ID#
very slightly/not at all a little moderately quite a bit extremely A. sad B. blue C. downhearted D. alone E. lonely
very much somewhat neither somewhat very much A. capableincapable B. kindunkind C. undesirabledesirable D. strongweak E. attractiveunattractive F. foolishwise G. unlovablelovable H. responsibleirresponsible I. worthwhileworthless J. boringinteresting K. goodbad L. fatthin
4. "I don't like the way I look."
very slightly/not at all a little moderately quite a bit extremely
5. "Other students like my looks."
6. "I wish I looked like someone else."
7. Look at the problems below. Mark each problem that occurred TODAY. Each event that occurred should be counted only once (for only one item below). If a problem did not occur, leave the accompanying check box blank.
A. school-related stressor (e.g., exam, paper, studying, grade) B. personal illness, injury, or accident C. hassle (e.g., parking problem, money problem) D. argument/conflict with romantic partner E. argument/conflict with friend or roommate F. argument/conflict with family member G. argument/conflict with acquaintance H. romantic partner ignored/snubbed me (not an argument) I. friend or roommate ignored/snubbed me (not an argument) J. family member ignored/snubbed me (not an argument)
8. What was the worst or most bothersome problem of TODAY? If it was one of the events listed in Question 7, type the letter of the item (A-J) in the space below. If it was NOT one of the events listed in Question 7, type the letter X.
letter
9. How much CONTROL did you have over its occurrence?
no control very little control some control almost complete control complete control
10. How UNDESIRABLE was it?
not undesirable slightly undesirable somewhat undesirable very undesirable extremely undesirable
11. Do you have what it TAKES TO SUCCESSFULLY COPE with the problem?
definitely not probably not maybe probably definitely
For each item below (12-24), indicate how often you used this particular coping strategy TODAY in dealing with TODAY'S WORST PROBLEM.
12. DIRECT ACTION: Thought about solutions to the problem or did something to try to solve it.
not at all a little bit medium amount a lot
13. MADE MYSELF VOMIT
not at all somewhat a lot
14. DISTRACTION: Turned attention away from the problem or did something to try to solve it.
15. SKIPPED ONE OR MORE MEALS, REDUCED MY EATING
16. POSITIVE REINTERPRETATION: Tried to see the problem in a different light that made it seem more bearable.
17. ENGAGED IN STRENUOUS EXERCISE
18. CATHARSIS: Expressed emotions in response to the problem to reduce tension or frustration.
19. SELF-BLAME: Thought about how I should have prevented it or about how it was my fault.
20. ACCEPTANCE: Accepted that the problem occurred, but that nothing could be done about it.
21. SEEKING SOCIAL SUPPORT: Sought or found emotional support from loved ones or friends.
22. USED A LAXATIVE OR DIET PILL (e.g., stimulant, appetite supressant, diuretic)
23. DENIAL: Made believe that the event never happened.
24. ATE FOOD EVEN THOUGH I WASN'T HUNGRY