Advice: creating a survey about Loneliness.

Advice: creating a survey about Loneliness.
I am in the process of creating a survey looking at Loneliness and trying to make sure I ask the right questions. Would you mind reading the draft survey below and let me know what I am missing? Any thing I should take out? Any thoughts?
I am NOT asking you to do the survey but to look at the survey itself and make suggestions.
1. What is your age range?
[ ] Elementary School (K-8)
[ ] High School (9-12)
[ ] College / University
[ ] 20’s
[ ] 30’s
[ ] 40’s
[ ] 50’s
[ ] 60’s
[ ] 70+
2. Are you
[ ] Female
[ ] Male
3. Marital Status:
[ ] Single
[ ] Engaged
[ ] Married
[ ] Separated
[ ] Dicorced
[ ] Widowed
Comment (optional)
4. Do you have children
[ ] No
[ ] Yes, I have children in Elementary School
[ ] Yes, I have children in High School
[ ] Yes, I have children in College / University
[ ] Yes, I have adult children
Comment (optional):
5. Where do you live?
Drop down of all countries
6. If you had to answer only yes or no. Is loneliness a struggle you have?
[ ] yes
[ ] no
7. On a scale of 1 to 10 what would your experience with loneliness rate
[ ] 1 – not lonely
[ ] 2
[ ] 3 – mildly lonely
[ ] 4
[ ] 5 – moderately lonely
[ ] 6
[ ] 7 – very lonely
[ ] 8
[ ] 9
[ ] 10 – painfully lonely
8. In what area(s) do you experience loneliness
[ ] marriage
[ ] singleness
[ ] parenting
[ ] leadership
[ ] you’re an introvert
[ ] mental health struggles
[ ] physical health struggles
[ ] seniors
[ ] lack of close friendships
[ ] lack of authentic church community
[ ] sin and disobedience
[ ] life circumstances
[ ] other?
9. Do you feel stuck in this place of loneliness?
[ ] yes
[ ] no
10. What have you tried to break free from the loneliness?
[ ] exercise
[ ] faith (church)
[ ] counselling
[ ] sports
[ ] volunteer
[ ] build authentic friendships
[ ] go on a date
[ ] grow your relationship with your spouse
[ ] get a pet
[ ] movies
[ ] TV
[ ] Social media
[ ] read books
[ ] hobbies
[ ] journal
[ ] others?
11. Have you ever tried other ways of dealing with your loneliness
[ ] alcohol
[ ] drugs
[ ] overeating
[ ] self hard
[ ] pornography
[ ] shopping
[ ] sleep
[ ] others?
12. How many deep friendships do you have? Friends who authentically accept you and you can be yourself around.
comment (optional):
13. I feel most lonely when…
comment (optional):
14. I don’t feel lonely when…
comment (optional):
15. How do you think we got to this place of loneliness as a society?
comment (optional):
Thanks for any help.

About The Author

Brett Ullman

Brett Ullman travels North America speaking to teens, young adults, leaders, and parents on topics including parenting, mental health, sexuality, pornography, men, dating and media. Brett's seminars engage and challenge attendees to try and connect our ancient faith with our modern culture we live in. Participants are inspired to reflect on what we know, what we believe and how our faith ought to serve as the lens through which we view and engage tough conversations in our society today.


  1. Janice

    Hi Brett,
    Here’s my suggestions regarding your loneliness poll.
    Question #2, not sure how to navigate this but kids are taught in public school that there are many genders. Maybe have an option of Other with a comment section for the person to enter their specific gender, if they wish.
    #4. Is there the option to select 2 answers because I have a son in grade 2 and a daughter in grade 9.
    For me, I’ve suffered a lot with loneliness because I grew up as a missionary kid, Third Culture Kid. Separated from my siblings at the age of 10, and often had to say good bye to family and friends. I miss the country where I was born, Brazil and grew up. (Have now reconnected with some friends through facebook) But I really don’t belong or have a home in Brazil and do often struggle living in Canada. I’ve been living in Canada for 30 years.
    My situation is a bit unique but I wonder about all the immigrants coming to Canada, especially so many in GTA. If they struggle with loneliness.
    Hoping this helps. Take care.

  2. Jen Hubbard


    I’m really excited about this research you’re doing. i work with Lifeteams & Youth Unlimited in Vancouver.

    Two things I’ve been reading about with loneliness that may play into questions you want to ask: 1) there’s a growing link between loneliness and trouble sleeping (and I’ve seen it evidenced in students I work with) and I also wonder about loneliness and living life through social media and the obvious connection (in some cases) between those two things…

  3. yvonne

    16. do you think loneliness has anything to do with the money you earn or don’t earn?

  4. Sarah

    For number 10, I’d add youtube and/or netflix, if you’re not meaning “movies” as something you say at home to do, but rather go out to do.

  5. Greg H.

    Hey Brett,
    Good questions to ask. Just wondering about what influences work has on loneliness. Associations at work is ok, but that’s not always real friendship. Work hours can keep a person from developing relationships that matter. Just a thought. Keep on trucking brother.

  6. Marina

    Hi. Maybe ask how long have you felt lonely?
    What has contributed to your feeling lonely? (Moved a lot hence it was hard to make and keep friends) (extremely religious parents controlled your time and didn’t allow you to make friends, shyness, low self esteem, depression)
    #11. What is self hard?


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