Table of Contents Locke-Wallace Relationship Adjustment TestLocke-Wallace Relationship Adjustment Test Scoring KeyWeiss-Cerretto Relationship Status Inventory Weiss-Cerretto Relationship Status Inventory Scoring & InterpretationThe Sound Relationship House DiagramOverview of the Sound Relationship HouseThe Sound Relationship House Assessment Questionnaires InterpretationsLove Maps Fondness and Admiration System Negative Sentiment Overide Harsh Startup Accepting Influence Repair AttemptsCompromise Gridlock on Perpetual Issues The Four Horsemen Flooding Emotional Disengagement and Loneliness Quality of Sex, Romance, and Passion in the RelationshipShared Meanings Questionnaire The Gottman 19 Areas Checklist for Solvable and Perpetual Problems Gottman 19 Areas Checklist for Solvable and Perpetual Problems in Your Relationship, InterpretationThe Six “Detour” ScalesFLOODINGCHAOSTRUST COMMITMENTMETA-EMOTIONS (YOUR OWN FEELINGS ABOUT EMOTIONS)MY FAMILY HISTORY The Six “Detour” Scales Scoring & Interpretation Gottman Emotional Abuse Questionnaire (EAQ) Emotional Abuse Scale Scoring & Interpretation Control & Fear QustionnairesScoring for Control, Fear and Acts of Physical Aggression Questionnaires SCL-90 Assessing Psychopathology SCL-90 Hand Scoring Instructions Drug and Alcohol Screening Test Drug & Alcohol Screening Test Scoring Suicide Potential QuestionnaireCopyright © 2000–2009 by Dr. John M. Gottman and Dr. Julie Schwartz Gottman. Distributed under license by The Gottman Institute, Inc.Name_________________________ ID# ___________________Date ______________SCL-90Below is a list of problems and complaints that people sometimes have. Please read each one care-fully. After you have done so, select one of the numbered descriptors that best describes HOW MUCH THAT PROBLEM HAS BOTHERED OR DISTRESSED YOU DURING THE PAST WEEK, INCLUDING TODAY. Circle the number in the space to the right of the prob-lem and do not skip any items. Use the following key to guide how you respond: Circle 0 if your answer is NOT AT ALL Circle 1 if A LITTLE BIT Circle 2 if MODERATELY Circle 3 if QUITE A BIT Circle 4 if EXTREMELYPlease read the following example before beginning:Example: In the previous week, how much were you bothered by: Backaches 0 1 2 3 4In this case, the respondent experienced backaches a little bit (1). Please proceed with the questionnaire. HOW MUCH WERE YOU BOTHERED BY:NOT AT ALL A LITTLE BITMODERATELYQUITE A BITEXTREMELY1.Headaches 0 1 2 3 42.Nervousness or shakiness inside 0 1 2 3 43.Unwanted thoughts, words, or ideas that won’t leave your mind 0 1 2 3 44.Faintness or dizziness 0 1 2 3 45.Loss of sexual interest or pleasure 0 1 2 3 46.Feeling critical of others 0 1 2 3 47.The idea that someone else can control your thoughts 0 1 2 3 48.Feeling others are to blame for most of your troubles 0 1 2 3 49.Trouble remembering things 0 1 2 3 410.Worried about sloppiness or carelessness 0 1 2 3 411.Feeling easily annoyed or irritated 0 1 2 3 412.Pains in heart or chest 0 1 2 3 413.Feeling afraid in open spaces or on the streets 0 1 2 3 414.Feeling low in energy or slowed down 0 1 2 3 415.Thoughts of ending your life 0 1 2 3 416.Hearing voices that other people do not hear 0 1 2 3 417.Trembling 0 1 2 3 418. Feeling that most people cannot be trusted0 1 2 3 419. Poor appetite 01 2 3 4Copyright © 2000–2009 by Dr. John M. Gottman and Dr. Julie Schwartz Gottman. Distributed under license by The Gottman Institute, Inc.SCL-90 (continued) HOW MUCH WERE YOU BOTHERED BY:NOT AT ALL A LITTLE BITMODERATELYQUITE A BITEXTREMELY20. Crying easily0 1 2 3 421. Feeling shy or uneasy with the opposite sex0 1 2 3 422. Feeling of being trapped or caught0 1 2 3 423. Suddenly scared for no reason0 1 2 3 424. Temper outbursts that you could not control0 1 2 3 425. Feeling afraid to go out of your house alone0 1 2 3 426. Blaming yourself for things0 1 2 3 427. Pains in lower back0 1 2 3 428. Feeling blocked in getting things done0 1 2 3 429. Feeling lonely0 1 2 3 430. Feeling blue0 1 2 3 431. Worrying too much about things0 1 2 3 432. Feeling no interest in things0 1 2 3 433. Feeling fearful0 1 2 3 434. Your feelings being easily hurt0 1 2 3 435. Other people being aware of your private thoughts0 1 2 3 436. Feeling others do not understand you or are unsympathetic0 1 2 3 437. Feeling that people are unfriendly or dislike you0 1 2 3 438. Having to do things very slowly to insure correctness0 1 2 3 439. Heart pounding or racing0 1 2 3 440. Nausea or upset stomach0 1 2 3 441. Feeling inferior to others0 1 2 3 442. Soreness of your muscles0 1 2 3 443. Feeling that you are watched or talked about by others0 1 2 3 444. Trouble falling asleep0 1 2 3 445. Having to check and double-check what you do0 1 2 3 446. Difficulty making decisions0 1 2 3 447. Feeling afraid to travel on buses, subways, trains0 1 2 3 448. Trouble getting your breath0 1 2 3 449. Hot or cold spells0 1 2 3 450.Having to avoid certain things, places, or activities because they frighten you0 1 2 3 451. Your mind going blank0 1 2 3 452. Numbness or tingling in parts of your body0 1 2 3 453. A lump in your throat0 1 2 3 454. Feeling hopeless about the future0 1 2 3 455. Trouble concentrating0 1 2 3 4Copyright © 2000–2009 by Dr. John M. Gottman and Dr. Julie Schwartz Gottman. Distributed under license by The Gottman Institute, Inc.SCL-90 (continued) HOW MUCH WERE YOU BOTHERED BY:NOT AT ALL A LITTLE BITMODERATELYQUITE A BITEXTREMELY56. Feeling weak in parts of your body0 1 2 3 457. Feeling tense or keyed up0 1 2 3 458. Heavy feelings in your arms or legs0 1 2 3 459. Thoughts of death or dying0 1 2 3 460. Overeating0 1 2 3 461. Feeling uneasy when people are watching or talking about you0 1 2 3 462. Having thoughts that are not your own0 1 2 3 463. Having urges to beat, injure, or harm someone0 1 2 3 464. Awakening in the early morning0 1 2 3 465. Having to repeat the same actions such as touching, counting, washing0 1 2 3 466. Sleep that is restless or disturbed0 1 2 3 467. Having urges to break or smash things0 1 2 3 468. Having ideas or beliefs that others do not share0 1 2 3 469. Feeling very self-conscious with others0 1 2 3 470. Feeling uneasy in crowds, such as shopping or at a movie0 1 2 3 471. Feeling everything is an effort0 1 2 3 472. Spells of terror or panic0 1 2 3 473. Feeling uncomfortable about eating or drinking in public0 1 2 3 474. Getting into frequent arguments0 1 2 3 475. Feeling