Protocol - Social Relationship Quality

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Description

The National Institutes of Health (NIH) Toolbox Adult Social Relationship (SR) Scales are a self-administered measure with 45 items across 6 scales, including emotional and instrumental support (aspects of social support), friendship and loneliness (aspects of companionship), and perceived rejection and hostility (aspects of social distress).

Specific Instructions

The PhenX Substance Use and Recovery Working Group (WG) recommends this National Institutes of Health (NIH) Toolbox® protocol. For additional information regarding NIH Toolbox® instruments (including scoring, validity, and interpretation), please visit: www.healthmeasures.net. For specific information about this instrument, please visit: 
www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=641&Itemid=992
www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=659&Itemid=992
www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=652&Itemid=992
www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=8844&Itemid=992
www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=681&Itemid=992
www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=679&Itemid=992

Protocols may include terms and language that could be triggering to respondents. Investigators are encouraged to have resources in place to help respondents cope with triggers as needed.

Terminology related to substances, substance use, and recovery is fluid. Updates in protocol language may be appropriate based on circumstance. Suggestions for revision have been offered to update answer responses or other components of the questionnaires to account for the constantly changing landscape. These suggestions have not been tested or validated in research studies but may be considered by investigators to enhance relevance.

Availability

This protocol is freely available; permission not required for use.

Protocol

NIH Toolbox Social Relationship (SR) Scales

Instruction Set for Social Support (Emotional/Instrumental Support) items: For the next set of questions, please read each statement and then decide how much each applies to you in the past month.
In the past month, please rate how often…

Emotional Support

 

1. I have someone who understands my problems

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

2. I have someone who will listen to me when I need to talk

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

3. I feel there are people I can talk to if I am upset

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

4. I have someone to talk with when I have a bad day

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

5. I have someone I trust to talk with about my problems

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

6. I have someone I trust to talk with about my feelings

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

7. I can get helpful advice from others when dealing with a problem

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

8. I have someone to turn to for suggestions about how to deal with a problem

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

Instrumental Support

 

1. Someone is around to make my meals if I am unable to do it myself

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

2. I have someone to take me shopping if I need it

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

3. I have someone to help me if I’m sick in bed

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

4. I have someone to pick up medicine for me if I need it

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

5. I have someone to take me to the doctor if I need it

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

6. There is someone around to help me if I need it

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

7. I can find someone to drive me places if I need it

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

8. I can get help cleaning up around my home if I need it

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

Instruction Set for Companionship (Friendship/Loneliness) items:
For the next set of questions, please read each statement and then decide how much each applies to you in the past month.
In the past month, please rate how often…

Friendship

 

1. I get invited to go out and do things with other people

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

2. I have friends I get together with to relax

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

3. There are people around with whom to have fun

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

4. I can find a friend when I need one

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

5. I feel like I have lots of friends

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

6. I have friends who will have lunch with me when I want

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

7. I feel close to my friends

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

8. I feel like I’m part of a group of friends

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

Loneliness

 

1. I feel alone and apart from others

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

2. I feel left out

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

3. I feel that I am no longer close to anyone

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

4. I feel alone

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

5. I feel lonely

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

Instruction Set for Social Distress (Perceived Rejection / Hostility) items:
For the next set of questions, please read each statement and then decide how much each applies to you in the past month.
In the past month, please rate how often people in your life…

Perceived Rejection

 

1. Don‘t listen when I ask for help

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

2. Act like my problems aren’t that important

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

3. Let me down when I am counting on them

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

4. Act like they don’t have time for me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

5. Act like they don’t want to hear about my problems

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

6. Act like they don’t care about me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

7. Act like they can’t be bothered by me or my problems

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

8. Avoid talking to me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

Perceived Hostility

 

1. Argue with me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

2. Act in an angry way toward me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

3. Criticize the way I do things

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

4. Yell at me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

5. Get mad at me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

6. Blame me when things go wrong

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

7. Act nasty to me

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

8. Tease me in a mean way

1[ ]= Never

2[ ]= Rarely

3[ ]= Sometimes

4[ ]= Usually

5[ ]= Always

Personnel and Training Required
None
Equipment Needs
None
Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual Yes
Mode of Administration

Self-administered questionnaire

Lifestage

Adult

Participants

Adults ages 18 and older

Selection Rationale

The NIH Toolbox Adult Relationship Scales is a well-established, reliable, and valid self-report instrument that is easy to administer and score.

