Independence Self-Test

This 10 question survey measures concepts of dependence and independence. You can take this self-test to get an indication of your independence levels, your aversion to dependence, and see how other peoples' responses compare to yours. It takes approximately 5 minutes to complete. This test is just one part of an assessment of whether independence might be a problem for you.

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* 1. Overall, how would you rate independence as a personal attribute?

Strongly devalue

Mostly devalue

Neutral

Mostly value

Strongly value

Strongly devalue

Mostly devalue

Neutral

Mostly value

Strongly value

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* 2. I would rather handle an emotional problem on my own instead of asking for help.

Strongly agree

Mostly agree

Neutral

Mostly disagree

Strongly disagree

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* 3. My economic survival depends on being physically or cognitively capable.

True

False

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* 4. How economically independent do you currently feel?

Highly independent

Mostly independent

Somewhat independent

Slightly independent

Not at all independent

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* 5. How physically independent do you currently feel?

Highly independent

Mostly independent

Somewhat independent

Slightly independent

Not at all independent

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* 6. When you're 80 years old, do you predict you will be more independent, or more dependent than you are right now?

More independent

Exactly the same as now (50)

More dependent

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 7. Imagine you've been diagnosed with a rare disease that erodes your physical independence. You are told that you will eventually need help with basics such as feeding, toileting, and bathing. Which of the following responses would you be most likely to have?

I tell friends and family about my diagnosis so I have a network of support ready when the time comes.

I plan for my diagnosis by saving up for long-term care insurance, and research care options until I have a plan in place.

I live each day to the fullest and 'cross that bridge' when I come to it.

I will myself to live on my own, surpassing everyone's expectations about what is possible with my diagnosis.

I live on my own as long as possible and if it's no longer possible to live independently, I find a way to end my life.

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* 8. This question measures how independence affects your self-esteem, if at all.

	Strongly Agree	Somewhat Agree	Somewhat Disagree	Strongly Disagree	Don't know (skip)
When I accomplish something on my own I get a bigger boost of self-esteem than when I'm part of a group that accomplishes something.	When I accomplish something on my own I get a bigger boost of self-esteem than when I'm part of a group that accomplishes something. Strongly Agree	When I accomplish something on my own I get a bigger boost of self-esteem than when I'm part of a group that accomplishes something. Somewhat Agree	When I accomplish something on my own I get a bigger boost of self-esteem than when I'm part of a group that accomplishes something. Somewhat Disagree	When I accomplish something on my own I get a bigger boost of self-esteem than when I'm part of a group that accomplishes something. Strongly Disagree	When I accomplish something on my own I get a bigger boost of self-esteem than when I'm part of a group that accomplishes something. Don't know (skip)
It's uncomfortable to admit when I don't know the right answer to something.	It's uncomfortable to admit when I don't know the right answer to something. Strongly Agree	It's uncomfortable to admit when I don't know the right answer to something. Somewhat Agree	It's uncomfortable to admit when I don't know the right answer to something. Somewhat Disagree	It's uncomfortable to admit when I don't know the right answer to something. Strongly Disagree	It's uncomfortable to admit when I don't know the right answer to something. Don't know (skip)
When I'm physically having trouble doing a task on my own I lose confidence in myself.	When I'm physically having trouble doing a task on my own I lose confidence in myself. Strongly Agree	When I'm physically having trouble doing a task on my own I lose confidence in myself. Somewhat Agree	When I'm physically having trouble doing a task on my own I lose confidence in myself. Somewhat Disagree	When I'm physically having trouble doing a task on my own I lose confidence in myself. Strongly Disagree	When I'm physically having trouble doing a task on my own I lose confidence in myself. Don't know (skip)
If I had to seek help for an emotional problem I'd question my inner strength.	If I had to seek help for an emotional problem I'd question my inner strength. Strongly Agree	If I had to seek help for an emotional problem I'd question my inner strength. Somewhat Agree	If I had to seek help for an emotional problem I'd question my inner strength. Somewhat Disagree	If I had to seek help for an emotional problem I'd question my inner strength. Strongly Disagree	If I had to seek help for an emotional problem I'd question my inner strength. Don't know (skip)
If I needed basic necessities from the government I'd question my life choices that led me there.	If I needed basic necessities from the government I'd question my life choices that led me there. Strongly Agree	If I needed basic necessities from the government I'd question my life choices that led me there. Somewhat Agree	If I needed basic necessities from the government I'd question my life choices that led me there. Somewhat Disagree	If I needed basic necessities from the government I'd question my life choices that led me there. Strongly Disagree	If I needed basic necessities from the government I'd question my life choices that led me there. Don't know (skip)

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* 9. To help us compare perceptions so we can better serve participants, what are three words or phrases you associate with dependence?

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* 10. Email address (we will email you to tell you about how your results compare with others. We will not store or sell your data).

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100% of survey complete.