JavaScript must be enabled in your web browser before using this form.
You can enable now JavaScript via the Tools/Options menu of your web browser.
After doing so, select the View/Reload or View/Refresh menu item to clear this message.

Social Perceptions Survey

Instructions

Hello, and welcome to the Social Perceptions Survey. In this survey you will be asked questions concerning your social attitudes and behaviors. You will be asked to provide information about your perceptions of various types of social interactions that people engage in as part of their everyday lives. You will also be asked how you feel about your interactions with family and friends; as well as, others you may come into contact with. Please take your time and answer each question as honestly as possible. Once again, thank you for agreeing to participate - you can begin by clicking the "continue" button below.

Part I - Demographics


Created with SurveyGold survey software - www.surveygold.com

Demographics

In the section that follows we would like to know a little bit more about you.


What is your age?


What is your gender?

Male (1)

Female (2)


Ethnic Background

Asian or Pacific Islander

African American

Caucasian (non-Hispanic)

Hispanic/Latino/Latina

American Indian

other

Other:


Marital Status

Single

Married or Living Together

Divorced

Widowed


Are you a US citizen?

Yes (1)

No (2)


What is your own yearly income?


Do you own a cell phone?

Yes (1)

No (2)


If you own a cell phone, on average, how many minutes do you spend per day TALKING on it?


If you own a cell phone, on average, how many minutes per day do you spend USING it?


Created with SurveyGold survey software - www.surveygold.com

Part II - Thoughts and Feelings


Created with SurveyGold survey software - www.surveygold.com

Below are a series of statements concerning peoples’ general reactions and behaviors toward you during the previous 6 months . We would like you to rate each statement according to the frequency scale below. Please remember that YOUR RESPONSES ARE COMPLETELY ANONYMOUS.

 

Never (1)

Rarely (2)

Sometimes (3)

Often (4)

Most of the time (5)

It seems like people go out of their way to avoid interacting with me

People tend to "rebuff" my thoughts/opinions.

People greet me in social situations.

People try to avoid talking to me.

People accept me for who I am.

Others try to avoid contact with me.

People talk to me only when they are required to (i.e., need something that I have).

My "friends" like to hang out with me.

People shut me out of their conversations.

People tend to physically avoid me.

People include me in various group activities.

People invite me to their social functions.

People like spending time with me.

It seems that other people tend to "shun" me.

People seem to deliberately try to avoid during social encounters.

People look the other way when they see me.

People pay attention to me.

People reply to my correspondence (e.g., phone messages, emails) in a timely fashion.

Other people tend to ostracize me


Created with SurveyGold survey software - www.surveygold.com

Part III - Social Perceptions


Created with SurveyGold survey software - www.surveygold.com

General Perceptions A

For each of the following statements, please indicate the likelihood that you would engage in the described activity or behavior if you were to find yourself in that situation.

 

Extremely Unlikely (1)

Moderately Unlikely (2)

Somewhat Unlikely (3)

Not Sure (4)

Somewhat Likely (5)

Moderately Likely (6)

Extremely Likely (7)

Admitting that your tastes are different from those of a friend

Going camping in the wilderness

Betting a day's income gambling

Investing 10% of your annual income in a moderate growth mutual fund

Drinking heavily at a social function

Taking some questionable deductions on your income tax return

Disagreeing with an authority figure on a major issue

Betting a day's income at a high stakes poker game

Having an affair with a married man/women

Passing off somebody else's work as your own

Going down a ski run that is beyond your ability

Investing 5% of your annual income in a very speculative stock

Going whitewater rafting at high water in the spring

Betting a day’s income on the outcome of a sporting event

Engaging in unprotected sex

Revealing a friend’s secret to someone else

Driving a car without wearing a seat belt

Investing 10% of your annual income in a new business venture

Taking a skydiving class

Riding a motorcycle without a helmet

Choosing a career that you truly enjoy over a more secure one

Speaking your mind about an unpopular issue in a meeting at work

Sunbathing without sunscreen

Bungee jumping off a tall bridge

Piloting a small plane

Walking home alone at night in an unsafe area of town

Moving to a city far away from your extended family

Starting a new career in your mid-thirties

Leaving your young children alone at home while running an errand

Not returning a wallet you found that contains $200


Created with SurveyGold survey software - www.surveygold.com

The next several questions ask about your relations with other family and friends. Please answer each item as honestly as possible.

