CET LOTUS SCREENING ENCARTA

SECTION 1 : CURRENT ENVIRONMENT

SCALE 1 : LIFE EVENTS
Think about the past year. For each of the works and the personal events listed below, please indicate how much each has been a source of
distress for you.

LIFE EVENTS Great Moderate Li le None/Didn't Occur

Fired, laid o , quit or re red 3 2 1 0
New job or employer 3 2 1 0
New type pf work 3 2 1 0
Downsizing or reorganiza on at my company 3 2 1 0
Some other change at work not listed above which
caused you distress 3 2 1 0
Financial loss or diminished income 3 2 1 0
Death of a close friend or family member 3 2 1 0
Move or reloca on 3 2 1 0
Your sepera o or divorce 3 2 1 0
Your marriage 3 2 1 0
Bought a new home 3 2 1 0
Crime vic m 3 2 1 0
Birth of baby, adop on, step child(ren) or other
person(s) added to household 3 2 1 0
Involvement in a legal system 3 2 1 0
Serious personal illness or injury 3 2 1 0
Serious illness or injury of a close friend or family
member⁺ 3 2 1 0
Increased caretaking responsibili es for an aging or
disabled family member 3 2 1 0
Some other change, not listed above, which caused you
distress 3 2 1 0

Scale 1
⁺ ⁺ ⁺ ⁼

SCALE 2 : WORK PRESSURES

Think about the past month. For each of the work pressures listed below, please indicate how much each has been a souce of distress for you.

WORK PRESSURES Great Moderate Li le None/Didn't Occur

Job security 3 2 1 0
Rela onship with an immediate supervisor 3 2 1 0
Shi ing priori es at work 3 2 1 0
Rela onship with co-workers 3 2 1 0
Opportunity for advancement and growth 3 2 1 0
Too much work 3 2 1 0
Control over my workload 3 2 1 0
Lack of job exibility to deal with family and/or personal
emergencies 3 2 1 0
Favori sm or unfair hiring and/or promo on policies at
work 3 2 1 0
Constant monitoring of job performance by
management 3 2 1 0

Boring or uninteres ng work 3 2 1 0

Special recogni on or award at my job 3 2 1 0
Pressure from the compe ng deadlines at my job
3 2 1 0

Loss of commitment to work 3 2 1 0

Feel bogged down in red tape and unable to accomplish
anything 3 2 1 0

Flexibility of hours of work 3 2 1 0

The commute to my job 3 2 1 0
Scale 2
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SCALE 3 : PERSONAL PRESSURES

Think about the past month. For each of the personal pressures listed below, please indicate how much each has been a souce of distress to
you.

PERSONAL PRESSURES Great Moderate Li le None/Didn't Occur

Financial di cul es 3 2 1 0
3 ve
Increased caretaking responsibili es for an aging adult or disabled rela 2 1 0
Con ict with partner or spouse 3 2 1 0
Raising a child 3 2 1 0
Being seperated from a spouse 3 2 1 0
Deteriora ng personal health 3 2 1 0
Finding quality day care or problems with current day
care situa on 3 2 1 0
Not enough me to spend with those closest to me
3 2 1 0

Dangerous or unsafe neighborhood 3 2 1 0

Rela onship with a close rela ve (parent, sibling, in-
laws) 3 2 1 0
Sexual con ict or frustra on 3 2 1 0
Work family con ict 3 2 1 0
Lonely or lack in macy 3 2 1 0
Fer lity or reproduc ve issues 3 2 1 0
Scale 3
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SECTION II : EMOTIONAL LITERACY

SCALE 4 : EMOTIONAL SELF-AWARENESS
For each items listed below, please indicate how well it describes the way you currently think or feel about yourself.

This describes me
EMOTIONAL SELF-AWARENESS Very Well Moderately Well A Li le Not At All
I can name my feelings 3 2 1 0
I'hv learned a lot about myself by listening to my feelings
3 2 1 0

I am aware of my feelings most of the me 3 2 1 0

I can tell when I am ge ng upset 3 2 1 0
When I am sad, I know the reason(s) why 3 2 1 0
I tend to judge myself by how I think others see me
0 1 2 3

I enjoy my emo onal life 3 2 1 0

People who show a lot of strong emo on scare me
0 1 2 3

I o en wish I were someone else 0 1 2 3

I pay a en on to my physical state to understand my
feelings 3 2 1 0
I accepts my feelings as my own 3 2 1 0
Scale 4
⁺ ⁺ ⁺ ⁼

SCALE 5 : EMOTIONAL EXPRESSION

For each items listed below, please indicate how well it describes the way you currently think or feel about yourself.

