* 1. What is your gender?

* 2. How old are you?

* 3. How often do you feel stressed?

On a scale ranging from Strongly Disagree to Strongly Agree, please rate the following statements based on a time you FELT EXTREMELY RELAXED.

* 4. Self-Esteem

  Strongly Disagree Disagree Neither Agree or Disagree Agree Strongly Agree
On the whole, I am satisfied with myself.
At times, I think I am no good at all.
I feel that I have a number of good qualities.
I am able to do things as well as most other people.
I feel I do not have much to be proud of.
I certainly feel useless at times.
I feel that I am a person of worth, at least on an equal plane with others.
I wish I could have more respect for myself.
All in all, I am inclined to feel that I am a failure.
I take a positive attitude toward myself.