 

Very Strongly Disagree (1)

Strongly Disagree (2)

Mildly Disagree (3)

Neutral (4)

Mildly Agree (5)

Strongly Agree (6)

Very Strongly Agree (7)

There is a special person who is around when I am in need.

There is a special person with whom I can share my joys and sorrows.

My family really tries to help me.

I get the emotional help and support I need from my family.

I have a special person who is a real source of comfort to me.

My friends really try to help me.

I can count on my friends when things go wrong.

I can talk about my problems with my family.

I have friends with whom I can share my joys and sorrows.

There is a special person in my life who cares about my feelings.

My family is willing to help me make decisions.

I can talk about my problems with my friends.


Created with SurveyGold survey software - www.surveygold.com

The next several questions ask you about YOUR feelings about various facets of your life. Please answer each statement as honestly as possible. Please write the number corresponding to the appropriate response on the blank preceding each statement.

 

Strongly Disagree (1)

Disagree (2)

Uncertain (3)

Agree (4)

Strongly Agree (5)

I am not a worrier

I like to have a lot of people around me

I don't like to waste my time daydreaming

I try to be courteous to everyone I meet

I keep my belongings neat & clean

I often get into arguments with my family and co-workers

I am pretty good about pacing myself so as to get things done on time

When I'm under a great deal of stress, sometimes I feel like I'm going to pieces

I don't consider myself especially "light-hearted"

I am intrigued by the patterns I find in art and nature

Some people think I'm selfish and egotistical

I am seldom sad or depressed

I really enjoy talking to people

I believe letting students hear controversial speakers can only confuse and mislead them

I would rather cooperate with others than compete with them

I try to perform all the tasks assigned to be conscientiously

I often feel tense and jittery

I like to be where the action is

Poetry has little or no effect on me

I tend to be cynical and skeptical of others' intentions

I have a clear set of goals and work toward them in an orderly fashion

Sometimes I feel completely worthless

I usually prefer to do things alone

I often try new and foreign foods

I believe that most people will take advantage of you if you let them

I waste a lot of time before settling down to work

I rarely feel fearful and anxious

I often feel as if I'm bursting with energy

I seldom notice the moods or feelings that different environments produce

Most people I know like me

I work hard to accomplish my goals

I often get angry at the way people treat me

I am a cheerful, high-spirited person

I believe we should look to our religious authorities for decisions on moral issues

Some people think of me as cold and calculating

When I make a comment, I can always be counted on to follow through

Too often, when things go wrong, I get discouraged and feel like giving up

I am not a cheerful optimist

Sometimes when I am reading poetry or looking at a work of art, I feel a chill or wave of excitement

I'm hard-headed and tough-minded in my attitudes

Sometimes I'm not as dependable or reliable as I should be

I am seldom sad or depressed

My life is fast-paced

I have little interest in speculating on the nature of the universe or the human condition

I generally try to be thoughtful and considerable

I am a productive person who always gets the job done

I often feel helpless and want someone else to solve my problems

I am a very active person

I have a lot of intellectual curiosity

If I don't like people, I let them know it

I never seem to be able to get organized

At times I have been so ashamed I just wanted to hide

I would rather go my own way than be the leader of others

I often enjoy playing with theories or abstract ideas

If necessary, I am willing to manipulate people to get what I want

I strive for excellence in everything I do

I am not a very methodological person


Created with SurveyGold survey software - www.surveygold.com

Instructions: These questions refer to your feelings about the quality of your social relationships. Indicate how often you have felt the way described in each of the following statements during the past year.

