QUESTIONNAIRE FOR Bell's ADJUSTMENT INVENTORY

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Consu mable Bookl et


~logy ~
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of /~
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Bel l's Ad1"ustinent Inv ento
_ ry \~se~~~?P1/:f r..fi,.;~
-:!~~ .
(Indian ~dapt ation) ~
.
Revi;,ed Edition '

R. K. Ojha (Moradabad)

Please. fill in the follow ing Inform ations : -



Nan1e .... ...................... :.. :.. . . ... ~ ............................ Class .......... ~ ·~·· ...........
.................... : ... .
Sex ........... ......: . .. ,. .\ ..:. ."........... ........... ........... ......... Age .............: ....
:·...... ·...... :... :.......;:_.~ ... ... .
Father' s Occupa tion .......... .. ... ... .... : .. :._. ................................. :...........
...................... ....: ....... ..
I

Monthl y Income ............. :.. :. '. .:.: .......:.. :.. . .... :'. ......... ·. Educat ion .. .-... .

INSTRUCTIONS
If you answe r each statem ent proper ly of .this invento ry hones
. .
tly and devote dly
' then I can tell you wheth er you posses s comple
te adjustm ent person ality or some
short-c oming s. If you are not living with your parent s, then answe
r such statem ent
· keep.In g in view the person s with w·hom you are J1~ing.
·
This invento ry consis ts of four parts. 35 statem ents are given
in each part. Two
alterna tives 'Yes' a~d 'No' are gl~en against ~ach statem ent. If you
wl~h _to _answe r the
statem ent in ..'Yes' I.e. you_agree ~!th the facts given ln ·the
~tatem ent then put a
cross ( x) la the box given below 'Yes'. If your answer Is negativ
e I.e. you do not agree .
with the facts g~ven in the statem ent then put a cross ( x) i·n the
box giv~n below 'No'.
Though .there Is not time limit, still try to answer all°the statem ents
quickly .
..
SCORING TABLE .

Area ·:..._ II Ill IV Total


Scores

l~terpr etatlon_

Estd. 1983 ({) (0522) 35480 7


ANH.UR PSY CHO LOG ICA L AG EN-C Y
2?/48 1, . INDIRA\ .NAGAR, l.,UCKNOW - 226 016
I
C,

·1, I l1w e ~qu ever had a firm Idea of absconding the home ?
I □ □
2, l} o you' t'VOr foel th at your parents are not satisfied with you ?
' □ □
:·I. Aro yo u trn d wit~• •.he work s done by your father to run your
fmnlly?
□ □
4. l) o your mother h~ve supremacy In your family.
□ □
6. Moo ony o nt, amon g your mother-father ever ·condemn you in
vnln?
□ □
o. Do you think th at th ere Is no true affection in the family ?
□ □
7. [)o you nlways h ave good rclatlons with your 'tather? ', .
□ □
8. ()o you r p arent i> str ess upon ob eying them instead of paying
ott ontlon to your matt ern.
□ □
o. Boln g your fomlly llfe s orrowful, has anyone in your family
l>ooomo Ill or died ?
□ □
fo. Do. your horn~ appears to yc;>u sorrowful because of shortage
of mo,:,oy?
□ []
1·1. Hoe y~ur pare~ts ever sus pected upon your character ?
[]

12. . Qo y()Ur p,o rc~ts forb~d you to remain with s~ch ty.pe of friend$
you romaln w,th ? . . . · · [j □-
·,
13. Do ypur m,~t~,er or fa~her Irritates soon_?
□ □
14. Do yo':' mostly remain s dls.~gree wi~h y~ur parents re.garding
the process o.f ~ork at h(?me ?
□ D
~15. . 0~ fQmlly, qua~rels usually occur between your relations ?
'
.□ □
' .
16. Do you ,mostly keep· on quarrelling with your brothers. and
sisjero ?
□ □
17. Do ·your parents und erstand you to be a child and do not think
th at you hove g ro~n up _now?
□ □
18. 'D 6 ·y·o·u · fc_cl ~hat yo.u r pa r en~ s are unnecessarily strict with
you?
□ □
10. Do ony o f your por c nt s h av e any peculi ar. habit which. you

