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Using the scale provided, please indicate how much each of the following statements reflects how you typically are.


I wish I had more self-discipline.
Not at all       1       2       3       4       5 Very Much

I have trouble concentrating.
Not at all       1       2       3       4       5 Very Much

I am lazy.
Not at all       1       2       3       4       5 Very Much

I am able to work effectively toward long-term goals.
Not at all       1       2       3       4       5 Very Much

Sometimes I can't stop myself from doing something, even if I know it is wrong.
Not at all       1       2       3       4       5 Very Much

I say inappropriate things
Not at all       1       2       3       4       5 Very Much

Pleasure and fun sometimes keep me from getting work done.
Not at all       1       2       3       4       5 Very Much

I have a hard time breaking bad habits.
Not at all       1       2       3       4       5 Very Much

I refuse things that are bad for me.
Not at all       1       2       3       4       5 Very Much

I do certain things that are bad for me, if they are fun.
Not at all       1       2       3       4       5 Very Much

I often act without thinking through all the alternatives.
Not at all       1       2       3       4       5 Very Much

People would say that I have iron self- discipline.
Not at all       1       2       3       4       5 Very Much

I am good at resisting temptation.
Not at all       1       2       3       4       5 Very Much

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