Questionnaire
F. These questions are about Self-Stimulation.
1. The first time I intentionally stimulated my genitals while alone
(masturbated), I was ____________ years old
(if you don't
know, write in your best guess.)
If never, circle 0 and skip to Section G.
2. In the last month, I have intentionally stimulated
my genitals when alone approximately_____________
times.
If you have not intentionally stimulated your genitals
when alone in the last 3 months, circle 0 and skip to Question
4.
3. In the last 3 months, I intentionally stimulated my genitals
when alone.
Check all that apply.
| Because self-stimulation feels good |
|
| Because I felt a physical urge to do so |
|
| To comfort myself |
|
| To help me sleep |
|
| To relieve menstrual cramps |
|
| To relax |
|
| To have one or more orgasms |
|
| To feel more finished or relieve frustration
after partner sex |
|
| Because a partner wasn't available right then |
|
| Because I was lonely |
|
| Because I was bored |
|
| Other |
|
4. I usually fantasize when I masturbate.
| Strongly Disagree
|
Strongly Agree
|
NA
|
|
1
|
2
|
3
|
4
|
5
|
6
|
7
|
0
|
Remember
The questionnaire is here for VIEWING ONLY.
Please DO NOT send your answers to me.
Copyright 1998, Carol Ellison, Ph.D.
