YRAI - 1

Name__________________________Date________________

INSTRUCTIONS:

Listed below are statements that a person might use to describe

himself or herself. Please read each statement and decide how
well it describes you. Then choose the highest rating from 1 to
6 that best describes you and write the number in the space
before the statement.

RATING SCALE:

1 = Completely untrue of me

2 = Mostly untrue of me

3 = Slightly more true than untrue

4 = Moderately true of me

5 = Mostly true of me

6 = Describes me perfectly

EXAMPLE:

A. 4 I try not think about things that bother me.

1._______I try not to think about things that upset me.

2._______I drink alcohol to calm myself.

3._______I am happy most of the time.

4._______I rarely feel sad or blue.

5._______I value reason over emotions.

6._______I believe that I should not get angry, even at people I don't like.

7._______I use drugs to feel better.

8._______I don't feel much when I remember my childhood.

9._______I smoke when I'm upset.

10._______I suffer from gastrointestinal problems (e.g. indigestion, ulcers,
colitis).

11._______I feel numb.

12._______I often get headaches.

13._______I withdraw when I'm angry.

14._______I don't have as much energy as most people my age.

15._______I suffer from muscular aches and pains.

16._______I watch a lot of TV when I'm alone.

17._______I believe that one should use reason to keep emotions under control.

18._______I cannot intensely dislike anyone.

19._______My philosophy when something goes wrong is to put it behind me as

soon as possible and move on.

20._______I withdraw from people when I feel hurt.

21._______I don't remember much about my childhood years.

22._______I take naps or sleep a lot during the day.

23._______I am happiest when I'm roaming or traveling around.

24._______ Sticking to the task at hand keeps me from feeling upset.

25._______I spend a lot of time daydreaming.

26._______When I'm upset, I eat to feel better.

27._______I try not to think about painful memories from my past.

28._______I feel better if I keep myself constantly busy, not leaving much time to
think.

29._______I had a very happy childhood.

30._______I withdraw when I'm sad.

31.______People say I'm like an ostrich with my head in the sand; in other
words, I tend to ignore unpleasant thoughts.

32._______I tend not to think about losses and disappointments.

33._______Often I don't feel anything, even when the situation seems to warrant
strong emotions.

34._______I was fortunate to have such good parents.

35._______I try to stay emotionally neutral most of the time.

36._______I find myself buying things that I don't need, to improve my mood.

37._______I try not to put myself in situations that are difficult or make me
uncomfortable.
38._______I get physically ill when things aren't going well for me.

39._______When people have left me or died, I didn't feel too upset.

40._______What others think of me does not bother me.

COPYRIGHT 2003 Jeffrey Young, Ph.D. and Jayne Rygh, Ph.D.

Unauthorized reproduction without written consent of the authors is
prohibited. For more information, write: Cognitive Therapy Center of New
York, 36 West 44th Street, Suite 1007, New York, NY 10036.