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ARE YOU A VICTIM?

THE FOLLOWING QUESTIONNAIRE IS FROM THE FAMILY SECRET

BY WILLIAM A. STACEY AND ANSON SHUPE 

Center for Social Research Abuse Index

This questionnaire is designed to help you decide if you are living in an abusive situation.  There are different forms of abuse, and not every person experiences all of them.  Below are various questions about your relationship with your partner.  As you can see, each possible answer has points assigned to it.  By answering each question and then totaling these points as directed, you can compare your score with our Abuse Index.  You will know if you are living in a potentially violent situation, and if you are abused, you will have some estimate of how really dangerous that abuse is.

Even if you feel that this questionnaire does not pertain to you personally, you may know someone who might benefit from it.   Show it to a friend!!!

For question 1-14, the answers and point values are as follows:

For questions 15-27, the point values are as follows:

When you have gone through the entire questionnaire, score your response by adding up the points on each answer.  This sum is your Abuse Index Score.  To get some idea of how abusive your relationship is, compare your Index Score with the chart and explanation that follows the questionnaire.

Person completing form:                                                                                    

                                                                  (name)

(Alleged) perpetrator:                                                                                           

                                                                  (name)

Date of completion:                                                                                          

A person with a score of 0 - 14 lives in a non-abusive relationship.  The sorts of strains this person experiences are not unusual in modern homes, and he/she and the two partners deal with them non-violently.  A person with a score in the 15 - 36 range, however, definitely does live in a home where some violence has been experienced at least once in a while.  It may be that this is a relationship where the violence is just beginning, or perhaps for whatever reason it has stopped at this level of severity.  But in a new relationship there is good reason to expect it will eventually escalate into more serious forms and may occur more frequently.

A person with scores in the 37 - 93 range is in a seriously abusive situation that can, under outside pressures, or with the sudden strain of a family emergency, move into the dangerously severe range.  In a seriously abusive situation serious injury is quite probable if it has not already occurred.  Much of this abuse is assault, pure and simple, by a violent person.  A person here needs to consider finding counseling, talking with the partner about counseling if he/she will accept the idea, or sorting things out after going to a shelter.  This person should seriously consider getting help, even leaving.

A person with scores in the top range of 94 - 120 needs to consider even more seriously the option of leaving the relationship at least temporarily (and possible soon).  The violence will not "take care of itself" or miraculously disappear.  Over time the chances are very good that the person's life will literally be in jeopardy more than once.

_______________________________________________________________

What Is Domestic Violence?

Domestic violence is a pattern of controlling behavior that may include physical, sexual, economic, emotional, and psychological abuse of one family member or intimate partner by another. The goal of domestic violence is to establish and maintain power and control.