Young Schema Questionnaire: Short Form

Subject: Young Schema Questionnaire: Short Form Date: Mon, 7 Dec 2009 12:40:41 -0500 MIME-Version: 1.0 Content-Type: text/html; charset="iso-8859-1" Content-Transfer-Encoding: quoted-printable Content-Location: file://C:\Documents and Settings\jfneveu\Local Settings\Temp\Young's Schemas Questionnaire - short form.htm X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.3350 Young Schema Questionnaire: Short Form

Schema Therapy=20

Young=20 Schema Questionnaire: Long Form =B7=20 Young Schema Questionnaire: Short=20 Form =B7 Young=20 Parenting Inventory =B7 = Young-Rygh=20 Avoidance Inventory =B7 = Young=20 Compensation Inventory

YSQ = -=20 S2

Name=20 = ___________________________________________________Date_________________<= /FONT>

INSTRUCTIONS:

Listed = below are=20 statements that a person might use to describe himself or herself. = Please read each statement and decide how well it describes = you.=20 When there you are not sure, base your answer on what you = emotionally=20 feel, not on what you think to be true. Choose = the=20 highest rating from 1 to 6 that describes you and write the = number=20 in the space before the statement.

RATING=20 SCALE:

1 =3D = Completely untrue=20 of me=20 = &= nbsp;

2 =3D = Mostly untrue of=20 me=20 = &= nbsp;

3 =3D = Slightly more=20 true than untrue=20 =

4 =3D = Moderately true=20 of me

5 =3D = Mostly true of=20 me

6 =3D = Describes me=20 perfectly

1. = _____ Most of the=20 time, I haven't had someone to nurture me, share him/herself with = me, or=20 care deeply about everything that happens to me.

2. = _____ In general,=20 people have not been there to give me warmth, holding, and=20 affection.

3. = _____ For much of=20 my life, I haven't felt that I am special to someone. =

4. = _____ For the most=20 part, I have not had someone who really listens to me, understands = me, or=20 is tuned into my true needs and feelings.

5. = _____ I have=20 rarely had a strong person to give me sound advice or direction = when I'm=20 not sure what to do.

*ed

6. = _____ I find=20 myself clinging to people I'm close to, because I'm afraid they'll = leave=20 me.

7.______I need other=20 people so much that I worry about losing them.

8. = _____ I worry that=20 people I feel close to will leave me or abandon = me.

9. = _____ When I feel=20 someone I care for pulling away from me, I get desperate.=20

10. = _____ Sometimes I=20 am so worried about people leaving me that I drive them away.=20

*ab

11. = _____ I feel that=20 people will take advantage of me.

12.______I feel that=20 I cannot let my guard down in the presence of other people, or = else they=20 will intentionally hurt me.

13.______It is only a=20 matter of time before someone betrays me.

14. = _____ I am quite=20 suspicious of other people's motives.

15. = _____ I'm usually=20 on the lookout for people's ulterior motives.

*ma

16. = _____ I don't fit=20 in.

17. = _____ I'm=20 fundamentally different from other people.

18. = _____ I don't=20 belong; I'm a loner.

19. = _____ I feel=20 alienated from other people.

20. = _____ I always=20 feel on the outside of groups.

*si

21. = _____ No=20 man/woman I desire could love me one he/she saw my defects.=20

22. = _____ No one I=20 desire would want to stay close to me if he/she knew the real me.=20

23. = _____ I'm=20 unworthy of the love, attention, and respect of others. =

24. = _____ I feel that=20 I'm not lovable.

25. = _____ I am too=20 unacceptable in very basic ways to reveal myself to other people.=20

*ds

26. = _____ Almost=20 nothing I do at work (or school) is as good as other people can = do.=20

27. = _____ I'm=20 incompetent when it comes to achievement.

28. = _____ Most other=20 people are more capable than I am in areas of work and = achievement.=20

29. = _____ I'm not as=20 talented as most people are at their work.

30. = _____ I'm not as=20 intelligent as most people when it comes to work (or school).=20

*fa

31. = _____ I do not=20 feel capable of getting by on my own in everyday = life.

32. = _____ I think of=20 myself as a dependent person, when it comes to everyday=20 functioning.

