Greetings!

We would like to seek your assistance in providing the needed information and data for our
research.
In view of the above, may we request you to please accomplish the attach questionnaire.
Rest assured that the information we will get from you will be treated with utmost confidentially.
Thank you so much!
Amaro, Ma. Blesziel M.
Mendoza, Kristina
Researchers
______________________________________________________________________________

A Study on the Implications of Verbal Harassment to Self-Esteem

of SHS Students
of AMA Computer College Caloocan

Survey Questionairre

Name(Optional):

Direction: Put a Check Mark to the line of your answer.

4- Strongly Agree
3- Agree
2- Disagree
1- Strongly Disagree

Possible reasons why people verbaly abusive

Strongly Disagree Agree Strongly
Disagree Agree
1. To impress my friends or build up some type
of reputation
2. I have been bullied and to deflect the attention
or because I am angry, I go onto bully someone
else.
3. I might be enjoying the attention or reaction
4. I might be having problems at home or at
school so I am taking this out on someone else
5. Lack of self-esteem of confidence so I act in a
negative way
6. I might be angry and frustrated and looking to
take things out on someone else.
Possible effects to the victim
Strongly Disagree Agree Strongly
Disagree Agree
1. Depression
2. Anxiousness
3. Isolated
4. Withdrawn (Not wanting to communicate to
others)
5. Suicide
6. Humiliation
7. Low Self-esteem
8. Be very angry and agressive
9. Feel anxious about going to school
10. Frustration

Prevention of Verbal Abuse

Strongly Disagree Agree Strongly
Disagree Agree
1. Report the Verbal Abuse incident to teacher or
school guidance counselor
2. Giving Seminar to the students about the
effects of verbal abuse
3. Be intimate to your family
4. Be friendly
5. Support the victims of abuse