Questionnaire on Self -Regulation [612322]

Questionnaire on Self -Regulation

Name: ____________________________________ Date: ___________________________

Rate how true each statement is for you ranging from never true to always true . Mark the box under the
rating that best applies to you.

Never True
Sometimes True
Mostly True
Always True

1. I have a hard time controlling
my temper.
   
2. I get so frustrated I feel ready
to explode.
   
3. I get upset easily.
   
4. I am afraid I will lose control
over my feelings.
   
5. I slam doors when I am mad.
   
6. I develop a plan for all my
important goals.
   
7. I think about the future
consequences of my actions.
   
8. Once I have a goal, I make a
plan to reach it.
   
9. I get distracted by little things.
   
10. As soon as I see things that are
not working, I do something
about it.
   
11. I get fidgety after a few
minutes if I am supposed to sit
still.
   
12. I have a hard time sitting still
during important tasks.
   
13. I find that I bounce my legs or
wiggle with objects.
   

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