Items:

Externalized Self-Perception
1. I tend to judge myself by how I think other people see me.
2. I feel dissatisfied with myself because I should be able to do all the things people are supposed to be able to do these days.
3. When I make decisions, other people's thoughts and opinions influence me more than my own thoughts and opinions.
4. I often feel responsible for other people's feelings.
5. I find it hard to know what I think and feel because I spend a lot of time thinking about how other people are feeling.
6. I never seem to measure up to standards I set for myself.

Care as Self-Sacrifice
7. I think it is best to put myself first because no one else will look out for me.*
8. Caring means putting the other person's needs in front of my own.
9. Considering my needs to be as important as those of the people I love is selfish.
10. In a close relationship, my responsibility is to make the other person happy.
11. Caring means choosing to do what the other person wants, even when I want to do something different.
12. In order to feel good about myself, I need to feel independent and self-sufficient.*
13. One of the worst thing I can do is to be selfish.
14. Doing things just for myself is selfish.
15. In a close relationship I don't usually care what we do, as long as the other person is happy.

Silencing the Self
16. I don't speak my feelings in an intimate relationship when I know they will cause disagreement.
17. When my partner's needs and feelings conflict with my own, I always state mine clearly.*
18. Instead of risking confrontations in close relationships, I would rather not rock the boat.
19. I speak my feelings with my partner, even when it leads to problems or disagreements.*
20. When my partner's needs or opinions conflict with mine, rather than asserting my own point of view I usually end up agreeing with himher.
21. When it looks as though certain of my needs can't be met in a relationship, I usually realize that they weren't very important anyway.
22. I rarely express my anger at those close to me.
23. I think it's better to keep my feelings to myself when they do conflict with my partner's.
24. I try to bury my feelings when they will cause trouble in my close relationship(s).

Divided Self
25. I find it harder to be myself when I am in a close relationship than when I am on my own.
26. I feel I have to act in a certain way to please my partner.
27. Often I look happy on the outside, but inwardly I feel angry and rebellious.
28. In order for my partner to love me, I cannot reveal certain things about myself to himher.
29. When I am in a close relationship I lose my sense of who I am.
30. My partner loves and appreciates me for who I am.*
31. I feel that my partner does not know my real self.

*Items are reverse scored

Response Options:
5-point Likert scale
Strongly disagree - 1
Strongly agree - 5