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Young Schema Questionnaire – Short Form INTRUCTIONS

Young Schema Questionnaire Short Form1 INTRUCTIONSL isted below are statement that a person might use to describe him or herself. Please read eachstatement and decide how well it describes you. When you are not sure, base your answer on what youemotionally feel, not on what you think to betrue. Choose the highest rating from 1 to 6 that describesyou and write the number in the space before the SCALE:1-Completely untrue of me2-Mostly untrue of me3-Slightly more true than untrue4-Moderately true of me5-Mostly true of me6-Describes me perfectly1. _____ Most of the time, I haven t had someone to nurture me, share him/herself with me, or caredeeply about everything that happens to _____ In general, people have not been there to give me warmth, holding and _____ For much of my life, I haven t felt that I am special to _____ For the most part, I have not had someone who really listens to me.

Young Schema Questionnaire – Short Form 5 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 …

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