INSTRUCTIONS: Please rate all 25 statements based on how you felt over the past month.

Encircle (0)
if not true at all, (1) rarely true, (2) sometimes true, (3) often true, and (4) always or nearly true all the
time.
Not Rarely Sometimes Often Always
Statements
true true true true true
1. I can adapt to change 0 1 2 3 4
2. I have close and secure
0 1 2 3 4
relationships
3. Sometimes, having faith or God can
0 1 2 3 4
help
4. I can deal with whatever comes 0 1 2 3 4
5. My past success gives confidence
0 1 2 3 4
for new challenge
6. I see the humorous side of things 0 1 2 3 4
7. Coping with stress strengthens me 0 1 2 3 4
8. I tend to bounce back after illness or
0 1 2 3 4
hardship
9. Things happen for a reason 0 1 2 3 4
10. I give my best effort no matter
0 1 2 3 4
what
11. I can achieve my goals 0 1 2 3 4
12. When things look hopeless, I don’t
0 1 2 3 4
give up
13. I know where to turn for help 0 1 2 3 4
14. I can focus and think clearly even
0 1 2 3 4
under pressure
15. I prefer to take the lead in problem
0 1 2 3 4
solving
16. I am not easily discouraged by
0 1 2 3 4
failure
17. I think of myself as strong person 0 1 2 3 4
18. I can make unpopular or difficult
0 1 2 3 4
decisions
19. I can handle unpleasant feelings 0 1 2 3 4
20. I have to act on a hunch 0 1 2 3 4
21. I have strong sense of purpose 0 1 2 3 4
22. I am in control of my life 0 1 2 3 4
23. I like challenges 0 1 2 3 4
24. I work hard and well to attain my
0 1 2 3 4
goals
25. I am proud of my achievements 0 1 2 3 4