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| Do People Treat
You Like a Child? Epstein-Dumas Infantilization Inventory (EDII) v. 3.0, © 2010, Dr. Robert Epstein Before we get to the inventory itself, we'll ask you a few basic questions about yourself. Demographic information is being collected for research purposes only and will be kept strictly confidential. *Your initials: *Age: *Highest Degree: None High school Community college Bachelors Masters Doctorate *Race/Ethnicity: White Black Hispanic Asian American Indian Other *Gender: Male Female Other *Sexual orientation: Straight Gay or lesbian Bisexual Other Unsure *Employed: Yes No *How much control do you feel you have over your life? No control 1 2 3 4 5 6 7 8 9 10 Complete control *How much success have you had lately in your personal life? Low 1 2 3 4 5 6 7 8 9 10 High *How much success have you had lately in your professional life? Low 1 2 3 4 5 6 7 8 9 10 High *How happy and fulfilled are you? Very unhappy 1 2 3 4 5 6 7 8 9 10 Extremely happy *How depressed have you felt in recent months? No depression 1 2 3 4 5 6 7 8 9 10 Severe depression *How angry have you felt in recent months? No anger 1 2 3 4 5 6 7 8 9 10 Extreme anger *Have you been in therapy within the past year? Yes No *Who, if anyone, is trying to control your life? Check all that apply: Your mother Your father Your boss Your co-worker(s) Your spouse Your boyfriend or girlfriend Your friend(s) Your child or children Your roommate(s) Your mother-in-law Your father-in-law Other relative(s) Your teacher(s) Others Please specify: Okay, here is the test itself. Over the past year, has anyone restricted your activities in any of the following ways? Click only on the statements with which you agree. 1. Listened to, read, or viewed your private communications? 2. Tried to restrict your communications? 3. Tried to send you to your room? 4. Tried to give you a time out? 5. Tried to cut off your money or credit? 6. Tried to limit your ability to drive? 7. Tried to make you drive? 8. Tried to take away your personal property? 9. Damaged or destroyed your personal property? 10. Tried to prevent you from leaving? 11. Searched your room? 12. Searched your belongings? 13. Violated your privacy? 14. Tried to restrict your use of the Internet? 15. Tried to restrict your television use? 16. Tried to restrict your access to videos, CDs, books, or other media? 17. Tried to prevent you from getting a tattoo or piercing? 18. Tried to make you get a tattoo or piercing? 19. Tried to make you cut your hair? 20. Tried to make you to wear your hair a certain way? 21. Tried to prevent you from wearing makeup? 22. Tried to make you use makeup or wear it a certain way? 23. Tried to stop you from using perfumes or colognes? 24. Tried to make you use perfumes or colognes? 25. Tried to prevent you from wearing certain clothing? 26. Tried to make you wear certain clothing? 27. Tried to stop you from contacting or associating with certain people? 28. Tried to make you contact or associate with certain people? 29. Spanked, paddled, or hit you (other than in play)? 30. Insisted that you lower the volume of your music or stop making noise? 31. Tried to restrict your social activities? 32. Tried to make you participate in certain social events? 33. Tried to make you to have an abortion? 34. Tried to prevent you from having an abortion? 35. Tried to prevent you from smoking? 36. Tried to make you smoke? 37. Tried to prevent you from drinking alcohol? 38. Tried to prevent you from using drugs? 39. Tried to prevent you from taking medication? 40. Tried to make you drink alcohol? 41. Tried to make you use drugs? 42. Tried to make you take medication? 43. Tried to prevent you from eating? 44. Tried to make you eat? 45. Tried to make you travel? 46. Tried to prevent you from traveling? 47. Tried to make you work? 48. Tried to prevent you from working? 49. Tried to make you get a job? 50. Tried to make you quit a job? 51. Tried to make you shower or bathe? 52. Tried to prevent you from showering or bathing? 53. Tried to make you engage in sexual acts? 54. Tried to restrict your sexual activity? 55. Tried to make you cook? 56. Tried to prevent you from cooking? 57. Tried to make you clean? 58. Tried to prevent you from cleaning? 59. Tried to make you do household chores? 60. Tried to stop you from doing household chores? 61. Tried to silence you? 62. Tried to make you speak? 63. Tried to subject you to a curfew? 64. Tried to make you do yardwork? 65. Tried to prevent you from doing yardwork? 66. Tried to make you go to bed? 67. Wouldn't let you sleep? 68. Tried to restrict your dating activities? 69. Tried to make you date someone? 70. Tried to make you attend school? 71. Tried to stop you from attending school? 72. Tried to make you quit school? 73. Tried to make you get certain grades? 74. Tried to make you take certain courses? 75. Tried to make you enter a certain profession? 76. Tried to prevent you from entering a certain profession? 77. Tried to make you see a therapist? 78. Tried to prevent you from seeing a therapist? 79. Tried to make you see a medical doctor? 80. Tried to prevent you from seeing a medical doctor? 81. Tried to make you have surgery? 82. Tried to prevent you from having surgery? 83. Tried to make you undergo shock therapy? 84. Tried to prevent you from undergoing shock therapy? 85. Tried to make you undergo some other extreme medical treatment? 86. Tried to admit you to a treatment facility? 87. Tried to prevent you from entering a treatment facility? 88. Threatened to have you arrested? 89. Examined the contents of your computer or other electronic device? 90. Tried to make you participate in religious activities? 91. Tried to stop you from participating in religious activities? 92. Tried to make you join a religion? 93. Tried to prevent you from joining a religion? 94. Tried to make you exercise or play certain sports? 95. Tried to prevent you from exercising or playing certain sports? 96. Tried to prevent you from entering certain areas of your home? 97. Tried to restrict your hobbies? 98. Shouted at you? 99. Insulted you? 100. Pushed you? 101. Blocked your way? 102. Physically restrained you? 103. Tried to control your diet? 104. Tried to kick you out of your bed or bedroom? 105. Tried to kick you out of your home? 106. Tried to make you live somewhere you didn't want to live? 107. Tried to take your money? 108. Tried to make you give him or her money? 109. Tried to stop you from viewing pornography? 110. Tried to make you view pornography? 111. Told you how to spend your time? 112. Tried to hurt you physically? 113. Shouted orders at you? 114. Threatened you? 115. Tried to make you commit a crime? 116. Tried to make you join or quit a gang? 117. Tried to stop you from joining or quitting a gang? 118. Tried to make you join or quit a group or organization? 119. Tried to stop you from joining or quitting a group or organization? 120. Tried to make you harm someone? 121. Bribed you to do something? 122. Demanded you do things you shouldn’t have to do? 123. Contacted you frequently to check up on you? 124. Demanded you contact him or her frequently? 125. Used electronic devices to track your location or spy on you? 126. Tried to make you hurt yourself? 127. Tried to prevent you from helping someone? 128. Tried to make you help someone you didn't want to help? 129. Tried to make you marry someone? 130. Tried to prevent you from marrying someone? 131. Humiliated you in front of other people? 132. Ignored what you had to say? 133. Blamed you for things that weren’t your fault? 134. Tried to make decisions for you? 135. Tried to make you move faster or slower? 136. Told you how to drive? 137. Made you feel inferior? 138. Spread rumors about you? 139. Corrected you? 140. Manipulated you? 141. Criticized you? 142. Made you feel guilty? 143. Other: |