.
hotoo ?
□ □
Consumable Booklet of BA I I 3

STATE M ENT
____]~_v_E_
s ~-N~]
l (l .
□ □
:! L H ~wc Y\,'> li t a I Nwo y ou r ho u se or k ee p quiet for maintaining
p o-ac~ fn th t, family ? D D
22. ~fas yo u r pu t} nts c r e:i t e d g re at f e ar in your 1nind for any
:;;poctfic w ork ? D D
23. Do yo u so m e tim o fu el angry. µnd sometime happy upon your
family members according \o the time ? D D
24. Do your moth er loves you very much? D D
· 25. Do yo ur m oth er or fath er gets angr_y soon ? D D
'
26. Do :tll th e t?ss e nti a l things ex ists in your house ? -□ D
27. ob the idea ls o f life of your lath er match with your ideals? . 0 o· .
28. Has yo ur p nre nt s ever prov oked you for your personal figure
and colo ur ? D D
29. Oo the id e as of your mother-father not match with each other? D D.

3 0. Did your pare nts oftenty beat you between the age .of 1 0 ~.n d 15
y ears? D D.
31. Are you not in agreem~nt wUh the ideas of your parents
reg~rding your aims of "lite ? D D.
3 2~ •~ a_ny of your molher-tath'er of irritant habit ?_ D D
33. Do your ·nother or father k.eep you in strict contro·1 ? 0 0·
34: Do you ev·~r think that.your pare_
n ts are·ur,able to understand
~1 d - o
35.. Do you feel that the family life of-your friends is more pleas;ant.
than your? D □-

PART II

I HEALTH I
1. Do you get afraid ~oon.with others ?
..
□ □
2. Do your eyes feel di~~ully in facing ver, bright light ? [1

3. Are y,ou a patient of asthama or malaria -etc.? Cl

4. Have you ever had Diphtheria or high·r~ver in childhood? D
D
l

---::-:-=.--=-===-=-==:;======= r==::-=::==i
____-::_:::::::_::::_===---=-=
I - --
Consvmn.ble B~ let of B A . I.. --::=:::::::::::::::_::::
...4
~~
·-
YES
/s. No:1 . _ ST_A_TE_ M_EN_T_ _ __ _

s. no you olwny e romn ln offllc t ~Y head ache ? □ □


any kind of
6. po you foe l dlfflc ulty In sl~ep lng -when there Is ----C:l
nolso In hous e ? □
Do you usua lly fool more tired a_t the end of the
day ? □ 0
7.
8. Hovo you rodu cod some of your bo~y weig ht these
days ?
□ □
9.
'
Hnv'e you ever had serio us Injury In any accid ent
?
□ □
.□
\
10. Hovo yo\e~or had any surgical operatlo~ ? □
11. Do you f e~m uch cold ? □ □
12. Do you usua lly get afflic t with Influenza ? □
o .,_
13. Did you ever beco me serio us Ill durin g last ten
year s ?
□. ..... □
... . .. .
. ' ' .
14. Are you suff erlng from the probl em of gas? □ □
[]
15. Do you feel giddi ness ? □
16. Do your eyes pains usua lly ? □ □
17. Do you feel tired ness when you wakes-up in the
mqrn ing ?
□ □
18. Do you often ly take medi cines ? □ □
19. Do you usua lly feel like tired ? □ .□
20. Do you usua lly get Indig estio n probl em·? □ [J

21. · Do you,usua lly get sour throa t ? •·


I •

:·□· □
22 . . · Do you us~a.11Y have disea se of vomi ting or
.diar rhore a ? .□ □
- □
23. Do you .have much prob lem . of cons tipati on'-...? . □.
. .

