Instructions
Over the page you will find some situations that might happen in your life. Please read each situation and vividly imagine it happening to you. Then, write the one major cause of the situation in the blank provided. By major cause, we mean the one primary reason you would give for this situation happening to you. Then, you will be asked to answer three questions about the cause. Circle the number corresponding to your feelings about each question. An example is provided below.
EXAMPLE
Example of a situation: You get into an argument with a shop assistant. One major cause:You may choose… “The shop assistant was in a bad mood.” Is the cause of the argument something about you OR something about other people or the outside world?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me (it’s mostly due to the shop assistant, so I will put a 2.)
In the future when you argue with shop assistants, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
(maybe the shop assistant was just in a bad mood; I will put a 4.)
Is the cause something that just affects you arguing with shop assistants OR does it also influence other aspects of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my
situation of my life life
(it is just about this one shop assistant, so I will put a 1.)
1. You misplace your wallet, and can’t remember where you put it last. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of your wallet being misplaced due to something about you OR
something about other people and/or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when looking for your wallet, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is this cause something that just influences misplacing your wallet OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
2. You meet a friend who compliments you on your appearance. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of your friend’s compliment due to something about you OR something about other people and/or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when you are with your friends, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just affects interacting with friends OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
3. Your doctor says you are in good shape. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of your doctor saying you are in good shape due to something about you OR something about other people and/or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In your future medical examinations, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just affects what your doctor says to you OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my
situation of my life life
4. A friend comes to you with a problem and you don’t try to help them. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of your not helping your friend due to something about you OR
something about other people or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when a friend comes to you with a problem, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just affects what happens when a friend comes to you with a problem OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
5. You fall and break your hip. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of the your accident due to something about you OR something about other people and/or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when having an accident, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just influences having accidents OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
6. Your performance as a volunteer is highly praised. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of being praised due to something about you or something about other people OR circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when volunteering, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just influences your volunteering OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
7. You meet a friend who acts in a hostile manner towards you. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of your friend acting in a hostile manner due to something about you OR something about other people or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when interacting with friends, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just influences interacting with friends OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
8. You are feeling especially tired and are experiencing a lack of energy. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of your feeling tired due to something about you or something about other people OR circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when feeling tired, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just affects feeling tired OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
9. Your family has been treating you more lovingly. One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of your family treating you more lovingly due to something about you OR something about other people or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In future interactions with your family, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just affects how your family treats you OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just influences influences all this particular several areas situations in my situation of my life life
10. The cashier at the supermarket makes a mistake and gives you too little change, and you point out the mistake.
One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of pointing out the mistake due to something about you OR something about other people or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when pointing out other people’s mistakes, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just influences pointing out other people’s mistakes OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just this influences several influences all particular situation areas of my life situations in my life
11. You go out to dinner with a friend or relative you have not seen for a long time and it goes badly.
One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of the dinner going badly due to something about you OR something about other people or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when interacting with people you have not seen in a long time, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just influences seeing people you have not seen in a long time OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just this influences several influences all particular situation areas of my life situations in my life
12. You get less sleep than normal one night and still have enough energy the next day.
One major cause:
_____________________________________________________________________ _____________________________________________________________________ Is the cause of you having enough energy despite not getting enough sleep due to something about you OR something about other people or circumstances?
1 2 3 4 5 6 7
totally due to other people equally totally due or circumstances due to both to me
In the future when you are not able to sleep as well as usual but have enough energy the next day anyway, will this cause again be present?
1 2 3 4 5 6 7
will never again may be will always be present present be present
Is the cause something that just affects your sleeping and energy level OR does it also influence other areas of your life?
1 2 3 4 5 6 7
influences just this influences several influences all particular situation areas of my life situations in my life