27

Below are a list of statements relating to your feelings of loneliness. Please read each statement very carefully and
rate how strongly you agree or disagree with it by selecting your answer.

1 - Strongly 2- 3 - Slightly 4 - Neither 5 - Slightly 6 - Agree 7 - Strongly

disagree Disagree Disagree Agree nor Agree Agree
Disagree

01. I feel alone when I am with o o o o o o o

my family.

02. I feel part of a group of o o o o o o o

friends.

03. I have a romantic partner with o o o o o o o

whom I share my most intimate
thoughts and feelings.

04. There is no one in my family I o o o o o o o

can depend on for support and
encouragement, but I wish there
was.

05. My friends understand my o o o o o o o

motives and reasoning.

06. I have a romantic or marital o o o o o o o

partner who gives me the support
and encouragement I need.

07. I don’t have any friends who o o o o o o o

share my views, but I wish I did.

08. I feel close to my family. o o o o o o o

09. I am able to depend on my o o o o o o o

friends for help.

10.I wish I had a more satisfying o o o o o o o

romantic relationship.

11. I feel part of my family. o o o o o o o

12. My family really cares about o o o o o o o

me.

13. I do not have any friends who o o o o o o o

understand me, but I wish I did.

14. I have a romantic partner to o o o o o o o

whose happiness I contribute.

15. I have an unmet need for a o o o o o o o

close romantic relationship.

Appendix C