Couples Survey

Part 1

Before you begin, please enter the serial number provided for you by your recruiter:

For male and female partners: please enter the birthdate of the female partner here (because you will both enter the same date it will allow us to match you as partners; e.g., 01-12-62):

1. Your sex:

Female

Male

2. Relationship status:

married

living together

3. How many years have you and your partner lived together?

4. Number of times you have been previously married, or in a relationship where you lived together (for at least 6 months):

5. Number of children:

6. Educational background:

7. Employment status:

8. Please indicate your annual income (NOT including the income of your partner):

9. What is your current religious affiliation (choose one)?

10. Are you

11. How would you describe your ethnic background (choose all that apply):

Part 2 Please rate yourself on the following items:

12. I am the life of the party

13. I feel little concern for others

14. I am always prepared

15. I get stressed out easily

16. I have a rich vocabulary

17. I don't talk a lot

18. I am interested in people

19. I leave my belongings around

20. I am relaxed most of the time

21. I have difficulty understanding abstract ideas

22. I feel comfortable around people

23. I insult people

24. I pay attention to details

25. I worry about things

26. I have a vivid imagination

27. I keep in the background

28. I sympathize with others' feelings

29. I make a mess of things

30. I seldom feel blue

31. I am not interested in abstract ideas

32. I start conversations

33. I am not interested in other people's problems

34. I get chores done right away

35. I am easily disturbed

36. I have excellent ideas

37. I have little to say

38. I have a soft heart

39. I often forget to put things back in their proper place

40. I get upset easily

41. I do not have a good imagination

42. I talk to a lot of different people at parties

43. I am not really interested in others

44. I like order

45. I change my mood a lot

46. I am quick to understand things

47. I don't like to draw attention to myself

48. I take time out for others

49. I shirk my duties

50. I have frequent mood swings

51. I use difficult words

52. I don't mind being the center of attention

53. I feel other's emotions

54. I follow a schedule

55. I get irritated easily

56. I spend time reflecting on things

57. I am quiet around strangers

58. I make people feel at ease

59. I am exacting in my work

60. I often feel blue

61. I am full of ideas

Part 3 Please indicate how you view your PARTNER on the following items:

62. My partner is the life of the party

63. My partner feels little concern for others

64. My partner is always prepared

65. My partner gets stressed out easily

66. My partner has a rich vocabulary

67. My partner doesn't talk a lot

68. My partner is interested in people

69. My partner leaves his/her belongings around

70. My partner is relaxed most of the time

71. My partner has difficulty understanding abstract ideas

72. My partner feels comfortable around people

73. My partner insults people

74. My partner pays attention to details

75. My partner worries about things

76. My partner has a vivid imagination

77. My partner keeps in the background

78. My partner sympathizes with others' feelings

79. My partner makes a mess of things

80. My partner seldom feels blue

81. My partner is not interested in abstract ideas

82. My partner starts conversations

83. My partner is not interested in other people's problems

84. My partner gets chores done right away

85. My partner is easily disturbed

86. My partner has excellent ideas

87. My partner has little to say

88. My partner has a soft heart

89. My partner often forgets to put things back in their proper place

90. My partner gets upset easily

91. My partner does not have a good imagination

92. My partner talks to a lot of different people at parties

93. My partner is not really interested in others

94. My partner likes order

95. My partner changes her/his mood alot

96. My partner is quick to understand things

97. My partner doesn't like to draw attention to his/herself

98. My partner takes time out for others

99. My partner shirks his/her duties

100. My partner has frequent mood swings

101. My partner uses difficult words

102. My partner doesn't mind being the center of attention

Very Inaccurate

Moderately Inaccurate

Neither Inaccurate nor Accurate