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This form contains a number of statements about relationships between adults and
their parents. Please read each statement carefully, and decide how well it describes
your relationship with your mother and your father as it has been over the last year.
Please circle the most appropriate response of the four possible responses.
Very true
Tick if you feel that the statement describes your relationship with your parent
accurately.
Moderately true
Tick if you feel that the statement describes your relationship with your parent for the
most part.
Somewhat true
Tick if you feel that the statement describes your relationship with your parent to a
small extent.
Not true at all
Tick if you feel that the statement does not describe your relationship with your parent
at all.
Relationship with Mother
(PACQM)
Not true at
all
(0)
(0)
(0)
(0)
(0)