Too Young for Love?

The Influence of Adolescents’ Romantic Relationship on Academic Performance

QUESTIONNAIRE

This questionnaire is part of this study that aims to determine the influence of adolescents’ romantic
relationship on academic performance.
Your participation is VOLUNTARY. If you decide to participate, you will fill out this Behavioral System
Questionnaire and return them to the researchers’ after filling up with your honest answers.
Please be assured that your responses will be dealt with utmost confidentiality and will be solely used
as a part of the data needed to realize the objective of this study.

Thank you very much, and God Bless.

- Researchers

PART I. Demographic Data Form

Directions: For preliminaries, please respond to the following questions by ticking the option that corresponds
to your response.
1. Age:_____
2. Sex: ( ) Female ( ) Male
3. Romantic Relationship Status: ( ) Currently in a romantic relationship
( ) Have experienced romantic relationship
( ) Never have experienced romantic relationship

4. First Quarter Grade Point Average (GPA) S.Y. 2022-2023

Grading Scale
(Interpreted based on the Grading Scale in the Philippines.)
Description Grading Scale Please Check
Outstanding 90-100%
Very Satisfactory 85-89%
Satisfactory 80-84%
Fairly Satisfactory 75-79%
Did Not Meet Expectations Below 75%

PART II. Student’s Assessment of Their Romantic Relationship

Behavioral System Questionnaire Revised (Adapted, Modified and Revised from Furman & Wehner, 1994;
Furman, Simon, Shaffer, & Bouchey, 2002)

Directions: For each statement in the survey, please indicate how much you agree or disagree with the
statement by putting a check in the box on the right side of each statement. There are no right
or wrong answers. Your answers will be kept strictly confidential, and you will not be identified.

For this questionnaire kindly assess how you TYPICALLY feel and act in your relationships with
your boy/girlfriends. Please consider both your past and present boy/girlfriends when answering this
questionnaire. Of course, your answers may be more influenced by the relationships that are/were more
important to you. Some of these questions may not apply to all your relationships but consider how they
TYPICALLY apply. In case, you have never experienced a relationship, consider how the questions
TYPICALLY apply if you will be engaged in a romantic relationship.

Scale:
4 – SA: Strongly Agree (Indicates that the characteristic is always manifested)
3 – A: Agree (Indicates that the characteristic is often manifested)
2 – D: Disagree (Indicates that the characteristic is seldom manifested)
1 – SD: Strongly Disagree (Indicates that the characteristic is never manifested)
A. Attachment
4 3 2 1
Strongly Agree Disagree Strongly
Statements
Agree Disagree
1. “MY BOY/GIRLFRIENDS” act as if I count on them too much.
2. I consistently turn to “MY BOY/GIRLFRIENDS” when upset or worried.
3. I am afraid that I turn to “MY BOY/GIRLFRIENDS” more often than they
want me to.
4. I seek out “MY BOY/GIRLFRIENDS” when something bad happens.
5. I am not the kind of person who quickly turns to “MY
BOY/GIRLFRIENDS” in times of need.
6. I do not often ask “MY BOY/GIRLFRIENDS” to comfort me
7. I feel that “MY BOY/GIRLFRIENDS” believe that I depend on them too
often.
8. I rely on “MY BOY/GIRLFRIENDS” when I’m having troubles.
9. I worry that “MY BOY/GIRLFRIENDS” think I need to be comforted too
much.
10. I rarely feel like I need help from “MY BOY/GIRLFRIENDS.
11. I rarely turn to “MY BOY/GIRLFRIENDS” when upset.
12. I seek out “MY BOY/GIRLFRIENDS” for comfort and support.
13. It’s easy for me to turn to “MY BOY/GIRLFRIENDS” when I have a
problem.
14. I do not like to turn to “MY BOY/GIRLFRIENDS” when I’m bothered
about something.
15. I am afraid that “MY BOY/GIRLFRIENDS” think I am too dependent.

B. Caregiving

4 3 2 1
Statements Strongly Agree Disagree Strongly
Agree Disagree
1. I would rather “MY BOY/GIRLFRIENDS” work out their problems by
themselves.
2. I am not comfortable dealing with “MY BOY/GIRLFRIENDS” when they
are worried or bothered about a problem.
3. I enjoy being able to take care of “MY BOY/GIRLFRIENDS.”
4. I often help “MY BOY/GIRLFRIENDS” more than they need or want.
5. I do not like having to comfort or reassure “MY BOY/ GIRLFRIENDS.”
6. I find it easy to be understanding of “MY BOY/GIRLFRIENDS” and their
needs.
7. I get too wrapped up in my “MY BOY/GIRLFRIENDS’” worries.
8. I feel comfortable with “MY BOY/GIRLFRIENDS” coming to me for help.
9. I do not like “MY BOY/GIRLFRIENDS” to depend on me for help.
10. I create difficulties by taking on “MY BOY/GIRLFRIENDS” problems as
if they were mine.
11. I am comfortable with the responsibilities of caring for “MY
BOY/GIRLFRIENDS.”
12. It is relatively easy to respond to “MY BOY/GIRLFRIENDS” needs.
13. I want “MY BOY/GIRLFRIENDS” to be independent and not need me.
14. I get over-involved in “MY BOY/GIRLFRIENDS” problems.
15. Sometimes I try to comfort “MY BOY/GIRLFRIENDS” more than the
situation calls for.

