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Please read the list below & consider whether the stated problem has been an issue for you with respect to any significant person in your life. Then choose the number that best describes how distressing that problem has been & circle that number.

It is hard for me to:

Question Not at all A little bit Moderately Quite a bit Extremely
1. Join in groups.
2. Do what another person wants me to do.
3. Get along with people who have authority over me.
4. Socialize with other people.
5. Feel comfortable around other people.
6. Be supportive of another person's goals in life.
7. Accept another person's authority over me.
8. Ignore criticism from another person.
9. Take instructions from people who have authority over me.
10. Be assertive without worrying about hurting the other person's feelings.
11. Be self-confident when I am with other people.
12. I fight with other people too much.
13. I am too sensitive to criticism.
14. I get irritated or annoyed too easily.
15. I am too sensitive to rejection.
16. I am too aggressive toward other people.
17. I try to please other people too much.
18. I feel attacked by other people too much.
19. I worry too much about other people's reactions to me.
20. I am influenced too much by another person's thoughts and feelings.
21. I worry too much about disappointing other pepole.
22. I lose my temper too easily.
23. I argue with other people too much.
24. I feel embarrassed in front of other people too much.
25. I feel too anxious when I am involved with another person.

calender