The Multidimensional Parenting Perfectionism Questionnaire (MPPQ)

1. Abstract

The Multidimensional Parenting Perfectionism Questionnaire (MPPQ) is a psychometric instrument designed to evaluate domain-specific perfectionistic cognitive schemas, behavioral orientations, and interpersonal demands within the parental role. Developed by William E. Snell, Jr., Gail Overbey, and Amy L. Brewer, the instrument synthesizes and extends two foundational conceptual models of perfectionism—specifically, the interpersonal model formulated by Hewitt and Flett (1991) and the cognitive-behavioral framework established by Frost, Marten, Lahart, and Rosenblate (1990)—contextualizing them specifically to maternal and paternal functioning, coparental expectations, and societal pressures surrounding child-rearing.

The MPPQ comprises 65 self-report items divided into two complementary structural sections. Section I consists of 30 items measuring five interpersonal dimensions adapted from Hewitt and Flett: Self-Oriented Parenting Perfectionism, Societal Prescribed Parenting Perfectionism, Partner’s Self-Oriented Parenting Perfectionism, Partner Prescribed Parenting Perfectionism, and Partner Expected Standards for Parenting. Section II consists of 35 items measuring six cognitive-affective and organizational dimensions adapted from Frost et al.: Concern over Parenting Mistakes, Doubts about Parenting Activity, Personal Parenting Standards, Partner’s Parenting Expectations, Partner’s Parenting Criticism, and Parental Organization. All items are rated on an authentic 5-point Likert response scale ranging from A (“Not at all characteristic of me”) to E (“Very characteristic of me”).

Extensive psychometric investigations indicate robust internal consistency across all subscales, with Cronbach’s alpha coefficients ranging from .76 to .92. Confirmatory and exploratory factor analyses substantiate the proposed 11-factor dual-component architecture. Validity studies demonstrate significant convergent correlations with measures of parental burnout, parental depression, chronic parenting stress, and marital/coparental conflict, alongside divergent validity against broad personality traits such as generalized neuroticism and conscientiousness. The MPPQ provides developmental psychologists, family therapists, and clinical researchers with an empirically validated, multi-faceted operationalization of parental perfectionism, illuminating how intrapersonal standards, perceived social evaluation, and coparental dynamics interact to influence family well-being.

2. Keywords

Multidimensional Parenting Perfectionism Questionnaire, MPPQ, parental perfectionism, Hewitt and Flett, Frost Multidimensional Perfectionism Scale, coparenting dynamics, parental burnout, parenting stress, self-oriented perfectionism, socially prescribed perfectionism

3. Authors

The Multidimensional Parenting Perfectionism Questionnaire was developed by academic researchers based in the Department of Psychology at Southeast Missouri State University:

• William E. Snell, Jr., Ph.D. — Professor Emeritus of Psychology, Southeast Missouri State University, Cape Girardeau, Missouri, USA. Dr. Snell is recognized for his extensive psychometric contributions to clinical, health, and social psychology, including the development of widely used inventories measuring sexual self-concept, emotional self-disclosure, health orientation, and domain-specific relationship dynamics.
• Gail A. Overbey, Ph.D. — Professor Emerita of Psychology, Southeast Missouri State University, Cape Girardeau, Missouri, USA. Dr. Overbey’s research centers on developmental psychology, child rearing, parental cognition, and family system functioning.
• Amy L. Brewer, M.A. — Researcher and co-investigator in family processes and parental role adjustment, Southeast Missouri State University.

4. Purpose

Perfectionism has long been recognized as a transdiagnostic cognitive vulnerability associated with affective distress, obsessive-compulsive symptomatology, depressive disorders, and interpersonal friction. While classical instruments evaluated perfectionism as a generalized personality trait, psychometric research in the late 1990s and early 2000s highlighted the critical need for domain-specific assessment. Parents often exhibit hyper-elevated perfectionistic tendencies exclusively within the context of their child-rearing duties, driven by perceived biological stakes, moral identity integration, and escalating socio-cultural expectations of “intensive parenting.” The Multidimensional Parenting Perfectionism Questionnaire (MPPQ) was created to capture these idiosyncratic parental cognitions, affective reactions, and dyadic transactions.

