Study Questionnaire
This questionnaire consists of a set of items aimed at identifying an individual's content of thoughts, emotions, and his meditation background. 𝑷𝒍𝒆𝒂𝒔𝒆 𝒓𝒆𝒂𝒅 𝒕𝒉𝒆 𝒔𝒕𝒂𝒕𝒆𝒎𝒆𝒏𝒕𝒔 𝒄𝒂𝒓𝒆𝒇𝒖𝒍𝒍𝒚 𝒂𝒏𝒅 𝒇𝒊𝒍𝒍 𝒕𝒉𝒆 𝒊𝒏𝒇𝒐𝒓𝒎𝒂𝒕𝒊𝒐𝒏 𝒉𝒐𝒏𝒆𝒔𝒕𝒍𝒚. You can take occasional short breaks of 2-4 minutes but ensure to 𝒄𝒐𝒎𝒑𝒍𝒆𝒕𝒆 𝒊𝒕 𝒊𝒏 𝒂 𝒔𝒊𝒏𝒈𝒍𝒆 𝒔𝒆𝒔𝒔𝒊𝒐𝒏.
participant (to be generated from Pavlovia) *
This scale consists of a number of words that describe different feelings and emotions. Read each item and then mark the appropriate answer in the space next to that word to 𝒊𝒏𝒅𝒊𝒄𝒂𝒕𝒆 𝒕𝒐 𝒘𝒉𝒂𝒕 𝒆𝒙𝒕𝒆𝒏𝒕 𝒚𝒐𝒖 𝑮𝑬𝑵𝑬𝑹𝑨𝑳𝑳𝒀 𝒇𝒆𝒆𝒍 𝒕𝒉𝒊𝒔 𝒘𝒂𝒚 𝒊𝒏 𝒍𝒊𝒇𝒆.
*
Not at all
A little
Moderately
Quite a bit
Extremely
Upset
Hostile
Alert
Ashamed
Inspired
Nervous
Determined
Attentive
Afraid
Active
Please read each statement and circle a number 0, 1 2, or 3 which indicates 𝒉𝒐𝒘 𝒎𝒖𝒄𝒉 𝒕𝒉𝒆 𝒔𝒕𝒂𝒕𝒆𝒎𝒆𝒏𝒕 𝒂𝒑𝒑𝒍𝒊𝒆𝒅 𝒕𝒐 𝒚𝒐𝒖 𝒐𝒗𝒆𝒓 𝒕𝒉𝒆 𝒑𝒂𝒔𝒕 𝒘𝒆𝒆𝒌𝒔. There are no right or wrong answers. Do not spend too much time on any statement.
*
Applied not at all
Applied some times
Applied considerably
Applied most times
Found it hard to slow down
Was aware of dryness of my mouth
Couldn’t seem to experience any positive feeling at all
Experienced breathing difficulty
Found it difficult to work up the initiative to do things
Tended to over-react to situations
Experienced trembling (e.g. in the hands)
Felt that I was using a lot of nervous energy
Was worried about situations in which I might panic
Felt that I had nothing to look forward to
Found myself getting agitated
Found it difficult to relax
Felt down-hearted and blue
Was intolerant of anything that kept me from getting on with what I was doing
Felt I was close to panic
Was unable to become enthusiastic about anything
Felt I wasn’t worth much as a person
Felt that I was rather touchy
Was aware of action of my heart in absence of physical exertion (eg.increased rate)
Felt scared without any good reason
Felt that life was meaningless
Below is a collection of statements about your everyday experience. Using the 1-6 scale below, please 𝒊𝒏𝒅𝒊𝒄𝒂𝒕𝒆 𝒉𝒐𝒘 𝒇𝒓𝒆𝒒𝒖𝒆𝒏𝒕𝒍𝒚 𝒐𝒓 𝒊𝒏𝒇𝒓𝒆𝒒𝒖𝒆𝒏𝒕𝒍𝒚 𝒚𝒐𝒖 𝒄𝒖𝒓𝒓𝒆𝒏𝒕𝒍𝒚 𝒉𝒂𝒗𝒆 𝒆𝒂𝒄𝒉 𝒆𝒙𝒑𝒆𝒓𝒊𝒆𝒏𝒄𝒆. Please answer according to what really reflects your experience rather than what you think your experience should be. Please treat each item separately from every other item.
1. I could be experiencing some emotion and not be conscious of it until some time later. *
2. I break or spill things because of carelessness, not paying attention, or thinking of something else. *
3. I find it difficult to stay focused on what's happening in the present. *
4. I tend to walk quickly to get where I'm going without paying attention to what I experience along the way. *
5. I tend not to notice feelings of physical tension or discomfort until they really grab my attention. *
6. I forget a person's name almost as soon as I've been told for the first time. *
7. It seems I am "running on automatic," without much awareness of what I'm doing. *
8. I rush through activities without being really attentive to them. *
9. I get so focused on the goal I want to achieve that I lose touch with what I'm doing right now to get there. *
10. I do jobs or tasks automatically, without being aware of what I'm doing. *
11. I find myself listening to someone with one ear, doing something else at the same time. *
12. I drive places on "automatic pilot" and then wonder why I went there. *
13. I find myself preoccupied with the future or the past. *
14. I find myself doing things without paying attention. *
15. I snack without being aware that I'm eating. *
Below are five statements with which you may agree or disagree. Using the 1-7 scale below, 𝒊𝒏𝒅𝒊𝒄𝒂𝒕𝒆 𝒚𝒐𝒖𝒓 𝒂𝒈𝒓𝒆𝒆𝒎𝒆𝒏𝒕 𝒘𝒊𝒕𝒉 𝒆𝒂𝒄𝒉 𝒊𝒕𝒆𝒎 by placing the appropriate number in the line preceding that item.
*
Strongly disagree
Disagree
Slightly disagree
Neither agree nor disagree
Slightly agree
Agree
Strongly agree
In most ways, my life is close to my ideal.
The conditions of my life are excellent.
I am satisfied with life.
So far I have gotten the important things I want in life.
If I could live my life over, I would change almost nothing.
Do you spare some time from your daily routine to sit for a formal meditation practice? *
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