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Domestic Violence
Abuse Questionnaire

 

     This questionnaire is designed to help you decide if you are living in an abusive situation. There are different forms of abuse, and not everyone experiences all of them. Below are various questions about your relationship with your partner. Each possible answer has points assigned to it. By answering each question and then totaling the points as directed, you can compare you score with our Abuse Index.

Directions: Use the scale to answer the following question to best describe your relationship.
 
Frequently Sometimes Rarely Never
3 2 1 0

_____ 1. Does your partner monitor your time and make you account for every minute (when you run errands, visit friends, commute to work, etc.)?

_____ 2. Does your partner accuse you of having affairs with others or act suspicious that you are?

_____ 3. Is your partner ever rude to your friends?

_____ 4. Does your partner ever discourage you from starting friendships with others?

_____ 5. Do you ever feel isolated and alone, as if there is no one close to confide in?

_____ 6. Is your partner overly critical of daily things, such as your cooking, clothes, or appearance?

_____ 7. Does your partner demand a strict account of how you spend your money?

_____ 8. Do your partner’s moods change radically, from very calm to very angry?

_____ 9. Is your partner disturbed by your working, or by the thought of you working?

_____ 10. Does your partner become more easily angry if he/she drinks?

_____ 11. Does your partner pressure you for sex more often than you’d like?

_____ 12. Does your partner become angry if you don’t want to go along with his/her request for sex?

_____ 13. Do you quarrel much about having children or raising them?

_____ 14. Do you quarrel much about financial matters?

_____ 15. Does your partner strike you with his/her hands or feet?

_____ 16. Does your partner ever strike you with an object?

_____ 17. Does your partner ever threaten you with an object or weapon?

_____ 18. Has your partner ever threatened to kill either himself/herself or you?

_____ 19. Does your partner ever give you visible injuries (such as welts, bruises, cuts and/or lumps)?

_____ 20. Have you ever had to treat any injury with first aid from his/her violence?

_____ 21. Have you ever had to seek professional aid for an injury at a medical clinic, doctor’s office, or hospital emergency room?

_____ 22. Does your partner ever hurt you sexually or make you have intercourse against your will?

_____ 23. Is your partner ever violent toward children?

_____ 24. Is your partner ever violent toward people outside of your home or family?

_____ 25. Does your partner ever throw objects or break things when he/she is angry?

_____ 26. Has your partner ever been in trouble with the police?

_____ 27. Have you ever called the police or tried to call them because you or a family member were in danger?

_____ 28. Does your partner put you down in front of others?

_____ 29. Does your partner injure your pets intentionally? 
 

 

Scoring your Answers:
 
0 – 14 Non-abusive relationship
15 - 36 Moderately Abusive 
37 – 93 Seriously Abusive
94 or Above Dangerously Abusive

     If your score was 0 – 14, you live in a Non-abusive relationship. The sorts of strains you experience are not unusual, and you and your partner deal with them non-violently.

     If your score was 15 – 36, you definitely live in a home where you have experienced some violence at least once in a while. It may be that this is a relationship where the violence is just beginning, or perhaps for some reason, it has stopped at this level of severity. But in a new relationship, there is good reason to expect it will eventually escalate into more serious forms and may occur more frequently.

     If your score was 37 – 93, you are in a seriously abusive situation that can, under outside pressures, or with the strain of a family emergency, move into the dangerously severe range. In a seriously abusive situation, serious injury is quite probable if it has not already occurred. Much of this abuse is assault, pure and simple, by a violent person. If this is your score-range, you may want to consider finding counseling or some kind of support group for yourself, or consider sorting things out after going to a shelter. Your partner may get help from counseling or a support group for those who are abusive to others, if he/she admits to the abuse and is willing to seek help. Couple counseling is not helpful when there has been abuse in the relationship. Regardless of the type of help you seek, you should seriously consider getting some kind of support for yourself, even leaving.

     If your score was 94 – 108, you need to consider even more seriously the option of leaving the relationship, at least temporarily (and for your own safety). The violence will not "take care of itself" or miraculously disappear. Over time, the chances are very good that your life will literally be in jeopardy more than once. Counseling and support groups are available in most areas through battered women's shelters to help women get out of such an abusive relationship, since it is often hard to do without support.