Language

English

Standards
StandardNameIDSource
Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

NIH Toolbox Adult Relationship Scales

Source

Cyranowski, J. M., Zill, N., Bode, R., Butt, Z., Kelly, M. A., Pilkonis, P. A., Salsman, J. M., & Cella, D. (2013). Assessing social support, companionship, and distress: National Institute of Health (NIH) Toolbox Adult Social Relationship Scales. Health Psychology, 32(3), 293-301.
doi.org/10.1037/a0028586

General References

Cohen, S., Mermelstein, R., Kamarck, T., & Hoberman, H. M. (1985). Measuring the Functional Components of Social Support. In S. Cohen, R. Mermelstein, T. Kamarck, & H. M. Hoberman (Eds.), Social Support: Theory, Research and Applications (pp. 73-94). Dordrecht, Netherlands: Springer Netherlands.

Russell, D., Peplau, L. A., & Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39(3), 472-480.
doi.org/10.1037//0022-3514.39.3.472

Protocol ID

590101

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX590101_Social_Relationship_Quality_Companionship_Friendship_Feel_Close_To_Friends
PX590101230000 In the past month, please rate how often I more
feel close to my friends show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Friendship_Feel_Have_Lots_Friends
PX590101210000 In the past month, please rate how often I more
feel like I have lots of friends show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Friendship_Feel_Like_Part_Group_Friends
PX590101240000 In the past month, please rate how often I more
feel like I'm part of a group of friends show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Friendship_Find_Friend_When_Need
PX590101200000 In the past month, please rate how often I more
can find a friend when I need one show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Friendship_Get_Invited_Go_Do_Things_Other_People
PX590101170000 In the past month, please rate how often I more
get invited to go out and do things with other people show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Friendship_Have_Friends_Get_Together_Relax
PX590101180000 In the past month, please rate how often I more
have friends I get together with to relax show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Friendship_Have_Friends_Have_Lunch_With_When_Want
PX590101220000 In the past month, please rate how often I more
have friends who will have lunch with me when I want show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Friendship_People_Around_Have_Fun
PX590101190000 In the past month, please rate how often more
There are people around with whom to have fun show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Loneliness_Feel_Alone
PX590101280000 In the past month, please rate how often I more
feel alone show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Loneliness_Feel_Alone_Apart_From_Others
PX590101250000 In the past month, please rate how often I more
feel alone and apart from others show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Loneliness_Feel_Left_Out
PX590101260000 In the past month, please rate how often I more
feel left out show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Loneliness_Feel_Lonely
PX590101290000 In the past month, please rate how often I more
feel lonely show less
N/A
PX590101_Social_Relationship_Quality_Companionship_Loneliness_Feel_No_Longer_Close_To_Anyone
PX590101270000 In the past month, please rate how often I more
feel that I am no longer close to anyone show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Act_Angry_Toward_Me
PX590101390000 In the past month, please rate how often Act more
in an angry way toward me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Act_Nasty_Me
PX590101440000 In the past month, please rate how often Act more
nasty to me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Argue_With_Me
PX590101380000 In the past month, please rate how often more
Argue with me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Blame_When_Things_Wrong
PX590101430000 In the past month, please rate how often more
Blame me when things go wrong show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Criticize_Do_Things
PX590101400000 In the past month, please rate how often more
Criticize the way I do things show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Get_Mad_Me
PX590101420000 In the past month, please rate how often Get more
mad at me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Tease_Me_Mean_Way
PX590101450000 In the past month, please rate how often more
Tease me in a mean way show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Hostility_Yell_At_Me
PX590101410000 In the past month, please rate how often more
Yell at me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Act_Like_Cant_Bothered_By_Problems
PX590101360000 In the past month, please rate how often Act more
like they can't be bothered by me or my problems show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Act_Like_Done_Care_About_Me
PX590101350000 In the past month, please rate how often Act more
like they don't care about me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Act_Like_Dont_Want_Hear_Problems
PX590101340000 In the past month, please rate how often Act more
like they don't want to hear about my problems show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Act_Like_Have_No_Time
PX590101330000 In the past month, please rate how often Act more
like they don't have time for me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Act_Like_Problems_Not_Important
