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NM-SW Questionnaire V1

NM-SW Questionnaire Focus Group


This survey is anonymous and confidential (see our privacy statement) and should take approximately 8 - 12 minutes to complete. The questionnaire has approximately 15 questions that cover your opinions and experiences. Feel free to check it out, knowing that at any point you can discontinue without consequence. If you have any questions or comments about this survey please contact Dr. Darien Thira or Dr. Zebroff at info@artofconnection.org. 

You must be 18 to participate. By completing the survey you are agreeing to participate in furthering our understanding of human relationships.

* This test works best on a desktop, laptop or tablet. 
 
2. My gender is: *This question is required.
3. My sexual orientation is:
5. My relationship status is:
I have been in my relationship for:
I would rate the general satisfaction of my relationship as:
6. The cultural group or ethnicity I identify with is:
If you are not currently in a relationship, please choose the person with which you have had the most significant relationship. 
7. Overall, how satisfactory or unsatisfactory is your present sex life? *This question is required.
8. Please rate the following on how much you agree or disagree:
(if you are in a relationship, choose your current partner, and if you are not in a relationship, choose a past partner that most comes to mind)
  *This question is required.
Space Cell strongly disagreedisagreeslightly disagreeneutralslightly agreeagreestrongly agree
It helps to turn to my romantic partner in times of need.
I need a lot of reassurance that I am loved by my partner.
I want to get close to my partner, but I keep pulling back.
I find that my partner(s) don’t want to get as close as I would like.
I turn to my partner for many things, including comfort and reassurance.
My desire to be very close sometimes scares people away.
I try to avoid getting too close to my partner.
I do not often worry about being abandoned.
I usually discuss my problems and concerns with my partner.
I get frustrated if romantic partners are not available when I need them.
I am nervous when partners get too close to me.
I worry that romantic partners won’t care about me as much as I care about them.
9. Experience of sexual initiation: To what  degree do you agree/disagree with the following statements: 
(if you are in a relationship, choose your current partner, and if you are not in a relationship, choose a past partner that most comes to mind)
  *This question is required.
Space Cell DisagreeSlightly disagreeNeutralSlightly agreeAgree
I find it easy and comfortable to approach my partner for sex.
I don't initiate sex because I am worried my partner might reject my advances.
I am confident that I know the best ways to approach my partner for sex.
I enjoy finding creative and new ways to initiate sex.
I generally believe my partner enjoys having sex with me.
I find it difficult to initiate sex, even if my partner may want me to.
10. Please rate the following on how much you agree or disagree:
(if you are in a relationship, choose your current partner, and if you are not in a relationship, choose a past partner that most comes to mind) *This question is required.
Space Cell Strongly disagreeDisagreeUnsureAgreeStrongly agree
Fear of failure sometimes stops me at the very beginning
I often give up, even if others support me
Life would be much better if people would think and work like I do
I cannot say "no" even when it is necessary
I often feel that I will not be able to do what is expected
Sometimes I feel very small and helpless
It is harder to notice my virtues than my weaknessess
I am not affraid of arguments because I know my opinion would be the correct one
There are many things that are beyond my reach
I am not self confident
I can win against anybody if I put my mind to it
Even when others think differently, my conclusions are better
11. If you had to choose between the following, which would you rather be: 
12. When it comes to your relationship, please rate the following on how much you agree or disagree:
(if you are in a relationship, choose your current partner, and if you are not in a relationship, choose a previous partner who was important to you.)
  *This question is required.
Space Cell Strongly disagreeDisagreeSlightly disagreeSlightly agreeAgreeStrongly agree
It is hard for me to take a stand if anyone's feelings may be hurt in the process.
I enjoy taking risks.
The men I know who are "assholes," tend to be ultra masculine.
I have more female friends than male friends.
I would rather be seen as an 'asshole', than be seen as a 'victim'.
It is more important to improve the relationship than it is to keep the peace in the moment.
I identify as a feminist.
It would be better if people lived according to traditional gender roles.
The women I know who act as "victims," tend to be ultra feminine.
13. When it comes to your relationship, please rate how frequently you experience the following:
(if you are in a relationship, choose your current partner, and if you are not in a relationship, choose a previous partner who was important to you.) *This question is required.
Space Cell Almost neverRarelyOccasionallyOftenAlmost always
I am often thinking about whether my partner would approve of what I am doing.
I am likely to give to my partner before I give to myself.
In my relationship, I often feel like I am in the role of the parent and my partner is the role of the child.
It is really easy to ask my partner to do things for me.
I often have trouble identifying what I need/want when I'm with my partner.
In my relationship, I am generally responding to my partner’s goals, rather than setting my own.
I hold back my feelings from my partner to avoid upsetting them.
I tend to hide who I am from my partner.
I tend to take action, rather than wait for someone to tell me what to do.
I do not feel secure unless I am the one to determine how things are done.
I tend to take more time to trust in a new relationship.
I tend to use my thoughts to override my feelings.
I do a lot of things to avoid being judged negatively by my partner.
Nothing gets under my skin more than when I'm not considered by my partner.
I am uncomfortable when my partner expresses strong feelings.
I apologize and say “Iʼm sorry” when I think they might be upset with me, even if I don't think I have done anything wrong.
Deep down I don't believe I am enough.
No matter how many times I tell my partner what I like, even when it's important, they seem to forget.
I am more sexually confident than my partner.
I avoid conflict.
I am attracted to situations that are challenging, even if they make me a little anxious.
I am often ashamed to share my real sexual desires with my partner.
I tend to feel resentment rather than express anger with my partner.
I can rely on my partner to do things right the first time.
I put duty before pleasure.
I try to follow the rules.
I often take the lead in the relationship.
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