33. = _____ I lack=20 common sense.

34. = _____ My judgment=20 cannot be relied upon in everyday situations.

35. = _____ I don't=20 feel confident about my ability to solve everyday problems that = come=20 up.

*di

36. = _____ I can't=20 seem to escape the feeling that something bad is about to=20 happen.

37. = _____ I feel that=20 a disaster (natural, criminal, financial, or medical) could strike = at any=20 moment.

38. = _____ I worry=20 about being attacked.

39. = _____ I worry=20 that I'll lose all my money and become destitute.

40. = _____ I worry=20 that I'm developing a serious illness, even though nothing serious = has=20 been diagnosed by a physician.

*vh

41. = _____I have not=20 been able to separate myself from my parent(s), the way other = people my=20 age seem to.

42. = _____ My=20 parent(s) and I tend to be overinvolved in each other's lives and=20 problems.

43. = _____ It is very=20 difficult for my parent(s) and me to keep intimate details from = each=20 other, without feeling betrayed or guilty.

44. = _____ I often=20 feel as if my parent(s) are living through me--I don't have a life = of my=20 own.

45. = _____I often feel=20 that I do not have a separate identity from my parent(s) or=20 partner.

*em

46. = _____ I think=20 that if I do what I want, I'm only asking for = trouble.

47. = _____ I feel that=20 I have no choice but to give in to other people's wishes, or else = they=20 will retaliate or reject me in some way.

48. = _____ In=20 relationships, I let the other person have the upper=20 hand.

49. = _____ I've always=20 let others make choices for me, so I really don't know what I want = for=20 myself.

50. = _____ I have a=20 lot of trouble demanding that my rights be respected and that my = feelings=20 be taken into account.

*sb

51. = _____ I'm the one=20 who usually ends up taking care of the people I'm close=20 to.

52. = _____ I am a good=20 person because I think of others more than of = myself.

53. = _____ I'm so busy=20 doing for the people that I care about, that I have little time = for=20 myself.

54. = _____ I've always=20 been the one who listens to everyone else's = problems.

55. = _____ Other=20 people see me as doing too much for others and not enough for=20 myself.

*ss

56. = _____ I am too=20 self-conscious to show positive feelings to others (e.g., = affection,=20 showing I care).

57. = _____ I find it=20 embarrassing to express my feelings to others.

58. = _____ I find it=20 hard to be warm and spontaneous.

59. = _____ I control=20 myself so much that people think I am = unemotional.

60. = _____ People see=20 me as uptight emotionally.

*ei

61. = _____ I must be=20 the best at most of what I do; I can't accept second best.=20

62. = _____ I try to do=20 my best; I can't settle for "good enough."

63. = _____ I must meet=20 all my responsibilities.

64. = _____ I feel=20 there is constant pressure for me to achieve and get things=20 done.

65. = _____ I can't let=20 myself off the hook easily or make excuses for my=20 mistakes.

*us

66. = _____ I have a=20 lot of trouble accepting "no" for an answer when I want something = from=20 other people.

67. = _____ I'm special=20 and shouldn't have to accept many of the restrictions placed on = other=20 people.

68. = _____ I hate to=20 be constrained or kept from doing what I want.

69. = _____ I feel that=20 I shouldn't have to follow the normal rules and conventions other = people=20 do.

70. = _____ I feel that=20 what I have to offer is of greater value than the contributions of = others.

*et

71. = _____ I can't=20 seem to discipline myself to complete routine or boring=20 tasks.

72. = _____ If I can't=20 reach a goal, I become easily frustrated and give = up.

73. = _____ I have a=20 very difficult time sacrificing immediate gratification to achieve = a=20 long-range goal.

74. = _____ I can't=20 force myself to do things I don't enjoy, even when I know it's for = my own=20 good.

75. = _____ I have=20 rarely been able to stick to my resolutions.

*is

COPYRIGHT 2003=20 Jeffrey Young, Ph.D., and Gary Brown, Ph.D. = Unauthorized=20 reproduction without written consent of the authors is prohibited. = For=20 more information, write: Cognitive Therapy Center of New = York, 130=20 West 42nd St., Suite 501, New York, NY=20 = 10036.