Instructions:	Participant #________

This form lists various attitudes and behaviors of parents and caretakers. As you remember your FATHER (or the person who is/was most like a father to you) over the years, please circle the most appropriate number next to each question.

Very likely	Moderately

likely	Moderately

unlikely	Very

unlikely
1. Spoke to me with a warm and

friendly voice	1	2	3	4	(28)

2. Did not help me as much as I needed	1	2	3	4	(29)
3. Let me do things I like doing	1	2	3	4	(30)
4. Seemed emotionally cold to me	1	2	3	4	(31)
5. Appeared to understand my problems

and worries	1	2	3	4	(32)
6. Was affectionate to me	1	2	3	4	(33)
7. Liked me to make my own decisions	1	2	3	4	(34)
8. Did not want me to grow up	1	2	3	4	(35)
9. Tried to control everything I did	1	2	3	4	(36)
10. Invaded my privacy	1	2	3	4	(37)
11. Enjoyed talking things over with me	1	2	3	4	(38)
12. Frequently smiled at me	1	2	3	4	(39)
13. Tended to baby me	1	2	3	4	(40)
14. Did not seem to understand what I needed or wanted	1	2	3	4	(41)
15. Let me decide things for myself	1	2	3	4	(42)
16. Made me feel I wasn't wanted	1	2	3	4	(43)
17. Could make me feel better when I

was upset	1	2	3	4	(44)
18. Did not talk with me very much	1	2	3	4	(45)
19. Tried to make me dependent on him	1	2	3	4	(46)
20. Felt I could not look after myself

unless he was around	1	2	3	4	(47)
21. Gave me as much freedom as I

wanted	1	2	3	4	(48)
22. Let me go out as often as I wanted	1	2	3	4	(49)
23. Was overprotective of me	1	2	3	4	(50)
24. Did not praise me	1	2	3	4	(51)
25. Let me dress in anyway I pleased	1	2	3	4	(52)

The person I just described is: (Circle one)

1 = My natural, biological father

2 = My adopted father

3 = My step-father	(53)

4 = My foster father

5 = Someone else (please give name and relationship to you) _________________________