This questionnaire is designed to help you decide if you are presently in an abusive situation. There are different forms of abuse and not every woman experiences them all. Please answer these questions honestly, then total the points. This will give you some indication as to whether or not you are in a potentially violent situation.
3 = Frequently 2 = Sometimes 1 = Rarely 0 = Never
6 = Frequently 5 = Sometimes 4 = Rarely 0 = Never
Although these issues may be difficult to think about or share with someone else, the tragic fact is that domestic violence is a reality. Do not overlook or minimize suspected violence in your relationship. ARE YOU BEHAVING IN AN ABUSIVE MANNER? This questionnaire is designed to help you decide if you are presently in an abusive situation. There are different forms of abuse to be aware of. Please answer these questions honestly, then total the points. This will give you some indication as to whether or not violence is a component of your relationship. Questions #1 - 13 3 = Frequently 2 = Sometimes 1 = Rarely 0 = Never ____ 1. Are you ever critical of things, such as your spouse's/partner's/girlfriend's cooking, her clothes, or her appearance? ____ 2. Do your moods change dramatically, from very calm to very angry, or vice versa? ____ 3. Do you become angry more easily if you drink? ____ 4. Are you disturbed by her working or by the thought of her working? ____ 5. Do you monitor her time and make her account for every minute when she runs errands, visits friends, commutes to work, etc.? ____ 6. Do you ever accuse her of having affairs with other men or act suspicious of her? ____ 7. Do you and she quarrel much over financial matters? ____ 8. Do you quarrel much about having children or raising them? ____ 9. Are you ever rude to her friends? ____ 10. Do you ever discourage her from starting friendships with other women? ____ 11. Do you demand a strict account of how she spends money? ____ 12. Do you pressure her for sex more often than she likes? ____ 13. Do you become angry if she doesn't want to go along with your requests for sex? ____ SUBTOTAL Questions #14 - 26 6 = Frequently 5 = Sometimes 4 = Rarely 0 = Never ____ 14. Do you ever throw objects or break things when you're angry? ____ 15. Do you ever push her, or hold her to prevent her from leaving an argument? ____ 16. Do you ever strike her with your hands or feet (slap, punch, kick, etc.)? ____ 17. Do you ever threaten her with an object or weapon? ____ 18. Do you ever strike her with an object or weapon? ____ 19. Have you ever threatened to kill yourself, or her, or another family member? ____ 20. Do you ever give her visible injuries such as welts, bruises, cuts, lumps on the head? ____ 21. Has she ever had to treat any injuries from your violence with first aid? ____ 22. Has she ever had to seek professional aid for any injury at a medical clinic, doctor's office or hospital emergency room? ____ 23. Do you ever hurt her sexually or make her have intercourse against her will? ____ 24. Are you ever violent toward children? ____ 25. Are you ever violent toward other people? ____ 26. Have you ever been in trouble with the police? ____ 27. Has she ever called the police or tried to call them because she felt she was in danger? ____ TOTAL Add up the points for each question. Compare your score with the following chart: 126 - 97 Dangerously abusive 96 - 39 Seriously abusive 38 - 13 Moderately abusive 12 - 0 Nonabusive Although these issues may be difficult to think about or share with someone else, the tragic fact is that domestic violence is a reality. Do not overlook or minimize suspected violence in your relationship. >/pre>