SELF - EVALUATION QUESTIONNAIRE

Developed by Charles D Spielberger In collaboration with RL Gorsuch,

R Lushene, PR Vagg and GA Jacobs

STAI (Form Y-1)

DIRECTIONS: A number of statements which people have used to describe themselves are given
below. Read each statement and then circle the appropriate number of the statement to indicate how
you feel right now, that is, at this moment. These are no right or wrong answers. Do not spend too
much time on any one statement but give the answer which seems to describe your present feelings
best.

Sl No STATEMENTS NOT SOME MODERATELY VERY

AT ALL WHAT SO MUCH SO
1 I feel calm 1 2 3 4
2 I feel secure 1 2 3 4
3 I am tense 1 2 3 4
4 I feel strained 1 2 3 4
5 I feel at ease 1 2 3 4
6 I feel upset 1 2 3 4
7 I am presently worrying over possible 1 2 3 4
misfortunes
8 I feel satisfied 1 2 3 4
9 I feel frightened 1 2 3 4
10 I feel comfortable 1 2 3 4
11 I feel self-confident 1 2 3 4
12 I feel nervous 1 2 3 4
13 I am jittery 1 2 3 4
14 I feel indecisive 1 2 3 4
15 I am relaxed 1 2 3 4
16 I feel content 1 2 3 4
17 I am worried 1 2 3 4
18 I feel confused 1 2 3 4
19 I fell steady 1 2 3 4
20 I feel pleasant 1 2 3 4
DIRECTIONS: A number of statements which people have used to describe themselves are given
below. Read each statement and then circle the appropriate number of the statement to indicate how
you feel right now, that is, at this moment. There is no right or wrong answers. Do not spend too much
time on any one statement but give the answer which seems to describe how you generally feel FOR
THE PAST TWO YEARS

Sl No STATEMENTS ALMOST SOMETIMES OFTEN ALMOST

NEVER ALWAYS
21 I feel pleasant 1 2 3 4
22 I feel nervous and restless 1 2 3 4
23 I feel satisfied with myself 1 2 3 4
24 I wish I could be as happy as other 1 2 3 4
seems to be
25 I feel like a failure 1 2 3 4
26 I feel rested 1 2 3 4
27 I am “calm, cool and collected” 1 2 3 4
28 I feel that difficulties are piling up so 1 2 3 4
that I cannot overcome them
29 I worry too much over something 1 2 3 4
that really doesn’t matter
30 I am happy 1 2 3 4
31 I have disturbing thoughts 1 2 3 4
32 I lack self-confidence 1 2 3 4
33 I feel secure 1 2 3 4
34 I make decisions easily 1 2 3 4
35 I feel inadequate 1 2 3 4
36 I am content 1 2 3 4
37 Some unimportant thought runs 1 2 3 4
through my mind and bothers me
38 I take disappointments so keenly that 1 2 3 4
I can’t put them out of my mind
39 I am a steady person 1 2 3 4
40 I get in a state of tension or turmoil 1 2 3 4
as I think over my recent concerns
and interests