Today’s date:
Your name: ________________________________ Date_______________
Your gender: Male___ Female ___
Your age:___
Instructions:
Please score each question by giving it the number that best describes how often you do the
activities described below. Use the following key:
0 = No, I never do this or feel this way.
1 = Yes, I do once a month or less often.
2 = Yes, I do 2-4 times a month.
3 = Yes, I do this 2-3 times a week.
4 = Yes, I do this 4 times a week or more.
Sudden Rage Indicators:
___ 1. My anger comes on both very quickly and very intensely.
___ 2. I get so angry I lose control over what I say or do.
___ 3. People say I act strange, scary, or crazy when I get really mad.
___ 4. I have “blacked out” (not from alcohol or drugs) when I became very angry so I did not remember things I said or did.
___ 5. I get so angry that I worry I might seriously harm or kill someone.
___ 6. I feel like I become a different person when I get angry – as if I am not really myself.
___ 7. I become instantly furious when I feel that somebody has insulted or threatened me.
Score on items 1-7: ___
Seething Rage Indicators:
___ 8. I am unable to quit thinking about past insults or injuries.
___ 9. My anger about some past insult sometimes seems to grow greater over time instead of
leveling off or diminishing.
___ 10. I sometimes have intense fantasies of revenge against people who have harmed me.
___ 11. I hate people for what they have done to me.
___ 12. People would be amazed if they knew how angry I get even though I don’t show it.
___ 13. I think a lot about how unfair life is.
___ 14. I have difficulty forgiving people.
___ 15. I “seethe” in anger but don’t say anything to others.
___ 16. I deliberately hurt people (physically or verbally) in order to pay them back for something
they did to me.
Score on items 8-16: ___
Survival Rage Indicators:
___ 17. I have gotten into a physical fight where it took several people to pull me away from the other person.
___ 18. I threaten to severely hurt or even to kill people when I become very angry.
___ 19. I startle easily in situations such as when somebody touches me on the shoulder from behind.
___ 20. I feel like I am fighting for my life when I become angry.
___ 21. I go into a “blind rage” when defending myself against real or imagined danger.
___ 22. People say I am paranoid or that I falsely believe people are trying to harm me.
___ 23. I have a “fight and flight” reaction during which I feel both really angry and really scared.
Score on items 17-23: ___
Impotent Rage Indicators:
___ 24. I feel like exploding when people don’t listen to me or understand me.
___ 25. I blow up after thinking thoughts such as “I just can’t take it anymore.”
___ 26. I feel both helpless and furious about situations I cannot control.
___ 27. I pound the ground, break things, and scream out loud, etc. when things don’t go the way I
want them to.
___ 28. I get so angry I have to do something – anything – even if it makes the problem worse.
___ 29. I harbor thoughts of violence or revenge towards people who have (or once had) power or
control over me.
Score on items 24-29: ___
Shame-Based Rage Indicators:
___ 30. I become furious when people seem to disrespect me.
___ 31. My reputation – my good name – is something I strongly defend.
___ 32. I frequently worry that people think I am stupid, ugly or incompetent.
___ 33. I get really mad after a moment of embarrassment, for instance if someone points out
something I did wrong.
___ 34. People say that I am way too sensitive to criticism.
___ 35. I dwell upon put downs that I believe people have made about me.
___ 36. I become irate when people seem to be ignoring me.
Score on items 30-36: ___
Abandonment Rage Indicators:
___ 37. I become furious when I think about times when I have been abandoned or betrayed.
___ 38. I struggle with intense feelings of jealousy.
___ 39. I look for proof that people who say they care about me cannot be trusted.
___ 40. Feeling neglected or ignored by the people I love seems almost intolerable to me.
___ 41. I become preoccupied with wanting to get back at my parents or partners because they left me, neglected me or betrayed me.
___ 42. I feel cheated by my partner, children, or friends because I give them way more love, care
and attention than I get back.
___ 43. I have been told that once I become really mad I can’t take in any reassurances or statements
of caring from the people I am angry with.
Score on items 37-43: ___
Moral Rage Indicators:
___ 44. I feel disgusted with people who break the rules.
___ 45. I have become furious with people whose views differ from mine.
___ 46. I feel personally attacked when people do things against my values.
___ 47. I feel outraged by what some people try to get away with.
___ 48. I am ready to fight to defend my values and beliefs.
___ 49. I get so mad at people who have different values or beliefs I can feel myself losing control.
Score on items: 44-49: ___
Total Score for all items: ___
Now that you have completed the questionnaire, please use the rest of the space on this page to answer
these two questions: Do you think you have a problem with rage? Why?