C. Affiliation

4 3 2 1
Statements Strongly Agree Disagree Strongly
Agree Disagree

1. I contribute more to making our relationship work than “MY

BOY/GIRLFRIENDS” do.

2. Both “MY BOY/GIRLFRIENDS” and I make frequent efforts to see or talk

with each other.

3. Spending time together is more important to me than to “MY

BOY/GIRLFRIENDS.”
 4. Truthfully, my relationships with “MY BOY/GIRLFRIENDS” are just not that
important to me.

5. I do not want to put much energy into my relationship with “MY

BOY/GIRLFRIENDS.”

6. “MY BOY/GIRLFRIENDS” and I jointly make the important decisions in our

relationship.

7. I want to do more things with “MY BOY/GIRLFRIENDS” than they want to.

8. I do not put much effort into trying to have good relationships with “MY
BOY/GIRLFRIENDS.”

9. “MY BOY/GIRLFRIENDS” and I both contribute a lot to our relationship.

10. Our relationship is valued by both “MY BOY/GIRLFRIENDS” and me.

11. I find that “MY BOY/GIRLFRIENDS” are reluctant to get as close as I

would like.

12. I am not very invested in my relationships with “MY BOY/GIRLFRIENDS.”

13. I want to be closer to “MY BOY/GIRLFRIENDS” than they want to be with

me.

14. I am not very interested in making my relationships with “MY

BOY/GIRLFRIENDS” the best they could be.

15. “MY BOY/GIRLFRIENDS” and I really try to understand each others’

points of view.

The following questions are about physical intimacy. The authors of this questionnaire defined physical intimacy very
broadly and include almost all physical aspects of romantic relationships. They consider kissing, necking/ making out
(extended kissing and hugging), petting (feeling inside or outside clothes) and intercourse to all be examples of physical
intimacy. Many students don’t engage in all forms of physical intimacy; therefore, answer the questions in terms of the
ones you engage in.

D. Physical Intimacy

4 3 2 1
Statements Strongly Agree Disagree Strongly
Agree Disagree
1. Physical intimacy with “MY BOY/GIRLFRIENDS” adds more commitment
than I like.
2. Physical intimacy with “MY BOY/GIRLFRIENDS” is mainly an opportunity
to experience physical pleasure and enjoyment.
3. Physical intimacy with “MY BOY/GIRLFRIENDS” is really about mutual
affection and caring.
4. The physical aspect of relationships with “MY BOY/ GIRLFRIENDS”
involves too much intimacy.
5. Physical intimacy with “MY BOY/GIRLFRIENDS” is mainly for fun.
6. Physical intimacy is primarily a chance to try new techniques and explore
them with “MY BOY/GIRLFRIENDS.”
7. I get too wrapped up in what “MY BOY/GIRLFRIENDS” want in terms of
physical intimacy.
8. Physical intimacy is best when I care deeply about the person.
9. “MY BOY/GIRLFRIENDS’” feelings about our physical intimacy are more
important than my own
10. Physical intimacy with “MY BOY/GIRLFRIENDS” is most pleasurable
when I am in love.
11. Physical intimacy with “MY BOY/GIRLFRIENDS” makes the relationship
too serious.
12. Physical intimacy with “MY BOY/GIRLFRIENDS” is a way of showing
love.
13. I cause trouble by being too concerned with “MY BOY/ GIRLFRIENDS’”
feelings about our physical intimacy.
14. Physical intimacy with “MY BOY/GIRLFRIENDS” is really about caring
for and being cared for by them.
15. Physical intimacy leads to a greater bond with “MY BOY/
GIRLFRIENDS” than I want.
16. Physical intimacy with “MY BOY/GIRLFRIENDS” is primarily a chance
to do something that feels good and is enjoyable.
17. I get over-involved in making “MY BOY/GIRLFRIENDS” satisfied with
our physical intimacy.
18. The intensity that comes with physical intimacy with “MY
BOY/GIRLFRIENDS” makes me uncomfortable.