "'
01
f:J;
1)
.j.J
b'>
f:J;
ca
Q)
Q)
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u
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~"'
Q)
Q)
"' ca"' ca"'
::l
(])
z
01
Ul
-.-i
Q
Q)
Q)
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01
ca
Ul
·.-i
Q
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01
..-(
..-(
Ul
.j.J
•.-i
Q
ca
0
8
-
Most people are O.K. once you get
to know them.
J
Look at the above example. To show how much a sentence describes
your attitude, you can check any point from totally agree to totally
disagree. In th~ above example, the checkmark at "agree slightly"
indicates that this statement is somewhat typical of the attitudes held
by the person completing the inventory.
Remember that your answer should describe the way you think
MOST OF THE TIME.
Now indicate your degree of argeement with each of the following
attitudes.
32
;
ATTITUDES
REMEMBER, ANSWER EACH STATEMENT
ACCORDING TO THE WAY YOU THINK
MOST OF THE TIME.
;:..,
..c::
()
Q)
Q)
~
0'1
oc:r::
;:..,
rl
rl
Ill
~
0
8
1) It is difficult to be happy,
unless one is good looking,
intelligent, rich and creative.
2) Happiness is more a matter of
my attitude towards myself than
the way other people feel
about me.
3) People will probably think
less of me if I make a mistake.
4) If I do not do well all the
time, people will not respect me.
5) Taking even a small risk is
foolish, because the loss is
likely to be a disaster.
6) It is possible to gain another
person's respect without being
especially talented at anything.
7) I cannot be happy unless most
peoole I know admire me.
8) If a person asks for help, it
is a sign of weakness.
9) If I do not do as well as other
people, it means I am an inferior
human being.
10) If I fail at my work, then I
am a failure as a person.
11) If you cannot do something
well, there is little point in
doing it at all.
12) Making mistakes is fine
because I can learn from them.
13) If someone disagrees with me,
it probably indicates that he
does not like me.
14) If I fail partly, it is as
bad as being a complete failure.
15) If other people know what you
are really like, they will think
less of you.
-----·
--~--
1
;:J
::0:
;:..,
~
0'1
·.-I
rl
Cf.l
Q)
Q)
Q)
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~
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Q)
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rl
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Q)
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Q)
Q)
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0'1
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Q)
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()
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rl
Q)
Q)
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Q)
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0'1
Ill
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Cl
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0'1
rl
rl
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·.-I
0
E-<
0'1
Ill
Cl
Ill
Cl
Ill
33
ATTITUDES
REMEMBER, ANSWER EACH STATEMENT
ACCORDING TO THE WAY YOU THINK
MOST OF THE TIME
,...
>.
QJ
QJ
1-<
0[;
<(
.c()
:;J
::;:
>.
1-1
Q)
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Ill
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0
8
~
I am nothing if a person I
love doesn't love me.
17) One can get pleasure from an
activity regardless of the
end result.
18) People should have a
reasonable likelihood of success
before undertaking anything.
19) Hy value as a person depends
greatly on what others thir..k
of me.
20) If I don't set the highest
standards for myself, I am likely
to end up a second rate person.
21) If I am to be a worthwhile
person, I must be truely
outstanding in at least one
major respect.
22) People who have good ideas
are more worthy than those who
do not.
23) I should be upset if I make
a mistake.
24) My own opinions of myself are
more important than others'
opinions of me.
25) To be a good, moral, worthwhile person, I must help everyone who needs i t .
26) If I ask a question, it makes
me look inferior.
27) It is awful to be disapproved
of by people important to you.
28) If you don't have other people
to lean on, you are bound to be
sad.
29) I can reach important goals
without slave driving myself.
16)
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+l
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01
·.-i
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Q)
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Q)
Q)
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01
01
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$.4
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01
Ill
1-1
en
Q)
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Q
Q)
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en
Ill
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Cl
8
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z
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1-1
Q)
Q)
en
Q)
Q)
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>.
1-1
01
Ill
:::J
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0:;J
Cl
>.
01
Ill
0
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~
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I
i
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I . ----
!
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i
I
34
ATTITUDES
REMEMBER, ANSWER EACH STATEMENT
ACCORDING TO THE WAY YOU THINK
MOST OF THE TIME.
;:..,
..c:()
Q)
Q)
1-l
0>
~
;:..,
.-i
.-i
Ill
+.1
0
E-<
30) It is possible for a person
to be scolded and not get upset.
31) I can not trust other people
because they might be cruel to me.
32) If others dislike you,
you cannot be happy.
33) It is best to give up your
own interests in order to please
other people.
