Questions:

1. I have to feel “needed” in order to be in a relationship.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

2. I feel responsible for my partner’s feelings.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

3. Even after the initial phase of infatuation, my sense of “me” disappears when I’m in a relationship.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

4. I would stop seeing my friends if my partner disapproved of them.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

5. When I’m not in a relationship, I feel completely empty and insignificant.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

6. When I’m unsure of my partner’s opinion on a particular matter, I’m unable to make even the smallest decisions on my own.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

7. I constantly worry about being rejected by my partner.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

8. I don’t feel good about myself when my relationship isn’t going well.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

9. I have a hard time confronting my partner when I see a problem with what they are doing or saying.
    Mostly true
    Sometimes true
    Very seldom the case
    Never true
   

10. I want to have a good relationship, but it never seems to work out that way.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

11. I spend a lot of time and effort maintaining the appearance that everything in my relationship with my partner is “fine.”
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

12. I have trouble being alone unless I make a point of keeping very busy.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

13. I tend to downplay my feelings when they aren’t in sync with my partner’s.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

14. I accept sex when what I really want is love.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

15. When my partner is upset, I feel responsible for making him/her feel better.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

16. I give in at the very first sign of my partner’s disapproval.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

17. If I broke up with my partner, I’d be so devastated that I’m not sure I’d survive.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

18. When my partner is in a bad mood, I automatically assume it’s my fault.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

19. I believe that doing things solely to care for or please myself is selfish.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true
    

20. I think that all my problems would be solved if I could just get my partner to change.
     Mostly true
     Sometimes true
     Very seldom the case
     Never true