1 – Strongly disagree
2 – Disagree
3 – Somewhat disagree
4 – Neither agree nor disagree
5 – Somewhat agree
6 – Agree
7 – Strongly agree
¹
1
2
3
4
5
6
7
1
I feel alone when I am with my family.
2
I feel part of a group of friends.
3
I have a romantic partner with whom I share my most intimate thoughts and feelings.
4
There is no one in my family I can depend on for support and encouragement, but I wish there was.
5
My friends understand my motives and reasoning.
6
I have a romantic or marital partner who gives me the support and encouragement I need.
7
I don't have any friends who share my views, but I wish I did.
8
I feel close to my family.
9
I am able to depend on my friends for help.
10
I wish I had a more satisfying romantic relationship.
11
I feel part of my family.
12
My family really cares about me.
13
I do not have any friends who understand me, but I wish I did.
14
I have a romantic partner to whose happiness I contribute.
15
I have an unmet need for a close romantic relationship.
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.