This describes me
EMOTIONAL EXPRESSION Very Well Moderately Well A Li le Not At All

I let other people know when they are doing a good job 3 2 1 0

3 2 1 0
I express my emo ons even when they are nega ve
I let others know what I want and need 3 2 1 0
My closest friends would say I express my apprecia on
of them 3 2 1 0

I keep my feelings to myself 0 1 2 3

I let people know when uncomfortable feelings get in the
way of our work 3 2 1 0
I have trouble reaching out to others when I need help
0 1 2 3
In interac ng with others, I can sense how they are
feeling 3 2 1 0
I would do anything to avoid looking foolish to my peers
0 1 2 3

Scale 5
⁺ ⁺ ⁺ ⁼

SCALE 6 : EMOTIONAL AWARENESS OF OTHERS

For each items listed below, please indicate how well it describes the way you currently think or feel about yourself.

This describes me
EMOTIONAL SELF-AWARENESS Very Well Moderately Well A Li le Not At All
I can recognize emo ons in others by watching their eyes 3 2 1 0
I nd it di cult to talk to people who do not share my
view 0 1 2 3

I focus on people's posi ve quali es 3 2 1 0

I rarely have the urge to tell someone o 3 2 1 0
I think about how others might feel before I give my openion 3 2 1 0
No ma er with whom I am speaking, I am always a good
listener 3 2 1 0

I can sense the mood of a group when I walk into a room 3 2 1 0

I can get new people I meet to talk about themselves
3 2 1 0

I am good at "reading between the lines"when someone is talking 3 2 1 0

I can usually tell how others feel about me 3 2 1 0
I can sense someone's feelings even if it is unspoken
3 2 1 0
I change my emo onal expression depending upon the
person I am with 0 1 2 3
I can tell when someone close to me is upset 3 2 1 0
Scale 6
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SECTION III : EQ COMPENTENCIES

SCALE 7 : INTENTIONALITY
Think about the past month. For each item below, please indicate how well the statement describe your behavior or inten on.

This describes me
INTENTIONALITY Very Well Moderately Well A Li le Not At All
I can easily shut our distrac ons when I need to concentrate 3 2 1 0
I nish most things that I start 3 2 1 0
I know how to say "no" when I have to 3 2 1 0
I know how to reward myself a er accomplishing a goal 3 2 1 0
I can put aside short-term rewards for long term goals 3 2 1 0
I can completely focus myself on a task when I need to
3 2 1 0

I do things that I later regret 0 1 2 3

I accept responsibility for managing my emo ons
3 2 1 0

When faced with a problem, I like to deal with it as soon as possible3 2 1 0

I think about what I want before I act 3 2 1 0
I can postpone my personal gra ca on for a greater
goal 3 2 1 0
when I am in a bad mood I can talk myself out of it
3 2 1 0
I get angry when I am cri cized 0 1 2 3
I do not know the source of my anger in situa ons
0 1 2 3

Scale 7
⁺ ⁺ ⁺ ⁼

SCALE 8 : CREATIVITY
Think about the past month. For each item below, please indicate how well the statement describe your behavior or inten on.

This describes me
CREATIVITY Very Well Moderately Well A Li le Not At All
I've suggested innova ve projects for my company
3 2 1 0
I par cipate in the sharing of informa on and ideas
3 2 1 0
I fantasize about the future to help me gure out where
I'm going 3 2 1 0

My best ideas happen when I am not really thinking

about them 3 2 1 0
I've had brilliant ideas that came to me in a ash and
were fully formed 3 2 1 0
I have a good sense of when ideas will succeed or fail
3 2 1 0

I am fascinated by new and unusual concepts 3 2 1 0

I've implemented innova ve projects at my company
3 2 1 0

I get excited by new ideas and solu ons 3 2 1 0

I am good at brainstorming on a problem to generate
op ons 3 2 1 0

Scale 8
⁺ ⁺ ⁺ ⁼

SCALE 9 : RESILIENCE
Think about the past month. For each item below, please indicate how well the statement describe your behavior or inten on.

