YSQSF

YSQ - S2
Name ___________________________________________________Date__________
INSTRUCTIONS:
Listed below are statements that a person might use to describe himself or herself.
Please read each statement and decide how well it describes you. When there you are
not sure, base your answer on what you emotionally feel, not on what you think to be
true. Choose the highest rating from 1 to 6 that describes you and write the number in
the space before the statement.
RATING SCALE:
1 = Completely untrue of me
2 = Mostly untrue of me
3 = Slightly more true than untrue
4 = Moderately true of me
5 = Mostly true of me
6 = Describes me perfectly
1._____ Most of the time, I haven't had someone to nurture me, share him/herself with
me, or care deeply about everything that happens to me.
2. _____In general, people have not been there to give me warmth, holding, and
affection.
3. _____For much of my life, I haven't felt that I am special to someone.
4. _____For the most part, I have not had someone who really listens to me,
understands me, or is tuned into my true needs and feelings.
5. _____I have rarely had a strong person to give me sound advice or direction when I'm
not sure what to do.
*ed
6.______I find myself clinging to people I'm close to, because I'm afraid they'll leave me.
7.______I need other people so much that I worry about losing them.
8.______I worry that people I feel close to will leave me or abandon me.
9.______When I feel someone I care for pulling away from me, I get desperate.
10._____Sometimes I am so worried about people leaving me that I drive them away.
*ab
11._____I feel that people will take advantage of me.

12._____I feel that I cannot let my guard down in the presence of other people, or else
they will intentionally hurt me.
13._____It is only a matter of time before someone betrays me.
14._____ I am quite suspicious of other people's motives.
15. _____I'm usually on the lookout for people's ulterior motives.
*ma
16. _____ I don't fit in.

17. _____ I'm fundamentally different from other people.
18. _____ I don't belong; I'm a loner.
19. _____ I feel alienated from other people.
20. _____ I always feel on the outside of groups.
*si
21. _____ No man/woman I desire could love me one he/she saw my defects.
22. _____ No one I desire would want to stay close to me if he/she knew the real me.
23. _____ I'm unworthy of the love, attention, and respect of others.
24. _____ I feel that I'm not lovable.
25. _____ I am too unacceptable in very basic ways to reveal myself to other people.
*ds
26. _____ Almost nothing I do at work (or school) is as good as other people can do.
27. _____ I'm incompetent when it comes to achievement.
28. _____ Most other people are more capable than I am in areas of work and
achievement.
29. _____ I'm not as talented as most people are at their work.
30. _____ I'm not as intelligent as most people when it comes to work (or school).
*fa
31. _____ I do not feel capable of getting by on my own in everyday life.

32. _____ I think of myself as a dependent person, when it comes to everyday
functioning.
33. _____ I lack common sense.
34. _____ My judgment cannot be relied upon in everyday situations.
35. _____ I don't feel confident about my ability to solve everyday problems that come
up.
*di
36. _____ I can't seem to escape the feeling that something bad is about to happen.
37. _____ I feel that a disaster (natural, criminal, financial, or medical) could strike at any
moment.
38. _____ I worry about being attacked.
39. _____ I worry that I'll lose all my money and become destitute.
40. _____I worry that I'm developing a serious illness, even though nothing serious has
been diagnosed by a physician.
*vh
41. _____I have not been able to separate myself from my parent(s), the way other
people my age seem to.
42. _____My parent(s) and I tend to be over involved in each other's lives and problems.
43. _____It is very difficult for my parent(s) and me to keep intimate details from each
other, without feeling betrayed or guilty.
44. _____ I often feel as if my parent(s) are living through me--I don't have a life of my
own.
45. _____I often feel that I do not have a separate identity from my parent(s) or partner.
*em
46. _____ I think that if I do what I want, I'm only asking for trouble.
47. _____ I feel that I have no choice but to give in to other people's wishes, or else they
will retaliate or reject me in some way.
48. _____ In relationships, I let the other person have the upper hand.
49. _____ I've always let others make choices for me, so I really don't know what I want
for myself.
50. _____ I have a lot of trouble demanding that my rights be respected and that my
feelings be taken into account.
*sb
51. _____ I'm the one who usually ends up taking care of the people I'm close to.
52. _____ I am a good person because I think of others more than of myself.
53. _____ I'm so busy doing for the people that I care about, that I have little time for
myself.
54. _____ I've always been the one who listens to everyone else's problems.
55. _____ Other people see me as doing too much for others and not enough for myself.
*ss
56. _____ I am too self-conscious to show positive feelings to others (e.g., affection,
showing I care).
57. _____ I find it embarrassing to express my feelings to others.
58. _____ I find it hard to be warm and spontaneous.
59. _____ I control myself so much that people think I am unemotional.
60. _____ People see me as uptight emotionally.
*ei
61. _____ I must be the best at most of what I do; I can't accept second best.
62. _____ I try to do my best; I can't settle for "good enough."
63. _____ I must meet all my responsibilities.

64. _____ I feel there is constant pressure for me to achieve and get things done.
65. _____ I can't let myself off the hook easily or make excuses for my mistakes.
*us
66. _____ I have a lot of trouble accepting "no" for an answer when I want something
from other people.
67. _____ I'm special and shouldn't have to accept many of the restrictions placed on
other people.
68. _____ I hate to be constrained or kept from doing what I want.
69. _____ I feel that I shouldn't have to follow the normal rules and conventions other
people do.
70. _____ I feel that what I have to offer is of greater value than the contributions of
others.
*et
71. _____ I can't seem to discipline myself to complete routine or boring tasks.
72. _____ If I can't reach a goal, I become easily frustrated and give up.
73. _____ I have a very difficult time sacrificing immediate gratification to achieve a longrange goal.
74. _____ I can't force myself to do things I don't enjoy, even when I know it's for my
own good.
75. _____ I have rarely been able to stick to my resolutions.
*is
COPYRIGHT 2003 Jeffrey Young, Ph.D., and Gary Brown, Ph.D. Unauthorized reproduction
without written consent of the authors is prohibited. For more information, write: Cognitive
Therapy Center of New York, 36 West 44th Street, Suite 1007, New York, NY 10036.

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YSQ - S2

11._____I feel that people will take advantage of me.

16. _____ I don't fit in.

31. _____ I do not feel capable of getting by on my own in everyday life.

63. _____ I must meet all my responsibilities.

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