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