34) My happiness depends more on
other people than it does on me.
35) I do not need the approval of
other people in order to be happy.
36) If a person avoids problems,
the problems tend to go away.
37) I can be happy even if I miss
out on many of the good things in
life.
38) What other people think about
me is very important.
39) Being isolated from others is
bound to lead to unhacpiness.
40) I can find happiness without
being loved by another person.
::l
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;:..,
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Q)
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Q)
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Ul
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Q)
Q)
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Ill
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Q)
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Q)
Q)
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Q)
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Q)
Q)
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Ill
Ill
Ill
Ill
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c
Cl
Q)
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Ill
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Cl
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+.1
0
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35
Appendix C
TOPIC APPROPRIATENESS SCALE
(TA)
36
TOPICS FOR COtNERSATION
This questionnaire lists a wide variety of topics for conversation.
Imagine you are interacting with a person you have just met for the
first time. Read each topic and decide if you think it is appropriate
for conversation on a scale of 1 to 7. 1 =least appropriate and
7 = most appropriate. Put a checkmark in the corresponding column
for each topic.
TOPIC
1 2
---------------------:-~-4-J-:..,.1-~-:
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13~ ! 4 5J 6
Q)
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o...
Q)
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o,.....joij.J~-o
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o~-~:
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co >-.co
,.....j
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0 j
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l Q) o..!
I
>
_A_t_t_i_t_u_d_e_s__a_n_d_Op"--1.-·n_i_o_n_s_ _ _ _ _ _
What I think and feel about religion.
2.
My ~~ws-·on ;~~sent government - the
president, government policies, etc.
3.
-
-
-
----
I
! I lJ l
-
- - ~~
My personal views on drinking.
: : ::ng: :::l=:::::~s
i
. .. "•" -~·.-
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I
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l
. . . ___. _.- . ,. . . . -
My favorite reading matter.
l
I
~
5.
gathering I like best, and the
kind that would bore me, or that
I wouldn '-~ -~_Tij?!:_· _ .. ____ _
.
I
I . .--._,.!. .
~-~~
The kinds of movies I like to see
best; the TV shows that are my
favorites.
•,
1
1
j
-~-
I
--·--+-i----:
!
... -.J----;
·--
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i'
.. !. .
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i
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l
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2. My likes and dislikes in music.
-----------------The kind of party or social
1
1
·--·----~--f-·-
---·----t-----J.. . . . .; . . J--·- ~- ·
Tastes and
_________ , _______________
1. My favorite foods, the ways I like
I
food prepared, and my food dinlikes. !
4.
..
_!
ought to deal with children. ,__ _.,.._. _____
l
1
,.__
Inter~~ts
!
~--~-- ,---1.~---~.:--.
-·
.... !~- .. -~,-- ·-·~.·. ·- ... :
I l ; j
- ...... ---. ··- -+ _____ ,___ _______
I
i \
--~,..------;
------·---------.-----~-------· ...... ' ..
3.
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a;·
0..·
<C
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1.
---
Q)
~~
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0. S
O..;..C 0.. !!-< 0 H 0
0 Q)
• !-< 0.. :>, 0. 00 0.. 'Q) !-< ! !-< !-< • :>, !-< !-<
:~ co '"' co ·.-l co-o O..r.-1 o..:~-< o..~
:X t:: · aJ t:::,....; t:: '0 O..ICO O...QJ 0. X
iW H
H (f) H jZ <C t:r.. <C ;> <C UJ
IS
7
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!
i'
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t ··-· 1I..-..-- -1
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l
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.
37
1
TOPIC
1
. >,
2
4
5
6
Cl)
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1-o ~
a..:>, 0.,:(1) •r-l
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1-o
l cucu oo..I
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7
cul afl---a:;--1cur
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ail
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cu '-'.
Cl.. E Cl..'
o
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o
cu o
~ 1-o o..:>, 0.. 00 0.. :(1) ~ 1-o 1-o ;>, 1-o 1-o 1-o 1
r~ ~:~ ~;:: ~;g ~·cci fr:liJ 8:'~ §:'!
E
!
o ..-~ o1-o
~
1-o :~
1-o
n_e_:_o_m_I~o-w_e_m_o_n_e_y_-;tthe ~nt; or
l
'
1-f
Whether or not others owe me money;
the amount, and who owes it to me.
4.
My most pressing need for money right
i
I
I
I
Whether or not I have savings, and
the amount.
3.
'-'·
r ~~<CJ~~:::_-:slf!...::::..:
II
:
'-',
>, 0..\
o·~
l
i --~-l-- .
whom I have borrowed from in the past.\
2.
