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The following questions concern how you generally feel in important close relationships in your life. Think about your
past and present relationships with people who have been especially important to you, such as family members, romantic
partners, and close friends. Respond to each statement in terms of how you generally feel in these relationships.
Please use the scale below by placing a number between 1 and 5 in the space provided to the right of each statement.
1---------------2---------------3---------------4---------------5
Not at all Very
characteristic characteristic
of me of me
FIRST, reverse-code every question that has a * next to it. That means, if you put a…
5, change it to a 1
4, change it to a 2
3, keep it as a 3
2, change it to a 4
1, change it to a 5 THEN,
Add #s: 1, 6, 8, 12, 13, 17 = ______/6 = CLOSE
Add #s: 2, 5, 7, 14, 16, 18 = ______/6 = DEPEND
Add #s: 3, 4, 9, 10, 11, 15 = ______/6 = ANXIETY
This scale contains three subscales, each composed of six items. The three subscales are CLOSE, DEPEND, and ANXIETY. The
CLOSE scale measures the extent to which a person is comfortable with closeness and intimacy. The DEPEND scale measures the
extent to which a person feels he/she can depend on others to be available when needed. The ANXIETY subscale measures the extent
to which a person is worried about being rejected or unloved.