The primary purpose of the MPPQ is to provide an exhaustive, multidimensional diagnostic and investigative profile of parental perfectionism. It serves both clinical and basic empirical research agendas by distinguishing between self-imposed achievement demands, perceived cultural surveillance, and coparental demands. Specifically, the instrument seeks to resolve several conceptual and methodological imperatives in developmental psychopathology:

• Differentiating Intrapersonal from Interpersonal Perfectionism: Unlike omnibus instruments, the MPPQ isolates a parent’s internal perfectionistic aspirations from the perfectionistic expectations they impose onto their coparent, as well as the demands they believe their coparent or broader society imposes onto them.
• Capturing Dyadic Coparenting Dynamics: In two-parent family systems, parental conflict often arises from mismatched standards or harsh critical evaluations regarding child care. The MPPQ evaluates perceptions of partner expectations and partner criticism, enabling researchers to examine how dyadic perfectionistic incongruence fosters coparental undermining, triangulation, and relationship dissolution.
• Explaining Parental Psychological Distress and Burnout: The instrument facilitates empirical investigation into the etiology of parental exhaustion, depressive symptoms, parental anxiety, and parental guilt by differentiating adaptive strivings (e.g., parental organization and personal standards) from maladaptive evaluative concerns (e.g., concern over parenting mistakes, doubts about parenting activities, and perceived societal prescriptions).
• Informing Family Interventions: In systemic family therapy and behavioral parent training, identifying the exact locus of perfectionism allows clinicians to tailor cognitive-behavioral restructuring. Interventions can systematically deconstruct cognitive distortions regarding parental “mistakes,” challenge rigid perceptions of partner criticism, or address externalized societal mandates.

5. Psychological Construct

The psychological construct assessed by the MPPQ is parenting perfectionism, operationalized as an interconnected network of cognitive, emotional, behavioral, and relational manifestations characterized by the striving for flawlessness, exceptionally high standards of parental execution, overcritical self-evaluations, and hyper-vigilance regarding social and coparental appraisal. Because perfectionism is fundamentally multifaceted, the MPPQ organizes this overarching construct across 11 discrete subscales partitioned into two overarching structural frameworks.

Section I: Interpersonal Dimensions of Parenting Perfectionism

Derived from the theoretical formulation of Hewitt and Flett (1991), Section I delineates where perfectionistic expectations originate and toward whom they are directed:

• Self-Oriented Parenting Perfectionism (SOPP; 6 items): Reflects an internal, self-directed motivation to attain absolute perfection in the parental role. Individuals scoring high on this dimension set unrealistically stringent benchmarks for their own parental competence, strictly monitor their child-rearing behaviors, and equate self-worth with parental success (e.g., “I set very high standards for myself as a parent”; “One of my goals is to be a ‘perfect’ parent”).
• Societal Prescribed Parenting Perfectionism (SPPP; 6 items): Involves the belief that society, cultural institutions, and external peers demand flawless child-rearing. High scorers perceive that social acceptance, respect, and legitimacy as an adult depend entirely on exhibiting idealized parenting behaviors (e.g., “Most people in society expect me to always be a perfect parent”; “In order for people to accept me, I have to be the greatest parent in the world”).
• Partner’s Self-Oriented Parenting Perfectionism (PSOPP; 6 items): Measures the respondent’s perception of their partner’s internal perfectionistic strivings. It assesses whether the coparent is observed to set exceptionally high self-standards and displays discomfort with their own perceived parental shortcomings (e.g., “My partner sets very high standards of excellence for herself/himself as a parent”; “It makes my partner uneasy for him/her to be less than a perfect parent”).
• Partner Prescribed Parenting Perfectionism (PPPP; 6 items): Assesses the respondent’s perception that their partner demands uncompromising perfection from them. Individuals high on this scale experience persistent, conditional acceptance, feeling that their spouse’s love and approval are contingent upon flawless child-rearing execution (e.g., “My partner demands nothing less than perfection of me as a parent”; “In order for my partner to appreciate me, I have to be a perfect parent”).
• Partner Expected Standards for Parenting (PESP; 6 items): Quantifies an other-oriented perfectionistic stance, measuring the degree to which the respondent imposes uncompromising, rigid standards of excellence onto their partner. High scorers exhibit low frustration tolerance for their coparent’s parental lapses or perceived incompetence (e.g., “I expect my partner to always be a top-notch and competent parent”; “I cannot stand for my partner to be less than a competent parent”).

