Responses for each item take the form of 1=always false‚ 2=mostly false‚ 3=partly false and partly true‚ 4=mostly true‚ and 5= always true.

1. I like the way I look.

2. I have a happy family.

3. I don't sleep well.

4. It's hard for me to do what's right.

5. I know as much as the other children in my class.

6. I'm happy with who I am.

7. I don't feel well as I should.

8. It's hard for me to be around other people.

9. I don't do well in school‚ even I try.

10. I really care about my family.

11. I'm as nice as I should be .

12. I don't feel happy when I'm smart.

13. It's hard for someone to be my friend.

14. My family doesn't trust me.

15. My teacher thinks I am smart.

16. I get along well with other people.

17. I hate myself.

18. I'm not the person I would like to be.

19. H am an honest person.

20. I feel good most of time.

21. My body is healthy.

22. I am a decent sort of person.

23. I'm a cheerful person.

24. I'm not important at all.

25. My family will always help me.

26. I am a friend person.

27. Boys like me.

28. I don't always tell the truth.

29. I get angry sometimes.

30. I have lots of aches and paints.

31. I am a sick person.

32. Math is hard.

33. I have a lot of self-control.

34. I'm not a nice person.

35. I am not loved by my family.

36. Girls like me.

37. I'm mad at the whole world.

38. Once in a while I think of things too bad to talk about.

39. Sometimes when I am not feeling well‚ I get cranky.

40. I don't want to change the way I look.

41. I'd like to change some part of my body.

42. I think I do the right things most of the time.

43. I understand what I read.

44. I wish I could be more trustworthy.

45. I know my family as well as I should.

46. I'm as friendly as I want to be.

47. I do not like everyone I know.

48. Sometimes I laugh at a dirty joke.

49. I shouldn't tell so many lies.

50. I'm as smart as I want to be.

51. I should love my family more.

52. I'm not as smart as the other children in my class.

53. It's easy for me to do a good job on my homework.

54. I am a bad person.

55. I should get along better with other people.

56. Sometimes h feel like swearing.

57. I take good care of my body.

58. I often clumsy.

59. I some times do very bad things.

60. I do things without thinking about them first.

61. I try to be fair with my friends and family.

62. I do what my parents want me to do‚ even when I don't agree with them.

63. I don't forgive other people easily.

64. I'm not good at sports and games.

65. I sometimes cheat.

66. I solve my problems very easily.

67. I fight with my family.

68. I don't act the way my family think I shoud.

69. Most people are good.

70. I find it hard to talk with people I don't know.

71. Sometimes I put off until tomorrow what I ought to do to day.

72. I know the answers to questions the teacher asks.

73. I do what's right most of times.

74. I'm happy with the way I treat other people.

75. I'll never be as smart as other people.

76. I like to do math.

W.H.Fitts‚ ph.D. and W.L.warren‚ ph.D.

Kramschuster. Jenny. Lynn :  A Research Paper‚ Submitted in Partial Fulfillment of the Requirements for the ma‎ster of Science Degree With a Major in Guidance and Counseling The Graduate College . University of Wisconsin-Stout. August‚ 2001