This describes me
RESILIENCE Very Well Moderately Well A Li le Not At All
I can bounce back a er feeling disappointed 3 2 1 0
I can accomplish what I need to if I put my mind to it
3 2 1 0
Obstacles or problems in my life have resulted in
unexpected changes for the be er 3 2 1 0

I nd it easy to wait pa entlywhen I need to 3 2 1 0

There is always more than one right answer 3 2 1 0
I know how to sa sfy all parts of myself 3 2 1 0
I am not one to procras nate 3 2 1 0
I am afraid to try something again when I have failed at it
before 0 1 2 3
I decide certain problems are not worth worrying about
3 2 1 0
I relax myself when tension builds up 3 2 1 0
I can see the humorous side of situa ons 3 2 1 0
I o en put things aside for a while to get a perspec ve
on them 3 2 1 0
When I encounter a problem, I focus on what I can do to
solve it 3 2 1 0

Scale 9
⁺ ⁺ ⁺ ⁼

SCALE 10 : INTERPERSONAL CONNECTIONS

Think about the past month. For each item below, please indicate how well the statement describe your behavior or inten on.

This describes me
INTERPERSONAL CONNECTIONS Very Well Moderately Well A Li le Not At All
I am able to grieve when I lose something important to
me 3 2 1 0
I feel uncomfortable when someone gets too close to me
emo onally 0 1 2 3
I have several friends I can count on in mes of trouble
3 2 1 0
I show a lot of love and a ec on to my friends
3 2 1 0
When I have a problem I know who to go to or what to
do to help solve it 3 2 1 0
My beliefs and values guide my daily ac ons 3 2 1 0
My family is always there for me when I need them 3 2 1 0
I doubt if my colleagues really care about me as a
person 0 1 2 3
I hve a di cult me making friends 0 1 2 3
I hardly cry 0 1 2 3
Scale 10
⁺ ⁺ ⁺ ⁼

SCALE 11 : CONSTRUCTIVE DISCONTENT

Think about the past month. For each item below, please indicate how well the statement describe your behavior or inten on.

This describes me
CONSTRUCTIVE DISCONTENT Very Well Moderately Well A Li le Not At All
I can disagree e ec vely to bring about change 3 2 1 0
I would not express my feelings if I believed they would
cause a disagreement 0 1 2 3
When it comes right down to it, I can only trust myself to
get things done 0 1 2 3
I remain calm even in situa ons when others get angry
3 2 1 0
It is be er not to s r up problems if you can avoid doing
so 0 1 2 3
I have a hard me ge ng consensus from my work
team 0 1 2 3
I solicit feedback from my peers on my performance 3 2 1 0
I am good at organizing and mo va ng groups of people
3 2 1 0
I enjoy the challenge of facing and solving problems at
work 3 2 1 0
I listen to cri cism with an open mind and accept it when
it is jus ed 3 2 1 0
I let things build up to a crisis point before talking about
it 0 1 2 3
When I make a cri cal comment I focus on the behavior
and not the person 3 2 1 0
I avoid confronta ons 0 1 2 3
Scale 11
⁺ ⁺ ⁺ ⁼

SECTION IV : EQ VALUES AND BELIEFS

SCALE 12 : COMPASSION
Think about the past month. For each item below, please indicate how well the statement describe your behavior or inten on.

This describes me
COMPASSION Very Well Moderately Well A Li le Not At All
I can see pain in others even if they don't talk about it
3 2 1 0
I am able to read people's emo ons from their body
language 3 2 1 0
I act ethically in my dealings with people 3 2 1 0
I would not hesitate to go out of my way to help
someone in trouble 3 2 1 0
I take the feelings of others into considera on in my
interac ons with them 3 2 1 0
I can put myself in someone else's shoes 3 2 1 0
There are some people I've never forgiven 0 1 2 3
I can forgive myself for not being perfect 3 2 1 0
When I succeed at something, I o en feel I could have
done be er 0 1 2 3
I help others to save face in a tough situa on 3 2 1 0
I constantly worry about my shortcomings 0 1 2 3
I am jealous of people who have more than I do
0 1 2 3

Scale 12
⁺ ⁺ ⁺ ⁼

SCALE 13 : OUTLOOK
Think about the past month. For each item below, please indicate how well the statement describes your behavior or inten on.

