Form: Five Needs Satisfaction Measure

1 – Strongly disagree
2 – Somewhat disagree
3 – Neither disagree nor agree
4 – Somewhat agree
5 – Strongly agree
¹
1
2
3
4
5
1

I am completely satisfied with...

The quality of the food I eat every day.
2
The amount of food that I eat every day.
3
The quality of the water I drink every day.
4
The amount of water that I drink every day.
5
The amount of heating I have when the weather is cold.
6
The amount of cooling I have when the weather is hot.
7
The quality of the air I breathe every day.
8
The amount of sex I am having.
9
The quality of sex I am having.
10
Every aspect of my physical health.
11
The amount of sleep I get to feel thoroughly relaxed.
12
The quality of sleep I get to feel fully refreshed.
13
The amount of exercise I get to keep me healthy.
14
The type of exercise I get to keep my body toned.
15
My overall physical strength.
16
The quality of the house/apartment I am living in.
17
The space available for me in my house/apartment.
18
How secure I am in my house/apartment.
19
How safe I am from being physically attacked.
20
The safety of my neighborhood.
21
How safe I am from catching any diseases.
22
How secure I am from disasters.
23
How protected I am from dangers in the environment.
24
The protection that the police provide for me.
25
The protection that the law provides for me.
26
How safe I am from destructive terrorist acts.
27
How safe I am from acts of war.
28
My financial security.
29
My ability to get money whenever I need it.
30
The money I reserved for me to have a secure retirement.
31
The amount of rapport I share with the people I know.
32
The quality of the relationships I have with my friends.
33
The love I receive from my spouse/partner.
34
The intimacy I share with my immediate family.
35
The camaraderie I share with my colleagues.
36
How much I am welcomed in my community.
37
The warmth I share with my relatives.
38
The emotional support I receive from my friends.
39
The feeling of togetherness I have with my family.
40
How much I am cared for by my spouse/partner.
41
The happiness I share with my companions.
42
The sympathy I receive from my confidants.
43
The enjoyment I share with associates.
44
The affection shown to me by my friends.
45
The closeness I feel with my associates.
46
The admiration given to me by others.
47
The honor that many people give me.
48
How much other people respect me as a person.
49
The prestige I have in the eyes of other people.
50
How highly other people think of me.
51
The high esteem that other people have for me.
52
The recognition I receive from various people.
53
The high regard that other people have for me.
54
How much I like the person that I am.
55
How sure I am of myself.
56
How much respect I have for myself.
57
All the good qualities I have as a person.
58
My sense of self-worth.
59
The amount of esteem I have for myself.
60
How positive I feel about myself as a person.
61

How much do you agree or disagree:

I am totally comfortable with all facets of my personality.
62
I feel that I am completely self-fulfilled.
63
I am now being the person I always wanted to be.
64
I am finally realizing all of my innermost desires.
65
I indulge myself as much as I want.
66
I am now enjoying everything I ever wanted from my life.
67
I completely accept all aspects of myself.
68
My actions are always according to my own values.
69
I am living my life the way I want.
70
I do the things I like to do whenever I want.
71
I am actually living up to all my capabilities.
72
I am living my life to the fullest.