Promoting and Protecting Subjective Well-Being Using Self-Affirmation
Phase: NA
Conditions: Mental Health Wellness 1, Anxiety, Self Esteem
Sponsor: University of Manchester

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Promoting and Protecting Subjective Well-Being Using Self-Affirmation  
 
 
Short Title: Enhancing One’s Sense of Self Using Self-Affirmtion 
 
 
 
 
 
 
 
 
 
IRAS Number: 241873 
Version 1.0 
April 2018 
 
 
 
 
 
 

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Study Contact Details 
 
Chief Investigator:        Professor Chris Armitage, 01612752556,    
                                      chris.armitage@manchester.ac.uk 
Principal Investigator:  Miss Charlotte Entwistle (MRes), 07481905566 
                                      charlotte.entwistle@postgrad.manchester.ac.uk 
Sponsor:                       Name: The University of Manchester  
                                             Sponsor contact: Ms Lynne Macrae 
                                             Role: Faculty Research Practice Governance Co-ordinator 
                                             Address:  
                                              Faculty of Biology, Medicine and Health 
                                              1.21a Simon Building 
                                              University of Manchester 
                                              M13 9PL 
                                            Email: FBMHethics@manchester.ac.uk 
                                            Telephone: 0161 275 5436 
 
 
All decisions made, regarding the study, will be made by the chief and principal 
investigators, The University of Manchester will not be contributing to the decisions made 
during the study. This study protocol has been written by the principal investigator and 
reviewed by the chief investigator.  
 
 

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Study Summary 
 
Title: Promoting and Protecting Subjective Well-Being Using Self-Affirmation. 
Short Title: Enhancing One’s Sense of Self.  
 
Study Design: Prospective randomised controlled trial. Between-participants factor: 
condition with 3 levels (self-affirmation vs self-affirmation ‘booster’ vs control). Within-
participants factor: time with 3 levels (baseline assessment vs ‘booster’ assessment vs follow-
up assessment). Outcome variable: subjective well-being. Self-esteem and state anxiety 
assessed as mediators. 
Study Participants: Recruited via opportunity sampling from those attending courses in the 
Health and Wellbeing College, which runs free courses designed to help improve people’s 
health and/or well-being. Participants will vary in age, gender, ethnicity and class but will all 
be aged 18 and above. Participants will be equally randomly assigned to each condition. 
Target Sample Size: 100 participants initially, to allow for attrition, and 81 participants on 
completion of the study, based on a power analysis to achieve a statistical power of .80. 
Time Interval Between Assessments: 1-week 
Planned Study Period: February 2018 - July 2018. 
Research Aims: To see whether a brief self-affirmation intervention can improve subjective 
well-being. To see whether this effect will be greater in those that receive the intervention 
twice compared to those that only receive the intervention once. To see whether this effect of 
self-affirmation is mediated by psychological variables, namely self-esteem and state anxiety. 
 

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Study Flow Diagram 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Eligibility assessment  
Follow-up of baseline 
assessments for the control 
condition  
1-week follow-up 
Baseline assessment and 
allocation to control 
condition 
Analysis of assessments for 
the control condition  
Allocation 
Analysis 
‘Booster’ Assessment 
Randomisation (target n = 100) 
Enrollment 
Baseline assessment and 
allocation to ‘standard’ self-
affirmation intervention  
Follow-up of baseline 
assessments for the self-
affirmation condition  
1-week follow-up 
Analysis of assessments for 
the self-affirmation condition  
Baseline assessment and 
allocation to ‘booster’ self-
affirmation intervention  
Follow-up of baseline 
assessments for the 
‘booster’ self-affirmation 
condition  
1-week follow-up 
Analysis of assessments for 
the ‘booster’ self-affirmation 
condition  
 Follow-Up 
Follow-up of assessments 
(target n = 26) 
1-week follow-up 
Follow-up of assessments 
(target n = 26) 
1-week follow-up 
Follow-up of assessments 
(target n = 26) 
1-week follow-up 

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Promoting and Protecting Subjective Well-Being Using Self-Affirmation  
 
Background 
       Subjective well-being refers to an appraisal of one’s own life as a whole (Diener et al., 
1999) and is being used by governments as a measure of social progress (Stiglitz et al., 2009). 
A key aim of government policies is therefore to find ways to improve people’s subjective 
well-being, as a way of improving quality of life (Stiglitz et al., 2009). This suggests the 
importance of developing an effective intervention that can improve subjective well-being, as 
this could then be used in practice to promote and maintain positive mental health and quality 
of life at a large scale. There are currently a number of ways in which the government is 
attempting to address this, with programs in place that are designed to improve people’s well-
being, such as Altogether Better (Yorkshire and Humber Strategic Health Authority) and 
Target Well-being (Federation of Groundwork Trust), as well as NHS programmes and free 
well-being courses (CLES Consulting and New Economics Foundation, 2013). However, 
these programmes were not always found to be effective in improving people’s well-being, 
particularly when the programmes involved health awareness activities (CLES Consulting 
and New Economics Foundation, 2013). This limited effectiveness of programmes involving 
health awareness activities makes them unlikely to be cost-effective as a well-being 
intervention. This suggests the importance of developing an effective intervention to improve 
people’s well-being, which could also be used within government/NHS well-being programs, 
to enhance the effectiveness of said programs in improving well-being to make them more 
cost-effective, particularly in those promoting health awareness.  
 

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       Self-affirmation theory (Steele, 1988) provides an approach to improve subjective well-
being by overcoming feelings of threat to the self. A threat to one’s sense of self could 
undermine one’s subjective well-being. Self-affirmation theory (Steele, 1988) states that 
people strive to maintain a positive, moral and adaptive self-image, and that threats to the self 
(e.g., a smoker being told that smoking is bad for them), motivates them to defend their 
global sense of self (e.g., by convincing themselves that the information is flawed). 
According to self-affirmation theory (Steele, 1988), people’s sense of self can also be 
protected by bolstering self-image in a domain that is not under direct threat. For example, if 
one feels that their sense of self is threatened in a certain domain (e.g., by anti-smoking 
messages), then one can bolster self-image by compensating in another domain (e.g., by 
doing charity work). There is a large amount of evidence to support this theory, mostly from 
studies in which self-affirmation manipulations (i.e. by reminding people of their ‘core 
values’) have been found to be effective in overcoming threats to the self and promoting 
receptiveness to health-risk communications (McQueen & Klein, 2006). However, the 
effectiveness of self-affirmation in overcoming threats to the self is not specific to health-risk 
communications as research has found self-affirmation also to be effective in overcoming 
threats to the self that occur within other domains, such as self-esteem, anxiety and well-
being (e.g., Morgan & Harris, 2015).  
       Accordingly, Armitage (2016) found self-affirmation manipulations improved and 
protected subjective well-being. This shows the effectiveness of self-affirmation in enhancing 
subjective well-being, suggesting that they could be employed to protect subjective well-
being across populations at a low cost. Something to acknowledge however, is that the 
sample only consisted of older women, and so the results may not be generalisable to the 
wider population. It would also be beneficial if research were to be conducted to determine 
the effects of self-affirmation in a sample of people who are already undergoing a well-being 

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intervention (e.g., a government programme or NHS course), to see whether self-affirmation 
can enhance the effectiveness of the intervention in improving well-being, as this has not yet 
been explored and could help to make the intervention more cost-effective. Also, no research 
to date has measured whether more self-affirmation interventions would produce greater 
effects. This is of importance as research has regularly demonstrated evidence of dose 
dependant relationships between a psychological intervention and its subsequent effects, with 
a greater number of psychological interventions being associated with greater effects (Sin & 
Lyubomirsky, 2009).   
       In addition to this, there has been research that has looked at examining mediators of the 
self-affirmation process, however the mechanisms for explaining the effects of self-
affirmation are not yet clearly understood (McQueen & Klein, 2006). A recent study by 
Armitage (2012) has found that self-esteem acted as a mediator in the self-affirmation 
process, as did shifts in the self-esteem domain. However, more research needs to be 
conducted to confirm findings of self-esteem acting as a mediator in the self-affirmation 
process as findings on this have been inconsistent (McQueen & Klein, 2006), with some 
research showing no evidence of self-esteem acting as a mediator (e.g. Armitage & Rowe, 
2011).   
       Furthermore, a study by Morgan and Harris (2015) found that self-affirmation led to 
reductions in state anxiety. This suggests state anxiety may be acting as a mediator in the 
self-affirmation process, as undergoing self-affirmation resulted in changes in state anxiety, 
with the self-affirming effects possibly being occurring due to reductions in state anxiety. 
Therefore, it could be that in Armitage’s (2016) study, state anxiety may have mediated the 
effect of self-affirmation on subjective well-being, with any changes in subjective well-being 
being explained by reductions in state anxiety. As Armitage (2016), and other researchers, 
have not addressed this possibility of state anxiety acting as a mediator in the self-affirmation 

