INFORMATION BLANK

Please fill in the fo llow ing information. Your information is needed for research purpose only,

which shall be kept most confidential.

Name :

Parentage

Age

Occupation

Monthly Income :

Level of Education (Please tick applicable box)

Yes No

> Literate : _____ |______|

> Illiterate : L- I t— —1

> Under/Middle : I_____ | |

> M iddle : \ \ | |

> Matric : I | |

> 10+2 : [ ^ ] \^ }

> B.A : ^ 2 d H

> B.Sc : | | \^ \/ _____

> M .A : Q \ \> M.Sc : I

> B.Ed : [ ^ ]

> M.Ed : r ~ i

> M .Phil :

> P h .D : Q H □

Syed Shafaq Naieema Investigator

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Consumable Booklet

of

Bell’s Adjustment Inventory(Indian Adaptation)

Revised Edition

R. K. Ojha (Moradabad)

Please fill in the following informations :—

N am e........................................................................... Class........................................ ...... .

Sex..................... .......................................................... Age...................................................

Father’s Occupation........................... .................................................................................

Monthly Income.............................................. ......... Education.....................................

INSTRUCTIONS

If you answer each statement properly of this inventory honestly and devotedly then 1 can tell you whether you possess complete adjustment personality or some short-comings. If you are not living with your parents, then answer such statement keeping in view the persons with whom you are living.

This inventory consists of four parts. 35 statements are given in each part. Two

alternatives ‘Yes’ and ‘No’ are given against each statement. If you wish to answer the statement in ‘Yes’ i.e. you agree with the facts given in the statement then put a cross ( x) in the box given below ‘Yes’. If your answer is negative i.e. you do not agree

with the facts given in the statement then put a cross ( x) in the box given below ‘No’. Though there is not time limit, still try to answer all the statements quickly.

SCORING TABLE

Area __„ I II III IV Total

Scores

Interpretation

Estd. 1983 ® (0522) 354807

ANKUR PSYCHOLOGICAL AGENCY22/481, INDIRA NAGAR, LUCKNOW - 226 016

2 1 Consumable Booklet of B A !

S. No. STATEMENT YES NO

PARTI

HOME

1. Have you ever had a firm idea of absconding the home ? □ □2. Do you ever feel that your parents are not satisfied with you ? □ □3. Are you sad with the works done by your father to run your

family ? □ □4. Do your mother have supremacy in your family. □ □

5. Has anyone among your mother-father ever condemn you in vain ? □ □

6. Do you think that there is no true affection in the family ? □ □

7. Do you always have good relations with your father ? □ □

8. Do your parents stress upon obeying them instead of paying attention to your matters. □ □

9. Being your family life sorrowful, has anyone in your family become ill or died ? □ □

10. Do your home appears to you sorrowful because of shortage of money ? □ □

11. Has your parents ever suspected upon your character ? □ □

12. Do your parents forbid you to remain with such type of friends you remain with ? □ □

13. Do your mother or father irritates soon ? □ □

14. Do you mostly remains disagree with your parents regarding the process of work at home ? □ □

15. Do family quarrels usually occur between your relations ? . □ □

16. Do you mostly keep on quarrelling with your brothers and sisters ? □ □

17. Do your parents understand you to be a child and do not think that you have grown up now ? □ □

18. Do you feel that your parents are unnecessarily strict with

you ? □ □

19. Do any of your parents have any peculiar habit which you hates ? □ □

Consumable Booklet of B A ! | 3

S. No. STATEMENT YES NO

20. Do you love your mother more than your father ? □ □

21. Have you to leave your house or keep quiet for maintaining peace in the family ? □ □

22. Has your parents created great fear in your mind for any specific work ? □ □

23. Do you sometime feel angry and sometime happy upon your family members according to the time ? □ □

24. Do your mother loves you very much ? □ □

25. Do your mother or father gets angry soon ? □ □

26. Do all the essential things exists in your house ? □ □

27. Do the ideals of life of ^our father match with your ideals ? □ □

28. Has your parents ever provoked you for your personal figure and colour ? □ □

29. Do the ideas of your mother-father not match with each other ? □ □

30. Did your parents oftenly beat you between the age of 10 and 15 years ? □ n

31. Are you not in agreem ent with the ideas of your parents regarding your aims of life ? □ □

32. Is any of your mother-father of irritant habit ? □ □

33. Do your nother or father keep you in strict control ? □ □

34. Do you ever think that your parents are unable to understand you ? □ □

35. Do you feel that the family life of your friends is more pleasant than your ? □ □

PART II

HEALTH

1 . Do you get afraid soon with others ? f~]

