| S/No | Question | Strongly Agree | Agree | Neither Agree Nor Disagree | Disagree | Strongly Disagree |
| 1 | My friends always miss my company. |
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| 2 | I do not think that I have anything to be proud of.* |
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| 3 | I feel that people like to be with me. |
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| 4 | I do not want to meet others because of my appearance.* |
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| 5 | In spite of all deficiencies i am still a good person. |
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| 6 | When I meet strangers they often like me. |
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| 7 | I sometimes tease/insist my parents.* |
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| 8 | I am fond of learning. |
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| 9 | I could never follow my time table.* |
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| 10 | I feel irritated when someone passes remarks on me.* |
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| 11 | I feel that my family members don’t give me any importance in my home.* |
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| 12 | I always take care of everybody. |
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