图式模式问卷2012双语完整版.doc

Name姓名:_ Date of Birth出生日期:_ Highest Educational Level教育水平:_Todays Date测试日期: _SMI (Version 1.1)图式模式问卷INSTRUCTION: Listed below are statements that people might use to describe themselves. Please rate each item based on how often you believe or feel each statement in general using the frequency scale. 指导语：下列是人们可能用来描述自己的陈述。请根据你一般而言用这些话描述自己的频繁程度如何FREQUENCY: In general频繁程度：一般而言1= Never or Almost Never从不或几乎从不4= Frequently频繁2= Rarely很少5= Most of the time大部分时间3= Occasionally偶尔6= All of the time总是如此Frequency频繁程度In general.一般而言1. I demand respect by not letting other people push me around. 我通过不让别人对我指手画脚，获得我需要的尊重2. I feel loved and accepted.我感到被爱，被人接受3. I deny myself pleasure because I dont deserve it.我否认自己的快乐，因为我不配4. I feel fundamentally inadequate, flawed, or defective.我觉得自己基本上是不合格的、有缺陷的、无能的5. I have impulses to punish myself by hurting myself (e.g., cutting myself).我又通过伤害自己而惩罚自己的冲动(如割伤自己）6. I feel lost.我感到失落7. Im hard on myself.我对自己苛刻8. I try very hard to please other people in order to avoid conflict, confrontation, or rejection.我非常努力地取悦别人，为的是避免冲突，对质或抛弃9. I cant forgive myself.我不能原谅我自己10. I do things to make myself the center of attention.我做些事情，让我成为注意的中心11. I get irritated when people dont do what I ask them to do.当人们不做我叫他们做的事情的时候，我就生气12. I have trouble controlling my impulses.要控制我的冲动，我觉得有困难13. If I cant reach a goal, I become easily frustrated and give up.如果我不能达到目标，我会很容易感受到挫折感，并放弃14. I have rage outbursts. 我会一阵阵暴怒发作15. I act impulsively or express emotions that get me into trouble or hurt other people.我会行事冲动或表达一些让我陷入麻烦或者伤害别人的情感FrequencyIn general.16. Its my fault when something bad happens.如果有些糟糕的事情发生，那是我的错17. I feel content and at ease.我感觉满足，轻松18. I change myself depending on the people Im with, so theyll like me or approve of me.我根据周围的人改变我自己，这样他们就会喜欢我或者赞赏我19. I feel connected to other people.我感到和别人有连结20. When there are problems, I try hard to solve them myself.当有问题时，我很努力地自己来解决它们21. I dont discipline myself to complete routine or boring tasks.我不会给自己做规矩，去完成日常的或无聊的任务22. If I dont fight, I will be abused or ignored.如果我不斗争，我就会被虐待或者忽略23. I have to take care of the people around me. 我必须照顾我身边的人24. If you let other people mock or bully you, youre a loser. 如果你让其他人欺负你，你就是个失败者25. I physically attack people when Im angry at them. 我对别人生气时，我就会打他们26. Once I start to feel angry, I often dont control it and lose my temper.一旦我开始觉得愤怒，我经常会失去控制，大发雷霆27. Its important for me to be Number One (e.g., the most popular, most successful, most wealthy, most powerful).成为第一对我很重要28. I feel indifferent about most things.我对大多数事情无动于衷29. I can solve problems rationally without letting my emotions overwhelm me.我可以理性地解决问题，而不让我被情绪淹没30. Its ridiculous to plan how youll handle situations.一个人计划如何处理情境，这是荒唐的31. I wont settle for second best.我不愿意成为第二名 32. Attacking is the best defense. 攻击是最好的防御33. I feel cold and heartless toward other people.我觉得对别人冷漠、不关心34. I feel detached (no contact with myself, my emotions or other people). 我感觉超然（和我自己，我的情绪，其他人，没有联系）35. I blindly follow my emotions. 我盲目地跟随自己的情绪36. I feel desperate.我感觉绝望37. I allow other people to criticize me or put me down.我允许别人批评我，打击我38. In relationships, I let the other person have the upper hand.在关系中，我让别人处于上风39. I feel distant from other people.我感觉远离其他人40. I dont think about what I say, and it gets me into trouble or hurts other people.我不会考虑我要说的话，这让我惹麻烦，伤害别人41. I work or play sports intensively so that I dont have to think about upsetting things. 我高强度地工作或锻炼，这样我就没必要考虑让我心烦的事情Frequency In general.42. Im angry that people are trying to take away my freedom or independence.对于试图拿走我的自由和独立的别人，我感觉愤怒43. I feel nothing.我感觉不到任何东西44. I do what I want to do, regardless of other peoples needs and feelings.我做我想做的事情，不管别人的需要和感受45. I dont let myself relax or have fun until Ive finished everything Im supposed to do.我不让我放松或娱乐，直到我完成了我应该做的所有事情。 46. I throw things around when Im angry. 当我愤怒是，我就乱扔东西47. I feel enraged toward other people.