Emotional Abuse Questionnaire

 

Developed by: Neil Jacobson, Ph.D. and John Gottman, Ph.D. –both experts in the field of Domestic Violence.  

Circle which answer best applies.
Score 1 point for every “never”, 2 points for every “rarely”, 4 points for every “occasionally”, and 5 points for every “very often.”
Total these points for your score.

If your score is between 73-94= you are being emotionally abused
If your score is higher than 95= you are being more severely abused than the average person.  

My Partner:  1. Tries to catch me at inconsistencies to show that I am lying.
Never              Rarely                                 Occasionally                        Very Often

2. Tries to convince other people that I am crazy.
Never              Rarely                                 Occasionally                        Very Often

3. Tells other people that there is something wrong with me.
Never              Rarely                                 Occasionally                        Very Often

4. Says things that hurt me out of spite.
Never              Rarely                                 Occasionally                        Very Often

5. Has told me I am sexually unattractive.
Never              Rarely                                 Occasionally                        Very Often

6. Tells me I am sexually inadequate.
Never              Rarely                                 Occasionally                        Very Often

7. Insults my religious background and beliefs.
Never              Rarely                                 Occasionally                        Very Often

8. Insults my ethnic background.
Never              Rarely                                 Occasionally                        Very Often

9. Insults my family.
Never              Rarely                                 Occasionally                        Very Often

10. Talks me into doing things that make me feel bad afterwards.
Never              Rarely                                 Occasionally                        Very Often

11. Tells me no one else would ever want me.
Never              Rarely                                 Occasionally                        Very Often

12. Humiliates me in front of others.
Never              Rarely                                 Occasionally                        Very Often

13. Makes me do degrading things.
Never              Rarely                                 Occasionally                        Very Often        

14. Questions my sanity.
Never              Rarely                                 Occasionally                        Very Often

15. Tells other people personal information or secret about me.
Never              Rarely                                 Occasionally                        Very Often

16. Verbally attacks my personality.
Never              Rarely                                 Occasionally                        Very Often  

17. Has insulted me by telling me that I am incompetent (stupid).
Never              Rarely                                 Occasionally                        Very Often

18. Ridicules me.
Never              Rarely                                 Occasionally                        Very Often

19. Forces me to do things against my will.
Never              Rarely                                 Occasionally                        Very Often

20. Questions whether my love is true.
Never              Rarely                                 Occasionally                        Very Often

21. Compares me unfavorably to other partners.
Never              Rarely                                 Occasionally                        Very Often

22. Intentionally does things to scare me.
Never              Rarely                                 Occasionally                        Very Often

23. Threatens me physically during arguments.
Never              Rarely                                 Occasionally                        Very Often

24. Warns me that if I keep doing something, violence will follow.
Never              Rarely                                 Occasionally                        Very Often

265. Our arguments often escalate out of control.
Never              Rarely                                 Occasionally                        Very Often

26. I’m worried most when my partner is quiet.
Never              Rarely                                 Occasionally                        Very Often

27. Drives recklessly or too fast when he is angry.
Never              Rarely                                 Occasionally                        Very Often  My Score: 

--- Also numerous affairs can be an indication of a form of emotional abuse