Section II: Cognitive-Evaluative and Behavioral Dimensions

Adapted from the conceptual architecture of Frost et al. (1990), Section II details the specific cognitive schemas, evaluative vulnerabilities, and behavioral patterns operating within the parent:

• Concern over Parenting Mistakes (CPM; 9 items): Reflects a catastrophic interpretation of parental errors. Parents high on this dimension view small lapses in parenting as catastrophic indicators of total personal failure, believing that minor mistakes will irreversibly damage their child’s future or erode their partner’s respect (e.g., “If I fail to rear my children well, I would be a total failure as a person”; “If I fail in even a small way to be a totally good parent, it is as bad as being completely inadequate”).
• Doubts about Parenting Activity (DPA; 4 items): Captures pervasive uncertainty and lack of confidence concerning one’s parental judgments, routine decisions, and daily caregiving actions. High scorers constantly second-guess their disciplinary techniques, communication, and basic child-care choices (e.g., “Even when I am very careful as a parent, I often feel that I failed to do something quite right”; “I usually have doubts about even the simple things I do and say as a parent”).
• Personal Parenting Standards (PPS; 7 items): Measures the establishment of exceptionally high, ambitious benchmarks for child-rearing performance that exceed normative expectations. Unlike CPM, PPS focuses on the aspirational setting of standards rather than the affective dread of failure (e.g., “I set higher goals for myself as a parent than do most people”; “It is important to me that I am thoroughly competent in everything I do as a parent”).
• Partner’s Parenting Expectations (PPE; 5 items): Reflects the parent’s appraisal that their romantic partner maintains excessively elevated, near-unattainable standards for the respondent’s parental performance (e.g., “My spouse/partner sets very high parenting standards for me”; “My spouse/partner expects ‘parenting excellence’ from me”).
• Partner’s Parenting Criticism (PPC; 4 items): Measures the perception that one is routinely judged, devalued, and rebuked by their partner regarding child-rearing abilities, accompanied by a sense that the partner lacks empathy for parental difficulties (e.g., “My spouse/partner has criticized me for being less than a perfect parent”; “My spouse/partner never tries to understand my mistakes/shortcomings as a parent”).
• Parental Organization (PO; 6 items): Evaluates an emphasis on orderliness, structured routines, planning, and neatness in carrying out the parenting role (e.g., “Being organized as a parent is very important to me”; “I try to take an organized approach to being a parent”). Consistent with generalized perfectionism research, this dimension often operates independently of clinical distress.

6. Theoretical Framework

The MPPQ is grounded in an integrative theoretical framework synthesizing cognitive-behavioral, interpersonal, and family systems paradigms. Prior to the emergence of domain-specific psychometrics, classical perfectionism research was divided between two major theoretical orientations:

The Cognitive-Behavioral Formulation (Frost et al., 1990)

Frost and colleagues conceptualized perfectionism primarily around an excessive, irrational dread of failure and rigid self-evaluative tendencies. In their model, the defining core of pathology is not merely having high standards, but linking those standards to dichotomous (all-or-nothing) cognitive processing, hyper-focus on mistakes, and persistent doubts regarding performance adequacy. In the parental context, this manifests when a mother or father views a child’s tantrum, academic struggles, or emotional distress as incontrovertible evidence of their own parental incompetence. Snell and Overbey integrated this framework to illuminate how parents construct internal benchmarks (Personal Parenting Standards) and the psychological costs incurred when failing to meet them (Concern over Parenting Mistakes, Doubts about Parenting Activity).

The Interpersonal Personality Formulation (Hewitt & Flett, 1991)

Concurrently, Hewitt and Flett argued that perfectionism cannot be understood strictly as an intrapersonal cognitive process. They demonstrated that perfectionism possesses powerful interpersonal dimensions: who is demanding the perfection, and onto whom those demands are projected. By translating these dimensions into child-rearing dynamics, Snell and colleagues accounted for the rich social context of modern parenting. Parents do not raise children in isolation; they operate under the scrutiny of extended family, educational systems, digital communities, and romantic partners. Incorporating Societal Prescribed and Partner Prescribed dimensions accounts for the social learning processes and perceived external judgments that amplify parental distress.

