Welcome to your UCLA Loneliness The following questions aim to understand your thoughts and feelings. The following statements describe how people sometimes feel. For each statement, please indicate how often you feel the way described by circling one of the responses below. Here is an example: How often do you feel happy? If you never felt happy, you would respond “never”; if you always feel happy, you would respond “always.” Estimated Time: 3-5 minutes Suitable For: Adults Name Email Phone Gender Age District Name 1. How often do you feel that you are NOT “in tune” with the people around you? Never Rarely Sometimes Always None 2. How often do you feel that you lack companionship? Never Rarely Sometimes Always None 3. How often do you feel that there is no one you can turn to? Never Rarely Sometimes Always None 4. How often do you feel alone? Never Rarely Sometimes Always None 5. How often do you feel like you are NOT a part of a group of friends? Never Rarely Sometimes Always None 6. How often do you feel that you don’t have a lot in common with the people around you? Never Rarely Sometimes Always None 7. How often do you feel that you are no longer close to anyone? Never Rarely Sometimes Always None 8. How often do you feel that your interests and ideas are not shared by those around you? Never Rarely Sometimes Always None 9. How often do you feel like you are NOT outgoing and friendly? Never Rarely Sometimes Always None 10. How often do you feel like you are NOT close to people? Never Rarely Sometimes Always None 11. How often do you feel left out? Never Rarely Sometimes Always None 12. How often do you feel that your relationships with others are not meaningful? Never Rarely Sometimes Always None 13. How often do you feel that no one really knows you well? Never Rarely Sometimes Always None 14. How often do you feel isolated from others? Never Rarely Sometimes Always None Time's up
