PHI stands for "Protected Health Information" (Y = Yes, N = No)
| Display | Field | Phi | Field type | Condition choices | Field note | Header | |
|---|---|---|---|---|---|---|---|
| I have experience in a relationship with my mother or with a mother figure | relationship_m_yes | N | yesno | - | - | - | |
| 1. I often worry that my mother doesn't really love me. | relationships_mother_1 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | Instructions: The statements below concern how you felt, when you were younger in your relationship with your mother or someone that you perceive as a mother figure to you. Respond to each statement by circling the number that most reflects your own beliefs. Please respond using the 7 point scale: | |
| 2. I worry that my mother doesn't care about me as much as I care about her. | relationships_mother_2 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 3. I am nervous when my mother gets too close to my space. | relationships_mother_3 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 4. I often wish that my mother's feelings for me were as strong as my feelings for her. | relationships_mother_4 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 5. When my mother is out of sight, I worry that she might forget about what I need. | relationships_mother_5 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 6. I prefer not to show my mother how I feel deep down. | relationships_mother_6 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 7. I feel comfortable sharing my private thoughts and feelings with my mother. | relationships_mother_7 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 8. When I show my feelings for my mother, I'm afraid she will not feel the same about me. | relationships_mother_8 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 9. I do not often worry about being abandoned. | relationships_mother_9 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 10. It's not difficult for me to get close to my mother. | relationships_mother_10 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 11. I find that my mother doesn't want to get as close as I would like. | relationships_mother_11 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 12. I find it easy to depend on my mother. | relationships_mother_12 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 13. It's easy for me to be affectionate with my mother. | relationships_mother_13 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 14. Sometimes my mother changes her feelings about me for no apparent reason. | relationships_mother_14 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 15. My desire to be very close sometimes drives my mother away. | relationships_mother_15 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 16. I don't feel comfortable opening up to my mother. | relationships_mother_16 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 17. I prefer not to be too close to my mother. | relationships_mother_17 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 18. I'm afraid once my mother gets to know me, she won't like who I really am. | relationships_mother_18 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 19. I feel comfortable depending on my mother. | relationships_mother_19 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 20. I worry that I won't measure up to my mother. | relationships_mother_20 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 21. My mother only seems to notice me when I'm angry. | relationships_mother_21 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 22. I find it difficult to allow myself to depend on my mother. | relationships_mother_22 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 23. I am very comfortable being close to my mother. | relationships_mother_23 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 24. I rarely worry about my mother leaving me. | relationships_mother_24 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 25. My mother makes me doubt myself. | relationships_mother_25 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 26. I get uncomfortable when my mother wants to be very close. | relationships_mother_26 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 27. I worry a lot about my relationship with my mother. | relationships_mother_27 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 28. I find it relatively easy to get close to my mother. | relationships_mother_28 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 29. I usually discuss my problems and concerns with my mother. | relationships_mother_29 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 30. It makes me mad that I don't get the affection and support I need from my mother. | relationships_mother_30 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 31. It helps to turn to my mother in times of need. | relationships_mother_31 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 32. I tell my mother just about everything. | relationships_mother_32 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 33. I'm afraid that I will lose my mother's love. | relationships_mother_33 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 34. I often worry that my mother will not want to be with me. | relationships_mother_34 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 35. I talk things over with my mother. | relationships_mother_35 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| 36. My mother really understands me and my needs. | relationships_mother_36 | N | radio | 1, 1 Disagree Strongly | 2, 2 | 3, 3 | 4, 4 Neutral/Mixed | 5, 5 | 6, 6 | 7, 7 Agree Strongly | - | - | |
| Notes | ecrm_notes | Y | notes | - | - | - |