AT MULTLPHASIC QUESTIONNAIRE, ‘The following statement intended to indicate your interests and attitudes. This is not an intelligence test and there are no right and wrong the corresponding statement is true and around “ 1.Lofen get red spots on my neck. 2. ike to be praised by my superiors 3.1 enjoy many different kinds of play and recreation, 4. Thave never fainted or felt like fainting, 5. have used alcohol excessively 6.1 would like to be a nurse, 7. My parents were generally reasonable in making me obey. 8. easily become inpatient with people. "9, Peculiar odours (smells) come to me at times. 7 10. The top of my head sometimes feels tender. 1. My soul sometimes leaves my body. 12, [do not always tell the truth, 13. Tusually feel that life is worthwhile 14, Lenjoy detective or mystery stories 15, [have very few quarrels with members of my family. 16, Lam interested in the latest fashions in clothes. 17. [feel that I have often been punished without cause, 18. { don’t like to study about things that | am working at, Draw a circle around “T" i is false. If you are not sure, guess. 1 y T T T T T 7 TE 7 T T T ay 4 i x i F . Scanned with CamScanner19,1 have never been fn love with anyone 29, often have feelings like burning, tingling oF crawling. 21. 1am not afraid to handle money. 22. 1 do not like everyone I know. 23.1 brood a great deal. 24.1 am worried about sex matters. 25. My comfort comes before that of others. 26. like mechanics (dealing with machine, automobiles etc.) magazines popular or otherwise. 27. [have had more than my share of things to worry about. 28.1 forget right away what people say to me. agen 1.29. I dislike having people about me. 30. 1 have a great deal of stomach trouble, 31. It does not bother me particularly to see an animal suffer. 32. Sometimes I put of until tomorrow what I should do today. 33. 1do not worry about catching diseases. 34, Many people exaggerate their trouble to gain sympathy. 35. I would rather enjoy the preset than plan for a future. 36. 1 am not interested in science 37. Lhave no enemies who really wish to harm me. 38. Unimportant thoughts sometime bother me for days. 39, Most of the time I wish I were dead. 40. Lam usually calm and not easily upset. 41. I get angry sometimes. T F T F T OF T OF Tenet T OF TO OF T OF TT aeeEEL TOF TO OF TOF T OF TOF TOF TOF TOF T OF T OF Taek et oF TOF Scanned with CamScanner42.1 would rather win than Tose in a game 43, Once in a while I laugh at a dirty joke. 444. When in trouble I Keep my mouth shut 45. Lhave very few fears compared to my friends, 46.1 never liked to play with dolls, 47, 1am sure 1 am being talked about, 48.1 get upset when I have to make a short trip away from home, 49.1 often feel as if things were not real. 50. [often feel pain in the back of my neck S51. ean sleep during the day but not at night. 52, Sometimes when | am not fecling well l get annoyed easily. 53.1 am easily awakened by noise 54, My eyes sight is as good as it has been for years. 55. There is very litle love and companionship in my family. 56. [like adventure stories better than romantic stories. 57.1 think I feel more intensely than most people do. 58. I must stop and think even before doing simple tasks. 59, Many of my dreams are about sex matters. 60. 1have no iulty in holding or moving my bowel. 61. A priest or a religious man can cure disease by putting his hand on your head. 62. am not always prompt 63.1 go to temple of church regularly. t F tT F eee tT F = F = F TO OF TOF TOF T F ny 7 E T F a F = z T F = F T F TOF TOF TOF Scanned with CamScanner64. My sleop is fitfal and disturbed. 65.1 have been quite independent and free from family rule 66. [would like to tend a flower garden. 67. Evil spirits never possess me. 68.1 often cross the street to avoid someone I see. 69.1 get ll the sympathy I should. 70. [have had no difficulty holding or starting my urine. 71, [believe in law enforcement. 72. Once in a while I have broken a promise. 73. Criticism or seolding hurts me terribly. 74, My home life is as pleasant as that of most people. 75. 1 liked school. 76. 1 like poetry. 77.1 don't believe anyone is plotting against me. 78. I have a habit of counting unimportant things. 79. [hear things when I am alone. 80. I have had several operations which did not benefit me. 81. Sometimes I feel that I must injure myself or someone else. 82, gossip a little at times. 83, When I leave home, I do not worry if locked the door. 84, My conduct is controlled by the customs about me, 85. [have not lived the right kind of life. 86. I like to cook. 4 Py Bs 88 8 8 = 7 sa 34 4 4 Scanned with CamScanner87. Some one has control over my mind. T OF 88. Bad words come to my mind and I can’t get rid of them. T F 89. Sometimes I enjoy hurting people I love. T F 90. I enjoy social gatherings just to be with people. T F 91. Some persons try to steal my thoughts and ideas. T F 92. At times I envy successfull people. T F 93. 1 work under a great deal of tension. T F 94. The sight of blood neither frightens nor makes me sick. T OF 95. Lust for pleasure often gets me into trouble. T OF 96. 1 often wish I were born of opposite sex. T F 97. 1am on guard with people who are too friendly. T F 98. I do not dread going into a room where people have gathered suddenly. T OF 99, At times I have enjoyed being hurt by some I love. aye F 100. I cannot do anything well. 7. F Scanned with CamScanner