Suggestibility Questionnaire 2

Name *

First

Last

Mobile Number/Contact Number *

Email *

2)1. Have you ever awakened in the middle of the night and felt that you could not move your body and/or talk? *

Yes
No

Choose only one response for each question.

2)2. As a child, did you feel that you were more affected by your parents' tone of voice, than by what they actually said? *

Yes
No

Choose only one response for each question.

2)3. If someone you are associated with talks about a fear that you have experienced before, do you have a tendency to have an apprehensive or fearful feeling also? *

Yes
No

Choose only one response for each question.

2)4. After having an argument with someone, do you have a tendency to dwell on what you could or should have said? *

Yes
No

Choose only one response for each question.

2)5. Do you tend to occasionally tune out when someone is talking to you and, therefore, do not hear what was said because your mind drifts to something totally unrelated? *

Yes
No

Choose only one response for each question.

2)6. Do you sometimes desire to be complimented for a job well done, but feel embarrasssed or uncomfortable when complimented? *

Yes
No

Choose only one response for each question.

2)7. Do you often have a fear or dread of not being able to carry on a conversation with someone you have just met? *

Yes
No

Choose only one response for each question.

2)8. Do you feel self-conscious when attention is drawn to your physical body or appearance? *

Yes
No

Choose only one response for each question.

2)9. If you had a choice, would you rather avoid being around children most of the time? *

Yes
No

Choose only one response for each question.

2)10. Do you feel that you are not relaxed or loose in body movements, especially when faced with unfamiliar people or circumstances? *

Yes
No

Choose only one response for each question.

2)11. Do you prefer reading non-fiction(true/facts) rather than fiction(imaginery or made-up)? *

Yes
No

Choose only one response for each question.

2)12. If someone describes a very bitter taste, do you have difficulty experiencing the physical feeling of it? *

Yes
No

Choose only one response for each question.

2)13. Do you generally feel that you see yourself less favorably than others see you? *

Yes
No

Choose only one response for each question.

2)14. Do you tend to feel awkward or self-conscious initiating touch (holding hands, kissing, etc) with someone you are in a relationship with, in front of other people? *

Yes
No

Choose only one response for each question.

2)15. In a new class or lecture situation, do you usually feel uncomfortbale asking questions in front of the group, even though you may desire further explanation? *

Yes
No

Choose only one response for each question.

2)16. Do you feel uneasy if someone you have just met, looks you directly in the eyes when talking to you, especially if the conversation is about you? *

Yes
No

Choose only one response for each question.

2)17. In a group situation with people you have just met, would you feel uncomfortable drawing attention to yourself by initiating a conversation? *

Yes
No

Choose only one response for each question.

2)18. If you are in a relationship, or are very close to someone, do you find it difficult or embarrassing to verbalize your love for them? *

Yes
No

Choose only one response for each question.

Comment or Message *