1. Do you feel like you are often blamed for problems within your family, even when you aren't at fault?
A. Yes, this happens all the time
B. I do feel this way sometimes
C. I never really feel this way
2. Does the issue of being the family scapegoat often create problems when it comes to forming healthy relationships with others?
A. Yes, this has caused many issues in other relationships
B. I never thought about it but I guess it has
C. No, this has never happened
3. Do people in your family regularly describe you using negative adjectives that take a toll on your self worth?
A. No, my family doesn't do this
B. Yes, my family talks about me negatively
C. My family does do this on occasion
4. Do you feel like you have been treated unfairly and unjustly by your own family?
A. Yes, I am made to feel like an outcast
B. Sometimes I do
C. I have never felt this way
5. Have you limited or cut off contact with certain family members in order to protect your mental health?
A. No, I am close with my entire family
B. There are some family members that I won't talk to at all
C. I have cut off contact with my entire family
6. When you are around your family, do you feel alone and like you don't belong?
A. Yes, I feel unwanted
B. No, I feel very welcome
C. I have felt like this once or twice
7. Do you have any trusted people in your family that you can always lean on for support?
A. No, that dynamic doesn't exist for me
B. Of course, I trust them all
C. I have few few family members that I'm close to
8. How do people in your family treat you overall?
A. They treat me like I'm worthless
B. They treat me with respect
C. They treat me alright I guess
9. Are you often yelled at, ridiculed, and made to believe that you are a burden?
A. No, I have never been treated that way
B. Yes, this exactly describes how my family treats me
C. I have felt this way at the hands of my family on occasion
10. How does being around your family generally make you feel?
A. Anxious and depressed
B. Happy and excited
C. Indifferent but fine