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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
