Questions | |
---|---|
Physical violence | Has your current partner or any other partner ever… |
1. Slapped you or thrown something at you that could hurt you? | |
2. Pushed you or shoved you or pulled your hair? | |
3. Hit you with his fist or with something else that could hurt you? | |
4. Kicked you, dragged you or beaten you up? | |
5. Choked or burnt you on purpose? | |
6. Threatened to use or actually used a gun, knife or other weapon against you? | |
Sexual violence | Have you ever had sexual intercourse with your current partner or other partner |
1. After he forced you by threatening you, holding you down or hurting you in some way? | |
2. When you did not want to because you were afraid that your partner would hurt you or someone you cared about if you refused? | |
3. When you did not want to because you were afraid that your partner would leave you or take another girlfriend if you refused? | |
Controlling behaviours | Thinking about your (current or most recent or past) partner, would you say it is generally true that he: |
1. Tries to keep you from seeing your friends | |
2. Tries to restrict contact with your family of birth | |
3. Insists on knowing where you are at all times | |
4. Is jealous and gets angry if you speak with another man | |
5. Is often suspicious that you are unfaithful | |
Economic abuse | Thinking about your (current or most recent/past) partner, would you say it is generally true that he: |
1. Refuses to give you enough money for household expenses, even when he has money for other things? | |
2. Takes money that you have earned away from you | |
3. Makes important financial decisions without consulting you | |
Emotional abuse | Has your current partner, or any other partner ever… |
1. Insulted you or made you feel bad about yourself? | |
2. Belittled or humiliated you in front of other people? | |
3. Done things to scare or intimidate you on purpose (e.g. by the way he looked at you, by yelling and smashing things)? | |
4. Verbally threatened to hurt you or someone you care about? |