 

1-NEVER

2-RARELY

3-SOMETIMES

4-OFTEN

5-VERY OFTEN

Most everyone around me seems like a stranger

I don't get much satisfaction from the groups I participate in.

There are good people around me who understand my views and beliefs.

There is no one I have felt close to for a long time.

I have a romantic partner who gives me support and encouragement.

I belong to a network of friends.

There are people I can count on for companionship.

I don't have one specific relationship in which I feel understood

I am an important part of the emotional well-being of another person.

I don't have a special love relationship.


Created with SurveyGold survey software - www.surveygold.com

General Feelings B

People often see some risk in situations that contain uncertainty about what the outcome or consequences will be and for which there is the possibility of negative consequences. However, the riskiness is a very personal and intuitive notion, and we are interested in YOUR GET LEVEL ASSESSMENT OF HOW RISKY each situation of behavior is.
For each of the statements below, please indicate HOW RISKY YOU PERCEIVE each situation.

 

Not at all Risky (1)

Slightly Risky (2)

Somewhat Risky (3)

Moderately Risky (4)

Risky (5)

Very Risky (6)

Extremely Risky (7)

Admitting that your tastes are different from those of a friend

Going camping in the wilderness

Betting a day’s income gambling

Investing 10% of your annual income in a moderate growth mutual fund.

Drinking heavily at a social function.

Taking some questionable deductions on your income tax return.

Disagreeing with an authority figure on a major issue.

Betting a day’s income at a high-stake poker game

Having an affair with a married man/woman

Passing off somebody else’s work as your own

Going down a ski run that is beyond your ability.

Investing 5% of your annual income in a very speculative stock.

Going whitewater rafting at high water in the spring.

Betting a day’s income on the outcome of a sporting event.

Engaging in unprotected sex.

Revealing a friend’s secret to someone else.

Driving a car without wearing a seat belt.

Investing 10% of your annual income in a new business venture.

Taking a skydiving class.

Riding a motorcycle without a helmet.

Choosing a career that you truly enjoy over a more secure one.

Speaking your mind about an unpopular issue in a meeting at work.

Sunbathing without sunscreen.

Bungee jumping off a tall bridge.

Piloting a small plane.

Walking home alone at night in an unsafe area of town.

.Moving to a city far away from your extended family

Starting a new career in your mid-thirties.

Leaving your young children alone at home while running an errand.

Not returning a wallet you found that contains $200.


Created with SurveyGold survey software - www.surveygold.com

The following section includes items assessing how you feel about your abilities. Please answer each question below according to your level of agreement/disagreement with each statement.

 

Disagree (1)

(2)

(3)

Neutral (4)

(5)

(6)

Agree (7)

Even when I'm feeling self-confident about most things, I still seem to lack the ability to control interpersonal situations.

I have no trouble making and keeping friends.

I'm not good at guiding the course of a conversations with several others.

I can usually establish a close personal relationship with someone I find sexually attractive.

When being interviewed I can usually steer the interviewer toward the topics I want to talk about and away from those I wish to avoid.

If I need help in carrying out a plan of mine, it's usually difficult to get others to help.

If there's someone I want to meet I can usually arrange it.

I often find it hard to get my point of view across to others.

In attempting to smooth over a disagreement I usually make it worse.

I find it easy to play an important part in most group situations.


Created with SurveyGold survey software - www.surveygold.com

General Feelings D

This scale consists of a number of words and phrases that describe different feelings and emotions. Read each item and then mark the appropriate answer in the space next to that word. Please indicate how you have generally felt during the PAST MONTH using the scale provided to record your answers.

 

Not at all (1)

A little bit (2)

Moderately (3)

Quite a bit (4)

Extremely (5)

Satisfied

Discontented

Optimistic

Hopeless

Useful

Insignificant

Confident

Helpless

Understood

Lonely

Loving

Withdrawn

Free-and-easy

Tense

Enthusiastic

Depressed

Good-natured

Impatient

Clear headed

Confused


Created with SurveyGold survey software - www.surveygold.com

General Feelings E

Please read each of the following items carefully, thinking about how it relates to your life, and then indicate how true it is for you.

