Subject ID___________________

Alcohol Abstinence Self-efficacy Scale

Listed below are a number of situations that lead some people to use alcohol.  We would like to know how confident you are that you would not drink too much in each situation.

Indicate the number that best describes your feeling of confidence to not drink too much in each situation according to the following scale:

                        1=Not at all confident

                        2=Not very confident

                        3=Moderately confident

                        4=Very confident

                        5=Extremely confident

                                                                                                          Not at all   Not Very   Moderately   Very      Extremely

                                                                                                                                            Confident  Confident  Confident  Confident  Confident

1. When I am feeling depressed.                                                                      O            O            O           O            O

2. When I see others drinking at a bar or a party.                                                                O             O           O           O            O

3. When I am worried.                                                                                                               O             O           O           O            O

4. When I have the urge to try just one drink to see what happens.                               O              O           O           O            O

5. When I am excited or celebrating with others.                                                                 O              O           O           O            O

6. When I am feeling a physical need or craving for alcohol.                                           O               O           O           O            O

7. When I am physically tired.                                                                                               O               O           O           O             O

8. When I am concerned about someone.                                                                          O               O           O           O             O

9. When I am experiencing some physical pain or injury.                                                O               O           O           O             O

10. When I feel like blowing up because of frustration.                                                     O               O           O           O             O

11. When I want to test my will power over drinking.                                                        O               O           O           O             O

12. When people I used to drink with encourage me to drink.                                          O               O           O           O             O