Appendix 8- Adapted Cognitive Emotion Regulation Questionnaire

Emotion Regulation Questionnaire (based on CERQ) Version 2, 20/7/12

How do you cope with events?

Sometimes nice things happen and sometimes bad things happen. When bad
things happen you may feel sad, angry, scared or worried.

Can you tell me about something bad that has happened to you in the last month? This
should be something you feel alright to talk about.
 

I want to ask you some questions about how you thought about what
happened to you.
Not Sometimes Always
True True True
1. I thought I was to blame

2. I thought of nicer things

3. I thought that others were to blame

for example _____ from your story or
someone else.

4. I thought about how terrible it all was

5. I thought that I can’t do anything about it

6. I thought of how I could change it

7. I thought I had been stupid

8. It just happened; there is nothing I could

do about it

9. I thought of how I could cope with it

10. I thought it was my own fault

11. I thought I could not change it

12. I thought of nice things that have
happened to me

13. I thought it was the worst thing that can

happen to you

14. I thought that it was the fault of others,

for example _____ from your story or
someone else.

15. I thought of what I could do best

16. I thought that it was all caused by others,

for example _____ from your story or
someone else.

17. I thought of something nice and not about

what had happened

18. I thought about how horrible it was

Thank You

Scoring

Not true= 0
Sometimes True = 1
Never true= 2

Self Blame- Questions 1,7,10 Total =

Acceptance- Questions 5, 8, 11 Total=
Positive Refocusing- Questions 2, 12, 17 Total=
Refocus on Planning- Questions 6, 9, 15 Total=
Catastrophizing- Questions 4, 13, 18 Total=
Other Blame- Questions 3, 14, 16 Total =
Appendix 9- Observer Alexithymia Scale

  Observer Alexithymia Scale

Please use the following scale for each item:
 
Never:   Sometimes:   Usually:   All  of  the  time:  
not  at  all  like  the  person   a  little  like  the  person   very  much  like  the  person   completely  like  the  person  
—————————   —————————   —————————   —————————  
0   1   2   3  
       
 
             He  or  she                                          Circle    
  18. likes to explore his or her 0 1 2 3
1. is a warm person. 0 1 2 3 feelings.
 
2. falls apart when things are 0 1 2 3 19. has  strong  emotions  that     0      1      2      3  
really tough.              he  or  she  cannot  explain.  
 
3. worries too much about his 0 1 2 3 20.    is  imaginative;  creative.       0      1      2      3  
or her health.
  21. seems to lack a sense of 0 1 2 3
4. has a good sense of humor. 0 1 2 3 purpose.

   5.    is  too  self-­‐controlled.       0      1      2      3   22. has physical problems that 0 1 2 3

               are  hard  to  treat.  
   6.    has  compassion.           0      1      2      3    
  23.    is  unexciting;  boring.       0      1      2      3  
   7.    is  good  at  relationships.       0      1      2      3    
  24.    is  flexible.         0      1      2      3  
8. becomes confused when 0 1 2 3  
things are very stressful. 25.    likes  to  have  close  friends.       0      1      2      3  
 
   9.    talks  a  lot  about  physical     0      1      2      3   26.    knows  himself  or  herself  well.     0      1      2      3  
         pain  or  discomfort.    
  27. has  physical  reactions  to  stress   0      1      2      3  
10. tells  jokes  and  makes  funny     0      1      2      3                (headaches,  sweating,  stomach  
             remarks.                problems,  muscle  pain).  
   
11.    must  "go  by  the  book."       0      1      2      3   28.    is  colorless;  uninteresting.       0      1      2      3  
   
12.    is  sensitive  to  other  people.     0      1      2      3   29.    likes  to  touch  or  be  touched.     0      1      2      3  
   
13. becomes  frustrated  in  the     0      1      2      3   30. has  trouble  finding  the  right     0      1      2      3  
             face  of  uncertainty.                words  to  describe  his  or  her  
               feelings.  
14. spends  a  lot  of  time  worrying   0      1      2      3    
             about  his  or  her  body.   31. sees  things  only  as  black  or     0      1      2      3  
               white  
15.    is  playful.         0      1      2      3  
  32. understands his or her needs 0 1 2 3
16.    is  stiff;  rigid.           0      1      2      3   very well.
 
17.    likes  to  be  close  to  people.     0      1      2      3   33. puts off enjoying the good 0 1 2 3
  things in life, even when it
  is not necessary to do so.
 
             He  or  she                                        Circle:  

Copyright  ©  2000,  Mark  G.  Haviland,  Ph.D.  

Not  to  be  reproduced  in  whole  or  in  part  without  written  permission.    All  rights  reserved.  
For  permission,  contact  Mark  G.  Haviland,  Ph.D.,  Department  of  Psychiatry,  
Loma  Linda  University  School  of  Medicine,  Loma  Linda,  CA  92350  or  mhaviland@llu.edu.