Alcohol: Self-Efficacy
How tempted you may be to drink in each situation?
Enter the number in the box that best describes the feelings of temptation in each situation at the present time according to the following scale:
1 = Not at all tempted
2 = Not very tempted
3 = Moderately tempted
4 = Very tempted
5 = Extremely tempted
| 1. | When I am concerned about someone | |
| 2. | When I see others drinking at a bar or at a party | |
| 3. | When I am very worried | |
| 4. | When I am in agony because of stopping or withdrawing from alcohol use | |
| 5. | When I have the urge to try just one drink to see what happens | |
| 6. | When I dream about taking a drink | |
| 7. | When people I used to drink encourage me to drink | |
| 8. | When I sense everything is going wrong for me | |
| 9. | When I am physically tired | |
| 10. | When I am feeling depressed | |
| 11. | When I feel like blowing up because of frustration | |
| 12. | When I experience an urge or impulse to take a drink that catches me unprepared | |
| 13. | When I am feeling angry inside | |
| 14. | When I am experiencing some physical pain or injury | |
| 15. | When I want to test my willpower over drinking | |
| 16. | When I am being offered a drink in a social situation | |
| 17. | When I am excited or celebrating with others | |
| 18. | When I am on vacation and want to relax | |
| 19. | When I am feeling a physical need or craving for alcohol | |
| 20. | When I have a headache |
How confident are you that you would not drink in each situation?
Enter the number in the box that best describes the feeling of confidence in each situation at the present time according to the following:
1 = Not at all confident
2 = Not very confident
3 = Moderately confident
4 = Very confident
5 = Extremely confident
| 1. | When I am in agony because of stopping or withdrawing from alcohol use | |
| 2. | When I have a headache | |
| 3. | When I am feeling depressed | |
| 4. | When I am on vacation and want to relax | |
| 5. | When I am concerned about someone | |
| 6. | When I am very worried | |
| 7. | When I have the urge to try just one drink to see what happens | |
| 8. | When I am being offered a drink in a social situation | |
| 9. | When I dream about taking a drink | |
| 10. | When I want to test my willpower over drinking | |
| 11. | When I am feeling a physical need or craving for alcohol | |
| 12. | When I am physically tired | |
| 13. | When I am experiencing some physical health or injury | |
| 14. | When I feel like blowing up because of frustration | |
| 15. | When I see others drinking at a bar or at a party | |
| 16. | When I sense everything is going wrong for me | |
| 17. | When people I used to drink with encourage me to drink | |
| 18. | When I am feeling angry inside | |
| 19. | When I experience an urge or impulse to take a drink that catches me unprepared |