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Surveys
2011
August
T
Tripartite Anguish Intensity Scale
Tripartite Anguish Intensity Scale
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1. Are you experiencing or have you recently experienced any chronic pain (i.e. back pains)?
Yes
No
1
Not At All
2
3
4
5 Moderately
6
7
8
9
10 Extremely
If so, how intense?
2. Have you recently experienced or are you experiencing rejection by another individual for whom you had or have feelings for?
Yes
No
1
Not At All
2
3
4
5 Moderately
6
7
8
9
10 Extremely
If so, how intense?
3. Are you experiencing or have you recently experienced an argument with a close friend or relative (i.e. regarding a monetary dispute, philosophical differences, etc.)?
Yes
No
1
Not At All
2
3
4
5 Moderately
6
7
8
9
10 Extremely
If so, how intense?
4. Have you recently or are you currently dealing with the loss of a former or current a significant other?
Yes
No
1
Not At All
2
3
4
5 Moderately
6
7
8
9
10 Extremely
If so, how intense?
5. Are you experiencing or have you recently experienced betrayal by a close or trusted friend (i.e. divulged secret)?
Yes
No
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