'-'
.ctl Cl!
o..;.c o.. :~-o
·-------------·------·--1\,...til_~-~~r>f
i
0
-:--.
;1-1
I
I'
l!
now, e.g., outstanding bills, some
major purchase that is desired or
needed.
~..
i
.
:.
1:
1
• .•
·
·
'
~----~
------
i
I
;
~
-··- ........ --·-·------·
.
5.
How I budget my money - the proportion
that goes to necessities, luxuries,
~-
.
etc.
---------------------------·-------------~---~·~~--~
Personality
:
I
-Things
-in the past or present that
--~--~-;--:-···-·~
.
:
1.
-+J--.-··-;__
___I_f_e_e_l_a_sh
__am_e_d_o_r-.:g::....u_i_l_t.:..y__
·a_bo_u._t_.__________ ,~.: ·
2.
The kinds of things that make me
happy.
3.
What it takes to get me feeling real
depressed and blue.
4. What it takes to hurt my feelings
_ _d_e_e.:..p.....:ly:_._ _ _ _ _ _ _ _ _ _ _ _ _ _
5.
·-.,
I
I
l
'\
t- ·---· :
I I
The kinds of things that make me
especially proud of myself, elated,
I
-~f~u=l=l~o=f_s~e~l=f:_-~e~st~e~e=m~o~r_s~e=l=f~-~r~e~sp~e=c=t~·--~---;--~--tl__rl
I
! -·--l~·--·-
J,·-- __
j
.~:____
_B_o_d_y--------------------·t--~---'--~--·t·--;--:_
1.
Any problems and worries that I had
with my appearance in the past.
\
..!
._.,...,. . .._-.. .. \
+--~-
i
;
.
__ ,___.;...._,. ______
1
J
:
·~··
! :
!
38
1DPIC
1
2
3
4
~~~--------------------------------------~~~2~~~-~2~;-
l
~
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co;
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•.-I ,:;...
5
w
6
w:
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w
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co
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1-< ·.j.J 1-< •CO 0. >, Cl...
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c..
Cl...:..C o.:l-< 0 .-1 0
0 Q) 0;
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co 1 ~-< co ...... co ro c.. •.-~ o. ,_, o...j.J
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, ;:.... 1-<
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t
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l I
2.
Whether or not I now have any
health problems- e.g., trouble
with sleep, digestion, heart
condition, allergies, headaches,
etc.
~------------------~~~---~----~-3. Whether or not I have any long
range worries or concerns about my
health, e.g., cancer, ulcers,
heart trouble.
4.
5.
J
'
(
>.
l
l .
<t;:U.. <(
I
~
l
i
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I
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1
<
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r·
f
'!
i
,
l
i
past record of physical illness
;
!.·
1:
:
1
f
i
,
Tl
What I find to be the most boring and
unenjoyable aspects of my studies/work.'
1
1
l
What I enjoy most, and get the most
.
satisfaction from in my present studies!
work.
!
What I feel are my shortcomings and .
handicaps that prevent me from
getting further ahead in my studies/
j
j
,
J
i
What I feel are my spec~al strong po~nts
and qualifications for my studies/work. \
I
~
'I
l
!,.
I,
1
iJ n
I
i
I
.i
'
,·-----(-·
I
I
!
;
L-
!
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!
I,
.
!,
i..
I
!
1
·---~w~o~r~k~·--------------------------------~----·-t---r---t--!1-
l
I
\
;
'---------------------~----l.---1-~
~5.
.
l
I\
J
I.
(
---..--,-rj
.
!
!
-~
my studies/work.
4.
__:.
II
j
:rk~:ts:u::: to be the-::st ~t:=-in -H~--I l
-
W -...•
;
1
,
.
I I :_.
and treatment.
. -~··-·-~-·-------··~-··J_,_j __ j_f -~-+-~-~
Whether or not I now make special
ll
~ ~
I ,1 ;
efforts to keep fit, healthy, and
f l
My
attractive, e.g., exercise, diet.
2.
<(
I
I
\,
j
I
39
Appendix D
LIFE EXPERIENCES SURVEY
(LES)
40
LIFE EXPERIENCES SURVEY
Listed below are a number of events which sometimes
bring about change in the lives of those who experience
them and which necessitate social readiustment.
Please
circle the number beside those events ~hich vou have
experienced in the past 6 weeks (since you tllled out
the 1st questionnaire).
Also, for each item circled please indicate the extent
to which you viewed the event as having either a
ositive or ne ative im act on our life at the time the
event occured by putting a c eck in t e appropriate
box opposite the event. The boxes range from
extremely negative, to no impact, to extremely positive.