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process, research should be conducted on this as this as this would allow greater 
understanding of the mechanisms involved.  
       Accordingly, the present study will test the ability of self-affirmation manipulations to 
promote and/or protect subjective well-being by comparing differences in subjective well-
being in those that undergo self-affirmation manipulations with those that do not. The study 
will also compare the difference between the effects of one self-affirmation intervention with 
that of two self-affirmation interventions (‘booster’ condition). The current study will also 
measure the effects of the self-affirmation manipulation on self-esteem and state anxiety to 
test the possibility of potential mediators in the process. Participants will be recruited from a 
college which runs free courses that are designed to help people improve their health and/or 
well-being.  It is likely that those who attend this college may feel threatened by talking 
through issues during the course, which would lead to defensive processing and therefore 
undermine the effectiveness of the course. For example, in a study by Armitage (2012), body 
shape and weight was perceived as threatening among young women. Self-affirmation may 
help to overcome these feelings of threat by reducing defensive processing, which may then 
enhance the effectiveness of the course in helping people improve their well-being. 
 
Rationale and Aims- 
       Moreover, the present study aims to confirm previous findings that brief self-affirmation 
measures can enhance and protect subjective well-being (Armitage, 2016). As the sample in 
the present study aims to consist of a wide-range of backgrounds, this should allow for a 
more representative sample. The present study also aims to examine the possibility of 
mediators involved in producing these effects of self-affirmation, namely state anxiety and 
self-esteem, to increase understanding of the mechanisms involved in the self-affirmation 

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process. The present study also aims to measure whether this effect of self-affirmation on 
subjective well-being is greater in those that undergo a greater number of self-affirmation 
interventions, as to whether or not there is a dose-dependent relationship between self-
affirmation and its’ effect on enhancing subjective well-being. This could then be used in 
practice to further enhance the positive effects of self-affirmation.  
 
Hypothesis- 
       It is hypothesised that there will be higher levels of subjective well-being, after 
controlling for baseline scores, in those that receive a self-affirmation manipulation compared 
to those that do not. Also, this effect will be greater, with more improved levels of subjective 
well-being, in those that receive the self-affirmation intervention twice compared to those 
that only receive it once. This is hypothesised due to findings from research in other domains 
of more psychological interventions producing greater effects; known as a dose-dependent 
relationship. It is also hypothesised self-esteem and state anxiety will act as mediators in the 
self-affirmation process.  
 
Methods 
Participants-  
       Based on the medium effect size of f = 0.25 for a between-participants MANOVA of 
three levels and three dependent variables (Faul, et al., 2013), G-power software (Faul, et al., 
2007) was used to conduct a power analysis to calculate the required sample size. A medium 
effect size was used for this analysis as there has been little previous research on self-
affirmation in which there were three levels of the between participants factor and three 

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dependant variables. Therefore, a medium effect size for this design was used, instead of 
using effect sizes from previous research on self-affirmation. As the analysis required an F-
test with a between-factors MANOVA with three levels, also assuming an error probability of 
0.05 and a statistical power of 0.80, as advised by Cohen (1992), it presented a required 
sample size estimated to be N = 81.  
       Accordingly, this study will aim to recruit a total of 100 participants to allow for attrition. 
This was calculated based on findings of a median retention rate (participants that had 
completed baseline and follow-up) of 89% from 151 longitudinal randomised control trials 
(RCT; Walters, et al., 2017). However, these RCT’s were clinical trials in which participants 
were often offered incentives for participating, with follow-up regularly being retrieved from 
medical files, as 84% of all trials were conducted in a hospital or general practice (GP) 
setting. Therefore, as the participants in the present study will not be offered any incentives 
for participation and the study is not a clinical trial, there are likely to be higher attrition rates 
when compared to those found by Walters, et al. (2017). To account for this likelihood of 
higher attrition rates, the initial participant recruitment aim will be rounded up to 100 
participants. 
       Participants will be recruited via opportunity sampling from the Health and Wellbeing 
College, in the North-West area of England, from a variety of courses lasting from 2-8 weeks. 
These courses aim to enhance people’s subjective well-being, as well as other types of well-
being and physical health. Examples of the courses run by the Health and Wellbeing College 
that I will be recruiting from include courses on improving sense of control, healthy 
relationships and anger management.  
       This study will aim to recruit participants from a variety of backgrounds with a mixture 
of different ages, genders, education levels and ethnicities to develop a representative sample 

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and enhance generalisability. Participants will all be aged 18 and above. Participants will not 
be offered any incentives for participating in the study. The only exclusion criteria will be 
any cognitive/psychological deficits that would affect the individual’s capacity to consent.  
 
Design- 
       The study will be a prospective randomised controlled trial with the design being mixed, 
consisting of between-participants and within-participants factors. The between-participants 
factor is condition which will consist of three levels; a ‘standard’ self-affirmation condition, a 
‘booster’ self-affirmation condition (whereby participants receive the self-affirmation 
manipulation twice) or a control condition. Participants will be randomly assigned to a 
condition using a web-based randomiser. The within-participants factor consists of three 
levels; baseline assessment, ‘booster’ assessment and follow-up assessment, with a 1-week 
time interval between them. The main outcome measure will be subjective well-being. Self-
esteem and state anxiety will be measured as to whether they act as mediators in the process. 
 
Materials- 
Measures 
       The questionnaire will first consist of questions assessing the participants’ demographic 
variables, such as age, gender and ethnicity. The questionnaire will then consist of measures 
that assess subjective well-being, self-esteem and state anxiety. To measure subjective well-
being a questionnaire will be presented to the participants identical to that used by Armitage 
(2016). This questionnaire will assess three main components of subjective well-being using 
the four items advised by the UK Office for National Statistics (Dolan et al., 2011). These 

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subjective well-being components include evaluation (“Overall, how satisfied are you with 
your life nowadays?”), experience (“Overall, how happy did you feel yesterday?” and 
“Overall, how anxious did you feel yesterday?”) and eudemonic (“Overall, to what extend do 
you feel the things you do in your life are worthwhile?”). Participants will be asked to 
respond to questionnaire items on 11-point Likert-type scales from ‘not at all’ (0) to 
‘completely’ (10). In Armitage’s (2016) these questionnaire items were found to have good 
internal reliability (Cronbach’s alpha baseline = .70; follow-up = .81) and good test-retest 
reliability (r = .84, p < .01). 
       Robins et al’s (2001) scale will be used to measure self-esteem. This scale only consists 
of one item, namely “I have high self-esteem”, which is measured on a 5-point Likert-type 
scale ranging from ‘not very true of me’ (1) to ‘very true of me’ (5). Four studies reported by 
Robins, et al (2001) using this single-item self-esteem scale demonstrated test-retest 
reliability over 4 years (mean r = .61), construct validity and predictive validity in relation to 
psychological and physical well-being.  
              Another self-esteem measure that will be used in the study is Geller et al.’s (1997) 
shape and weight-based self-esteem scale. Participants will be presented with a list of 8 items, 
from 7 domains, of which they may derive their self-esteem from. They will be asked to 
identify which domains are important to them and then rank these in terms of their personal 
importance. The domains include: personality, face, friendships, body shape/weight, intimate 
relationships, competence at school and competence in other activities. Participants will then 
be presented with a circle in which they will be asked to divide this circle into segments 
based on the rank order of the domains that they identified as being important. The proportion 
of self-esteem derived from each domain can be calculated from the angle of each segment.   

