Uploaded by Gena Brown

Survey Media Self Image Research Survey

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Social Media, Body Image, and Self-Esteem
A survey to find the correlation between media and how it relates to body image and selfesteem in women.
* Required
1.
I have read the explanation about the study described above and was given
sufficient time to ask questions and review my options. By clicking “ok,” I am
agreeing to participate in this study for East Central University and certify that I am
at least 18 years of age. *
Mark only one oval.
Yes, I agree to participate
No, I do not agree to participate
Stop filling out this form.
Part A
2.
1. Which of the following social media networks do you use (Check all that apply) *
Check all that apply.
Facebook
Twitter
Instagram
YouTube
Snapchat
3.
2. How many friends/followers do you have? (Facebook, Instagram, Twitter, etc.
combined) *
Mark only one oval.
0-100
101-500
501-999
1,000-9,999
10,000 or more
I do not know how many friends/followers I have.
4.
3. Does the number of followers you have on each networking site affect the use on
the site? *
Mark only one oval.
Yes
No
5.
4. Why do you use social networking sites? *
Mark only one oval.
Personal or business networking reasons
To become well known on the internet
To connect with new people
To stay current on news
To stay current on celebrity and fashion trends
6.
5. How much time do you spend on social networking sites each day? *
Mark only one oval.
Less than 1 hour a day
1-3 hours a day
4-6 hours a day
7+ hours a day
7.
6. Please select your gender *
Mark only one oval.
Male
Female
8.
7. Please select your age group *
Mark only one oval.
Under 18
18-25
26-45
46+
Part B
9.
1. Evaluate the following statements *
Check all that apply.
Strongly
Disagree
When I gain
friends/followers I feel an
increase in my self-esteem.
When I lose friends/followers
I feel a decrease in my selfesteem.
I use social media to
connect with old friends and
make new friends.
I use social media to
promote myself/ my
business.
I aspire to become famous
via social networking sites.
The number of
followers/friends I have are
important to me.
It is important that I am well
liked on social networking
sites.
I worry about how many
people will like/respond to
the things I post.
I am willing to spend money
to gain social network
connections. (friends,
followers, likes, etc.)
I think the number of
followers/friends I have
makes me feel important.
I have many friends outside
of social networking sites.
It is important to impress
others on social networking
sites.
Who I am on social
networking sites is different
from who I am in real life.
I feel somewhat envious of
those who have more
friends/followers than me.
Sometimes I go out of my
way to interact with others
on social networking sites.
Being a member of certain
social networking sites
makes me feel accepted.
Who I am on social
networking sites accurately
reflects who I am in real life.
Disagree
Agree
Strongly
Agree
N/A
Strongly
Disagree
Disagree
How I feel about myself is
more important than others'
opinions of me.
I am more comfortable with
myself while on social
networking sites than I am in
real life.
10.
2. How would you describe your level of self-esteem *
Mark only one oval.
Often high
Often low
Often varies
Part C
Agree
Strongly
Agree
N/A
11.
Check all that apply.
Never
True
I get on with my
life even when I
feel bad about
my body.
Worrying about
my weight
makes it difficult
for me to live a
life that I value
I would gladly
sacrifice
important things
in my life to be
able to stop
worrying about
my weight
There are many
things I do to try
and stop feeling
bad about my
body weight and
shape
I worry about not
being able to
control bad
feelings about
my body.
I do not need to
feel better about
my body before
doing things that
are important to
me.
I don’t do things
that might make
me feel fat.
I shut down
when I feel bad
about my body
shape or weight.
My worries about
my weight do not
get in the way of
my success.
I can move
toward important
goals, even
when feeling bad
about my body.
There are things
I do to distract
myself from
thinking about
Very
Seldom
True
Seldom
True
Sometimes
True
Frequently
True
Almost
Always
True
Always
True
Never
True
my body shape
or size
My thoughts and
feelings about
my body weight
and shape must
change before I
can take
important steps
in my life
My thoughts
about my body
shape and
weight do not
interfere with the
way I want to live
I cannot stand
feeling fat.
Worrying about
my body takes
up too much of
my time.
If I start to feel
fat, I try to think
about something
else.
Worrying about
my weight does
not get in my
way.
Before I can
make any
serious plans, I
have to feel
better about my
body.
I will have better
control over my
life if I can
control my
negative
thoughts about
my body
I avoid putting
myself in
situations where
I might feel bad
about my body.
To control my
life, I need to
control my
weight.
My worries and
fears about my
weight are true.
Very
Seldom
True
Seldom
True
Sometimes
True
Frequently
True
Almost
Always
True
Always
True
Never
True
Feeling fat
causes problems
in my life.
I do things to
control my
weight so I can
stop worrying
about the way
my body looks
When I start
thinking about
the size and
shape of my
body, it’s hard to
do anything else
My relationships
would be better if
my body weight
and/or shape did
not bother me
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Very
Seldom
True
Seldom
True
Sometimes
True
Frequently
True
Almost
Always
True
Always
True
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