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1. Does he continually monitor your time and make you account for every minute (when you run errands, visit friends, commute to work, etc.)?
F: 3
S: 2
R: 1
N: 0
3. Is he ever rude to your friends?
F: 3
S: 2
R: 1
N: 0
5. Do you ever feel isolated and alone, as if there was nobody close to you to confide in?
F: 3
S: 2
R: 1
N: 0
7. Does he demand a strict account of how you spend money?
F: 3
S: 2
R: 1
N: 0
9. Is he disturbed by you working or by the thought of you working?
F: 3
S: 2
R: 1
N: 0
11. Does he pressure you for sex much more often than you'd like?
F: 3
S: 2
R: 1
N: 0
13. Do you quarrel much over financial matters?
F: 3
S: 2
R: 1
N: 0
15. Does he ever strike you with his hands or feet(slap, punch, kick)?
F: 6
S: 5
R: 4
N: 0
17. Does he ever threaten you with an object or weapon?
F: 6
S: 5
R: 4
N: 0
19. Does he ever give you visible injuries (such as welts, bruises, cuts, lumps on head)?
F: 6
S: 5
R: 4
N: 0
21. Have you ever had to seek professional aid for an injury at a medical clinic, doctor's office or hospital emergency room?
F: 6
S: 5
R: 4
N: 0
23. Is he ever violent toward children?
F: 6
S: 5
R: 4
N: 0
25. Does he ever throw objects or break things when he is angry?
F: 6
S: 5
R: 4
N: 0
27. Have you ever called the police or tried to call them because you felt you or other members of your family were in danger?
F: 6
S: 5
R: 4
N: 0 |
2. Does he ever accuse you of having affairs with other men or act suspicious that you are?
F: 3
S: 2
R: 1
N: 0
4. Does he ever discourage you from starting friendships with other women?
F: 3
S: 2
R: 1
N: 0
6. Is he overly critical of daily things, such as your cooking, your clothes, or your appearance?
F: 3
S: 2
R: 1
N: 0
8. Do his moods change radically, from very calm to very angry or vice-versa?
F: 3
S: 2
R: 1
N: 0
10. Does he become angry more easily if he drinks?
F: 3
S: 2
R: 1
N: 0
12. Does he become angry if you don't want to go along with his requests for sex?
F: 3
S: 2
R: 1
N: 0
14. Do you quarrel much about having children or raising them?
F: 3
S: 2
R: 1
N: 0
16. Does he ever strike you with an object?
F: 6
S: 5
R: 4
N: 0
18. Has he ever threatened to kill either himself or you?
F: 6
S: 5
R: 4
N: 0
20. Have you ever had to treat any injuries from his violence with first aid?
F: 6
S: 5
R: 4
N: 0
22. Does he ever hurt you sexually or make you have intercourse against your will?
F: 6
S: 5
R: 4
N: 0
24. Is he ever violent toward other people outside your home and family?
F: 6
S: 5
R: 4
N: 0
26. Has he ever been in trouble with the police?
F: 6
S: 5
R: 4
N: 0 |