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Marriage
L-·-· Detenrl-on-Tn··-JaTr-or ·: -
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camparable
institution
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--3~----Dea-th-·a"f ...
·-q:-:-Major cnange In----;-·----.--·-----------···--------·
sleeping habits
(much more or much
spo_u_se ·
s.---B~-:~11~~-p=~-t-ose----------------··· ------------6-.-
·
~-~ j ~ ~ Ycii-~-~i~ITn-~----- . -· '---- ----------·--·-------..---------·--·--·--
eating habits
(much more or much
less food intake)
7. Foreclosure ·an·---------------------·-·-------·--·---·----·--..·--·-------------------_..J!!_Qr.t_gg_gg__Q.L_to_q!L.......... [. _ . _, __ .......... .
8. Death of close
friend
9:--ou.-ts-tariCfing -p·el-s.on-a.T; --· ·
achievement
·
10. Minor-law ~l6iaiions
(tratfic tickets,
disturbing the
peace etc.)
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Male: Wife/
girltriend's
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pre g n a_l.l£.Y. ________..........~~-~--- ·---~~--~--~·";_ ..... __ ...... _.....
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12. Female:
Pregnancy
T3·:·--ch"ang·e-<r~worl<-··-------------·--·
--~-------··- · ·-------- -- ··· --·
situation (different
work responsibility,;
major change in
working condition,
working hours,etc.
.
_14 :·--Ne~. ~jo·~- -----~~: .. ·- --~-----·-·:··-~~--~- ---·:--~-- .....---_-:......... · ·-- · · · ·--------- - · ··· ·
15. Serious illness or :
:
injq_ry of close
f?_mily member
16. Sexual dlffic~ltie~
17. Ti-oti"bTe--·wi th· - -------employer (in danger
of losing job,
being suspended,
11.
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Trouble with in-laws
19. · Ma Ja·r:-··c-l1-ari8'e ir( ·-~·" ··-···· ----+financial status (a
lot better off or
a lot worse off)
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-2 ci'. ---· -Ma Jo rcli'"i:i"n g e in··-~-·-r·- ·- -~~ ............ ~ ~----~-~ ---....-~ . ·r- ···-·· ·•· .....,.. · ----··· "·· ··-·--···--····•
closeness of family '
members (increased
or decreased
.
closeness)
.
---··
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n.ew-·ralii1T}iT_..____ ------~--member (through
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birth, adoption,
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family member
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23. · Harital ·sepai-a'tfon
from mate (due to
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37.
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Maior change in
living condition of
family
(building new
home, remodeling,
deterioration of
home, neighborhood,
.
.
______ gJ_<;_,_ _______________~------'~~-~------.....,---·--~---~-38. Divorce
;
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.
39. --·ser-roils--irljur:Y- ----------·- -- ·-- r-----· .. ·-
or illness of
·
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close friend
40. ·Retirement Tram
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____
work
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41-~--- . s;r;··ar:·-a iiiugn£-et---·-----r -----:- ---------~ . . ---- --~-leaving ho~e
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(due to marriage,
______ c:<:>l\~ge, etc. )
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Ending of foim~l
schooling
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T--~:------~----;·---------- . ·;---43. Separation from
spouse (due to
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\vork travel,etc.) i
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-.. . . ._---r- ···t ---------·--·-----...t ------ t·· ·
A~ . J:ng~e:~~e:r:;f~-.--~- _._~45.
Breaking up with
boyfriend/girlfriend
....
···-. - ... .. ..
. ·r: 46. Leaving home LOr
the first time
~-R:e.conc'iTfaTfon.. _-with boyfriend/
girlfriend
48.
Be~inniri~ -~ "rie~
school experienc~
at a higher
academic level
(college, graduate
school,
professional,etc.
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Major change in
social activities,
e . g • , par t i es ,
movies, visiting
(increased or
decreased
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Changing to a new
school at same
academic level
5o"""__-.__-_-_A-7-----c ~-:~~e-iniu-£9~~iEi~~!L~~----~::·.~~-=-------~=~~~~
51. Being dismissed
·-·-,-- ------·------ ----·---....... __
from dormitory
or_ oth~_r_ __r_~E;ic;!gn~-~-------·----·--·-'"·-____ ,_____ ..·-------------------··-----.-52. Failing an
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important exam
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m~mi:y~robtems '
concerning school
(in danger of
not having
sufficient money
to continue)
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o-th:---e-r -r·e-cenf·--ex::p-errencest·
which have had an impact!
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