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Schema Questionnaire Short Form

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100% found this document useful (1 vote)
4K views6 pages

Schema Questionnaire Short Form

Uploaded by

Syed Abdulllah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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1 = Completely untrue of me 4 = Moderately true of me Page

2 = Mostly untrue of me 5 = Mostly true of


me
3 = Slightly more true than untrue 6 = Describes me perfectly

Young Schema Questionnaire – short version (2005)


(YSQ – S3)

Name Date

INSTRUCTIONS
Listed below are statements that people might use to describe themselves. Please read each
statement, then rate it based on how accurately it fits you over the past year. When you are not
sure, base your answer on what you emotionally feel, not on what you think to be true.

A few of the items ask about your relationships with your parents or romantic partners. If any of
these people have died, please answer these items based on your relationships while they were
alive. If you do not currently have a partner but had partners in the past, please answer the item
based on your most recent significant romantic partner.

Choose the highest score from 1 to 6 on the rating scale below that best describes you, then write
your answer in the block on the right of each statement.

RATING SCALE

1 = Completely untrue of me 4 = Moderately true of me


2 = Mostly untrue of me 5 = Mostly true of
me
3 = Slightly more true than untrue 6 = Describes me perfectly

1 I haven't had someone to nurture me, share him/herself with me, or care deeply about
everything that happens to me.
2 I find myself clinging to people I'm close to because I am afraid they’ll leave me.

3 I feel that people will take advantage of me.

4 I don't fit in.

5 No man/woman I desire could love me once he or she saw my defects.

6 Almost nothing I do at work (or school) is as good as other people can do.

7 I do not feel capable of getting by on my own in everyday life.

8 I can't seem to escape the feeling that something bad is about to happen.
1 = Completely untrue of me 4 = Moderately true of me Page
2 = Mostly untrue of me 5 = Mostly true of
me
3 = Slightly more true than untrue 6 = Describes me
perfectly

9 I have not been able to separate myself from my parent(s) the way other people my age
seem to do.
10 I think that if I do what I want, I'm only asking for trouble.

11 I’m the one who usually ends up taking care of the people I’m close to

I am too self-conscious to show positive feelings to others (e.g. affection, showing I care)
12

13 I must be the best at most of what I do; I can't accept second best

I have a lot of trouble accepting "no" for an answer when I want something from other
14 people

15 I can't seem to discipline myself to complete routine or boring tasks

16 Having money and knowing important people make me feel worthwhile

17 Even when things seem to be going well, I feel that it is only temporary

18 If I make a mistake, I deserve to be punished

19 I don’t have people to give me warmth, holding and affection

20 I need other people so much that I worry about losing them

I feel that I cannot let my guard down in the presence of other people, or else they will
21 intentionally hurt me

22 I'm fundamentally different from other people

23 No one I desire would want to stay close to me if he or she knew the real me

24 I'm incompetent when it comes to achievement

25 I think of myself as a dependent person when it comes to everyday functioning

I feel that a disaster (natural, criminal, financial, or medical) could strike at any moment
26
1 = Completely untrue of me 4 = Moderately true of me Page
2 = Mostly untrue of me 5 = Mostly true of
me
3 = Slightly more true than untrue 6 = Describes me perfectly

27 My parent(s) and I tend to be overinvolved in each other’s lives and problems


I feel I have no choice but to give in to other peoples' wishes, or else they will retaliate or
28 reject me in some way
I am a good person because I think of others more than of myself
29

30 I find it embarrassing to express my feelings to others

31 I try to do my best; I can't settle for "good enough"


I'm special and shouldn't have to accept many of the restrictions placed on other people
32

33 If I can’t reach a goal, I become easily frustrated and give up

34 Accomplishments are most valuable to me if other people notice them

35 If something good happens, I worry that something bad is likely to follow

36 If I don’t try my hardest, I should expect to lose out

37 I haven't felt that I am special to someone

38 I worry that people I feel close to will leave me or abandon me

39 It is only a matter of time before someone betrays me

40 I don't belong; I'm a loner

41 I'm unworthy of the love, attention and respect of others

42 Most other people are more capable than I am in areas of work and achievement

43 I lack common sense

44 I worry about being physically attacked by people


It is very difficult for my parent(s) and me to keep intimate details from each other, without
45 feeling betrayed or guilty
1 = Completely untrue of me 4 = Moderately true of me Page
2 = Mostly untrue of me 5 = Mostly true of
me
3 = Slightly more true than untrue 6 = Describes me
perfectly

