Survey SHS

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Questionnaire

Directions: Please provide the necessary information. Check the box that corresponds to your answer.
Name:________________________________________________________________Sex: Male Female
School Graduated from: _________________________________________________ Age: _____Grade Level____
Residence: ____________________________________________________________________________________
Which of the following are applicable to your living Which statement best describes your current living
situation? arrangement?

I live alone. I pay rent for my housing.


I live with roommates who are not students. I am living at home with family.
I live with other students.
I live in housing where I do not pay rent.
I live with parents(s), relative(s), or guardian(s).

What is your total household income?


Less than 10,000 50,000 to 59,999 100,000 to 149,999
10,000 to 19,999 60,000 to 69,999 150,000 or more
20,000 to 29,999 70,000 to 79,999
30,000 to 39,999 80,000 to 89,999
90,000 to 99,999
40,000 to 49,999
Chosen Track:
Accountancy, Business and Management (ABM) Strand
Humanities and Social Sciences (HUMSS) Strand
Science, Technology, Engineering and Mathematics (STEM) Strand
Academic Standing: __________________________________________________________________________

COPING ACROSS SITUATION QUESTIONNAIRE


We want to find out what you do when there are problems in your life. Start with the first area school and mark all of the things you
might find if there is a problem at school. Then continue with parents and so on

When I When I have When I have When I have When I have When I have
have a problems problems problems in problems concerns about
problem at with my with friends my romantic with myself my future
school parents interests
1. I discuss the problem with my
parents/other adults.
2. I talk about the problem
when it appears and dont
worry much.
3. I try to get help from
institutions. (school)
4. I expect the worst.
5. I accept my limits.
6. I try to talk about the
problem with the person
concerned.
7. I behave as if everything is
alright.
8. I try to let my energy out
(with loud music, riding my bike,
wild dancing, sports, etc.).
9. I do not worry because
usually everything turns out
alright
10. I think about the problem
and try to find different
solutions.
11. I compromise.
12. I let out my anger by
shouting, crying, slamming
doors, etc.
13. I tell myself that there
always be problems.
14. I only think about the
problem when it appears
15. I look for information in
magazines, internet or books.
16. I try not to think about the
problem.
17.I try to forget the problem
with alcohol or drugs
18.I try to get help and comfort
from people who are in a similar
situation.
19. I try to solve the problem
with help from my friends.
20. I withdraw because I cannot
change anything anyway.
PROBLEM QUESTIONNAIRE
On the following pages you will find a list of worries and difficulties that adolescents of your age have identified as their
problems. Probably, some are less stressful for you. Please check the items that are applicable to you.

5- Highly Stressful 4-Very stressful3- Moderately Stressful 2- Minimally Stressful 1- Not stressful at all

PROBLEMS RELATED TO SCHOOL 5 4 3 2 1


1. There is a great pressure to get the best grades in university
2. There is no sharing in my courses, only competition
3.Interactions with other students and teachers are mostly not personal
4. I cant do anything with the schools prescribed learning material.
5. Differences in opinions with my teacher could result in bad grades.
6. Learning material is too difficult for me.
PROBLEMS RELATED TO THE FUTURE
7. I may not get into the training program or university of my choice.
8. The increasing destruction of the environment aggrieves me
9. It may be difficult to combine my studies and job with marriage and
family.
10. I might lose myself in the chaotic everyday life in social norms and
pressures.
11. I would like very much to discover my real interests.
12. I dont know what I am going to do after finishing university.
13. I am unsure which profession I am best suited for.
14. I might become unemployed
PROBLEMS RELATED TO LIFE WITH PARENTS AT HOME
15. My parents show little understanding for my problems in university
16. My parents are only interested that I get good marks in university.
17. I fight with my parents because my opinions about many things differ
from theirs.
18. I wish my parents let me make my own decisions.
19. I cant talk with my parents.
20. My parents dont approve of my friends.
21. My parents dont have much time for me
22. Its difficult for me to pursue my own interests because I dont want to
disappoint my parents.
23. I wish I wasnt so dependent on my parents
PROBLEMS RELATED TO RELATIONSHIPS WITH PEERS
24. I have very few friends.
25. Its difficult for me to approach others.
26. I dont have a real friend with whom I can talk about personal worries
and problems.
27. Some of my peers are only willing to have superficial contact with me.
28. I am unsure if others will accept me.
29. I dont like the fact that outsiders cant join existing cliques
30. My peers are often very stubborn and intolerant towards each other.
31. I have too little time for my friends
PROBLEMS THAT ARE RELATED TO RELATIONSHIPS WITH THE OPPOSITE SEX
32. I dont have a boyfriend/girlfriend
33. I feel insecure in dealing with the opposite sex
34. I am afraid of losing contact with my other friends if I pair up with a
boyfriend/girlfriend.
35. I sometimes have to pretend about certain things just to please my
boyfriend/girlfriend because I am unsure of his/her feelings.
36. I sometimes have to pretend about certain things just to please my
boyfriend girlfriend.
37. Its difficult for me to develop a truly equal and balanced romantic
relationship.
PROBLEMS RELATED TO MY OWN SELF
38. I feel lonely.
39. Even little things make me angry.
40. I am dissatisfied with my appearance.
41. I am often sad and dejected.
42. I find it difficult to talk about my feelings with others
43. I am different from my friends.
44. I am dissatisfied with my behavior, my own traits and abilities
45. I dont trust myself to say anything in the presence of others
46. I have guilty feeling about a few things I have done
47. I find it difficult to live up to my own decisions.
48. All new things make me afraid.

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