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1、February 2009 revision1Name姓名:_ Date of Birth出生日期:_Highest Educational Level教育水平:_ Todays Date测试日期: _SMI (Version 1.1)图式模式问卷图式模式问卷INSTRUCTION: Listed below are statements that people might use to describe themselves. Please rate each item based on how often you believe or feel each statement in gene
2、ral using the frequency scale. 指导语：下列是人们可能用来描述自己的陈述。请根据你一般而言用这些话描述自 己的频繁程度如何FREQUENCY: In general频繁程度：一般而言频繁程度：一般而言1= Never or Almost Never从不或几乎从不4= Frequently频繁 2= Rarely很少5= Most of the time大部分时间 3= Occasionally偶尔6= All of the time总是如此Frequency频繁程度频繁程度In general.一般而言一般而言1. I demand respect by not
3、letting other people push me around. 我通过不让别人对我指手画脚，获得我需要的尊重 2. I feel loved and accepted. 我感到被爱，被人接受 3. I deny myself pleasure because I dont deserve it. 我否认自己的快乐，因为我不配 4. I feel fundamentally inadequate, flawed, or defective. 我觉得自己基本上是不合格的、有缺陷的、无能的 5. I have impulses to punish myself by hurting mys
4、elf (e.g., cutting myself). 我又通过伤害自己而惩罚自己的冲动(如割伤自己） 6. I feel lost. 我感到失落 7. Im hard on myself. 我对自己苛刻 8. I try very hard to please other people in order to avoid conflict, confrontation, or rejection. 我非常努力地取悦别人，为的是避免冲突，对质或抛弃 9. I cant forgive myself. 我不能原谅我自己 10. I do things to make myself the cen
5、ter of attention. 我做些事情，让我成为注意的中心February 2009 revision211. I get irritated when people dont do what I ask them to do. 当人们不做我叫他们做的事情的时候，我就生气 12. I have trouble controlling my impulses. 要控制我的冲动，我觉得有困难 13. If I cant reach a goal, I become easily frustrated and give up. 如果我不能达到目标，我会很容易感受到挫折感，并放弃 14. I
6、have rage outbursts. 我会一阵阵暴怒发作 15. I act impulsively or express emotions that get me into trouble or hurt other people. 我会行事冲动或表达一些让我陷入麻烦或者伤害别人的情感 FrequencyIn general.16. Its my fault when something bad happens. 如果有些糟糕的事情发生，那是我的错 17. I feel content and at ease. 我感觉满足，轻松 18. I change myself depending
7、 on the people Im with, so theyll like me or approve of me. 我根据周围的人改变我自己，这样他们就会喜欢我或者赞赏我 19. I feel connected to other people. 我感到和别人有连结 20. When there are problems, I try hard to solve them myself. 当有问题时，我很努力地自己来解决它们 21. I dont discipline myself to complete routine or boring tasks. 我不会给自己做规矩，去完成日常的或
8、无聊的任务 22. If I dont fight, I will be abused or ignored. 如果我不斗争，我就会被虐待或者忽略 23. I have to take care of the people around me. 我必须照顾我身边的人 24. If you let other people mock or bully you, youre a loser. 如果你让其他人欺负你，你就是个失败者 25. I physically attack people when Im angry at them. 我对别人生气时，我就会打他们 26. Once I start
9、 to feel angry, I often dont control it and lose my temper. 一旦我开始觉得愤怒，我经常会失去控制，大发雷霆 27. Its important for me to be Number One (e.g., the most popular, most successful, most wealthy, most powerful). 成为第一对我很重要 28. I feel indifferent about most things. 我对大多数事情无动于衷 29. I can solve problems rationally wi
10、thout letting my emotions overwhelm me. 我可以理性地解决问题，而不让我被情绪淹没 30. Its ridiculous to plan how youll handle situations. 一个人计划如何处理情境，这是荒唐的 31. I wont settle for second best. 我不愿意成为第二名 32. Attacking is the best defense. 攻击是最好的防御 33. I feel cold and heartless toward other people. 我觉得对别人冷漠、不关心 34. I feel d
11、etached (no contact with myself, my emotions or other people). 我感觉超然（和我自己，我的情绪，其他人，没有联系）February 2009 revision335. I blindly follow my emotions. 我盲目地跟随自己的情绪 36. I feel desperate. 我感觉绝望 37. I allow other people to criticize me or put me down. 我允许别人批评我，打击我 38. In relationships, I let the other person
12、have the upper hand. 在关系中，我让别人处于上风 39. I feel distant from other people. 我感觉远离其他人 40. I dont think about what I say, and it gets me into trouble or hurts other people. 我不会考虑我要说的话，这让我惹麻烦，伤害别人 41. I work or play sports intensively so that I dont have to think about upsetting things. 我高强度地工作或锻炼，这样我就没必要
13、考虑让我心烦的事情 Frequency In general.42. Im angry that people are trying to take away my freedom or independence. 对于试图拿走我的自由和独立的别人，我感觉愤怒43. I feel nothing. 我感觉不到任何东西 44. I do what I want to do, regardless of other peoples needs and feelings. 我做我想做的事情，不管别人的需要和感受 45. I dont let myself relax or have fun unti
14、l Ive finished everything Im supposed to do. 我不让我放松或娱乐，直到我完成了我应该做的所有事情。 46. I throw things around when Im angry. 当我愤怒是，我就乱扔东西 47. I feel enraged toward other people. 我对别人感觉很愤怒 48. I feel that I fit in with other people. 我感觉我融入其他人 49. I have a lot of anger built up inside of me that I need to let out
15、. 我内心有很多愤怒在积累，我需要发泄 50. I feel lonely. 我感到孤独 51. I try to do my best at everything. 我在所有事情上都尽力而为 52. I like doing something exciting or soothing to avoid my feelings (e.g., working, gambling, eating, shopping, sexual activities, watching TV). 我喜欢做些让我兴奋或舒畅的事情，从而避免体验到我的感情（如工作、赌博、吃 东西、购物、性活动，看电视） 53. Equality doesnt exist, so its better to be superior to other people. 平等并不存在，所以最好是在别人之上 54. When Im angry, I often lose control and threaten other people. 当我愤怒时，我经常失控并威胁别人 55. I let other people get their own way instead of expressing my own needs. 我让别人自行其事，而不是表达我自己的需要February 20