我对别人感觉很愤怒48. I feel that I fit in with other people.我感觉我融入其他人49. I have a lot of anger built up inside of me that I need to let out.我内心有很多愤怒在积累，我需要发泄50. I feel lonely.我感到孤独51. I try to do my best at everything.我在所有事情上都尽力而为52. I like doing something exciting or soothing to avoid my feelings (e.g., working, gambling, eating, shopping, sexual activities, watching TV).我喜欢做些让我兴奋或舒畅的事情，从而避免体验到我的感情（如工作、赌博、吃东西、购物、性活动，看电视） 53. Equality doesnt exist, so its better to be superior to other people. 平等并不存在，所以最好是在别人之上54. When Im angry, I often lose control and threaten other people.当我愤怒时，我经常失控并威胁别人 55. I let other people get their own way instead of expressing my own needs.我让别人自行其事，而不是表达我自己的需要56. If someone is not with me, he or she is against me.如果某人不和我一起，他（她）就是反对我57. In order to be bothered less by my annoying thoughts or feelings, I make sure that Im always busy. 为了少被我自己的烦人的念头或情绪打扰，我让自己总是忙碌58. Im a bad person if I get angry at other people.我是个坏人，如果我对别人感到愤怒的话59. I dont want to get involved with people.我不希望和人有瓜葛60. I have been so angry that I have hurt someone or killed someone. 我很愤怒，以至于我都要伤人或杀人了。61. I feel that I have plenty of stability and security in my life.我感觉到我的生命中有足够的稳定性和安全感62. I know when to express my emotions and when not to. 我知道什么时候表达我的情绪，什么时候不表达63. Im angry with someone for leaving me alone or abandoning me.对我离开我或者抛弃我的人，我会感到愤怒。64. I dont feel connected to other people.我感到自己和别人没有连接65. I cant bring myself to do things that I find unpleasant, even if I know its for my own good. 我不能做我觉得不愉快的事情，即便我知道那对我好66. I break rules and regret it later. 我突破规则，事后又后悔67. I feel humiliated. 我感到被羞辱68. I trust most other people.我信任大部分其他人69. I act first and think later. 我行动在先，事后思考FrequencyIn general.70. I get bored easily and lose interest in things.我很容易厌倦，失去对事物的兴趣71. Even if there are people around me, I feel lonely. 即便周围有人，我仍然感觉孤独72. I dont allow myself to do pleasurable things that other people do because Im bad.我不让自己做那些别人也做的快乐的事情，因为我很坏73. I assert what I need without going overboard.我会声明我需要的，而不会过火74. I feel special and better than most other people.我感觉自己比大多数人要特殊，要更好些。75. I dont care about anything; nothing matters to me.我不关心任何事情，所有事情都无所谓76. It makes me angry when someone tells me how I should feel or behave.当别人告诉我我应该如何感觉或行事的时候，我感觉到愤怒77. If you dont dominate other people, they will dominate you. 如果你不控制其他人，他们就会控制你78. I say what I feel, or do things impulsively, without thinking of the consequences.我会冲动地说我所感受的，或冲动做事，而不考虑后果79. I feel like telling people off for the way they have treated me.我喜欢谴责别人对待我的方式80. Im capable of taking care of myself.我能够照顾我自己81. Im quite critical of other people.我很会挑剔别人82. Im under constant pressure to achieve and get things done.我一直都有压力，要完成某些事情或达到某些目标83. Im trying not to make mistakes; otherwise, Ill get down on myself.我力图不犯错误，否则，我会开始不喜欢自己84. I deserve to be punished.我应该被惩罚85. I can learn, grow, and change.我可以学习、成长、该表86. I want to distract myself from upsetting thoughts and feelings.我希望自己可以从让人心烦的念头或感受中分心转开注意力87. Im angry at myself.我对自己愤怒88. I feel flat.我感觉单调89. I have to be the best in whatever I do. 无论做任何事情，我必须成为最好90. I sacrifice pleasure, health, or happiness to meet my own standards.我牺牲愉悦、健康或快乐，为了达到我的标准91. Im demanding of other people.我对别人有很多要求92. If I get angry, I can get so out of control that I injure other people. 如果我感到愤怒，我会失控，以至于会伤害到其他人93. I am invulnerable.我很脆弱94. Im a bad person.我是个坏人95. I feel safe.我感觉到安全96. I feel listened to, understood, and validated.我感到别人倾听、理解和肯定97. It is impossible for me to control my impulses.我不可能控制我的冲动98. I destroy things when Im angry.我愤怒时摧毁东西FrequencyIn general.99. By dominating other people, nothing can happen to you.通过控制别人，就不会出现不顺心的事情100. I act in a passive way, even when I dont like the way things are.我以被动的方式行事，即便我不喜欢某些事情101. My anger gets out of control.我的愤怒常会失控102. I mock or bully other people.我欺负其他人103. I feel like lashing out or hurting someone for what he/she did to me.