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       Marteau and Bekker’s (1992) short version of the state scale of the Spielberger State-
Trait Anxiety Inventory (1979) will be used to measure state anxiety. It consists of six items 
on 4-point Likert-type scales ranging from ‘not at all’ (1) to ‘very much’ (4). The six items 
used in the inventory are “I feel calm”, “I am tense”, “I feel upset”, “I am relaxed”, “I feel 
content” and “I am worried”. Marteau & Bekker (1992) found that this six-item inventory 
had good internal reliability (Cronbach’s alpha = .82) and high concurrent validity as there 
were no significant differences found between state anxiety scores when the full twenty-item 
inventory was used compared to when the six-item inventory was used. 
 
Manipulation 
       Self-affirming implementation intentions (Armitage et al., 2011) will be used for the self-
affirmation manipulation. These will be identical to the ones used by Armitage et al., (2011) 
and Armitage et al., (2014) that were found to be effective in reducing defensiveness and 
improving health behaviour. Implementation intentions encourage people to link critical 
situations with appropriate behavioural responses (Gollwitzer, 1993). This will involve an if-
then statement in which participants will have to link the ‘if’ statement with one of four 
possible ‘then’ statements. Participants will first be presented with the stem, for example, “If 
I feel threatened or anxious, then I will…” (Harris et al., 2011). They will then be presented 
with four self-affirming responses to choose from, for example, “…remember things that I 
have succeeded in” (Harris et al., 2011). Participants will be encouraged to write out the stem 
and their response to the stem from the four options, as a way of enhancing self-affirmation.  
       Participants in the control condition will also complete a questionnaire, as in the self-
affirmation condition, however it will be designed to ensure that it will not provide an 

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opportunity for participants to self-affirm. Minus the self-affirmation manipulation, the 
control questionnaire will be identical to that in the self-affirmation condition.  
 
Procedure- 
       Potential participants will be recruited from the Health and Wellbeing College. The study 
will be advertised to students that attend this college by their course tutors in their usual 
course classroom. Participants will be asked whether they would like to take part in a study 
that will assess “personal and social beliefs”, which will involve filling out three 
questionnaires separated by a 1-week time interval. For those that agree to participate in the 
study, a questionnaire will be given to them to complete titled “Personal and Social Beliefs 
Questionnaire”. The first page of this questionnaire will provide participants with instructions 
for completing the questionnaire, as well as information on ethics and participant consent. 
Following this, there will be a series of questions that assess the participants’ demographic 
variables (age, gender), subjective well-being, self-esteem and state anxiety. The 
questionnaires will be randomised using blocked randomisation beforehand, via a web-based 
randomiser, and equally spread across the three conditions. The participants will then either 
receive a questionnaire with the self-affirmation manipulation included, or without this self-
affirmation manipulation, based on the group they are randomly assigned to.  
       Participants that are randomly allocated to the ‘standard’ self-affirmation condition will 
have a self-affirmation manipulation included on the last page of the baseline questionnaire, 
but not on the ‘booster’ or follow-up questionnaires. Participants allocated to the ‘booster’ 
self-affirmation condition will have a self-affirmation manipulation included on the last page 
of both baseline and ‘booster’ questionnaires but not in the follow-up questionnaire. 
Participants allocated to the control condition will not have a self-affirmation manipulation 

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included on any of the questionnaires and will instead complete the questionnaires without 
this. Other than the inclusion of the self-affirmation manipulation, the questionnaires given to 
those in both the control and self-affirmation conditions will be identical. The questionnaire 
administrator and participants will be blind to the condition as the participants will return 
their questionnaires in sealed envelopes.  
 
Study Setting 
       The study will take place in the Health and Wellbeing College, in both Tameside and 
Bury campuses in Greater Manchester. Participants will be asked whether they would like to 
participate in the study in their natural classroom environment by the principal investigator. 
This will ensure that participants will feel relaxed and comfortable throughout the study as 
they will be remaining in their natural setting. Participants will be asked to complete the 
questionnaires, which should take no longer than 5 minutes to fill out. The questionnaires will 
be provided to the participants, and collected from, by the principal investigator. The course 
tutors will remain present whilst the study is being carried out. The questionnaires will be 
filled out under exam conditions in order to ensure the quality of the data. Those who do not 
wish to participate in the study will instead be provided with course-related reading by the 
course tutor.  
 
Statistical Analysis Plan 
       To measure the effectiveness of the randomisation procedure a MANOVA, using SPSS, 
will be conducted. The independent variable will be condition with 3 levels: ‘standard’ self-
affirmation, ‘booster’ self-affirmation and a control. The dependant variables will be age, 
gender and baseline measures of subjective well-being, self-esteem and state anxiety. If the 

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multivariate and univariate tests are non-significant then this will demonstrate that the 
participants were successfully randomised to the conditions.  
       To measure the effects of self-affirmation on subjective well-being a mixed 3 x 3 
ANOVA, using SPSS, will be conducted. The between-participants factor will be condition 
with 3 levels (‘standard’ self-affirmation vs ’booster’ self-affirmation vs control), and the 
within participants factor will be time with 3 levels (baseline assessment vs ‘booster’ 
assessment vs follow-up assessment). The dependent variable will be subjective well-being. 
An ANCOVA will be conducted to explore any significant interactions. For the ANCOVA, 
the between-participants factor will be condition, the dependent variable will be follow-up 
scores and the covariate will be baseline scores. Mediator analysis will also be conducted to 
examine whether self-esteem and state anxiety act as mediators in the self-affirmation 
process. This will be done using R software via the ‘mediation’ package. 
 
Ethical Considerations 
       Ethical approval will be requested via HRA and REC ethics. Participants will be 
informed that by completing and handing in the questionnaire they are consenting to 
participate in the study. Participants will be informed that they do not have to participate in 
the study if they do not want to and they can choose to withdraw from the study, and 
withdraw their data, at any time. Participants will also be informed that their data will remain 
anonymous and confidential as participants’ names, and any other identifiable information, 
will not be required.  
       Due to the follow-up nature of the study, the participants’ baseline and follow-up 
questionnaires will need to be matched. In order to match the participants’ two 
questionnaires, whilst keeping their data anonymous and confidential, they will be asked to 

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create an identifiable code and state this on both questionnaires. Data storage will comply 
with the requirements of the Data Collection Act 1998. All manual data (i.e. participant 
questionnaires) will be immediately transferred onto a protected university computer, by 
copying the data onto an Excel spreadsheet once the data has been collected. The manual data 
will be shredded immediately after it has been transferred onto the protected university 
computer. All data will be stored on the protected university computer under password 
protected folders and removed once the 5-year data storage period ends, via deleting the files 
and removing them from the recycling bin, only the chief and principal investigators will 
have access to the protected university computer. Study data and material may be looked at 
by individuals from the University of Manchester, from regulatory authorities or from the 
NHS Trust, for monitoring and auditing purposes. 
      Although participants will originally be informed that the questionnaires are assessing 
personal and social beliefs, participants will be verbally debriefed on the true nature of the 
study by the principal investigator, after the follow-up questionnaires have been completed. 
Not informing participants of the true nature of the study, that it will involve using self-
affirmation, is necessary as research has found that awareness of the self-affirmation process 
may diminish its impact (Sherman et al., 2009). Participants’ demographic variables will also 
be assessed (e.g., age, gender, income), which some may find intrusive. However, 
participants will be advised that they do not have to provide this information if they do not 
wish to and instead they can leave this blank. Appropriate contact details from The 
University of Manchester will be provided to participants to allow them to contact someone if 
they have any issues surrounding the research, during or after the study. 
 
Dissemination Policy 

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       The data from the study will be owned by the principal investigator and supervisor and a 
final study report will be written up following completion of the study, authorship of the final 
study report will be granted to the principal investigator and supervisor. The study will aim to 
publish to an academic journal, provided this is advised and aided by the study supervisor and 
The University of Manchester. The results from the study will also be disseminated to the 
Health and Wellbeing College, which can then feedback to the members of the college and 
participants of the study. The full study report will also be available to participants upon 
request.  
 
