Have you ever participated in an activity (group session, rally, etc) in your community or workplace on violence against women?

Have you done any of these things [involving emotional intimate partner violence] in the past 12 months?

Have you threatened to hurt your spouse in the last twelve months?

Have you done things to scare or intimidate your spouse on purpose for example by the way you looked at her, by yelling and smashing things in the last twelve months?

Have you hurt people your spouse cares about as a way of hurting her, or damaged things of importance to her in the last twelve months?

Have you insulted your spouse or deliberately made her feel bad about herself in the last twelve months?

How often have you threatened to hurt your partner?

Have you belittled or humiliated your partner in front of other people in the last twelve months?

How many times have you ever threatened to hurt your spouse?

Have you ever hurt people your partner cares about as a way of hurting her, or damaged things of importance to her? If yes, did this happen once, a few times or many times?