因为别人对我做的事情，我会还击或伤害他104. I know that there is a right and a wrong way to do things; I try hard to do things the right way, or else I start criticizing myself.我知道有做事的正确或错误的标准，我努力做正确的事，否则的话我就会批评自己105. I often feel alone in the world.我经常感觉到在世界中孤独106. I feel weak and helpless.我感觉虚弱、无助107. Im lazy.我很懒108. I can put up with anything from people who are important to me.我能和对我重要的人在任何事情上都保持一致109. Ive been cheated or treated unfairly.我被欺骗了，被不公平地对待了110. If I feel the urge to do something, I just do it.如果我感觉有冲动做某事，我就去做111. I feel left out or excluded.我感觉被甩了，被排除在外112. I belittle others.我轻视别人113. I feel optimistic.我比较乐观114. I feel I shouldnt have to follow the same rules that other people do.我感觉我不该遵循其他人遵守的规则115. My life right now revolves around getting things done and doing them right.我现在的生活就是每天围绕着“把事情做完”，“把事情做对”进行116. Im pushing myself to be more responsible than most other people.我逼迫自己比大多数人更负责任117. I can stand up for myself when I feel unfairly criticized, abused, or taken advantage of. 当我觉得自己被不公正地批判、虐待或占便宜的时候，我会维护自己118. I dont deserve sympathy when something bad happens to me.当我身上发生糟糕事情的时候，我不值得同情119. I feel that nobody loves me.我感觉到没有人爱我120. I feel that Im basically a good person.我感觉我基本上是个好人121. When necessary, I complete boring and routine tasks in order to accomplish things I value.必要的时候，我会完成无聊和常规的任务，为的是完成我珍视的事情122. I feel spontaneous and playful.我感觉自在，轻松。123. I can become so angry that I feel capable of killing someone.我会变得非常愤怒，以至于我觉得自己都会杀人了124. I have a good sense of who I am and what I need to make myself happy.我明确知道我是谁，我需要什么让我觉得快乐 2008 Young, J., Arntz, A., Atkinson, T., Lobbestael, J., Weishaar, M., van Vreeswijk, M and Klokman, J. Unauthorized reproduction without written consent of the authors is prohibited. This version is equivalent to the Dutch 1.0 version. For more information, write: Schema Therapy Institute, 130 West 42nd St., Ste. 501, New York, NY 10036, or for the Dutch version: J. Lobbestael, Clinical Psychological Science, PO Box 616, 6200 MD Maastricht, the Netherlands (Jill.lobbestaeldmkep.unimaas.nl).SMI (English: Version 1.1, Dutch Version 1.0)Scoring Key & Interpretation 计分和解释There are 124 items for the inventory. Listed below are the item numbers for each of the 14 modes. Compute the mean score for each mode for the client, then compare the score against the means and standard deviations on the next page for various samples.本问卷共124道问题，下面列出了所测试的14个模式，请填入分值，并计算出均值。1. Vulnerable child脆弱儿童 (n = 10): Items条目 4, 6, 36, 50, 67, 71, 105, 106, 111, 119.Items条目4636506771105106111119Mean均值Score计分2. Angry Child 愤怒儿童(n = 10): Items条目 22, 42, 47, 49, 56, 63, 76, 79, 103, 109.Items条目2242474956637679103109Mean均值Score计分3. Enraged Child被激怒儿童 (n = 10): Items条目 14, 25, 26, 46, 54, 60, 92, 98, 101, 123.Items条目1425264654609298101123Mean均值Score计分4. Impulsive Child冲动儿童 (n = 9): Items条目 12, 15, 35, 40, 66, 69, 78, 97, 110.Items条目1215354066697897110Mean均值Score计分5. Undisciplined Child 无自律性儿童(n = 6): Items条目 13, 21, 30, 65, 70, 107.Items条目1321306570107Mean均值Score分值6. Happy Child 快乐儿童(n = 10): Items条目 2, 17, 19, 48, 61, 68, 95, 96, 113, 122.Items条目217194861689596113122Mean均值Score分值7. Compliant Surrender 抱怨屈从者(n = 7): Items条目 8, 18, 37, 38, 55, 100, 108.Items条目818373855100108Mean均值Score分值8. Detached Protector 远离的保护者(n = 9): Items条目 28, 33, 34, 39, 43, 59, 64, 75, 88.Items条目283334394359647588Mean均值Score计分9. Detached Self-Soother远离的自我抚慰者 (n = 4): items 条目41, 52, 57, 86.Items条目41525786Mean均值Score分值10. Self-aggrandizer 自我夸大者(n = 10): Items条目 10, 11, 27, 31, 44, 74, 81, 89, 91, 114.Items条目101127314474818991114Mean均值Score分值11. Bully and Attack mode 欺负与攻击模式(n = 9): Items条目 1, 24, 32, 53, 77, 93, 99, 102, 112.Items条目1243253779399102112Mean均值Score分值12. Punishing Parent 惩罚性父母(n = 10): Items条目 3, 5, 9, 16, 58, 72, 84, 87, 94, 118.Items条目35165872848794118Mean均值Score分值13. Demanding Parent 要求性父母(n =10): Items条目 7, 23, 45, 51, 82, 83, 90, 104, 115, 116.Items条目7234551828390104115116Mean均值Score分值14. Healthy Adult 健康成人(n = 1