 
 
 
 
 
 
 
 
 
 
 
 

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affirmation. Journal of Personality and Social Psychology, 97(5), 745-764.  
       Sin, N. L. & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive 
symptoms with positive psychology interventions: a practice-friendly meta-analysis. Journal 
of Clinical Psychology, 65(5), 467-487. 

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       Steele, C. M. (1988). The psychology of self-affirmation: Sustaining the integrity of the 
self. In L. Berkowitz (Ed.). Advances in Experimental Social Psychology, 21, 261-302. New 
York: Academic Press. 
       Spielberger, C. D. (1979). Preliminary Manual for the State-Trait Personality Inventory 
(STPI). University of Florida: Test Forms and Psychometric Data. 
       Walters, S. J., Bonacho dos Anjos Henriques-Cadby, I., Bortolami, O., Flight, L., Hind, 
D., Jacques, R. M., … Julious, S. A. (2017). Recruitment and retention of participants in 
randomised controlled trials: a review of trials funded and published by the United Kingdom 
Health Technology Assessment Programme. BMJ Open, 7(3), e015276. 
http://doi.org/10.1136/bmjopen-2016-015276 
 
 
 
 
 
 
 
 
 
 
 

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Appendices 
 
       Appendix 1: Baseline questionnaire provided to participants assessing demographic 
variables, subjective well-being, self-esteem and state anxiety with the self-affirmation 
manipulation included for those in the self-affirmation conditions (meeting point 1). 
       Appendix 2: Baseline questionnaire provided to participants assessing demographic 
variables, subjective well-being, self-esteem and state anxiety with the self-affirmation 
manipulation not included for those in the control condition (meeting point 1). 
       Appendix 3: ‘Booster’ questionnaire provided to participants in the ‘booster’ self-
affirmation condition 1-week following the baseline questionnaire (meeting point 2); 
assessing subjective well-being, self-esteem and state anxiety with the self-affirmation 
manipulation included. 
       Appendix 4: Follow-up questionnaire provided to participants assessing subjective well-
being, self-esteem and state anxiety with the self-affirmation manipulation not included. 
Provided to those in the standard self-affirmation condition and the control condition at 
meeting points 2 and 3, and those in the ‘booster’ self-affirmation condition at meeting point 
3 only. 

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       Appendix 5: Participant information sheets.  
        
 
 
 
Appendix 1: Participant baseline questionnaire (including self-affirmation manipulation) 
 
 
 
This questionnaire asks lots of different types of questions about your personal and social 
beliefs.  It is completely anonymous, and we do not need to know your name. We are only 
interested in the answers of large groups of people, and not the answers of individuals. Please 
do not sign the questionnaire. The HRA has granted ethical approval. 
 
By completing and handing in this questionnaire you are confirming that:  
 You have read the participant information sheet 
 Received enough information about the study 
 You understand that you do not need to take part in the study and that you are free to 
withdraw:  
-at any time   
-without having to give a reason for withdrawing, and  
-without detriment to you 
 You agree to take part in the study 
 
Please try to be as honest as possible and do not think too long about your answers – your 
first answer is usually your best.  
Personal and Social 
Beliefs Questionnaire 
 

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Version 1.0- 23/04/2018 
 
For this research to be a success we need you to complete another questionnaire at a 
later date. However, we also want to ensure that your answers are anonymous and that 
no-one knows your name. In order to match your answers here to any future answers, 
we would like you to create a personal code using the questions below.   
 
 
 
 
 
 
The code consists of six components: 
 The first letter of your mum’s first name 
 The day of your birthday (e.g., 02 for 2nd of month) 
 The last two numbers of your phone number 
 The last letter of your last name 
 
Please write your code in the boxes below: 
1.  First letter 
of your mum’s 
first name: 
 
2.  Day of your birthday (e.g., 
02 for 2nd day of the month): 
 
3.  Last two numbers of your 
phone number: 
4.  Last letter 
of your last 
name: 
 
 
 
 
 
 
 
The code should consist of: letter-number-number-number-number-letter (e.g., A0256N) 
 
Please tell us: 
Are you: female / male (please circle 1)? 
What is your age ____________ (years)? 
What is your height?  _____________ 
What is your weight? ___________ 
 
How would you describe your ethnicity (e.g., are you Black, White, Asian)? __________ 
If your parent(s)/guardian(s) work, what do they do? ____________________________ 
 

241873 
 
Version 1.0- 23/04/2018 
 
For most of the answers all you need to do is either write in an answer or circle the 
single number that best represents your answer.  For example, on the following scale, 
you might circle ‘4’ if you felt slightly positive about strawberry ice cream or ‘2’ if you 
felt slightly negative.  
 
 Example: How do you feel about strawberry ice cream? 
Extremely negative 
1 
2 
3 
4 
5 
Extremely positive 
 
Overall, how satisfied are you with your life nowadays?  
Not satisfied at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely satisfied 
 
Overall, how happy did you feel yesterday?  
Not happy at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely happy 
 
Overall, how anxious did you feel yesterday?  
Not anxious at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely anxious 
 
Overall, to what extent do you feel the things you do in your life are worthwhile?  
Not at all worthwhile 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely worthwhile 
 
How many cigarettes do you smoke in a typical day? (please circle one) 
None  
10 or less 
11-15  
16-20  
21-25  
26 or more 
 
If you drink alcohol, how many units do you usually drink in a typical week? _______ units 
(1 unit of alcohol = 1 small glass of wine; half pint of beer; pub measure of spirits).  
 
Think about the time you spent sitting on weekdays during the last 7 days.  Include time 
spent at work, at home, while doing course work and during leisure time.  This may include 
time spent sitting at a desk, visiting friends, reading, or sitting or lying down to watch 
television. 
During the last 7 days, how much time did you spend sitting on a week day?  _____ hours 
per day _____ minutes per day 
 

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Version 1.0- 23/04/2018 
 
How many portions of fruits and/or vegetables do you eat each day in the average 
week? _______ portions (a portion is a serving spoon of vegetables, a whole banana, 
orange, etc)  
 
I have high self-esteem (please circle the number that best describes you) 
Not very true of me 
1 
2 
3 
4 
5 
Very true of me 
 
How much do you like your name, in total? 
Not at all 
1 
2 
3 
4 
5 
6 
7 
8 
9 
Very much 
 
For each of the following statements, please circle one option on each line to tell us how you 
feel at the moment 
 
Not at all 
Somewhat 
Moderately 
Very much 
1. I feel calm 
1 
2 
3 
4 
2. I am tense 
1 
2 
3 
4 
3. I feel upset 
1 
2 
3 
4 
4. I am relaxed 
1 
2 
3 
4 
5. I feel content 
1 
2 
3 
4 
6. I am worried 
1 
2 
3 
4 
 
 

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Version 1.0- 23/04/2018 
 
What matters most to how you feel about yourself? 
 
STEP 1: Which parts matter?  Look at the list below.  Pick out the parts about you that are 
most important to how you feel about yourself.  Place an ‘X’ on the line next to the parts that 
are most important to you. 
STEP 2: Of the parts you picked, which parts matter most?  Put a ‘1’ in the box next to 
the most important part.  Put a ‘2’ in the box next to the second most important part and 
continue (3, 4, etc.) doing this until you have ranked all the parts against which you put an 
‘X’ in STEP 1. 
 