.24. .
Hav~ you been too muc h Ill ducing your child. hood
'r
. . □ -0
25. · 1?0 iou feel diffic ulty In bret1thlng with nose ? □ Cl
'26. Do you ever have shar p headache ? □ □
. 27. Is your body weig h_t less than;im av~rage? □ □
_28. Do you _u suall y_take your food befo re feelln g t,ung
ry ? _
□ □
29. Do you use spec tac_les ? □ [l

30. Do _you think nece ssar y to take care of your hea~th? D CJ


31 . Are ~ou usµa lly abse nt beca use of..lllness ? .o ·□
V
F 0
Consumable Booklet of BA/ I 5

I
·_.__
No ]
.._S~.~N_ ~=-::::::=-= --~:--:-:~ -S-TA_T:_E_M_E_N_T~ - - - - - - _ J ~Y~E:S~_:
32. Are your teeth ·such that y_o u feel ne~essary for medication ?
□ □
33. Do you have any trouble in heart," lungs or kidney ?
□ □
34. Have you ever had -skin disease ?
□ □
~5. Do you have trouble in getting rid of cold ?
□ □
PART III

j soc1il\L I
· Do you enjoy ~ocial gatheri"ngs )us~ to meet the persons ?
1.
□ □
2. oo·you like to meet the c~lef guest- while attending any
..
reception function ?

3. Do you take responsibil ity of introducing persons while
attending such functions ? □ [J
4. Do you feel difficulty in giving proper answer while takin~ part
in group conversation ?
. .- ?
□ 0
Have you been le_a der of any party • []
5.

6. Do you i,esitate in going any meeting when all t-he person~
have seated.? "" ·
□ □
; ' .
all in the class? -
7. Can you deliver
.
speech in the.presence of
.
□ □
8. Do you ke~p on talkln ·g with you·r fellQw travellets whll.e
travelliryg by rail or bus ? . □ □
9. · _ Do you feel easy in a~king help from others ? □ [J
1o. r;>o you get harrass with your shynes_s ? □ -[]
11.· _. Do you enjotin s(arting conversation in public? O. O
. 12. . Do yqu have experien,ce of planning and directing the works of-
Pl:Jblic ? -□ .□
13. . · Do you _feel difficulty in talking wit~ any new known person ? 0 0
14. Do you find yourself unable in answering in tfae ciass even
rem~mbering the answer ? D D
15. Do you feel easy in having friendship with opposite sex
person? ·□ D
C,

Cons umab le Book let of BA I

/s. 'No. /
6
STATEMENT 1-~ ~~]
g other s
Would you like to do work for others instea d. of askin
16. □ □
to do work for you if you are given a dinne r .? -----
□ D
17. Do you have experience in delivering speec h in meet ings?
of
□•
nce
Do you have diffic ulty in delive ring spee ch in pres·e
18.
perso ns? □
19. Do you enjoy more social dances ? - □ □
you want
20. Will you prefe r to go perso nally and take some_!hlng
g a letter or askin g
from an unkno wn perso n instea d of writih
any other perso n to bring it ? □ □
admir e
21. Do you feel self-r espec t in living with the perso ns you
most and not known fully ? □ □
22. Have you ever been a leader of any socia·1·progr amme
1 □ D
ht of any
23. Do you move sidew ays on road to side the-e ye-sig
speci fic perso n ? □ □
24. -~
Will you prefe r to stand or come back on reach ing late
meeti ng instea d of sitting inf ront?
in any
□ □
- □
25. Do you make friend s with readiness ? □
26. Are you leade r in any party ? □ □
speci fic
27. . Do yo·u prefe r to have hearti ry friend_ship ~•~h some
perso ns instea d of havin g _acquaintance with more perso ns 1· □ □
•.