PX590101310000 In the past month, please rate how often Act more
like my problems aren't that important show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Avoid_Talking_To_Me
PX590101370000 In the past month, please rate how often more
Avoid talking to me show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Dont_Listen_When_Ask_Help
PX590101300000 In the past month, please rate how often more
Don't listen when I ask for help show less
N/A
PX590101_Social_Relationship_Quality_Social_Distress_Perceived_Rejection_Let_Me_Down_When_Counting_On_Them
PX590101320000 In the past month, please rate how often Let more
me down when I am counting on them show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Feel_There_Are_People_Can_Talk_If_Upset
PX590101030000 In the past month, please rate how often I more
feel there are people I can talk to if I am upset show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Get_Helpful_Advice_Dealing_Problems
PX590101070000 In the past month, please rate how often I more
can get helpful advice from others when dealing with a problem show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Have_Someone_Talk_Bad_Day
PX590101040000 In the past month, please rate how often I more
have someone to talk with when I have a bad day show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Have_Someone_Trust_Talk_About_Feelings
PX590101060000 In the past month, please rate how often I more
have someone I trust to talk with about my feelings show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Have_Someone_Trust_Talk_About_Problems
PX590101050000 In the past month, please rate how often I more
have someone I trust to talk with about my problems show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Have_Someone_Turn_Suggestions_Deal_Problems
PX590101080000 In the past month, please rate how often I more
have someone to turn to for suggestions about how to deal with a problem show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Someone_Who_Listen_Need_Talk
PX590101020000 In the past month, please rate how often I more
have someone who will listen to me when I need to talk show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Emotional_Support_Someone_Who_Understands_My_Problems
PX590101010000 In the past month, please rate how often I more
have someone who understands my problems show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_Find_Someone_Drive_Me_Places_If_Need
PX590101150000 In the past month, please rate how often I more
can find someone to drive me places if I need it show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_Get_Help_Cleaning_Around_Home_If_Need
PX590101160000 In the past month, please rate how often I more
can get help cleaning up around my home if I need it show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_Have_Someone_Help_If_Sick_In_Bed
PX590101110000 In the past month, please rate how often I more
have someone to help me if I'm sick in bed show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_Have_Someone_Pickup_Medicine_If_Need
PX590101120000 In the past month, please rate how often I more
have someone to pick up medicine for me if I need it show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_Have_Someone_Take_Me_Doctor_If_Need
PX590101130000 In the past month, please rate how often I more
have someone to take me to the doctor if I need it show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_Have_Someone_Take_Me_Shopping
PX590101100000 In the past month, please rate how often I more
have someone to take me shopping if I need it show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_Someone_Around_Make_Meals_Unable_Todo_Myself
PX590101090000 In the past month, please rate how often more
Someone is around to make my meals if I am unable to do it myself show less
N/A
PX590101_Social_Relationship_Quality_Social_Support_Instrumental_Support_There_Someone_Around_To_Help_If_Need
PX590101140000 In the past month, please rate how often more
There is someone around to help me if I need it show less
N/A
Substance Use Recovery
Measure Name

Social Relationship

Release Date

May 8, 2025

Definition

Social relationship quality is described as encompassing three areas: (1) social support (the extent to which an individual views his or her social relationships as available to provide aid in times of need); (2) companionship (encompassing friendship, or the availability of companions with whom to interact or affiliate; intimacy, or the availability of people with whom one feels emotionally close or connected; and absence of loneliness, or the perception that one is lonely or socially isolated from others); and (3) social distress (defined as the extent to which an individual perceives his or her daily social interactions as negative or distressing).

Purpose

Social relationship quality has been linked to broader health outcomes, is widely relevant to the population, and may change over time (and in response to interventions). Social relationship quality has been related to substance use disorder (SUD) recovery outcomes and is often focal in SUD interventions.

Keywords

substance use disorder, SUD, mental health services, social relationship, SR, loneliness, depression, polysubstance use, relapse, social network, SN, substance use, addiction, recovery, social connectedness

Measure Protocols
Protocol ID Protocol Name
590101 Social Relationship Quality