 

Not at all true (1)

2

3

Somewhat true (4)

5

6

Very true (7)

I feel I am free to decide for myself how to live my life.

I really like the people I interact with.

Often, I do not feel very competent.

I feel pressured in my life.

People I know tell me I am good at what I do.

I get along with people I come into contact with.

I pretty much keep to myself and don't have a lot of social contacts.

I generally feel free to express my ideas and opinions.

I consider the people I generally interact with to be my friends.

I have been able to learn interesting new skills lately.

In my daily life, I frequently have to do what I am told.

People in my life care about me.

Most days I feel a sense of accomplishment from what I do.

People I interact with on a daily basis tend to take my feelings into consideration.

In my life I do not get much of a chance to show how capable I am.

There are not many people that I am close to.

I feel like I can pretty much be myself in my daily situations.

The people I interact with regularly do not seem to like me much.

I often do not feel very capable.

There is not much opportunity for me to decide for myself how to do things in my daily life.

People are generally pretty friendly towards me.


Created with SurveyGold survey software - www.surveygold.com

In a previous section of this survey you were asked about the extent to which you feel others, including friends, family and acquaintances have ignored, rejected, or excluded you during the past 6 months. In the section below we would like additional information on how you may have felt rejected or excluded by others during the previous 6 month period.


Did the experience include:

Being excluded or ignored in the physical presence of others

Being excluded or ignored by others physically leaving your presence

Both


How often did the unwanted behavior occur?

Once

Once a month or less

2-4 times a month

Every few days

Everyday


How long did this unwanted behavior last?

Single episode (specific time and place)

A few hours

An entire day

2-4 days

A week

2-4 weeks

More than a month


How upsetting was the experience?

Not at all upsetting

Slightly upsetting

Upsetting

Very upsetting

Extremely upsetting


How angry were you by the experience?

Not at all angry

Slightly angry

Angry

Very angry

Extremely angry


How stressful was the experience?

Not at all stressful

Slightly stressful

Stressful

Very stressful

Extremely stressful


Who did this to you?

A single person

2 people

3-4 people

more than 4 people


What was the ethnicity of the person (people)

Same ethnicity as me

Different ethnicity


How close did you feel toward this person (people) prior to this experience?

Not at all close

Slightly close

Close

Very close

Extremely close


How close did you feel to the person (people) who perpetrated this behavior?

Not at all close (1)

Slightly close (2)

Moderately close (3)

Close (4)

Very close (5)

Extremely close (6)


What was the age of the person?

Older than you

About your age

Younger than you


Created with SurveyGold survey software - www.surveygold.com

Following are some ways of coping with difficult situations. Think of the situation mentioned above. We want to know how you coped with that difficult situation.

 

I didn't do this at all (1)

I did this a little bit (2)

I did this a medium amount (3)

I did this a lot (4)

I turned to work or other activities to take my mind off things

I concentrated my efforts on doing something about the situation I'm in

I said to myself "this isn't real."

I used alcohol or other drugs to make myself feel better

I got emotional support from others

I gave up trying to deal with it

I took action to try to make the situation better

I refused to believe that it has happened

I said things to let my unpleasant feelings escape

I used alcohol or other drugs to help me get through it

I tried to see it in a different light, to make it seem more positive

I tried to come up with a strategy about what to do

I got comfort and understanding from someone

I gave up the attempt to cope

I looked for something good in what is happening

I made jokes about it

I did something to think about it less, such as going to movies, watching TV, reading, daydreaming, sleeping, or shopping

I accepted the reality of the fact that it has happened

I expressed my negative feelings

I tried to find comfort in my religion or spiritual beliefs

I learned to live with it

I thought hard about what steps to take

I prayed or meditated

I made fun of the situation


Created with SurveyGold survey software - www.surveygold.com