This describes me
OUTLOOK Very Well Moderately Well A Li le Not At All
I look on the bright side of things 3 2 1 0
I love my life 3 2 1 0
I know I can nd solu ons to di cult problems
3 2 1 0
I believe things usually work out for the best 3 2 1 0
I have been con nually frustrated in my life because of
bad breaks 0 1 2 3
I like who I am 3 2 1 0
I see challenges as opportuni es for learning 3 2 1 0
Under pressure I am con dent I will gure out a solu on
3 2 1 0

Scale 13
⁺ ⁺ ⁺ ⁼

SCALE 14 : INTUITION
Think about the past month. For each item below, please indicate how well the statement describes your behavior or inten on.

This describes me
INTUITION Very Well Moderately Well A Li le Not At All
Some mes I have the right answer without having the
reasons 3 2 1 0
My hunches are usually right 3 2 1 0
I visualize my future goals 3 2 1 0
I can see the nished product or picture before it is
completed 3 2 1 0
I believe in my dreams even when others can't see or
understand them 3 2 1 0
When faced with a tough choice, I follow my heart
3 2 1 0
I pay a en on when things don't feel quite right to me
3 2 1 0
Once I've made up my mind I seldom change it 0 1 2 3
People say I am a visionary 3 2 1 0
When someone presents an opinion di erent from my
own, I have a hard me accep ng it 0 1 2 3

I use my "gut reac ons" when making decisions

3 2 1 0

Scale 14
⁺ ⁺ ⁺ ⁼

SCALE 15 : TRUST RADIUS

Think about the past month. For each item below, please indicate how well the statement describes your behavior or inten on.

This describes me
TRUST RADIUS Very Well Moderately Well A Li le Not At All
People would take advantage of me if I let them
0 1 2 3
I trust un l I have reason not to 0 1 2 3
I am very careful about whom I trust 0 1 2 3
I respect my colleagues 3 2 1 0
People similar to me at my company have go en be er
deals (i.e. raises, promo ons, opportuni es, rewards, 0 1 2 3
etc) than I have
The people I associate with are trustworthy 3 2 1 0
I seem to get the short end of the s ck 0 1 2 3
Very li le in life is fair or equitable 0 1 2 3
When something isn't working I try to come up with an
alterna ve plan 3 2 1 0
When I meet new people I disclose very li le personal
informa on about myself 0 1 2 3

Scale 15
⁺ ⁺ ⁺ ⁼

SCALE 16 : PERSONAL POWER

Think about the past month. For each item below, please indicate how well the statement describes your behavior or inten on.

This describes me
PERSONAL POWER Very Well Moderately Well A Li le Not At All
I can make things happen 3 0 1 2
Fate plays a strong role in my life 0 1 2 3
I nd it useless to ght the established heirarchy at my
company 0 1 2 3
Circumstances are beyond my control 0 1 2 3
I need recogni on from others to make my work
worthwhile 0 1 2 3
I am easy to like 3 2 1 0
I have a hard me accep ng compliments 0 1 2 3
I have the ability to get what I want 3 2 1 0
I feel in control of my life 3 2 1 0
If I re ect on my life, I might nd I am basically unhappy
0 1 2 3
I feel frightened and out of control when things change
rapidly 0 1 2 3
I enjoy taking charge of things 3 2 1 0
I know what I want and go a er it 3 2 1 0
Scale 16
⁺ ⁺ ⁺ ⁼

SCALE 17 : INTEGRITY
Think about the past month. For each item below, please indicate how well the statement describes your behavior or inten on.

This describes me
INTEGRITY Very Well Moderately Well A Li le Not At All
I am willing to admit it when I make a mistake 3 2 1 0
I feel like a fraud 0 1 2 3
If I no longer had a passion for my work I would change
jobs 3 2 1 0
My job is an extension of my personal value system
3 2 1 0
I never tell lies 3 2 1 0
I nd myself going along with a situa on even if I don't
believe in it 0 1 2 3
I exaggerate my abili es in order to get ahead 0 1 2 3
I tell the truth even when it is di cult 3 2 1 0
I have done things on my job that are against my beliefs
0 1 2 3

Scale 17
⁺ ⁺ ⁺ ⁼

SECTION V : EQ OUTCOMES
SCALE 18 : GENERAL HEALTH
Think about the past month. Please indicate how o en (if ever) you have experienced the following symptons.