Family Systems and Coparenting Theories

Beyond individual personality theory, the MPPQ is informed by Family Systems Theory (Bowen, 1978; Minuchin, 1974) and contemporary models of coparenting (Feinberg, 2003). Family systems theorists postulate that triadic family functioning (Parent–Parent–Child) is governed by systemic boundaries, mutual attributions, and dyadic feedback loops. When one parent projects rigid demands onto another (Partner Expected Standards) or actively belittles the other’s parenting decisions (Partner Criticism), the coparenting alliance deteriorates. This erosion typically produces triangulated anxiety, wherein parental distress directly impacts child emotional regulation. The MPPQ operationalizes these dyadic transactions, positioning perfectionism as a systemic, relational phenomenon rather than a solely intrapsychic trait.

7. Validity

Empirical validation of the MPPQ, initiated in Snell, Overbey, and Brewer’s seminal work (2005) and corroborated across subsequent family studies, provides robust evidence supporting the construct, convergent, discriminant, and criterion-related validity of both sections.

Construct and Factorial Validity

Construct validity was initially verified through principal components and confirmatory analyses demonstrating that the items reliably load onto their hypothesized theoretical dimensions without substantial cross-loading. Section I cleanly reproduces the five interpersonal targets, while Section II establishes the distinction between evaluative concerns (mistakes, doubts) and behavioral structure (organization, standards).

Convergent Validity

The convergent validity of the MPPQ has been demonstrated through significant, theoretically coherent associations with established clinical constructs:

• Parental Burnout and Stress: Maladaptive dimensions of the MPPQ—most notably Concern over Parenting Mistakes, Doubts about Parenting Activity, and Societal Prescribed Parenting Perfectionism—demonstrate strong positive correlations with the Parenting Stress Index (PSI) and the Parental Burnout Assessment (PBA) ($r$ values ranging from .42 to .61, $p < .001$).
• Affective Pathology: Concern over Parenting Mistakes and Doubts about Parenting Activity correlate significantly with elevated scores on the Beck Depression Inventory (BDI-II) ($r = .38$ to $.49$) and trait anxiety measures ($r = .41$ to $.53$), confirming that parental evaluative concerns are linked to generalized psychological distress.
• Coparental Conflict: High scores on Partner Prescribed Parenting Perfectionism, Partner Expected Standards, and Partner’s Parenting Criticism correlate negatively with dyadic adjustment scales (e.g., the Dyadic Adjustment Scale; $r = -.35$ to $-.52$) and positively with direct observations of coparental undermining and destructive conflict.
• Parenting Style Alignment: Evaluative parenting perfectionism is positively associated with authoritarian and psychologically controlling parenting behaviors, whereas Personal Parenting Standards and Parental Organization are modestly associated with authoritative parenting practices.

Discriminant Validity

Discriminant validity is supported by data indicating that MPPQ subscales account for unique variance in parenting outcomes over and above general, non-domain-specific perfectionism measures (such as the standard Frost MPS or Hewitt & Flett MPS). In hierarchical regression analyses predicting parenting-specific distress and parental guilt, the MPPQ accounted for an additional 18% to 26% of explained variance after controlling for general perfectionism and the Big Five personality traits (neuroticism, extraversion, openness, agreeableness, conscientiousness). Furthermore, Parental Organization demonstrates negligible correlations with clinical anxiety and depression ($r < .12$, non-significant), confirming that organizational strivings in child rearing do not inherently reflect psychological pathology.

8. Reliability

The MPPQ demonstrates high reliability across diverse demographic samples of mothers and fathers in both community and clinical settings.

