MARITAL ADJUSTMENT QUESTIONNAIRE

Name of the Husband / Wife : Age: Sex: M / F Qualification:

Occupation: Age at marriage: No of children:
Address:

INSTRUCTION: Below are given a list of statements relating with different aspects of married
life. You are requested to read each statement carefully. If the statement is true for you, you
are to under line ‘Yes’. If it is not true, you are to underline ‘No’ on a separate answer sheet. As
many of these statements are very personal in nature, your replies will be kept strictly
confidential. Kindly answer each statement frankly and truthfully.

Sl.No STATEMENTS ANSWERS

1. I mostly prefer to go out together Yes No
2. I have full confidence in each other Yes No
3. I am religious-minded Yes No
4. I often develop tension over family expenditure Yes No
5. I agree that taking care of children is a joint responsibility Yes No
6. I believe in family planning Yes No
7. I agree that I got married at the right age Yes No
8. I feel incomplete when required to live alone Yes No
9. I fully enjoy sex Yes No
10. I like to keep some of my personal secrets to myself Yes No
11. I try to squeeze out maximum possible time to be with each other Yes No
12. I respect each other’s family members Yes No
13. I am proud of my partner Yes No
14. I try to solve your family problems jointly Yes No
15. I treat each other more as a partner (friend) than a husband or wife Yes No
16. I often praise each other Yes No
17. I take care of each other’s interests, habits and likings Yes No
18. I have got similar views regarding the number of children in the family Yes No
19. I often have arguments taking household issues Yes No
20. I take care of each other’s needs and satisfactions in sexual matters Yes No
21. I feel that I did the right thing that I got married with each other Yes No
22. I feel quite miserable in the absence of each other Yes No
23. I agree that marriage provides the most satisfying sex Yes No
24. I have got similar interests and aptitudes Yes No
25. I try to maintain newness in our sexual relationship Yes No

Raw Score: Social= Sexual= Emotional=

Total Raw Score= Percentile= Remarks: