National Alzheimer's Coordinating Center
National Alzheimer's Coordinating Center
The NIA Alzheimer’s Disease Research Centers Program
National Alzheimer’s Coordinating Center

Calculators

Form C2F: Social Norms Questionnaire

Directions: Following is a list of behaviors that a person might engage in. Please decide whether or not it would be socially acceptable and appropriate to do these things in the mainstream culture of the United States and answer yes or no to each. Think about these questions as if they were occurring in front of or with a stranger or aquaintance, NOT a close friend or family member.

Would it be socially acceptable to:

(0) No
(1) Yes
1.
Tell a stranger you don't like their hairstyle?
2.
Spit on the floor?
3.
Blow your nose in public?
4.
Ask a coworker their age?
5.
Cry during a movie at the theater?
6.
Cut in line if you are in a hurry?
7.
Laugh when you yourself trip and fall?
8.
Eat pasta with your fingers?
9.
Tell a coworker your age?
10.
Tell someone your opinion of a movie they haven't seen?
11.
Laugh when someone else trips and falls?
12.
Wear the same shirt every day?
13.
Keep money you find on the sidewalk?
14.
Pick your nose in public?
15.
Tell a coworker you think they are overweight?
16.
Eat ribs with your fingers?
17.
Tell a stranger you like their hairstyle?
18.
Wear the same shirt twice in two weeks?
19.
Tell someone the ending of a movie they haven't seen?
20.
Hug a stranger without asking first?
21.
Talk out loud during a movie at the theater?
22.
Tell a coworker you think they have lost weight?

For clinic use only

SNQ22 Total Score (0–22):
12
Break Score (0–12):
0
Overadhere Score (0–10):
10
Yes / No Ratio Score (0–22):
0