46 In relationships, I usually let the other person have the upper hand
I am so busy doing for the people that I care about that I have little time for myself
47

48 I find it hard to be free-spirited and spontaneous around people

49 I must meet all my responsibilities

50 I hate to be constrained or kept from doing what I want

I have a very difficult time sacrificing immediate gratification or pleasure to achieve a


51 long-range goal

52 Unless I get a lot of attention from others, I feel less important

53 You can’t be too careful. Something will always go wrong

54 If I don’t do the job right I should suffer the consequences


I have not had someone who really listens to me, understands me or is tuned into my true
55 needs and feelings

When someone I care for seems to be pulling away or withdrawing from me, I feel
56 desperate

57 I am quite suspicious of other people's motives

58 I feel alienated or cut off from other people

59 I feel that I’m not lovable

60 I am not as talented as most people are at their work

61 My judgment cannot be counted on in everyday situations

62 I worry that I'll lose all my money and become destitute or very poor
1 = Completely untrue of me 4 = Moderately true of me Page
2 = Mostly untrue of me 5 = Mostly true of
me
3 = Slightly more true than untrue 6 = Describes me perfectly

I often feel as if my parent(s) are living through me - that I don’t have a life of my own
63
I’ve always let others make choices for me, so I really don't know what I want for myself
64

65 I’ve always been the one who listens to everyone else’s problems

I control myself so much that many people think that I am unemotional or unfeeling
66

67 I feel there is constant pressure for me to achieve and get things done
I feel that I shouldn’t have to follow the normal rules and conventions that other people do
68
I can’t force myself to do things I don’t enjoy, even when I know its for my own good
69
If I make remarks at a meeting, or am introduced in a social situation, it’s important for me
70 to get recognition and admiration

No matter how hard I work, I worry that I could be wiped out financially and lose almost
71 everything
It doesn’t matter why I make a mistake. When I do something wrong I should pay the
72 consequences
I haven’t had a strong or wise person to give me sound advice or direction when I am not
73 sure what to do

74 Sometimes I am so worried about people leaving me that I drive them away

75 I am usually on the lookout for other people’s ulterior or hidden motives

76 I always feel on the outside of groups

I am too unacceptable in very basic ways to reveal myself to other people or let them get to
77 know me well

78 I am not as intelligent as most people when it comes to work (or school)

79 I don’t feel confident about my ability to solve everyday problems that come up

80 I worry that I'm developing a serious illness, even though nothing serious has been
diagnosed by a doctor

81 I often feel that I do not have a separate identity from my parent(s) or partner
1 = Completely untrue of me 4 = Moderately true of me Page
2 = Mostly untrue of me 5 = Mostly true of
me
3 = Slightly more true than untrue 6 = Describes me
perfectly

I have a lot of trouble demanding that my rights be respected and that my feelings be taken
82 into account

83 Other people see me as doing too much for others and not enough for myself

84 People see me as uptight emotionally

85 I can’t let myself off the hook easily or make excuses for my mistakes

I feel that what I have to offer is of greater value than the contributions of others
86

87 I have rarely been able to stick to my resolutions

88 Lots of praise and compliments make me feel like a worthwhile person

89 I worry that a wrong decision could lead to disaster

90 I’m a bad person who deserves to be punished

© 2005 Jeffrey Young, Ph.D. Special thanks to Gary Brown, Ph.D., Scott Kellogg, Ph.D., Glenn Waller,,
Ph.D., and the many other therapists and researchers who contributed items and feedback in the development
of the YSQ. Unauthorized reproduction, translation or modification in any form whatsoever without written
consent of the author is prohibited. For more information write: Schema Therapy Institute, 36 West 44 th
Street, Suite. 1007, New York, NY 10036.

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