Informed Consent
Thank you for considering participation in this study 💙 Please read the following information carefully before continuing. 🎓 This study is part of an academic research project in psychology ⏱ It will take approximately 10–15 minutes. *Participation is completely anonymous 🔒 Your responses will be kept confidential and used only for research purposes
By checking the box, you indicate that you understand the information above and voluntarily agree to participate.
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I have read the information and agree to participate
Initials(full name not required)
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First initial
Last initial
Average Social Media usage (in hours)
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Gender
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Male
Female
Other
Age
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only between the ages 20-35
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When I am tense I notice where the tension is located in my body.
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0 NEVER
1 VERY RARELY
2 RARELY
3 OCCASIONALLY
4 VERY FREQUENTLY
5 ALWAYS
I notice when I am uncomfortable in my body
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0 N
1 VR
2 R
3 O
4 VF
5 A
I notice where in my body I am comfortable.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I notice changes in my breathing, such as whether it slows down or speeds up
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0 N
1 VR
2 R
3 O
4 VF
5 A
I ignore physical tension ordiscomfort until theybecome more severe.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I distract myself from sensations of discomfort.
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I feel pain or discomfort, I try to power through it
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0 NEVER
1 VERY RARELY
2 RARELY
3 OCCASIONALLY
4 VERY FREQUENTLY
5 ALWAYS
I try to ignore pain.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I push feelings of discomfort away by focusing on something.
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I feel unpleasant body sensations, I occupy myself with something else so I don’t have to feel
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I feel physical pain, I become upset
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0 N
1 VR
2 R
3 O
4 VF
5 A
I start to worry that something is wrong if I feel any discomfort.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I can notice an unpleasant body sensation without worrying about it.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I can stay calm and not worry when I have feelings of discomfort or pain.
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I am in discomfort or pain I can’t get it out ofmy mind.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I can pay attention to my breath without being distracted by things happening around me.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I can maintain awareness of my inner bodily sensations even when there is a lot going on around me.
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I am in conversation with someone, I can pay attention to my posture.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I can return awareness to my body if I am distracted.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I can refocus my attention from thinking to sensing my body.
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0 NEVER
1 VERY RARELY
2 RARELY
3 OCCASIONALLY
4 VERY FREQUENTLY
5 ALWAYS
I can maintain awareness of my whole body even when a part of me is in pain or discomfort.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I am able to consciously focus on my body as a whole
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0 N
1 VR
2 R
3 O
4 VF
5 A
I notice how my body changes when I am angry
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0 N
1 VR
2 R
3 O
4 VF
5 A
When something is wrong in my life I can feel it in my body
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0 N
1 VR
2 R
3 O
4 VF
5 A
I notice that my body feels different after a peaceful experience.
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0 NEVER
1 VERY RARELY
2 RARELY
3 OCCASSIONALLY
4 VERY FREQUENTLY
5 ALWAYS
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I notice that my breathing becomes free and easy when I feel comfortable.
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0 NEVER
1 VERY RARELY
2 RARELY
3 OCCASIONALLY
4 VERY FREQUENTLY
5 ALWAYS
I notice how my body changes when I feel happy /joyful.
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I feel overwhelmed I can find a calm place inside.
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I bring awareness to my body I feel a sense of calm.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I can use my breath to reduce tension.
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0 N
1 VR
2 R
3 O
4 VF
5 A
When I am caught up in thoughts, I can calm my mindby focusing on my body/breathing.
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0 N
1 VR
2 R
3 O
4 VF
5 A
I listen for information from my body about my emotional state.
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0 N
1 VR
2 R
3 O
4 VR
5 A
When I am upset, I take time to explore how my body feels
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0 N
1 VR
2 R
3 O
4 VF
5 A
I listen to my body to inform me about what to do
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0 N
1 VR
2 R
3 O
4 VF
5 A
I am at home in my body
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0 N
1 VR
2 R
3 O
4 VF
5 A
I feel my body is a safe place
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0 N
1 VR
2 R
3 O
4 VF
5 A
I trust my body sensations
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0 NEVER
1 VERY RARELY
2 RARELY
3 OCCASIONALLY
4 VERY FREQUENTLY
5 ALWAYS
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Authenticity
I think it is better to be yourself, than to be popular
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1 DOES NOT DESCRIBE ME AT ALL
2 VERY SLIGHTLY
3 SLIGHTLY
4 MODERATELY
5 QUITE A BIT
6 VERY MUCH
7 DESCRIBE ME VERY WELL
I don’t know how I really feel inside
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I am strongly influenced by the opinions of others
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I usually do what other people tell me to do
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I always feel I need to do what others expect me to do
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
Other people influence me greatly
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I fell as if I don’t know myself very well
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I always stand by what I believe in
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I am true to myself I most situations
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I feel out of touch with the ‘real me’
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I live in accordance with my values and beliefs
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
I feel alienated from myself
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1 DOES NOT DESCRIBE ME AT ALL
2 VS
3 S
4 M
5 QB
6 VM
7 DESCRIBE ME VERY WELL
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Life Satisfaction
In most ways my life is close to my ideal.
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1 STRONGLY DISAGREE
2 DISAGREE
3 SLIGHTLY DISAGREE
4 NEITHER AGREE NOR DISAGREE
5 SLIGHTLY AGREE
6 AGREE
7 STRONGLY AGREE
The conditions of my life are excellent
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1 STRONGLY D
2 D
3 SLIGHTLY D
4 NA NOR D
5 SLIGHTLY A
6 A
7 STRONGLY A
I am satisfied with my life.
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1 STRONGLY D
2 D
3 SLIGHTLY D
4 NA NOR D
5 SLIGHTLY A
6 A
7 STRONGLY A
So far I have gotten the important things I want in life.
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1 STRONGLY D
2 D
3 SLIGHTLY D
4 NA NOR D
5 SLIGHTLY A
6 A
7 STRONGLY A
If I could live my life over, I would change almost nothing.
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1 STRONGLY D
2 D
3 SLIGHTLY D
4 NA NOR D
5 SLIGHTLY A
6 A
7 STRONGLY A
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Attachment styles
I find it relatively easy to get close to others.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY CHARACTERISTIC OF ME
3 SOMEWHAT CHARACTERISTIC OF ME
4 FAIRLY CHARACTERISTIC OF ME
5 VERY CHARACTERISTICS OF ME
I do not worry about being abandoned.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I find it difficult to allow myself to depend on others.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
In relationships, I often worry that my partner does not really love me.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I find that others are reluctant to get as close as I would like.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I am comfortable depending on others.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY CHARACTERISTIC
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I do not worry about someone getting too close to me.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY CHARACTERISTIC
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I find that people are never there when you need them.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I am somewhat uncomfortable being close to others.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
In relationships, I often worry that my partner will not want to stay with me.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I want to merge completely with another person.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
My desire to merge sometimes scares people away.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I am comfortable having others depend on me.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I know that people will be there when I need them.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I am nervous when anyone gets too close.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I find it difficult to trust others completely.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
Often, partners want me to be closer than I feel comfortable being.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
I am not sure that I can always depend on others to be there whenI need them.
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1 NOT AT ALL CHARACTERISTICS OF ME
2 SLIGHTLY C
3 SOMEWHAT C
4 FC
5 VERY CHARACTERISTICS OF ME
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