leavi ng
Do yo.j feel dlshe a-rt.e d in seeki ng perm is_sion for
1
2a.-
any"_specl flt: party of perso ns if you wish to leave ~t ? CJ □
29. Do you lag behin d in social functi ons ? D □
all of a
30. Do you get perpl ex all togeth er, if any teach er calls you
.sudd en?.
.
□ □
31. oo·yo_u feel dlfflcutt to talk-wit~ a stran ger? □ □
32. Are you deligh te.d In taking .part in fairs. and gathe rings
? D 0
subject
33. Do you ~nde ratan d self-r espec ted In ·spea king on any
[ l
In the class ? □
34. Do yo~ hesitate In speaking In the class ? . [] [] ,,.
"
na are
35. Do you h~•lt ate In enter ing the room If some· perso
D {-J .
,.

talkin g with each other there ?


Consuma ble Booklet of BA I I 7

STATEMENT YES I~
PA~T IV

. I. EM_o ,:ioNAL I
1. Do you· day.;dream s ? □ □
2. Is testing by doctor for any disease frightens you ? D □
3. Do you sometimes get ~ad for u·n known reasons ? D □
4. Have you ever felt that some~e may hypnotise you and make
you work against your Will ? ·_ □ □
5. Do you feel lonely while staying in a crowd ? □ □
!r: · 9. Do you feel tire~ at the en~ o( tJle. day ? □ □
7. Do you get frighten with the idea of earthquak e or fire ? □ □
-
8. Do tears in you eyes come soon? □ □
9. Do you get frighten on seei_ng a _snake ? □ □
1'0. Are you held convicted even if-you are not guilty ? □ □
[].
11. Do lightening _frightens you? - □
12. ·oo you gef~iscou rage r·epeatedly on ··s ecuring le~s- marks ih
exa~inatio n·~ ·i-' : . □ □
□·
13. Do you fe~I jealous of other.s beirig _happy?

14~- - Do. yo·u loo~e courage very easily ? .
□ . □
Do you usu~lly feel sad ·upc:m your acts ?
15. .
□ □·

16. Have you ever got frighten Qf faiJing-.down after c_limbing a high
,riountain ·1 . · · · -□



06 yo'u get angry· very soon ? ·Q '

17.

_you usua·lfy remain sad ? -


□ □
18. Do

19. Oo you get perplexed with the feeling of inferiority ? □. □


20. · Do you understan d yourself strong ?·
□ □
21 . Do y·o u easily get shy ?
□ □
'" ···
. .,
,
8 I Consumable Booklet of.BA I

l_s'. No. j
22.
_ _____ . STATEMENT

Do you feel troubled with any hearsay?


I YES
I NO
\
• □ □
23. Do your feeling get hurt with any .hearsay?
□ □
24. D~ you become: troubled with prq~_~ble dtfflcultles ?
□ □·
25. Do you ever get wor'rled for the persons may not read your
Ideas? - · '
□ □
26. Do yqu ever have an Idea that persons .are sepoying you on-
the road? · · ·
□ □
27. .Do you get much troubled on hearing yc;,~r complaint s?
□ □
28. Do you usually get Irritate?
□ □
29. Do you sometime s have useless ideas- In your brain and feel
distressed ·with them 1 ·... .. .. ·
·□ D
30. Do you get agitated soon?
□ □
31 .' ~o you get too much distresse d with your experien ces of
poverty?
tJ □
32. Do you get too much frighte~ with a person even knowing that
he cannot ·harm you ?
□ □
33. Do you get hap.py and sad on and of without any specific
reason? •
□ □
34. .Do you··ever ~aye an .Idea of your being unable to sleep ?
I ••
D o.
35. Do you-fear fr, living al_one In dark ?. □- 0

(0. Revised Edition 1999. All rights r.eserved. Reproduction In any form is a violation oJ
Copyright Act. Bell's Adjustment l~ventory (BAi). (English Version) .

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