PMWI-F
This questionnaire asks about actions you may have experienced in your relationship with your partner. Answer each item as carefully as you can by placing a number beside each one as follows:
1=NEVER
2= RARELY
3= OCCASIONALLY
4= FREQUENTLY
5= VERY FREQUENTLY
NA= NOT APPLICABLE
IN THE PAST SIX MONTHS:
1. My partner put down my physical appearance. 1 2 3 4 5 NA
2. My partner insulted me or shamed me in front of others. 1 2 3 4 5 NA
3. My partner treated me like I was stupid. 1 2 3 4 5 NA
4. My partner was insensitive to my feelings. 1 2 3 4 5 NA
5. My partner told me I couldn't manage or take care of myself without him. 1 2 3 4 5 NA
6. My partner put down my care of the children. 1 2 3 4 5 NA
7. My partner criticized the way I took care of the house. 1 2 3 4 5 NA
8. My partner said something to spite me. 1 2 3 4 5 NA
9. My partner brougt up something from the past to hurt me. 1 2 3 4 5 NA
10. My partner called me names. 1 2 3 4 5 NA
11. My partner swore at me. 1 2 3 4 5 NA
12. My partner yelled and screamed at me. 1 2 3 4 5 NA
13. My partner treated me like an inferior. 1 2 3 4 5 NA
14. My partner sulked or refused to talk about a problem. 1 2 3 4 5 NA
15. My partner stomped out of the house or yard during a disagreement. 1 2 3 4 5 NA
16. My partner gave me the silent treatment or acted like I wasn't there. 1 2 3 4 5 NA
17. My partner withheld affection from me. 1 2 3 4 5 NA
18. My partner did not let me talk about my feelings. 1 2 3 4 5 NA
19. My partner was insensitive to my sexual needs and desires. 1 2 3 4 5 NA
20. My partner demanded obedience to his whims. 1 2 3 4 5 NA
21. My partner became upset if dinner, housework, or laundry was not done when he
thought it should be. 1 2 3 4 5 NA
22. My partner acted like I was his personal servant. 1 2 3 4 5 NA
23. My partner did not do a fair share of the household tasks. 1 2 3 4 5 NA
24. My partner did not do a fair share of child care. 1 2 3 4 5 NA
25. My partner ordered me around. 1 2 3 4 5 NA
26. My partner monitored my time and made me account for my whereabouts. 1 2 3 4 5 NA
27. My partner was stingy in giving me money to run our home. 1 2 3 4 5 NA
28. My partner acted irresponsibly with our financial resources. 1 2 3 4 5 NA
29. My partner did not contribute enough to supporting our family. 1 2 3 4 5 NA
30. My partner used our money or made important financial decisions without talking
to me about it. 1 2 3 4 5 NA
31. My partner kept me from getting medical care that I needed. 1 2 3 4 5 NA
32. My partner was jealous or suspicious of my friends. 1 2 3 4 5 NA
33. My partner was jealous of other men. 1 2 3 4 5 NA
34. My partner did not want me to go to school or other self-improvment activities. 1 2 3 4 5 NA
35. My partner did not want me to socialize with my female friends. 1 2 3 4 5 NA
36. My partner accused me of having an affair with another man. 1 2 3 4 5 NA
37. My partner demanded that I stay home and take care of the children. 1 2 3 4 5 NA
38. My partner tried to keep me from seeing or talking to my family. 1 2 3 4 5 NA
39. My partner interfered in my relationships with other family members. 1 2 3 4 5 NA
40. My partner tried to keep my from doing things to help myself. 1 2 3 4 5 NA
41. My partner restricted my use of the car. 1 2 3 4 5 NA
42. My partner restricted my use of the telephone. 1 2 3 4 5 NA
43. My partner did not allow me to leave the house. 1 2 3 4 5 NA
44. My partner did not allow me to work. 1 2 3 4 5 NA
45. My partner told me my feelings were irrational or crazy. 1 2 3 4 5 NA
46. My partner blamed me for his problems 1 2 3 4 5 NA
47. My partner tried to turn my family against me. 1 2 3 4 5 NA
48. My partner blamed me for causing his violent behavior. 1 2 3 4 5 NA
49. My partner tried to make me feel crazy. 1 2 3 4 5 NA
50. My partners moods changed radically 1 2 3 4 5 NA
51. My partner blamed me when he was upset ... 1 2 3 4 5 NA
52. My partner tried to convince me I was crazy. 1 2 3 4 5 NA
53. My partner threatened to hurt himself if I left. 1 2 3 4 5 NA
54. My partner threatened to hurt himself if I didn't do what he wanted me to do. 1 2 3 4 5 NA
55. My partner threatened to have an affair. 1 2 3 4 5 NA
56. My partner threatened to leave the relationship. 1 2 3 4 5 NA
57. My partner threatened to take our children away from me. 1 2 3 4 5 NA
58. My partner threatened to commit me to an institution. 1 2 3 4 5 NA
Richard M. Tolman 1995