2. Do your eyes feel difficulty in facing very bright light ? □ □

3. Are you a patient of asthama or malaria etc. ? £ ] Q

4 . Have you ever had Diphtheria or high fever in childhood ? D O

4 | Consumable Booklet of B A !

S. No. STATEMENT YES NO

5. Do you always remain afflict by headache ? □ □6. Do you feel difficulty in steeping when there is any kind of

noise in house ? □ □7. Do you usually feel more tired at the end of the day ? □ □8. Have you reduced some of your body weight these days ? □ □9. Have you ever had serious injury in any accident ? □ □

10. Have you ever had any surgical operation ? □ □

11. Do you feel much cold ? □ □

12. Do you usually get afflict with influenza ? □ □

13. Did you ever become serious III during last ten years ? □ □

14. Are you suffering from the problem of gas ? □ □

15. Do you feel giddiness ? □ □

16. Do your eyes pains usually ? □ □

17. Do you feel tiredness when you wakes-up in the morning ? □ □

18. Do you oftenly take medicines ? □ □

19. Do you usually feel like tired ? □ □

20. Do you usually get indigestion problem ? □ n

21. Do you usually get sour throat ? □ □

22. Do you usually have disease of vomiting or diarrhorea ? □

23. Do you have much problem of constipation ? □ □

24. Have you been too much ill durjng your childhood ? □ n

25. Do you feel difficulty in breathing with nose ? □ □

26. Do you ever have sharp headache ? □ □

. 27. Is your body weight less than an average ? □ □

28. Do you usually take your food before feeling hungry ? □ □

29. Do you use spectacles ? □ □

30. Do you think necessary to take Care of your health ? □ n

31. Are you usually absent because of illness ? □ □

Consumable Booklet of BA I | 5

S. No. STATEMENT YES NO

□ □□ D□ □□ □

□ □

□ □

□ □

□ □□ □

□ □□ □

□ □□ □□ n□ □

□ □□ □

□ □

□ □

32.

33.

34.

35.

Are your teeth such that you feel necessary for medication ?

Do you have any trouble in heart, lungs or kidney ?

Have you ever had skin disease ?

Do you have trouble in getting rid of cold ?

PART III

SOCIAL

1 . Do you enjoy social gatherings just to meet the persons ?

2. Do you like to meet the chief guest w hile attending any reception function ?

3 . Do you take responsibility of introducing persons while attending such functions ?

4. Do you feel difficulty in giving proper answer while taking part in group conversation ?

5 . Have you been leader of any party ?

6. Do you hesitate in going any meeting when all the persons have seated ?

7 . Can you deliver speech in the presence of all in the class ?

8. Do you keep on talking with your fellow travellers w hile travelling by rail or bus ?

9. Do you feel easy in asking help from others ?

1 0. Do you get harrass with your shyness ?

1 1 . Do you enjoy in starting conversation in public ?

12. Do you have experience of planning and directing the works of public ?

13. Do you feel difficulty in talking with any new known person ?

14.

15.

Do you find yourself unable in answering in the class even remembering the answer ?

Do you feel easy in having friendship with opposite sex person ?

