National Mental Health Service Provider

Research Code:

Please complete this questionnaire independently.

Do not share your answers with your partner. Insert your personal Research Code above only.

Select the most appropriate answer for each question.
Please do not put your name on this survey.
DYADIC ADJUSTMENT SCALE

Most persons have disagreements in their relationships.

Please indicate below the approximate extent of agreement or disagreement between you and your partner for each item on the following list.

1- Handling family finances

2- Matters of recreation

3- Religious matters

4- Demonstrations of affection

5- Friends

6- Sex relations

7- Correct or proper behavior

8- Philosophy of life

9- Dealing with parents or in-laws

10- Aims, goals, and things believed important

11- Amount of time spent together

12- Making major decisions

13- Household tasks

14- Leisure time interests and activities

15- Career decisions

16- How often do you discuss or have you considered divorce, separation, or terminating your relationship?

17- How often do you or your mate leave the house after a fight?

18- In general, how often do you think that things between you and your partner are going well?

19- Do you confide in your mate?

20- Do you ever regret that you married? (or lived together)

21- How often do you and your partner quarrel?

22- How often do you and your mate “get on each other’s nerves”?

23- Do you kiss your mate?

24- Do you and your mate engage in outside interests together?

How often would you say the following events occur between you and your mate?

25- Have a stimulating exchange of ideas

26- Laugh together

27- Calmly discuss something

28- Work together on a project

These are some things about which couples sometimes agree and sometimes disagree. Indicate if either item below caused differences of opinions or were problems in your relationship during the past few weeks. (Select yes or no)

29- Being too tired for sex

30- Not showing love

Different degrees of happiness in your relationship

31- Which best describes the degree of happiness, all things considered, of your relationship.

32-Which of the following statements best describes how you feel about the future of your relationship?

Honour the Fallen, Help the Living

Donate

Help us make a difference today!

#INTHISTOGETHER

Wounded Warriors Canada is a registered charity. CRA# 82808-2727-RR0001

©2019 WoundedWarriors.ca all rights reserved.