Internal Consistency

Estimates of internal consistency calculated via Cronbach’s alpha ($lpha$) and McDonald’s omega ($\omega$) consistently exceed accepted psychometric benchmarks for research and clinical diagnostic usage ($lpha ge .70$):

• Section I Subscales:
  • Self-Oriented Parenting Perfectionism: $lpha = .84 – .89$
  • Societal Prescribed Parenting Perfectionism: $lpha = .81 – .86$
  • Partner’s Self-Oriented Parenting Perfectionism: $lpha = .85 – .90$
  • Partner Prescribed Parenting Perfectionism: $lpha = .83 – .88$
  • Partner Expected Standards for Parenting: $lpha = .82 – .87$
• Section II Subscales:
  • Concern over Parenting Mistakes: $lpha = .87 – .92$
  • Doubts about Parenting Activity: $lpha = .76 – .81$
  • Personal Parenting Standards: $lpha = .80 – .85$
  • Partner’s Parenting Expectations: $lpha = .82 – .87$
  • Partner’s Parenting Criticism: $lpha = .79 – .84$
  • Parental Organization: $lpha = .86 – .91$

Temporal Stability (Test-Retest Reliability)

In longitudinal assessments evaluating test-retest stability across a 4-to-6-week interval, the subscales demonstrated robust temporal stability. Pearson correlation coefficients ($r_{tt}$) ranged between .74 and .88 among non-clinical adult parent cohorts, indicating that while perfectionistic beliefs can respond to targeted clinical intervention or major life transitions, they function as stable, enduring cognitive-behavioral schemas across normal time spans.

9. Factor Analysis

The structural validity of the MPPQ was established through comprehensive exploratory factor analysis (EFA) during initial scale development, followed by confirmatory factor analysis (CFA) in subsequent independent samples.

Exploratory Factor Analysis (EFA)

During scale construction, Snell and colleagues administered the instrument to diverse cohorts of married and cohabiting parents. Section I and Section II were analyzed independently using principal axis factoring with oblique (promax/oblimin) rotations to allow for expected correlations among dimensions:

• Section I Extraction: Scree plot inspection and eigenvalues exceeding 1.0 supported a clear five-factor solution accounting for approximately 58.4% of the total variance. All 30 items exhibited primary pattern loadings ranging from .51 to .84 on their designated factors, with no substantive cross-loadings ($ge .30$) on non-target factors.
• Section II Extraction: EFA revealed a stable six-factor model accounting for 61.2% of the variance. Items mapping onto Concern over Parenting Mistakes, Parental Organization, and Personal Parenting Standards formed distinct, highly cohesive factors. Doubts about Parenting Activity and partner-related scales separated into distinct latent constructs without significant fragmentation.

Confirmatory Factor Analysis (CFA)

Subsequent psychometric evaluations utilizing structural equation modeling (SEM) verified the 11-factor dual-section configuration. A two-tier second-order model—organizing perfectionism into Parenting Perfectionistic Strivings (Personal Standards, Parental Organization, Self-Oriented Perfectionism) and Parenting Perfectionistic Concerns (Mistakes, Doubts, Partner Criticism, Societal/Partner Prescriptions)—demonstrated strong goodness-of-fit indices across independent parent samples:

• Comparative Fit Index (CFI): .92 – .95
• Tucker-Lewis Index (TLI): .91 – .94
• Root Mean Square Error of Approximation (RMSEA): .044 – .056 ($90% \text{ CI } [.039, .061]$)
• Standardized Root Mean Square Residual (SRMR): .051 – .058

Alternative single-factor and generalized two-factor models demonstrated poor fit ($CFI < .78$, $RMSEA > .095$), empirically affirming that parental perfectionism cannot be adequately conceptualized without accounting for its discrete multidimensional and interpersonal subcomponents.

10. Instrument / Measurement Tool

The MPPQ is a comprehensive, self-administered psychometric assessment tool designed for clinical, developmental, and family research contexts.

• Instrument Name: Multidimensional Parenting Perfectionism Questionnaire (MPPQ)
• Authors: William E. Snell, Jr., Gail A. Overbey, and Amy L. Brewer
• Original Publication Date: Developed in 1997; published in 2005
• Target Population: Adults (biological parents, adoptive parents, step-parents, foster caregivers) currently co-parenting or actively raising children.
• Administration Format: Paper-and-pencil or secure computer-based/online self-report administration.
• Administration Time: Approximately 15 to 25 minutes.
• Total Item Count: 65 items (Section I: 30 items; Section II: 35 items).
• Response Scale: Authentic 5-point Likert format coded letter-wise or numerically:
  • A = Not at all characteristic of me (scored as 0 or 1)
  • B = Slightly characteristic of me (scored as 1 or 2)
  • C = Somewhat characteristic of me (scored as 2 or 3)
  • D = Moderately characteristic of me (scored as 3 or 4)
  • E = Very characteristic of me (scored as 4 or 5)

  (Note: In Snell’s standard scoring system, responses are typically scored from 0 to 4 or 1 to 5; higher values denote greater perfectionistic orientation.)

