Interpersonal/Dyadic/Relationship Level

How much can you rely on your partner for help if you have a serious problem?

Are you currently in a relationship with a primary partner? By primary partner we mean someone who you are committed to above anyone else and with whom you might or might not be having sex.

I talk things over with people.

How long have you and your primary partner been in a relationship? - Months:

How long have you and your primary partner been in a relationship? - Years:

How much does your partner understand the way you feel about things?

I often worry that other people do not really care for me.

Specify other

Specify other

Specify other

Specify other

There are people who admire my talents and abilities.

If something went wrong, no one would come to my assistance.

I feel part of a group of people who share my attitudes and beliefs.

I feel a strong emotional bond with at least one other person.

No one needs me to care for them.

I feel that I do not have close personal relationships with other people.

Other people do not view me as competent.

There is no one who shares my interests and concerns.

There are people I can depend on to help me if I really need it.

There are people I can count on in an emergency.

There are people who depend on me for help.

There is someone I could talk to about important decisions in my life.

I lack a feeling of intimacy with another person.

There is no one who likes to do the things I do.

There is no one I can depend on for aid if I really need it.

There is no one I can turn to for guidance in times of stress.

There is no one I feel comfortable talking about problems with. (19)

There is no one who really relies on me for their well-being.

I do not think other people respect my skills and abilities.

I feel personally responsible for the well-being of another person.

I have close relationships that provide me with a sense of emotional security and well-being.

I have relationships where my competence and skills are recognized.

There are people who enjoy the same social activities I do.

There is a trustworthy person I could turn to for advice if I were having problems

Casual sexual partners

Family

Friends

Main sexual partners

Other Person

Healthcare provider

Religious Figure

Acquaintances

People in your church

Created family (e.g. Friends in your life that you consider to be family)

Biological family (e.g. Mother, father, siblings, children)

Friends

Other (specify)

Primary partner(s) (e.g. boyfriend(s), girlfriends(s), husband/wife)

Co-workers