The following questions concern information about your potential involvement with drugs.
Carefully read each statement and decide your answer is “YES or NO”
1. Have you used drugs other than those required for medical reasons? …………………………………………………Yes / No
2. Have you abused prescription drugs?........................................................................................................Yes / No
3. Do you abuse more than one drug at a time?...........................................................................................Yes / No
4. Can you get through the week without using drugs?................................................................................Yes / No
5. Are you always able to stop using drugs when you want to?....................................................................Yes / No
6. Have you had "blackouts" or "flashbacks" as a result of drug use? ………………………………………………………Yes / No
7. Do you ever feel bad or guilty about your drug use?............................................................................... Yes / No
8. Does your spouse (or parents) ever complain about your involvement with drugs?................................Yes / No
9. Has drug abuse created problems between you and your spouse or your parents?................................Yes / No
10. Have you lost friends because of your use of drugs?................................................................................Yes / No
11. Have you neglected your family because of your use of drugs?...............................................................Yes / No
12. Have you been in trouble at work because of drug abuse?......................................................................Yes / No
13. Have you lost a job because of drug abuse?.............................................................................................Yes / No
14. Have you gotten into fights when under the influence of drugs?.............................................................Yes / No
15. Have you engaged in illegal activities in order to obtain drugs?...............................................................Yes / No
16. Have you been arrested for possession of illegal drugs?..........................................................................Yes / No
17. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs?..............Yes / No
18. Have you had medical problems as a result of your drug use (e.g. memory loss, hepatitis, convulsions, bleeding,
etc.)?................................................................................................................................................................Yes / No
19. Have you gone to anyone for help for a drug problem?............................................................................Yes / No
20. Have you been involved in a treatment program specifically related to drug use?...................................Yes / No
PPSQ REVISED {Read all statement carefully}
1. Strongly Disagree 2. Disagree 3. Can’t say 4. Agree 5. Strongly Agree
SD D CS A SA
1 Sometimes I miss classes because my friends urge me to do so. 1 2 3 4 5
2 I cannot resist going for a late night party with friends. 1 2 3 4 5
3 I go for a date with my friend despite parental warnings. 1 2 3 4 5
4 Sometimes I do things because my friends want me to do so. 1 2 3 4 5
5 I feel pressure to chat long hours on internet. 1 2 3 4 5
6 Sometimes I do something wrong just to be good on friends’ view. 1 2 3 4 5
7 I cannot say "NO" to my friends even if my parents do not agree. 1 2 3 4 5
8 There is always a peer pressure for dating. 1 2 3 4 5
9 At times I feel peer pressure to smoke. 1 2 3 4 5
10 Sometimes I do violent acts to keep up with peers. 1 2 3 4 5
11 In close relationships, we have to approve pressures of peers. 1 2 3 4 5
12 I know my limits when with friends. 1 2 3 4 5
13 I find it difficult to escape from peer pressure. 1 2 3 4 5
14 Sometimes I have to undergo peer pressure to be liked in a group. 1 2 3 4 5
15 Many times I put off my homework and other important assignments for friends' party. 1 2 3 4 5
16 Sometimes I have to appease my peers by doing things that I don’t want to do. 1 2 3 4 5
17 To maintain a status in a peer group, sometimes I pressurize my parents to buy an expensive 1 2 3 4 5
item.
18 I do not take advice from my parents about peer group activities. 1 2 3 4 5
19 It is difficult to think about the negative consequences of what we do with peers. 1 2 3 4 5
20 There is no harm in doing one wrong with friends when we do a number of good things with 1 2 3 4 5
them.
21 It is very difficult for me to deny friend’s request to drink in a party or on other occasions. 1 2 3 4 5
22 Sometimes I do risky and harmful acts to get acceptance in the peer group. 1 2 3 4 5
23 When I feel uncomfortable in a group I do not know how to say NO. 1 2 3 4 5
24 I usually compromise with peers’ request for a movie, party, etc. 1 2 3 4 5
25 At times I feel peer pressure to watch pornography. 1 2 3 4 5
ACADEMIC PERFORMANCE SCALE
Please answer each question. Be as honest as possible because the information can be utilized
to discover areas of strength.
SA-StronglyAgree A - Agree N - Neutral D - Disagree SD - StronglyDisagree
QUESTIONS SA A N D SD
1 I made myself ready in all my subjects.
2 I pay attention and listen during every discussion.
3 I want to get good grades in every subject.
4 I actively participate in every discussion.
5 I start papers and projects as soon as they are assigned
6 I enjoy homework and activities because they help me improve my skills in every subject
7 I exert more effort when I do difficult assignments.
8 Solving problems is a useful hobby for me.