This describes me
Once or Twice a
PHYSICAL SYMPTOMS Never Every Week Nearly Every Day
Month
Back pain 0 1 2 3
Problem(s) with weight (either underweight or
overweight) 0 1 2 3
Tension headaches 0 1 2 3
Migraines 0 1 2 3
Cold or respiratory problems 0 1 2 3
Stomach problrems (frequent gas, irritable bowel
syndrome, or ulcers) 0 1 2 3
Chest pain 0 1 2 3
Unexplanable aches and pains 0 1 2 3
Some other kind of chronic pain not listed above
0 1 2 3

BEHAVIORAL SYMPTOMS:
Ea ng *loss ps appe te, overea ng, no me to eat)
0 1 2 3
Smoking 0 1 2 3
Drinking alcoholic beverages 0 1 2 3
Taking tranquilizers 0 1 2 3
Taking aspirin or other pain killers 0 1 2 3
Taking other drugs 0 1 2 3
Withdrawing from close rela onships 0 1 2 3
Cri cizing, blaming or ridiculing others 0 1 2 3
Feeling vic mized or taken advantage of 0 1 2 3
Watching T.V. (Over 2 hours per day) 0 1 2 3
Playing video/computer games or using the
Internet(Over 2 hours per day) 0 1 2 3
Resen ng people I encountered 0 1 2 3
Accidents or injuries 0 1 2 3

EMOTIONAL SYMPTOMS :
Trouble concentra ng 0 1 2 3
Overwhelmed at work 0 1 2 3
Being easily distracted 0 1 2 3
Can't get things out o my mind/ constant worrying or
dwelling 0 1 2 3
Feeling depressed, dejected, or hopeless 0 1 2 3
Feeling lonely 0 1 2 3
Mind goes blank 0 1 2 3
Feeling fa guedor overwhelmed 0 1 2 3
Trouble making up mind or making decisions 0 1 2 3
Trouble ge ng myself going or trouble calming down
0 1 2 3

Scale 18
⁺ ⁺ ⁺ ⁼

SCALE 19 : QUALITY OF LIFE

Please indicate how well each of the following statements describes the way you currently think or feel about yourself.

This describes me
QUALITY OF LIFE Very Well Moderately Well A Li le Not At All
I am deeply sa s ed with my life 3 2 1 0
I feel energe c, happy, and healthy 3 2 1 0
I have feelings of inner-peace well-being 3 2 1 0
I would need to make lots of changes in my life to be
truly happy 0 1 2 3
My life meets my deepest needs 3 2 1 0
I have go en less than I hoped for out of life 0 1 2 3
I like myself just the way I am 3 2 1 0
Work for me is fun 3 2 1 0
I have found meaningful work 3 2 1 0
I am on a path that brings me sa sfac on 3 2 1 0
I have made the most of my own abili es 3 2 1 0
Scale 19
⁺ ⁺ ⁺ ⁼

SCALE 20 : RELATIONSHIP QUOTIENT

Please indicate how well each of the following statements describes the way you currently think or feel about yourself.

This describes me
RELATIONSHIP QUOTIENT Very Well Moderately Well A Li le Not At All
There are some people I "connect with" at a deeper level
3 2 1 0
I am honest with people close to me and they are honest
with me 3 2 1 0
I have deeply loved another person 3 2 1 0
I can usually nd people to socialize with 3 2 1 0
I am able to make a long-term commitment to a
rela onship 3 2 1 0
I know I am important to the people closest to me
3 2 1 0
I nd it easy to tell people I care about them 3 2 1 0
Scale 20
⁺ ⁺ ⁺ ⁼

SCALE 21 : OPTIMAL PERFORMANCE

Please indicate how well each of the following statements describes the way you currently think or feel about yourself.

This describes me
OPTIMAL PERFORMANCE Very Well Moderately Well A Li le Not At All
I am sa s ed with my work performance 3 2 1 0
My co-workers would say I facilitate good
communica on among the members of my work group 3 2 1 0

I feel distant and uninvolved at work 0 1 2 3

It is di cult for me to pay a en on to work tasks
0 1 2 3
In my work team, I am involved in decision-making
3 2 1 0
I have di culty mee ng commitments or comple ng
tasks 0 1 2 3
My work performance is consistently the best I can do
3 2 1 0

Scale 21
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