 
STEP 1 
STEP 2 
 
Place an ‘X’ next to 
the important parts 
Rank order the most 
important parts 
A:  Your intimate or romantic relationships 
(e.g., as reflected in the level of closeness you 
feel in close relationships) 
 
 
B: Your body shape and weight (e.g., your 
actual current shape and weight) 
 
 
C: Your competence at school/college (e.g., 
as reflected by your grades) 
 
 
D: Your personality (e.g., warmth, level-
headedness, openness, self-control) 
 
 
E: Your friendships (e.g., as reflected by the 
quality and number of relationships) 
 
 
F: Your face (e.g., how ‘good looking’ you 
are) 
 
 
G: Your personal development (e.g., your 
sense of morality, ethics or spirituality) 
 
 
H: Your competence at activities other than 
school/college (e.g., your competence in music, 
sports, hobbies) 
 
 
I: Other  Please describe: _______________ 
_____________________________________ 
 
 
 
 

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Version 1.0- 23/04/2018 
 
STEP 3: Using the parts you picked in STEP 1, divide the circle at the bottom into 
pieces according to the rank order you gave them in STEP 2.  For example, the part you 
rated as ‘1’ should have the biggest piece, the part that you labelled ‘2’ should have the 
second biggest piece, etc.  Finally, place letters corresponding to the parts (e.g., D = your 
personality) inside the circle pieces, as in the example below. 
 
Two examples: 
 
 
 
 
Your circle: 
 
 
 
 
 
 
 
 
 
 
The beginning to a sentence appears below.  Below it are 4 different ways of completing 
the sentence.  On the lines below, please write out the beginning of the sentence and 
then complete it with 1 of the 4 options we have given you.  
 
 
If I feel threatened or anxious, then I will… …remember things that I have succeeded in 
 
 
 
 
 
 
…think about what I stand for 
                                                                        …think about the things I value about myself 
 
 
 
 
 
 
…think about things that are important to me 
 
 
If…_____________________________________________________________________ 
_________________________________________________________________________                 
_________________________________________________________________________ 
 
End of questionnaire. 
Thank you for your time. 
B 
 
A     B    
             D 

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Version 1.0- 23/04/2018 
 
Appendix 2: Participant baseline questionnaire (control condition) 
 
 
 
This questionnaire asks lots of different types of questions about your personal and social 
beliefs.  It is completely anonymous, and we do not need to know your name. We are only 
interested in the answers of large groups of people, and not the answers of individuals. Please 
do not sign the questionnaire. The HRA has granted ethical approval. 
 
By completing and handing in this questionnaire you are confirming that:  
 You have read the participant information sheet 
 Received enough information about the study 
 You understand that you do not need to take part in the study and that you are free to 
withdraw:  
-at any time   
-without having to give a reason for withdrawing, and  
-without detriment to you 
 You agree to take part in the study 
 
Please try to be as honest as possible and do not think too long about your answers – your 
first answer is usually your best.  
 
For this research to be a success we need you to complete another questionnaire at a 
later date. However, we also want to ensure that your answers are anonymous and that 
no-one knows your name. In order to match your answers here to any future answers, 
we would like you to create a personal code using the questions below.   
 
 
 
 
 
 
Personal and Social 
Beliefs Questionnaire 
 

241873 
 
Version 1.0- 23/04/2018 
 
 
The code consists of six components: 
 The first letter of your mum’s first name 
 The day of your birthday (e.g., 02 for 2nd of month) 
 The last two numbers of your phone number 
 The last letter of your last name 
 
Please write your code in the boxes below: 
1.  First letter 
of your mum’s 
first name: 
 
2.  Day of your birthday (e.g., 
02 for 2nd day of the month): 
 
3.  Last two numbers of your 
phone number: 
4.  Last letter 
of your last 
name: 
 
 
 
 
 
 
 
The code should consist of: letter-number-number-number-number-letter (e.g., A0256N) 
 
Please tell us: 
Are you: female / male (please circle 1)? 
What is your age ____________ (years)? 
What is your height?  _____________ 
What is your weight? ___________ 
 
How would you describe your ethnicity (e.g., are you Black, White, Asian)? __________ 
If your parent(s)/guardian(s) work, what do they do? ____________________________ 
 

241873 
 
Version 1.0- 23/04/2018 
 
For most of the answers all you need to do is either write in an answer or circle the 
single number that best represents your answer.  For example, on the following scale, 
you might circle ‘4’ if you felt slightly positive about strawberry ice cream or ‘2’ if you 
felt slightly negative.  
 
 Example: How do you feel about strawberry ice cream? 
Extremely negative 
1 
2 
3 
4 
5 
Extremely positive 
 
Overall, how satisfied are you with your life nowadays?  
Not satisfied at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely satisfied 
 
Overall, how happy did you feel yesterday?  
Not happy at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely happy 
 
Overall, how anxious did you feel yesterday?  
Not anxious at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely anxious 
 
Overall, to what extent do you feel the things you do in your life are worthwhile?  
Not at all worthwhile 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely worthwhile 
 
How many cigarettes do you smoke in a typical day? (please circle one) 
None  
10 or less 
11-15  
16-20  
21-25  
26 or more 
 
If you drink alcohol, how many units do you usually drink in a typical week? _______ units 
(1 unit of alcohol = 1 small glass of wine; half pint of beer; pub measure of spirits).  
 
Think about the time you spent sitting on weekdays during the last 7 days.  Include time 
spent at work, at home, while doing course work and during leisure time.  This may include 
time spent sitting at a desk, visiting friends, reading, or sitting or lying down to watch 
television. 
During the last 7 days, how much time did you spend sitting on a week day?  _____ hours 
per day _____ minutes per day 
 

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Version 1.0- 23/04/2018 
 
How many portions of fruits and/or vegetables do you eat each day in the average 
week? _______ portions (a portion is a serving spoon of vegetables, a whole banana, 
orange, etc)  
 
I have high self-esteem (please circle the number that best describes you) 
Not very true of me 
1 
2 
3 
4 
5 
Very true of me 
 
How much do you like your name, in total? 
Not at all 
1 
2 
3 
4 
5 
6 
7 
8 
9 
Very much 
 
For each of the following statements, please circle one option on each line to tell us how you 
feel at the moment 
 
Not at all 
Somewhat 
Moderately 
Very much 
1. I feel calm 
1 
2 
3 
4 
2. I am tense 
1 
2 
3 
4 
3. I feel upset 
1 
2 
3 
4 
4. I am relaxed 
1 
2 
3 
4 
5. I feel content 
1 
2 
3 
4 
6. I am worried 
1 
2 
3 
4 
 
 

241873 
 
Version 1.0- 23/04/2018 
 
What matters most to how you feel about yourself? 
 
STEP 1: Which parts matter?  Look at the list below.  Pick out the parts about you that are 
most important to how you feel about yourself.  Place an ‘X’ on the line next to the parts that 
are most important to you. 
STEP 2: Of the parts you picked, which parts matter most?  Put a ‘1’ in the box next to 
the most important part.  Put a ‘2’ in the box next to the second most important part and 
continue (3, 4, etc.) doing this until you have ranked all the parts against which you put an 
‘X’ in STEP 1. 
 
 
STEP 1 
STEP 2 
 
Place an ‘X’ next to 
the important parts 
Rank order the most 
important parts 
A:  Your intimate or romantic relationships 
(e.g., as reflected in the level of closeness you 
feel in close relationships) 
 
 
B: Your body shape and weight (e.g., your 
actual current shape and weight) 
 
 
C: Your competence at school/college (e.g., 
as reflected by your grades) 
 
 
D: Your personality (e.g., warmth, level-
headedness, openness, self-control) 
 
 
E: Your friendships (e.g., as reflected by the 
quality and number of relationships) 
 
 
F: Your face (e.g., how ‘good looking’ you 
are) 
 
 
G: Your personal development (e.g., your 
sense of morality, ethics or spirituality) 
 
 
H: Your competence at activities other than 
school/college (e.g., your competence in music, 
sports, hobbies) 
 
 
I: Other  Please describe: _______________ 
_____________________________________ 
 
 
 
 

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Version 1.0- 23/04/2018 
 
STEP 3: Using the parts you picked in STEP 1, divide the circle at the bottom into 
pieces according to the rank order you gave them in STEP 2.  For example, the part you 
rated as ‘1’ should have the biggest piece, the part that you labelled ‘2’ should have the 
second biggest piece, etc.  Finally, place letters corresponding to the parts (e.g., D = your 
personality) inside the circle pieces, as in the example below. 
 
Two examples: 
 
 
 
 
Your circle: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
End of Questionnaire. 
Thank you for your time. 
 
