CAMIR -R QUESTIONNAIRE

First and last

name:...........................................................................................................................

Age: ....................... Sex: Date of birth: ...................................

The CAMIR-R form has a series of short sentences that allow you to describe the relationship
you established with your loved ones. Therefore, you must indicate the extent to which you
agree with each of the following statements.

(1) In total disagreement

(2) Disagree
(3) Neutral (neither agree nor disagree)
(4) Agreed
(5) Totally agree

1 2 3 4 5
1 When I was a child, my loved ones made me feel that they liked to
share their time with me.
2 When I was a child, I knew that I would always find comfort in my
loved ones.
3 In case of need, I am confident that I can count on my loved ones
for comfort.
4 When I was a child I found enough affection in my loved ones not
to look elsewhere for it.
5 My loved ones have always given me the best of themselves.
6 My relationships with my loved ones during my childhood seem to
me, on the whole, positive
7 I feel confidence in my loved ones
8 I can't concentrate on anything else knowing that one of my loved
ones is in trouble.
9 I am always worried about the grief I may cause my loved ones by
leaving them.
10 I often feel worried, for no reason, about the health of my loved
ones.
11 I have the feeling that I would never get over the death of one of
my loved ones.
12 The idea of a momentary separation from one of my loved ones
leaves me with an uneasy feeling.
13 When I am away from my loved ones I don't feel good about
myself.
14 When I was a child, they were so concerned about my health and
safety that I felt imprisoned.
15 My parents couldn't help but control everything: my appearance,
my
 school results and even my friends
16 My parents have not realized that when a child grows up, he/she
needs to have a life of his/her own.
17
I wish my children were more autonomous than I have been.
18 It is important that the child learns to obey
19 Children should feel that there is respected authority within the
family.
20 In family life, respect for parents is very important.
21 My parents have given me too much freedom to do whatever I
wanted to do.
22 When I was a child, they had a let-me-do-it attitude.
23 My parents were incapable of having authority when it was
necessary.
24 I hate the feeling of depending on others.
25
As a teenager, no one around me fully understood my concerns.
26 I only count on myself to solve my problems
27 From my experience as a child, I have come to understand that we
are never good enough for parents.
28
Threats of separation, of moving to another place or of breaking
family ties are part of my childhood memories.
29 When I was a child, there were unbearable fights at home.
30 When I was a child, I had to face violence from one of my loved
ones.
31 When I was a child, my loved ones were often impatient and
irritable.
32 When I was a child, we had a lot of difficulty making decisions as a
family.
1. Safety: availability and support of attachment fi gures:1,2,3,4,5,6,7.

2. Family concern : 8,9,10,11,12,13.

3. Parental interference: 14,15,16,17.

4. Value of parental authority: 18,19, 20.

5. Parental leave: 21,22,23.

6. Self-sufficiency and resentment against parents: 24,25,26,27.

7. Childhood trauma: 28,29,30,31,32.