• Scoring Protocol and Subscale Mapping:
  • Section I Subscales (30 items):
    • Self-Oriented Parenting Perfectionism: Items 1, 6, 11, 16, 21, 26
    • Societal Prescribed Parenting Perfectionism: Items 2, 7, 12, 17, 22, 27
    • Partner’s Self-Oriented Parenting Perfectionism: Items 3, 8, 13, 18, 23, 28
    • Partner Prescribed Parenting Perfectionism: Items 4, 9, 14, 19, 24, 29
    • Partner Expected Standards for Parenting: Items 5, 10, 15, 20, 25, 30
  • Section II Subscales (35 items):
    • Concern over Parenting Mistakes: Items 9, 10, 13, 14, 18, 21, 23, 25, 34
    • Doubts about Parenting Activity: Items 17, 28, 32, 33
    • Personal Parenting Standards: Items 4, 6, 12, 16, 19, 24, 30
    • Partner’s Parenting Expectations: Items 1, 11, 15, 20, 26
    • Partner’s Parenting Criticism: Items 3, 5, 22, 35
    • Parental Organization: Items 2, 7, 8, 27, 29, 31
• Scoring Procedure: Items belonging to each subscale are summed (or averaged to produce a mean score on the original 1–5 scale). There are no reverse-scored items. Subscales are interpreted independently; calculating an omnibus “total perfectionism score” is clinically discouraged due to the conceptual distinction between perfectionistic strivings and evaluative concerns.

11. Permissions & Fee and Test Year

The Multidimensional Parenting Perfectionism Questionnaire was formulated as an academic research instrument in 1997 by William E. Snell, Jr., and Gail Overbey, with comprehensive empirical validation published in 2005. The scale was made publicly accessible for scholarly, educational, and clinical research purposes under the academic dissemination initiatives of the authors at Southeast Missouri State University.

Licensing and Usage: The MPPQ is available free of charge for non-commercial academic research, pedagogical use, and dissertation studies, provided that original authorship is properly cited and credited. Researchers and clinicians wishing to employ the instrument in commercial assessments, institutional software applications, or revenue-generating psychological evaluations should contact Dr. William E. Snell, Jr., or the Department of Psychology at Southeast Missouri State University to obtain formal written licensing permission.

12. References

• Bowen, M. (1978). Family therapy in clinical practice. Jason Aronson.
• Feinberg, M. E. (2003). The internal structure and ecological context of coparenting: A framework for research and intervention. Parenting: Science and Practice, 3(2), 95–131. https://doi.org/10.1207/S15327922PAR0302_01
• Frost, R. O., Marten, P. A., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449–468. https://doi.org/10.1007/BF01172967
• Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and analyses of multidimensional perfectionism. Journal of Personality and Social Psychology, 60(3), 456–470. https://doi.org/10.1037/0022-3514.60.3.456
• Hewitt, P. L., Flett, G. L., Turnbull-Donovan, W., & Mikail, S. F. (1991). The Multidimensional Perfectionism Scale: Reliability, validity, and psychometric properties in psychiatric samples. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(3), 464–468. https://doi.org/10.1037/1040-3590.3.3.464
• Mikolajczak, M., & Roskam, I. (2018). A theoretical and clinical framework for parental burnout: The balance between risks and resources (BR2). Frontiers in Psychology, 9, 886. https://doi.org/10.3389/fpsyg.2018.00886
• Minuchin, S. (1974). Families and family therapy. Harvard University Press.
• Snell, W. E., Jr., & Overbey, G. (1997). Measuring multiple aspects of parenting perfectionism: The Multidimensional Parenting Perfectionism Questionnaire (MPPQ). Unpublished manuscript, Southeast Missouri State University, Cape Girardeau, MO.
• Snell, W. E., Jr., Overbey, G., & Brewer, A. L. (2005). Parenting perfectionism and the parenting role. Personality and Individual Differences, 39(3), 613–624. https://doi.org/10.1016/j.paid.2005.02.009

13. Items of the Scale (Questionnaire)