B 
 
A     B    
             D 

241873 
 
Version 1.0- 23/04/2018 
 
Appendix 3: Participant ‘booster’ questionnaire (including self-affirmation manipulation) 
 
 
 
 
This questionnaire asks lots of different types of questions about your personal and social 
beliefs.  It is completely anonymous, and we do not need to know your name. We are only 
interested in the answers of large groups of people, and not the answers of individuals. Please 
do not sign the questionnaire. The HRA has granted ethical approval. 
 
By completing and handing in this questionnaire you are confirming that:  
 You understand that you do not need to take part in the study and that you are free to 
withdraw:  
-at any time   
-without having to give a reason for withdrawing, and  
-without detriment to you 
 You continue to agree to take part in the study 
 
Please try to be as honest as possible and do not think too long about your answers – your 
first answer is usually your best.  
 
For this research to be a success we need to match your answers here to any previous 
and/or future answers, we would like you to write your personal code that you created 
in the last questionnaire using the questions below.   
 
 
The code consists of six components: 
 The first letter of your mum’s first name 
 The day of your birthday (e.g., 02 for 2nd of month) 
 The last two numbers of your phone number 
 The last letter of your last name 
 
Personal and Social 
Beliefs Questionnaire 
 

241873 
 
Version 1.0- 23/04/2018 
 
Please write your code in the boxes below: 
1.  First letter 
of your mum’s 
first name: 
 
2.  Day of your birthday (e.g., 
02 for 2nd day of the month): 
 
3.  Last two numbers of your 
phone number: 
4.  Last letter 
of your last 
name: 
 
 
 
 
 
 
 
The code should consist of: letter-number-number-number-number-letter (e.g., A0256N) 
 
 

241873 
 
Version 1.0- 23/04/2018 
 
For most of the answers all you need to do is either write in an answer or circle the 
single number that best represents your answer.  For example, on the following scale, 
you might circle ‘4’ if you felt slightly positive about strawberry ice cream or ‘2’ if you 
felt slightly negative.  
 
 Example: How do you feel about strawberry ice cream? 
Extremely negative 
1 
2 
3 
4 
5 
Extremely positive 
 
Overall, how satisfied are you with your life nowadays?  
Not satisfied at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely satisfied 
 
Overall, how happy did you feel yesterday?  
Not happy at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely happy 
 
Overall, how anxious did you feel yesterday?  
Not anxious at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely anxious 
 
Overall, to what extent do you feel the things you do in your life are worthwhile?  
Not at all worthwhile 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely worthwhile 
 
How many cigarettes do you smoke in a typical day? (please circle one) 
None  
10 or less 
11-15  
16-20  
21-25  
26 or more 
 
If you drink alcohol, how many units do you usually drink in a typical week? _______ units 
(1 unit of alcohol = 1 small glass of wine; half pint of beer; pub measure of spirits).  
 
Think about the time you spent sitting on weekdays during the last 7 days.  Include time 
spent at work, at home, while doing course work and during leisure time.  This may include 
time spent sitting at a desk, visiting friends, reading, or sitting or lying down to watch 
television. 
During the last 7 days, how much time did you spend sitting on a week day?  _____ hours 
per day _____ minutes per day 
 

241873 
 
Version 1.0- 23/04/2018 
 
How many portions of fruits and/or vegetables do you eat each day in the average 
week? _______ portions (a portion is a serving spoon of vegetables, a whole banana, 
orange, etc)  
 
I have high self-esteem (please circle the number that best describes you) 
Not very true of me 
1 
2 
3 
4 
5 
Very true of me 
 
How much do you like your name, in total? 
Not at all 
1 
2 
3 
4 
5 
6 
7 
8 
9 
Very much 
 
For each of the following statements, please circle one option on each line to tell us how you 
feel at the moment 
 
Not at all 
Somewhat 
Moderately 
Very much 
1. I feel calm 
1 
2 
3 
4 
2. I am tense 
1 
2 
3 
4 
3. I feel upset 
1 
2 
3 
4 
4. I am relaxed 
1 
2 
3 
4 
5. I feel content 
1 
2 
3 
4 
6. I am worried 
1 
2 
3 
4 
 
 

241873 
 
Version 1.0- 23/04/2018 
 
What matters most to how you feel about yourself? 
 
STEP 1: Which parts matter?  Look at the list below.  Pick out the parts about you that are 
most important to how you feel about yourself.  Place an ‘X’ on the line next to the parts that 
are most important to you. 
STEP 2: Of the parts you picked, which parts matter most?  Put a ‘1’ in the box next to 
the most important part.  Put a ‘2’ in the box next to the second most important part and 
continue (3, 4, etc.) doing this until you have ranked all the parts against which you put an 
‘X’ in STEP 1. 
 
 
STEP 1 
STEP 2 
 
Place an ‘X’ next to 
the important parts 
Rank order the most 
important parts 
A:  Your intimate or romantic relationships 
(e.g., as reflected in the level of closeness you 
feel in close relationships) 
 
 
B: Your body shape and weight (e.g., your 
actual current shape and weight) 
 
 
C: Your competence at school/college (e.g., 
as reflected by your grades) 
 
 
D: Your personality (e.g., warmth, level-
headedness, openness, self-control) 
 
 
E: Your friendships (e.g., as reflected by the 
quality and number of relationships) 
 
 
F: Your face (e.g., how ‘good looking’ you 
are) 
 
 
G: Your personal development (e.g., your 
sense of morality, ethics or spirituality) 
 
 
H: Your competence at activities other than 
school/college (e.g., your competence in music, 
sports, hobbies) 
 
 
I: Other  Please describe: _______________ 
_____________________________________ 
 
 
 
 

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Version 1.0- 23/04/2018 
 
STEP 3: Using the parts you picked in STEP 1, divide the circle at the bottom into 
pieces according to the rank order you gave them in STEP 2.  For example, the part you 
rated as ‘1’ should have the biggest piece, the part that you labelled ‘2’ should have the 
second biggest piece, etc.  Finally, place letters corresponding to the parts (e.g., D = your 
personality) inside the circle pieces, as in the example below. 
 
Two examples: 
 
 
 
 
Your circle: 
 
 
 
 
 
 
 
 
 
 
The beginning to a sentence appears below.  Below it are 4 different ways of completing 
the sentence.  On the lines below, please write out the beginning of the sentence and 
then complete it with 1 of the 4 options we have given you.  
 
 
If I feel threatened or anxious, then I will… …remember things that I have succeeded in 
 
 
 
 
 
 
…think about what I stand for 
                                                                        …think about the things I value about myself 
 
 
 
 
 
 
…think about things that are important to me 
 
 
If…_____________________________________________________________________ 
_________________________________________________________________________                 
_________________________________________________________________________ 
 
End of questionnaire. 
Thank you for your time. 
B 
 
A     B    
             D 

241873 
 
Version 1.0- 23/04/2018 
 
Appendix 4: Follow-up questionnaire (self-affirmation manipulation not included) 
 
 
 
 
This questionnaire asks lots of different types of questions about your personal and social 
beliefs.  It is completely anonymous, and we do not need to know your name. We are only 
interested in the answers of large groups of people, and not the answers of individuals. Please 
do not sign the questionnaire. The HRA has granted ethical approval. 
 
By completing and handing in this questionnaire you are confirming that:  
 You understand that you do not need to take part in the study and that you are free to 
withdraw:  
-at any time   
-without having to give a reason for withdrawing, and  
-without detriment to you 
 You continue to agree to take part in the study 
 
Please try to be as honest as possible and do not think too long about your answers – your 
first answer is usually your best.  
For this research to be a success we need to match your answers here to any previous 
and/or future answers, we would like you to write your personal code that you created 
in the last questionnaire using the questions below.   
 
