1 – Not at All
2 – Sometimes
3 – Moderately Often
4 – Often
5 – All of the Time
¹
1
2
3
4
5
1
I don't deserve to be happy.
2
I deserve to be lonely.
3
I hate myself.
4
No one cares what I think.
5
I am not worth caring about.
6
I can never be heard by others.
7
Right now, I deserve to be alone.
8
I don't matter to anyone.
9
I make terrible decisions.
10
Right now, I should just hate myself.
11
I am terrible at things.
12
I deserve to be mistreated.
13
My feelings are unimportant.
14
I am hateful.
15
I mess everything up.
16
No one cares about my opinions.
17
I am a horrible person.
18
Right now, I hate most things about myself.
19
I will never accomplish anything.
20
No one cares what I feel.
21
I deserve to fail.
22
I am loathsome.
23
I can't do anything right.
24
I do nothing right.
The presented answer sheet is not an original form and is not intended for printing or use as a handout.
The answer numbers are used only to label response columns. They are NOT scores and should not be used for calculating results.