6 | Consumable Booklet of BA I

S. No. STATEMENT YES NO

16. Would you like to do work for others Instead of asking othersto do work for you if you are given a dinner ? □ □

17. Do you have experience in delivering speech in meetings ? CD CD

18. Do you have difficulty in delivering speech in presence ofpersons ? □ □

19. Do you enjoy more social dances ? □ □

20. Will you prefer to go personally and take something you want from an unknown person instead of writing a letter or askingany other person to bring it ? CD CD

21. Do you feel self-respect in living with the persons you admiremost and not known fully ? I~) l~~|

22. Have you ever been a leader of any social programme ? CD CD

23. Do you move sideways on road to side the eye-sight of anyspecific person ? CD CD

24. Will you prefer to stand or come back on reaching late in anymeeting instead of sitting infront ? CD CD

25. Do you make friends with readiness ? CD CD

26. Are you leader in any party ? D O

27. Do you prefer to have heartily friendship with some specificpersons instead of having acquaintance with more p e rs o n s ? CD CD

28. Do you feel dishearted in seeking permission for leavingany specific party of persons if you wish to leave it ? CD CD

29. Do you lag behind in social functions ? CD Q

30. Do you get perplex all together, if any teacher calls you all of asudden? CD Q

3 1 . Do you feel difficult to talk with a stranger ? CD CD

32. Are you delighted In taking part in fairs and gatherings ? □ □

3 3 . Do you understand self-respected in speaking on any subjectIn the class ? □ □

34. Do you hesitate In speaking in the class ? CD CD

3 5 . Do you hesitate In entering the room if some persons aretalking with each other there ? CD O

Consumable Booklet of BA I | 7

S. No. STATEMENT YES NO

PART IV

EMOTIONAL

t. Do you day-dreams ? □ □

2. Is testing by doctor for any disease frightens you ? □ □

3. Do you sometimes get sad for unknown reasons ? □ □

4. Have you ever felt that someone may hypnotise you and make you work against your will ? □ □

5. Do you feel lonely while staying in a crowd ? □ □

6. Do you feel tired at the end of the day ? □ □7. Do you get frighten with the idea of earthquake or fire ? □ □

8. Do tears in you eyes come soon ? □ n9. Do youfiet frighten on seeing a snake ? □ □

10. Are you held convicted even if you are not guilty ? □ □

11. Do lightening frightens you ? □ □

12. Do you get discourage repeatedly on securing less marks in examinations ? □ □

13. Do you feel jealous of others being happy ? □ □

14. Do you loose courage very easily ? □ □

15. Do you usually feel sad upon your acts ? □ □

16. Have you ever got frighten of falling down after climbing a high mountain ? □ □

17. Do you get angry very soon ? □ p18. Do you usually remain sad ? □ □

19. Do you get perplexed with the feeling of inferiority ? □ □

20. Do you understand yourself strong ? □ □21. Do you easily get shy ? □ □

^ -p p e t u ' O x <1 -

8 | Consumable Booklet of B A I

S. No. STATEMENT YES NO

22. Do you feel troubled with any hearsay ? □ □

23. Do your feeling get hurt with any hearsay ? □ □

24. Do you become troubled with probable difficulties ? □ □

25. Do you ever get worried for the persons may not read your ideas ? □ □

26. Do you ever have an Idea that persons are sepoying you on the road ? □ □

27. Do you get much troubled on hearing your complaints ? □ □

28. Do you usually get irritate? □ n29. Do you sometimes have useless ideas in your brain and feel

distressed with them ? □ □

30. Do you get agitated soon ? □ □

31. Do you get too much distressed with your experiences of poverty ? □ □

32. Do you get too much frighten with a person even knowing that he cannot harm you ? □ □

33. Do you get happy and sad on and of without any specific reason ? □ □

34. Do you ever have an idea of your being unable to sleep ? □ □

35. Do you fear in living alone in dark ? □ □

© Revised Edition 1999. All rights reserved. Reproduction in any form is a violation of Copyright Act. Beil’s Adjustment Inventory (BAI). (English Version)

Confidential

Dr. Har Mohan Singh (Agra)

Consumable Booklet

of

M A I(Literate)

(Form A & B)

Please fill in the following informations

Name...........................................................................

Age................................................................... Sex........

Education..................................................... ...................

Occupation...................................................... Income.

Rural/Urban.....................................................................