The code consists of six components: 
 The first letter of your mum’s first name 
 The day of your birthday (e.g., 02 for 2nd of month) 
 The last two numbers of your phone number 
 The last letter of your last name 
 
 
 
Personal and Social 
Beliefs Questionnaire 
 

241873 
 
Version 1.0- 23/04/2018 
 
Please write your code in the boxes below: 
1.  First letter 
of your mum’s 
first name: 
 
2.  Day of your birthday (e.g., 
02 for 2nd day of the month): 
 
3.  Last two numbers of your 
phone number: 
4.  Last letter 
of your last 
name: 
 
 
 
 
 
 
 
The code should consist of: letter-number-number-number-number-letter (e.g., A0256N) 
 
For most of the answers all you need to do is either write in an answer or circle the 
single number that best represents your answer.  For example, on the following scale, 
you might circle ‘4’ if you felt slightly positive about strawberry ice cream or ‘2’ if you 
felt slightly negative.  
 
 Example: How do you feel about strawberry ice cream? 
Extremely negative 
1 
2 
3 
4 
5 
Extremely positive 
 
Overall, how satisfied are you with your life nowadays?  
Not satisfied at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely satisfied 
 
Overall, how happy did you feel yesterday?  
Not happy at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely happy 
 
Overall, how anxious did you feel yesterday?  
Not anxious at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely anxious 
 
Overall, to what extent do you feel the things you do in your life are worthwhile?  
Not at all worthwhile 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely worthwhile 
 
How many cigarettes do you smoke in a typical day? (please circle one) 
None  
10 or less 
11-15  
16-20  
21-25  
26 or more 
 

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If you drink alcohol, how many units do you usually drink in a typical week? _______ units 
(1 unit of alcohol = 1 small glass of wine; half pint of beer; pub measure of spirits).  
 
Think about the time you spent sitting on weekdays during the last 7 days.  Include time 
spent at work, at home, while doing course work and during leisure time.  This may include 
time spent sitting at a desk, visiting friends, reading, or sitting or lying down to watch 
television. 
During the last 7 days, how much time did you spend sitting on a week day?  _____ hours 
per day _____ minutes per day 
 
How many portions of fruits and/or vegetables do you eat each day in the average 
week? _______ portions (a portion is a serving spoon of vegetables, a whole banana, 
orange, etc)  
 
I have high self-esteem (please circle the number that best describes you) 
Not very true of me 
1 
2 
3 
4 
5 
Very true of me 
 
How much do you like your name, in total? 
Not at all 
1 
2 
3 
4 
5 
6 
7 
8 
9 
Very much 
 
For each of the following statements, please circle one option on each line to tell us how you 
feel at the moment 
 
Not at all 
Somewhat 
Moderately 
Very much 
1. I feel calm 
1 
2 
3 
4 
2. I am tense 
1 
2 
3 
4 
3. I feel upset 
1 
2 
3 
4 
4. I am relaxed 
1 
2 
3 
4 
5. I feel content 
1 
2 
3 
4 
6. I am worried 
1 
2 
3 
4 
 
 

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What matters most to how you feel about yourself? 
 
STEP 1: Which parts matter?  Look at the list below.  Pick out the parts about you that are 
most important to how you feel about yourself.  Place an ‘X’ on the line next to the parts that 
are most important to you. 
STEP 2: Of the parts you picked, which parts matter most?  Put a ‘1’ in the box next to 
the most important part.  Put a ‘2’ in the box next to the second most important part and 
continue (3, 4, etc.) doing this until you have ranked all the parts against which you put an 
‘X’ in STEP 1. 
 
 
STEP 1 
STEP 2 
 
Place an ‘X’ next to 
the important parts 
Rank order the most 
important parts 
A:  Your intimate or romantic relationships 
(e.g., as reflected in the level of closeness you 
feel in close relationships) 
 
 
B: Your body shape and weight (e.g., your 
actual current shape and weight) 
 
 
C: Your competence at school/college (e.g., 
as reflected by your grades) 
 
 
D: Your personality (e.g., warmth, level-
headedness, openness, self-control) 
 
 
E: Your friendships (e.g., as reflected by the 
quality and number of relationships) 
 
 
F: Your face (e.g., how ‘good looking’ you 
are) 
 
 
G: Your personal development (e.g., your 
sense of morality, ethics or spirituality) 
 
 
H: Your competence at activities other than 
school/college (e.g., your competence in music, 
sports, hobbies) 
 
 
I: Other  Please describe: _______________ 
_____________________________________ 
 
 
 
 

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STEP 3: Using the parts you picked in STEP 1, divide the circle at the bottom into 
pieces according to the rank order you gave them in STEP 2.  For example, the part you 
rated as ‘1’ should have the biggest piece, the part that you labelled ‘2’ should have the 
second biggest piece, etc.  Finally, place letters corresponding to the parts (e.g., D = your 
personality) inside the circle pieces, as in the example below. 
 
Two examples: 
 
 
 
 
Your circle: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
End of questionnaire. 
Thank you for your time. 
 
B 
 
A     B    
             D 

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Appendix 5: Participant information sheet 
 
 
 
School of HEALTH Sciences 
 
Participant Information Sheet 
 
 
Title of project: 
Enhancing One’s Sense of Well-Being. 
 
Introduction 
I am carrying out this study for the independent research component of my degree in order 
to understand people’s personal and social beliefs, as well as exploring ways to enhance 
people’s sense of well-being. 
 
What will I be asked to do if I take part? 
You will be asked to fill in a questionnaire, which asks you questions about yourself and your 
beliefs and well-being.  It should not take longer than 5 minutes to fill in.  We will also ask if 
you would be prepared to be contacted again in 1-weeks-time and again 1 week following 
this to answer further questionnaires.   
 
Will my data be anonymous? 
Once the questionnaires are collected in, there will be no way of knowing which one is yours.   
The data on the questionnaires will be analysed to determine average students’ beliefs 
about themselves and their well-being, but there will be no way to link specific answers to 
you. The questionnaires will be stored on encrypted University servers until permanently 
deleted when no longer needed. 
 
Do I have to take part? 
You do not have to take part in this study.  If you decide to take part, and then later change 
your mind, either before or during the study, you can ask not to take part any longer without 
explaining why, and if you wish, your questionnaires will be destroyed.  After the 
questionnaires have been collected in, there will be no way of knowing which is yours, so it 
will not be possible to identify or delete your questionnaire.   
 
 
Project no 
1 

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Where can I obtain further information if I need it? 
If you would like further information, please contact Charlotte Entwistle 
charlotte.entwistle@postgrad.manchester.ac.uk or contact the supervisor of this project, 
Professor Christopher Armitage at: chris.armitage@manchester.ac.uk 
 
What if something goes wrong? 
If there are any issues regarding this research that you would prefer not to discuss with 
members of the research team, please contact the Research Governance and Integrity 
Team by either writing to 'The Research Governance and Integrity Manager, Research 
Office, Christie Building, The University of Manchester, Oxford Road, Manchester M13 9PL', 
by emailing: Research.Complaints@manchester.ac.uk, or by telephoning 0161 275 7583 or 
275 8093. 
 
 
This project has been approved by the 
NHS via HRA, REC ethics. 
 
 
        
 
 
 
 
 
 
 
 
 

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Appendix 1: Participant questionnaires 
 
 
 
This questionnaire asks lots of different types of questions about your personal and social 
beliefs.  It is completely anonymous, and we do not need to know your name. We are only 
interested in the answers of large groups of people, and not the answers of individuals. Please 
do not sign the questionnaire. The HRA has granted ethical approval. 
 
By completing and handing in this questionnaire you are confirming that:  
 You have read the participant information sheet 
 Received enough information about the study 
 You understand that you do not need to take part in the study and that you are free to 
withdraw:  
-at any time   
-without having to give a reason for withdrawing, and  
-without detriment to you 
 You agree to take part in the study 
 
Please try to be as honest as possible and do not think too long about your answers – your 
first answer is usually your best.  
Personal and Social 
Beliefs Questionnaire 
 

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For this research to be a success we need you to complete another questionnaire at a 
later date. However, we also want to ensure that your answers are anonymous and that 
no-one knows your name. In order to match your answers here to any future answers, 
we would like you to create a personal code using the questions below.   
 
