Attach 16

OMB #: 0925-NEW
Expiration Date: xx/xxxx
This survey should take approximately 10 minutes to complete

Will Genome Information Change How You View Yourself?
Smithsonian Self Concept Survey 1
Genes are the main instructions that tell the body how to develop and work. Your ‘genome’ includes all of your genetic
information. Using a new technology called “sequencing”, we can read the instructions your genome uses to make your body
function. Currently we know some of the ways these instructions affect your future health.
The following questions ask about how your views of yourself might be affected if you learned new information about yourself
from your genome. Our views of ourselves come from our life experiences, values, accomplishments, family and friends. Views
of yourself might also come from information you receive from your doctor. We are interested in hearing from you how learning
about your genome sequence might compare.
Imagine that you have the instructions in your genome read. The results reveal something new about your health that you did
not know. Please read the items below and indicate how much this might change your views of yourself as compared to
information that you might hear from your doctor. Rate how much more from 1 (much less) to 5 (much more).
Compared to learning about a risk to my future health from my doctor, if my genome sequence identified a new
risk to my future health…

a. It may change whether I view myself as a healthy person
b. My ideas about who I am are likely to change

Q1a-h.

c. I may feel more vulnerable
d. It may complicate my understanding of who I really am
e. It may help to clarify aspects of how I think about myself
f. It may enlighten me about who I will be in the future
g. It may change how I think of myself
h. It may broaden my ideas about myself

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Somewhat Less

The Same

Somewhat More

Much More

1

2

3

4

5

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Indicate below the extent to which you agree with each statement from 1 to 7. Please answer as honestly as you can even if you
feel unsure.

a. My self-esteem would
suffer if I neglected my health

b. Doing something I
know is wrong makes
me lose my self-respect
c. W henever I follow my
moral principles, my sense of
self-respect gets a boost

Q2a-j.

d. When I take responsibility
for my health, it boosts my
self-respect
e. I couldn’t respect myself if
I didn’t live up to a moral
code
f. I couldn’t respect myself if I
didn’t live a healthy lifestyle
g. My self-esteem would
suffer if I did something
unethical
h. Living an unhealthy
lifestyle makes me lose my
self-respect

Disagree

Disagree
Somewhat

1

2

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Strongly
Disagree

Neutral

Agree
Somewhat

Agree

Strongly
Agree

3

4

5

6

7

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i. My self-esteem depends
on whether I follow my
moral/ethical principles
j. My self-esteem depends
on whether I follow a healthy
lifestyle

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Indicate below the extent to which you agree with each statement from 1 to 5. Please answer as honestly as you can even if you
feel unsure.

Q3a-d.

Strongly Disagree

Somewhat Disagree

Neutral

Somewhat Agree

Strongly Agree

1

2

3

4

5

My beliefs about myself conflict with one
another

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I feel that I am not really the person I
appear to be

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My beliefs about myself seem to change

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If I were asked to describe my personality,
my description might end up being different
today compared to another day

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Will Genome Information Change How You View Yourself
Smithsonian Self Concept Survey 2
Genes are the main instructions that tell the body how to develop and work. Your ‘genome’ includes all of your genetic
information. Using a new technology called “sequencing”, we can read the instructions your genome uses to make your body
function. These instructions are passed down from parents to children. By looking at patterns in the instructions, we can tell
where in the world our ancestors came from.
The following questions ask about how your views of yourself might be affected if you learned new information about your
origins from your genome. Our views of ourselves come from our life experiences, values, accomplishments, family and
friends. Views of yourself might also come from information about your family history that you receive from a relative. We are
interested in hearing from you how learning about your ancestry through genome sequence might compare to learning your
family history from a relative.
Imagine that you have the instructions in your genome read. The results reveal something new about your ancestry that you did
not know. Please read the items below and indicate how much this might change your views of yourself as compared to
information that you might hear from your relative. Rate how much more or less this might change your self-concept as rated
from 1 (much less) to 5 (much more).
Compared to learning about my family history from a relative, if my genome sequence identified new
information about my ancestry…

Q1a-h.

a. It may change whether I view myself as a healthy person
b. My ideas about who I am are likely to change
c. I may feel more vulnerable
d. It may complicate my understanding of who I really am
e. It may help to clarify aspects of how I think about myself

Much Less

Somewhat Less

The Same

Somewhat More

Much More

1

2

3

4

5

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f. It may enlighten me about who I will be in the future

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g. It may change how I think of myself

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h. It may broaden my ideas about myself

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Indicate below the extent to which you agree with each statement from 1 to 7. Please answer as honestly as you can even if you
feel unsure.

a. Doing something I know is
wrong makes me lose my selfrespect
b. When I learn about my
ancestors, it boosts my selfesteem

Q2a-j.

c. W henever I follow my moral
principles, my sense of selfrespect gets a boost
d. My self worth would suffer if
I ignored my family origins
e. I couldn’t respect myself if I
didn’t live up to a moral code
f. I lose my self-respect when I
think about negative aspects of
where my ancestors came
from

Disagree

Disagree
Somewhat

Neutral

Agree
Somewhat

Agree

Strongly
Agree

1

2

3

4

5

6

7

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Strongly
Disagree

g. My self-esteem would suffer
if I did something unethical
h. I wouldn’t respect myself if I
didn’t honor my ancestry
i. My self-esteem depends on
whether I follow my
moral/ethical principles

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Indicate below the extent to which you agree with each statement from 1 to 5. Please answer as honestly as you can even if you
feel unsure.

Q3a-d.

Strongly Disagree

Somewhat Disagree

Neutral

Somewhat Agree

Strongly Agree

1

2

3

4

5

My beliefs about myself conflict with one
another

□

□

□

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I feel that I am not really the person I
appear to be

□

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My beliefs about myself seem to change

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If I were asked to describe my personality,
my description might end up being
different today compared to another day

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