SCORING TABLE

Question No. 1 2 3 4 5 6 7 8 9 10 Total

Score

Estd. 1971 © (0562)364926

NATIONAL PSYCHOLOGICAL CORPORATION4/230, KACHERI GHAT, AGRA - 282 004 (INDIA)

.v___________ _________________ — ------------------------- . . ----------- . — -

2 | Consumable Booklet of M A I

INSTRUCTIONS FOR FILLING THE INVENTORY FORM A & B

Below are given ten questions which should be replied in yes or no.

After alvf'fi^your consent for yes or no, mark yes ( V ) on the right place

best (fitting) explaining your opinion towards the issue. The rating scale

ranges from + 10 (most favourable) to + 1 (least favourable). Avoid

doubtful situations.

AN EXAMPLE : Do you quarrel with your wife/husband ?

Yes — — — — — — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

Since I sometimes quarrel with my wife hence I have replied in yes

and have marked ( V ) on 4th place on the scale.

Meaning of the Terms :

Number Meaning of number

10 stands for most favourable

9 stands for significantly favourable

8 stands for more than slightly favouraBle

7 stands for slighty favourable

6 stands for just favourable

5 stands for favourable

4 stands for definitely favourable

3 stands for comparatively favourable

2 stands for more than least favourable

and 1 stands for least favourable

Consumable Booklet of M A I j 3

M A I (LITERATE) QUESTIONNAIRE FORM - A

For Husbands Only

S. N. STATEMENTS

1 . Do you still offer your wife with gifts on important times of the year like birthday, marriage day and the like or with unexpected attention ?

Yes — — — — — — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

2. Are you fond of criticizing your wife before others.

Yes — — — — — — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

3. Have you made your wife free for spending money in household affairs ?

Yes — — — — — — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

4. Are you careless for her fem inine moods and do not help her in periods of fatigue, nervousness and irritability ?

Yes — — — — — — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

5. Do you share recreational hours with your wife ?

Yes— — _ — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

6. Do you compare her preparations with other women’s expect in her advantage ?

Yes — — — — — — — — — No10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

7. Do you welcome her intellectual life, her friends, the books she reads and her views on

civic problems ?Yes— _ _ _ _ _ — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

8. Do you withdraw her from moving outside home and sharing company of strangers ?

Yes — — — — — — — — — No10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

9. Do you admire her in certain cases and like to notice those times when you can appreciate

her ?Yes — — — — — — — — — No10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

1 o. Do you help your wife in purchasing articles of her choice for dressing ?

Yes— — — — — — — — — No10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

M A I (LITERATE) QUESTIONNAIRE FORM - B

For Wives Only

Consumable Booklet of M A I________ __________

S. N. STATEMENTS

1 . Do you give your husband complete freedom in his business affairs, and do you refrain from criticizing his associates, his choice of friends or the hours he keeps ?Yes — — — — — — — _ _ No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 102. Do you try your best to make the home interesting and attractive ?

Yes — — — — — — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

3. Do you vary household menu so that he never quite knows what to expect when he sits down to the table ?Yes — — — — — — — — — No

10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

4 . Do you have an intelligent grasp of your business and you can discuss it with him ?

Yes — — — — — — — — — No10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

5. Do you avoid clashes with him on financial difficulties of the family ?

Yes — — — — — — — — — No10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

6. Do you not like to welcome his parents and relations to your home ?

Yes — — — — — — — — — N°10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

7. Do you not care in dressing about the likes and dislikes of your husband for colour and

style ?Yes — — — — — — — — — N°10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

8. Do you care about opinion given by him in matters of common interest ?

Yes — — — — — — — — N°10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

9. Do you not care about the interests of your husband, so that you may be in hinderance to

him in his leisure hours ?Yes — — — — — — —10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10

10. Are you a conservative and do not appreciate news of the day thereby not helpful in

husband’s intellectual interests ?

Y e s -- - - - - ~ No10 9 8 7 1 2 3 4 5 6 7 8 9 10

© 1972 ,99 . All rights reserved. Reproduction in any form is a violation of Copyright Act.Marital Adjustment Inventory (MAI) Literate (Form A & B).