 
 
 
 
 
The code consists of six components: 
 The first letter of your mum’s first name 
 The day of your birthday (e.g., 02 for 2nd of month) 
 The last two numbers of your phone number 
 The last letter of your last name 
 
Please write your code in the boxes below: 
1.  First letter 
of your mum’s 
first name: 
 
2.  Day of your birthday (e.g., 
02 for 2nd day of the month): 
 
3.  Last two numbers of your 
phone number: 
4.  Last letter 
of your last 
name: 
 
 
 
 
 
 
 
The code should consist of: letter-number-number-number-number-letter (e.g., A0256N) 
 
Please tell us: 
Are you: female / male (please circle 1)? 
What is your age ____________ (years)? 
What is your height?  _____________ 
What is your weight? ___________ 
 
How would you describe your ethnicity (e.g., are you Black, White, Asian)? __________ 
If your parent(s)/guardian(s) work, what do they do? ____________________________ 
 

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For most of the answers all you need to do is either write in an answer or circle the 
single number that best represents your answer.  For example, on the following scale, 
you might circle ‘4’ if you felt slightly positive about strawberry ice cream or ‘2’ if you 
felt slightly negative.  
 
 Example: How do you feel about strawberry ice cream? 
Extremely negative 
1 
2 
3 
4 
5 
Extremely positive 
 
Overall, how satisfied are you with your life nowadays?  
Not satisfied at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely satisfied 
 
Overall, how happy did you feel yesterday?  
Not happy at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely happy 
 
Overall, how anxious did you feel yesterday?  
Not anxious at all 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely anxious 
 
Overall, to what extent do you feel the things you do in your life are worthwhile?  
Not at all worthwhile 
0 
1 
2 
3 
4 
5 
6 
7 
8 
9 
10 
Completely worthwhile 
 
How many cigarettes do you smoke in a typical day? (please circle one) 
None  
10 or less 
11-15  
16-20  
21-25  
26 or more 
 
If you drink alcohol, how many units do you usually drink in a typical week? _______ units 
(1 unit of alcohol = 1 small glass of wine; half pint of beer; pub measure of spirits).  
 
Think about the time you spent sitting on weekdays during the last 7 days.  Include time 
spent at work, at home, while doing course work and during leisure time.  This may include 
time spent sitting at a desk, visiting friends, reading, or sitting or lying down to watch 
television. 
During the last 7 days, how much time did you spend sitting on a week day?  _____ hours 
per day _____ minutes per day 
 

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How many portions of fruits and/or vegetables do you eat each day in the average 
week? _______ portions (a portion is a serving spoon of vegetables, a whole banana, 
orange, etc)  
 
I have high self-esteem (please circle the number that best describes you) 
Not very true of me 
1 
2 
3 
4 
5 
Very true of me 
 
How much do you like your name, in total? 
Not at all 
1 
2 
3 
4 
5 
6 
7 
8 
9 
Very much 
 
For each of the following statements, please circle one option on each line to tell us how you 
feel at the moment 
 
Not at all 
Somewhat 
Moderately 
Very much 
1. I feel calm 
1 
2 
3 
4 
2. I am tense 
1 
2 
3 
4 
3. I feel upset 
1 
2 
3 
4 
4. I am relaxed 
1 
2 
3 
4 
5. I feel content 
1 
2 
3 
4 
6. I am worried 
1 
2 
3 
4 
 
 

241873 
 
Version 1.0- 23/04/2018 
 
What matters most to how you feel about yourself? 
 
STEP 1: Which parts matter?  Look at the list below.  Pick out the parts about you that are 
most important to how you feel about yourself.  Place an ‘X’ on the line next to the parts that 
are most important to you. 
STEP 2: Of the parts you picked, which parts matter most?  Put a ‘1’ in the box next to 
the most important part.  Put a ‘2’ in the box next to the second most important part and 
continue (3, 4, etc.) doing this until you have ranked all the parts against which you put an 
‘X’ in STEP 1. 
 
 
STEP 1 
STEP 2 
 
Place an ‘X’ next to 
the important parts 
Rank order the most 
important parts 
A:  Your intimate or romantic relationships 
(e.g., as reflected in the level of closeness you 
feel in close relationships) 
 
 
B: Your body shape and weight (e.g., your 
actual current shape and weight) 
 
 
C: Your competence at school/college (e.g., 
as reflected by your grades) 
 
 
D: Your personality (e.g., warmth, level-
headedness, openness, self-control) 
 
 
E: Your friendships (e.g., as reflected by the 
quality and number of relationships) 
 
 
F: Your face (e.g., how ‘good looking’ you 
are) 
 
 
G: Your personal development (e.g., your 
sense of morality, ethics or spirituality) 
 
 
H: Your competence at activities other than 
school/college (e.g., your competence in music, 
sports, hobbies) 
 
 
I: Other  Please describe: _______________ 
_____________________________________ 
 
 
 
 

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STEP 3: Using the parts you picked in STEP 1, divide the circle at the bottom into 
pieces according to the rank order you gave them in STEP 2.  For example, the part you 
rated as ‘1’ should have the biggest piece, the part that you labelled ‘2’ should have the 
second biggest piece, etc.  Finally, place letters corresponding to the parts (e.g., D = your 
personality) inside the circle pieces, as in the example below. 
 
Two examples: 
 
 
 
 
Your circle: 
 
 
 
 
 
 
 
 
 
 
The beginning to a sentence appears below.  Below it are 4 different ways of completing 
the sentence.  On the lines below, please write out the beginning of the sentence and 
then complete it with 1 of the 4 options we have given you.  
 
 
If I feel threatened or anxious, then I will… …remember things that I have succeeded in 
 
 
 
 
 
 
…think about what I stand for 
                                                                        …think about the things I value about myself 
 
 
 
 
 
 
…think about things that are important to me 
 
 
If…_____________________________________________________________________ 
_________________________________________________________________________                 
_________________________________________________________________________ 
 
End of Questionnaire. 
Thank you for your time. 
B 
 
A     B    
             D 

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Appendix 2: Participant information sheet 
 
 
 
School of HEALTH Sciences 
 
Participant Information Sheet 
 
 
Title of project: 
Exploring Differences in Well-Being, Self-Esteem and Anxiety.  
 
Introduction 
I am carrying out this study for the independent research component of my degree in order 
to understand people’s personal and social beliefs, as well as exploring differences in well-
being, self-esteem and anxiety. 
 
What will I be asked to do if I take part? 
You will be asked to fill in a questionnaire, which asks you questions about yourself and your 
beliefs and well-being.  It should not take longer than 5 minutes to fill in.  We will also ask if 
you would be prepared to be contacted again in 1-weeks-time and again 1 week following 
this to answer further questionnaires.   
 
Will my data be anonymous? 
Once the questionnaires are collected in, there will be no way of knowing which one is yours.   
The data on the questionnaires will be analysed to determine average students’ beliefs 
about themselves and their well-being, but there will be no way to link specific answers to 
you. The questionnaires will be stored on encrypted University servers until permanently 
deleted when no longer needed. 
 
Do I have to take part? 
You do not have to take part in this study.  If you decide to take part, and then later change 
your mind, either before or during the study, you can ask not to take part any longer without 
explaining why, and if you wish, your questionnaires will be destroyed.  After the 
questionnaires have been collected in, there will be no way of knowing which is yours, so it 
will not be possible to identify or delete your questionnaire.   
 
 
Project no 
1 

241873 
 
Version 1.0- 23/04/2018 
 
Where can I obtain further information if I need it? 
If you would like further information, please contact Charlotte Entwistle 
charlotte.entwistle@postgrad.manchester.ac.uk or contact the supervisor of this project, 
Professor Christopher Armitage at: chris.armitage@manchester.ac.uk 
 
What if something goes wrong? 
If there are any issues regarding this research that you would prefer not to discuss with 
members of the research team, please contact the Research Governance and Integrity 
Team by either writing to 'The Research Governance and Integrity Manager, Research 
Office, Christie Building, The University of Manchester, Oxford Road, Manchester M13 9PL', 
by emailing: Research.Complaints@manchester.ac.uk, or by telephoning 0161 275 7583 or 
275 8093. 
 
 
This project has been approved by the 
NHS via HRA, REC ethics.