37.4 Survey

OMB #: 0925-0593

OMB Expiration Date: 8/31/2014

Major Life Events SAQ, Phase 2g

OMB Specification

Major Life Events SAQ

Event Category:	Time-Based
Event:	36M, 60M
Administration:	N/A
Instrument Target:	Primary Caregiver
Instrument Respondent:	Primary Caregiver
Domain:	Neuro-Psychosocial
Document Category:	Scored Assessment
Method:	Self-Administered
Mode (for this instrument*):	In-Person, PAPI
OMB Approved Modes:	In-Person, PAPI; Phone, PAPI; Web, CAI
Estimated Administration Time:	8 minutes
Multiple Child/Sibling Consideration:	Per Event
Special Considerations:	When primary caregiver is female
Version:	1.0
MDES Release:	4.0

​​*This instrument is OMB-approved for multi-mode administration but this version of the instrument is designed for administration in this/these mode(s) only.

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Major Life Events SAQ

TABLE OF CONTENTS

GENERAL PROGRAMMER INSTRUCTIONS: 1

MAJOR LIFE EVENTS QUESTIONNAIRE 3

FOR OFFICE USE ONLY: 23

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Major Life Events SAQ

GENERAL PROGRAMMER INSTRUCTIONS:

WHEN PROGRAMMING INSTRUMENTS, VALIDATE FIELD LENGTHS AND TYPES AGAINST THE MDES TO ENSURE DATA COLLECTION RESPONSES DO NOT EXCEED THOSE OF THE MDES. SOME GENERAL ITEM LIMITS USED ARE AS FOLLOWS:

DATA ELEMENT FIELDS	MAXIMUM CHARACTERS PERMITTED	DATA TYPE	PROGRAMMER INSTRUCTIONS
ADDRESS AND EMAIL FIELDS	100	CHARACTER
UNIT AND PHONE FIELDS	10	CHARACTER
_OTH AND COMMENT FIELDS	255	CHARACTER	Limit text to 255 characters
FIRST NAME AND LAST NAME	30	CHARACTER	Limit text to 30 characters
ALL ID FIELDS	36	CHARACTER
ZIP CODE	5	NUMERIC
ZIP CODE LAST FOUR	4	NUMERIC
CITY	50	CHARACTER
DOB AND ALL OTHER DATE FIELDS (E.G., DT, DATE, ETC.)	10	NUMERIC CHARACTER	DISPLAY AS MM/DD/YYYY STORE AS YYYY-MM-DD HARD EDITS: MM MUST EQUAL 01 TO 12 DD MUST EQUAL 01 TO 31 YYYY MUST BE BETWEEN 1900 AND CURRENT YEAR.
TIME VARIABLES	TWO-DIGIT HOUR AND TWO-DIGIT MINUTE, AM/PM DESIGNATION	NUMERIC	HARD EDITS: HOURS MUST BE BETWEEN 00 AND 12; MINUTES MUST BE BETWEEN 00 AND 59

Instrument Guidelines for Participant and Respondent IDs:

PRENATALLY, THE P_ID IN THE MDES HEADER IS THAT OF THE PARTICIPANT (E.G. THE NON-PREGNANT WOMAN, PREGNANT WOMAN, OR THE FATHER).

POSTNATALLY, A RESPONDENT ID WILL BE USED IN ADDITION TO THE PARTICIPANT ID BECAUSE SOMEBODY OTHER THAN THE PARTICIPANT MAY BE COMPLETING THE INTERVIEW. FOR EXAMPLE, THE PARTICIPANT MAY BE THE CHILD AND THE RESPONDENT MAY BE THE MOTHER, FATHER, OR ANOTHER CAREGIVER. THEREFORE, MDES VERSION 2.2 AND ALL FUTURE VERSIONS CONTAIN A R_P_ID (RESPONDENT PARTICIPANT ID) HEADER FIELD FOR EACH POST-BIRTH INSTRUMENT. THIS WILL ALLOW ROCs TO INDICATE WHETHER THE RESPONDENT IS SOMEBODY OTHER THAN THE PARTICIPANT ABOUT WHOM THE QUESTIONS ARE BEING ASKED.

A REMINDER:

ALL RESPONDENTS MUST BE CONSENTED AND HAVE RECORDS IN THE PERSON, PARTICIPANT, PARTICIPANT_CONSENT AND LINK_PERSON_PARTICIPANT TABLES, WHICH CAN BE PRELOADED INTO EACH INSTRUMENT. ADDITIONALLY, IN POST-BIRTH QUESTIONNAIRES WHERE THERE IS THE ABILITY TO LOOP THROUGH A SET OF QUESTIONS FOR MULTIPLE CHILDREN, IT IS IMPORTANT TO CAPTURE AND STORE THE CORRECT CHILD P_ID ALONG WITH THE LOOP INFORMATION. IN THE MDES VARIABLE LABEL/DEFINITION COLUMN, THIS IS INDICATED AS FOLLOWS: EXTERNAL IDENTIFIER: PARTICIPANT ID FOR CHILD DETAIL.

MAJOR LIFE EVENTS QUESTIONNAIRE

MLE00100. Within the past year, have you...

PARTICIPANT INSTRUCTIONS

• Listed in the following survey, there are some life experiences that might have occurred during the past year.

• Please mark "Yes" for those life experiences you have had in the last year and mark "No" for those life experiences you have not had in the last year.

• If you answer "Yes" to any of the life experiences, mark one of the boxes to show the level of impact.

• For example, mark the box for "Extremely Negative" if it had an extremely negative impact. Mark the box for "No Impact" if you felt there was no impact. Mark the box for "Extremely Positive" if you felt it had an extremely positive impact.

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

 

MLE01000/(GOTTEN_MARRIED). Gotten married?

Label	Code	Go To
Yes	1
No	2	IN_JAIL

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE02000/(GOTTEN_MARRIED_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE03000/(IN_JAIL). Been in jail or similar institution?

Label	Code	Go To
Yes	1
No	2	PARTNER_DIE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE04000/(IN_JAIL_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE05000/(PARTNER_DIE). Had your spouse or partner die?

Label	Code	Go To
Yes	1
No	2	SLEEP_CHANGE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE06000/(PARTNER_DIE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE07000/(SLEEP_CHANGE). Had a major change in sleeping habits (much more sleep or much less sleep)?

Label	Code	Go To
Yes	1
No	2	DEATH_FAMILY

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE08000/(SLEEP_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE09000/(DEATH_FAMILY). Experienced the death of a close family member (your child, father, mother, sister, brother, grandparent or other)?

Label	Code	Go To
Yes	1
No	2	EAT_CHANGE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE10000/(DEATH_FAMILY_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE11000/(EAT_CHANGE). Had a major change in your eating habits (ate much more or less food)?

Label	Code	Go To
Yes	1
No	2	EXPER_FORCLOSURE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE12000/(EAT_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE13000/(EXPER_FORCLOSURE). Experienced a foreclosure on a mortgage or a loan?

Label	Code	Go To
Yes	1
No	2	DEATH_FRIEND

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

 

MLE14000/(EXPER_FORCLOSURE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE15000/(DEATH_FRIEND). Experienced the death of a close friend?

Label	Code	Go To
Yes	1
No	2	PERSONAL_ACHIEVE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE16000/(DEATH_FRIEND_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE17000/(PERSONAL_ACHIEVE). Had an outstanding personal achievement?

Label	Code	Go To
Yes	1
No	2	MINOR_VIOLATION

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE18000/(PERSONAL_ACHIEVE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE19000/(MINOR_VIOLATION). Had a minor law violation (such as a traffic ticket or disturbing the peace)?

Label	Code	Go To
Yes	1
No	2	WORK_CHANGE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE20000/(MINOR_VIOLATION_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE21000/(WORK_CHANGE). Changed your work situation (such as a different work responsibility, a major change in working conditions or working hours)?

Label	Code	Go To
Yes	1
No	2	NEW_JOB

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE22000/(WORK_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE23000/(NEW_JOB). Started a new job?

Label	Code	Go To
Yes	1
No	2	FAMILY_ILLNESS

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE24000/(NEW_JOB_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE25000/(FAMILY_ILLNESS). Had one of your close family members have a serious injury (your spouse/partner, child, father, mother, sister, brother, grandparent or other)?

Label	Code	Go To
Yes	1
No	2	SEXUAL_DIFF

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE26000/(FAMILY_ILLNESS_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE27000/(SEXUAL_DIFF). Had sexual difficulties?

Label	Code	Go To
Yes	1
No	2	BOSS_TROUBLE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE28000/(SEXUAL_DIFF_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE29000/(BOSS_TROUBLE). Had trouble with your boss (such as you were in danger of losing your job, being suspended or demoted)?

Label	Code	Go To
Yes	1
No	2	TROUBLE_INLAWS

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE30000/(BOSS_TROUBLE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE31000/(TROUBLE_INLAWS). Had trouble with your in-laws?

Label	Code	Go To
Yes	1
No	2	FINANCIAL_CHANGE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE32000/(TROUBLE_INLAWS_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE33000/(FINANCIAL_CHANGE). Had a major change in your financial status (a lot better off or a lot worse off)?

Label	Code	Go To
Yes	1
No	2	CHANGE_FAMILY_CLOSE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE34000/(FINANCIAL_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE35000/(CHANGE_FAMILY_CLOSE). Had a major change in closeness of family members (increased or decreased closeness)?

Label	Code	Go To
Yes	1
No	2	NEW_FAMILY_MEMBER

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE36000/(CHANGE_FAMILY_CLOSE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE37000/(NEW_FAMILY_MEMBER). Gained a new family member (through adoption or a family member moving in, not including your pregnancy)?

Label	Code	Go To
Yes	1
No	2	NEW_PLACE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE38000/(NEW_FAMILY_MEMBER_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE39000/(NEW_PLACE). Moved to a new place?

Label	Code	Go To
Yes	1
No	2	SEPARATION_HUSBAND

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE40000/(NEW_PLACE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE41000/(SEPARATION_HUSBAND). Had a separation from your spouse or partner because you were not getting along?

Label	Code	Go To
Yes	1
No	2	CHURCH_CHANGE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE42000/(SEPARATION_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE43000/(CHURCH_CHANGE). Had a major change in church activities (increased or decreased)?

Label	Code	Go To
Yes	1
No	2	REUNITE_HUSBAND

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE44000/(CHURCH_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE45000/(REUNITE_HUSBAND). Gotten back together with your spouse or partner after a separation?

Label	Code	Go To
Yes	1
No	2	ARGUMENTS_HUSBAND

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE46000/(REUNITE_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE47000/(ARGUMENTS_HUSBAND). Had a major change in number of arguments you have with your spouse or partner (a lot more or a lot fewer arguments)?

Label	Code	Go To
Yes	1
No	2	JOB_CHANGE_HUSBAND

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE48000/(ARGUMENTS_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE49000/(JOB_CHANGE_HUSBAND). Had a change in your spouse's or partner's work (he lost a job or started a new job)?

Label	Code	Go To
Yes	1
No	2	RECREATION_CHANGE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE50000/(JOB_CHANGE_HUSBAND_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE51000/(RECREATION_CHANGE). Had a major change in usual type and/or amount of recreation?

Label	Code	Go To
Yes	1
No	2	BORROWED_MORE_15000

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE52000/(RECREATION_CHANGE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE53000/(BORROWED_MORE_15000). Borrowed more than $15,000 (such as buying a home or business)?

Label	Code	Go To
Yes	1
No	2	BORROWED_LESS_15000

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE54000/(BORROWED_MORE_15000_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE55000/(BORROWED_LESS_15000). Borrowed less than $15,000 (such as buying a car or getting a school loan)?

Label	Code	Go To
Yes	1
No	2	FIRED_JOB

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE56000/(BORROWED_LESS_15000_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE57000/(FIRED_JOB). Been fired from a job?

Label	Code	Go To
Yes	1
No	2	MAJOR_ILLNESS

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE58000/(FIRED_JOB_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE59000/(MAJOR_ILLNESS). Had a major personal illness or injury?

Label	Code	Go To
Yes	1
No	2	CHANGE_SOCIAL_ACTIVITY

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE60000/(MAJOR_ILLNESS_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE61000/(CHANGE_SOCIAL_ACTIVITY). Had a major change in social activities such as parties, movies, visiting (either increased or decreased)?

Label	Code	Go To
Yes	1
No	2	CHANGE_LIVING_COND

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE62000/(CHANGE_SOCIAL_ACTIVITY_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE63000/(CHANGE_LIVING_COND). Had a major change in living conditions of your family (built a new home, remodeled, had your home or neighborhood decline)?

Label	Code	Go To
Yes	1
No	2	DIVORCE

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE64000/(CHANGE_LIVING_COND_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE65000/(DIVORCE). Gotten a divorce?

Label	Code	Go To
Yes	1
No	2	FRIEND_ILLNESS

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE66000/(DIVORCE_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE67000/(FRIEND_ILLNESS). Had a close friend with a serious injury or illness?

Label	Code	Go To
Yes	1
No	2	CHILD_LEAVE_HOME

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE68000/(FRIEND_ILLNESS_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE69000/(CHILD_LEAVE_HOME). Had a son or daughter leave home because of a marriage or school?

Label	Code	Go To
Yes	1
No	2	DROP_GRAD_SCHOOL

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE70000/(CHILD_LEAVE_HOME_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE71000/(DROP_GRAD_SCHOOL). Dropped out or graduated from school?

Label	Code	Go To
Yes	1
No	2	SEPAR_HUSB_WORK

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE72000/(DROP_GRAD_SCHOOL_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE73000/(SEPAR_HUSB_WORK). Had a separation from your spouse or partner because of work, travel, or family needs?

Label	Code	Go To
Yes	1
No	2	ENGAGED

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE74000/(SEPAR_HUSB_WORK_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE75000/(ENGAGED). Gotten engaged to be married?

Label	Code	Go To
Yes	1
No	2	LEFT_HOME

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE76000/(ENGAGED_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE77000/(LEFT_HOME). Left home for the first time?

Label	Code	Go To
Yes	1
No	2	MLE79000

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE78000/(LEFT_HOME_IMPACT). Negative/Bad or Positive/Good Impact on your life?

Label	Code	Go To
Extremely Negative	1
Moderately Negative	2
Somewhat Negative	3
No Impact	4
Somewhat Positive	5
Moderately Positive	6
Extremely Positive	7

SOURCE

Legacy Life Experiences Survey, Sarason Major Life Experiences

MLE79000. Thank you for participating in the National Children's Study and for taking the time to complete this survey.

FOR OFFICE USE ONLY:

FOU01000/(P_ID). PARTICIPANT ID:______________________________

FOU02000/(R_P_ID). RESPONDENT ID:____________________________

FOU03000. Click here to insert ROC contact information

Public reporting burden for this collection of information is estimated to average 8 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*). Do not return the completed form to this address.