MPAS Self Assessment - MEN
For new parents—or answer while remembering how you felt when you were a new parent.

Depending on how true each statement is, score yourself with 0, 1 or 2, where 0= not true, 1=sometimes true, 2=most true, and then add your total.

Excerpted from Ending the Epidemic of Disappearing Dads
© 2014, John W. Travis, MD, MPH
Sign in to Google to save your progress. Learn more
Where are you in your partner and/or postpartum/parenting journey? *
 I feel excluded, disconnected, or out of sorts *
 I am experiencing decreased intimacy—physical, emotional, etc. *
 I am experiencing frustration with differing sexual responsiveness of partner since the birth *
 I am bothered by unpleasant childhood memories *
 I am experiencing  increased sexual interest in others *
 I am experiencing  increased use of addictive substances: alcohol, drugs (prescription or otherwise), gaming, TV, etc *
 I am experiencing increased irritability *
 I am experiencing increased levels of depression, anxiety or agitation *
 I am feeling inadequate *
 I am experiencing an increase in number of disagreements with partner *
 I am experiencing an increased amount of time away from home/family (work, sports, bar, or pub, etc.) *
 I am spending regular 1 on 1 time with my child(ren) *
 I am spending regular 1 on 1 time with my partner *
Email (optional - agree to be added to CCTF mailing list)
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy