Form NSDUH Questionnair NSDUH Questionnair NSDUH Questionnaire Change Flexibilities Survey
National Survey on Drug Use and Health: Methodological Field Tests
Attachment E_Survey_Questions
National Survey on Drug Use and Health: Questionnaire Change Flexibilities Online Panel/Platform Test
OMB: 0930-0290
Attachment E
Survey Questions
[ADULT/ADOLESCENT INFORMED CONSENT/ASSENT SCREENs (ATTACHMENTS C AND D) WILL BE INSERTED HERE]
Basic Demographics
age1 What is your date of birth?
ENTER MM-DD-YYYY
DOB: ________________
DK/REF
DEFINE CALCAGE:
CALCAGE = AGE CALCULATED BY "SUBTRACTING" DATE OF BIRTH FROM DATE OF INTERVIEW.
HARD ERROR: [IF YEAR OF BIRTH ENTERED IS 2021]: Please check to make sure the date of birth you have entered is correct.
HARD ERROR: [IF CALCAGE > 120]: Your age ([CALCAGE]) is greater than the maximum age allowed. Please check to make sure the date of birth you have entered is correct.
AGEREF [IF AGE1 = DK OR REF] The interview cannot be completed without your age. Please back up to enter your date of birth or click Next to exit the survey.
confirm [IF AGE1 NE DK/REF AND CONFDOB NE DK/REF] That would make you [CALCAGE] years old. Is this correct?
1 YES
2 NO
DK/REF
AGEREF2 [IF CONFIRM = DK OR REF] The interview cannot be completed without your age. Please back up to confirm your date of birth or click Next to exit the survey.
HARD ERROR: [IF CONFIRM = 2] Please go back to the previous question and correct your date of birth. If your age is now correct, select Yes.
[IF CONFIRM = 2, GO BACK TO AGE1]
under12 [IF CONFIRM = 1 OR DK/REF AND CALCAGE < 12] Since you are [CALCAGE] years old, you cannot complete the interview. Thank you for your time.
PROGRAM SHOULD ROUTE TO FIEXIT.
DEFINE CURNTAGE:
IF CALCAGE > 11 AND CONFIRM = 1, CURNTAGE = CALCAGE
IF CALCAGE > 11 AND CONFIRM = DK/REF AND DKREFAGE > 11, CURNTAGE = DKREFAGE
IF AGE1= DK/REF AND DKREFAGE > 11, CURNTAGE = DKREFAGE
ELSE RESPONDENT IS INELIGIBLE; ROUTE TO FIEXIT
QD01 What is your sex?
5 Male
9 Female
QD03 The first few questions are for statistical purposes only, to help us analyze the results of the study.
Are you of Hispanic, Latino, or Spanish origin or descent?
1 YES
2 NO
DK/REF
QD04 [IF QD03 = 1] Which of these Hispanic, Latino, or Spanish groups best describes you? Select all that apply.
1 Mexican, Mexican American, Mexicano, or Chicano
2 Puerto Rican
3 Central or South American
4 Cuban or Cuban American
5 Dominican (from Dominican Republic)
6 Spanish (from Spain)
7 Other
DK/REF
QD04othr [IF QD04 = 7] Which other Hispanic, Latino or Spanish group best describes you.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD04othr.
QD05 Which of these groups describes you? Select all that apply.
1 White
2 Black or African American
3 American Indian or Alaska Native, including North American, Central American, and South American Indians
4 Native Hawaiian
5 Guamanian or Chamorro
6 Samoan
7 Other Pacific Islander
8 Asian,including Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese
9 Other
DK/REF
QD05ASIA [IF QD05 = 8] Which of these Asian groups describes you?
1 Asian Indian
2 Chinese
3 Filipino
4 Japanese
5 Korean
6 Vietnamese
7 Other
DK/REF
QD05OTHA [IF QD05ASIA = 7] Please tell me which other Asian group or groups describes you.
OTHER ASIAN GROUP: _____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD05OTHA.
QD05OTHR [IF QD05 = 9] Which other racial group or groups describes you.
OTHER RACIAL GROUP: _____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD05OTHR.
QD07 [IF CURNTAGE = 15 OR OLDER] Are you now married, widowed, divorced or separated, or have you never married?
1 Married
2 Widowed
3 Divorced or Separated
4 Have Never Married
DK/REF
QD11 What is the highest grade or year of school you have completed?
Please include junior or community college attendance. Do not include technical school attendance.
No Schooling Completed
1st Grade Completed
2nd Grade Completed
3rd Grade Completed
4th Grade Completed
5th Grade Completed
6th Grade Completed
7th Grade Completed
8th Grade Completed
9th Grade Completed
10th Grade Completed
11th Grade Completed
12 Regular High School Diploma
13 12th Grade, No Diploma
14 GED Certificate of High School Completion
15 Some College Credit, but No Degree
16 Associate’s Degree (AA, AS)
17 Bachelor’s Degree (BA, BS)
18 Master’s Degree (MA, MS, MEng, M. Ed, MSW, MBA)
Doctorate Degree (PhD, EdD)
Professional Degree Beyond a Bachelor’s Degree (MD, DDS, DVM, LLB, JD)
DK/REF
QD12 This question is about your overall health. Would you say your health in general is excellent, very good, good, fair, or poor?
1 Excellent
2 Very Good
3 Good
4 Fair
5 Poor
DK/REF
Substance Use
DRUGSCRa These next questions are about the types of substances you may have used in the past 12 months.
Please type in the number for each substance you have used during the past 12 months.
Select all that apply
A drink of any type of alcoholic beverage. Please do not include times when you only had a sip or two from a drink.
Marijuana or hashish
Cocaine
Crack
Heroin
Methamphetamine
95 I have not used any of these substances in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF 1-6.
DRUGSCRb During the past 12 months, have you used, even once, any of the following hallucinogens?
LSD, also called ‘acid’
PCP, also called ‘angel dust’ or phencyclidine
Peyote
Mescaline
Psilocybin
‘Ecstasy’ or ‘Molly’, also called MDMA
Ketamine, also called “Special K” or “Super K”
DMT, also called dimethyltryptamine
AMT, also called alpha-methyltryptamine
Foxy, also called 5-MeO-DIPT
Salvia divinorum
1 Yes
2 No
DK/REF
DRUGSCRc During the past 12 months, have you used, even once, any of the following liquids, sprays, or gases that people sniff or inhale to get high or to make them feel good.
Amyl nitrite, ‘poppers,’ locker room odorizers, or ‘rush’
Correction fluid, degreaser, or cleaning fluid
Gasoline or lighter fluid
Glue, shoe polish, or toluene
Halothane, ether, or other anesthetics
Lacquer thinner, or other paint solvents
Lighter gases, such as butane or propane
Nitrous oxide or ‘whippits’
Felt-tip pens, felt-tip markers, or magic markers
Spray paints
Computer keyboard cleaner, also known as air duster
Other aerosol sprays
1 Yes
2 No
DK/REF
DRUGSCRd In the past 12 months, which, if any, of these pain relievers have you used in anyway a doctor did not direct you to use it?
Select all that apply
1 OxyContin
2 Percocet
3 Percodan
4 Roxicodone
5 Oxycodone (generic)
6 Ultram or Ultram ER
7 Ultracet
8 Tramadol (generic) or extended-release tramadol (generic)
9 Tylenol with codeine 3 or 4 (NOT over-the-counter Tylenol)
10 Codeine pills (generic)
11 Avinza
12 Kadian
13 MS Contin
14 Morphine (generic) or extended-release morphine (generic)
15 Duragesic
16 Fentora
17 Fentanyl (generic)
18 Suboxone
19 Buprenorphine (generic) or Buprenorphine plus naloxone (generic)
20 Opana or Opana ER
21 Oxymorphone (generic) or extended-release oxymorphone (generic)
22 Demerol
23 Dilaudid or hydromorphone
24 Exalgo or extended-release hydromorphone
25 Methadone
95 I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF 1-25.
IFPY [IF DRUGSCRd=15, 16 OR 17] Now think again about your fentanyl use in the past 12 months.
In the past 12 months, was any of the fentanyl you used prescribed to you by a doctor or other health professional?
Yes
No
DK/REF
IFMED [IF IFPY = 1] Was all of the fentanyl you used prescribed to you by a doctor or other health professional?
1 Yes
2 No
DK/REF
DRUGSCRe In the past 12 months, which, if any, of these tranquilizers have you used in anyway a doctor did not direct you to use it?
Select all that apply
Xanax or Xanax XR
Alprazolam (generic) or extended-release alprazolam (generic)
Ativan
Klonopin
Lorazepam (generic)
Clonazepam (generic)
Valium
Diazepam (generic)
9 Cyclobenzaprine (generic), also known as Flexeril
10 Soma
95 I have not used any of these tranquilizers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF 1-10.
DRUGSCRf In the past 12 months, which, if any, of these stimulants have you used in anyway a doctor did not direct you to use it?
Adderall or Adderall XR
Dexedrine
Dextroamphetamine (generic)
4 Mixed amphetamine-dextroamphetamine pills other than Adderall (generic)
5 Extended-release amphetamine-dextroamphetamine pills other than Adderall XR (generic)
6 Ritalin or Ritalin LA
7 Concerta
8 Daytrana
9 Metadate CD or Metadate ER
10 Methylphenidate (generic) or extended-release methylphenidate (generic)
11 Focalin or Focalin XR
12 Dexmethylphenidate (generic) or extended-release dexmethylphenidate (generic)
13 Benzphetamine
14 Didrex
15 Diethylpropion
16 Phendimetrazine
17 Phentermine
18 Provigil
19 Tenuate
20 Vyvanse
95 I have not used any of these stimulants in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF 1-20.
DRUGSCRg In the past 12 months, which, if any, of these sedatives have you used in anyway a doctor did not direct you to use it?
Ambien
Ambien CR
Zolpidem (generic)
Extended-release zolpidem (generic)
Lunesta or eszopiclone
Sonata or zaleplon
Halcion
Restoril
Flurazepam (generic), also known as Dalmane
Temazepam (generic)
Triazolam (generic)
Butisol
Seconal
Phenobarbital (generic)
95 I have not used any of these sedatives in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF 1-14.
KAINTRO This next question is about kratom, which can come in forms such as powder, pills, or leaf.
Click Next to continue.
KA01 Have you ever, even once, used kratom?
1 Yes
2 No
DK/REF
KALAST3 [IF KA01 = 1] How long has it been since you last used kratom?
1 Within the past 30 days – that is, since [DATEFILL]
2 More than 30 days ago but within the past 12 months
3 More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
Substance Dependence and Abuse
INTRODR Now we’d like for you to tell us about your experiences with the drugs that you used.
Click Next to continue.
DRALC [IF DRUGSCRa = 1] Think about your use of alcohol during the past 12 months as you answer these next questions.
Press [ENTER] to continue.
DRALC01 [IF DRUGSCRa = 1] During the past 12 months, was there a month or more when you spent a lot of your time getting or drinking alcohol?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC02 [IF DRALC01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of time getting over the effects of the alcohol you drank?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC04 [IF DRUGSCRa = 1] During the past 12 months, did you try to set limits on how often or how much alcohol you would drink?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC05 [IF DRALC04 = 1] Were you able to keep to the limits you set, or did you often drink more than you intended to?
1 Usually kept to the limits set
2 Often drank more than intended
DK/REF
DRALC06 [IF DRUGSCRa = 1] During the past 12 months, did you need to drink more alcohol than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC07 [IF DRALCO6=2 OR DK/REF] During the past 12 months, did you notice that drinking the same amount of alcohol had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC08 [IF DRUGSCRa = 1] During the past 12 months, did you want to or try to cut down or stop drinking alcohol?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC09 [IF DRALC08 = 1] During the past 12 months, were you able to cut down or stop drinking alcohol every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC10 [IF DRALC08 = 2 OR DK/REF OR DRALC09 = 2 OR DK/REF] During the past 12 months, did you cut down or stop drinking at least one time?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC11 [IF DRALC09 = 1 OR DRALC10 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms after you cut back or stopped drinking alcohol?
• Sweating or feeling that your heart was beating fast
• Having your hands tremble
• Having trouble sleeping
• Vomiting or feeling nauseous
• Seeing, hearing, or feeling things that weren’t really there
• Feeling like you couldn’t sit still
• Feeling anxious
• Having seizures or fits
1 Yes
2 No
DK/REF
DRALC12 [IF DRALC11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped drinking alcohol?
• Sweating or feeling that your heart was beating fast
• Having your hands tremble
• Having trouble sleeping
• Vomiting or feeling nauseous
• Seeing, hearing, or feeling things that weren’t really there
• Feeling like you couldn’t sit still
• Feeling anxious
• Having seizures or fits
1 Yes
2 No
DK/REF
DRALC13 [IF DRUGSCRa = 1] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by drinking alcohol?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC14 [IF DRALC13 = 1] Did you continue to drink alcohol even though you thought drinking was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRALC15 [IF DRALC13 = 2 OR DK/REF OR DRALC14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by drinking alcohol?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC16 [IF DRALC15 = 1] Did you continue to drink alcohol even though you thought drinking was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRALC17 [IF DRUGSCRa = 1] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did drinking alcohol cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC18 [IF DRUGSCRa = 1] Sometimes people who drink alcohol have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did drinking alcohol cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRALC19 [IF DRUGSCRa = 1] During the past 12 months, did you regularly drink alcohol and then do something where being drunk might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC20 [IF DRUGSCRa = 1] During the past 12 months, did drinking alcohol cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC21 [IF DRUGSCRa = 1] During the past 12 months, did you have any problems with family or friends that were probably caused by your drinking?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC22 [IF DRALC21 = 1] Did you continue to drink alcohol even though you thought your drinking caused problems with family or friends?
1 Yes
2 No
DK/REF
DRMJ [IF DRUGSCRa = 2] Think about your use of marijuana or hashish during the past 12 months as you answer these next questions.
Click Next to continue.
DRMJ01 [IF DRUGSCRa = 2] During the past 12 months, was there a month or more when you spent a lot of your time getting or using marijuana or hashish?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ02 [IF DRMJ01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the marijuana or hashish you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ04 [IF DRUGSCRa = 2] During the past 12 months, did you try to set limits on how often or how much marijuana or hashish you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ05 [IF DRMJ04 = 1] Were you able to keep to the limits you set, or did you often use marijuana or hashish more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRMJ06 [IF DRUGSCRa = 2] During the past 12 months, did you need to use more marijuana or hashish than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ07 [IF DRMJ06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of marijuana or hashish had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ08 [IF DRUGSCRa = 2] During the past 12 months, did you want to or try to cut down or stop using marijuana or hashish?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ09 [IF DRMJ08 = 1] During the past 12 months, were you able to cut down or stop using marijuana or hashish every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ13 [IF DRUGSCRa = 2] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of marijuana or hashish?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ14 [IF DRMJ13 = 1] Did you continue to use marijuana or hashish even though you thought it was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRMJ15 [IF DRMJ13 = 2 OR DK/REF OR DRMJ14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of marijuana or hashish?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ16 [IF DRMJ15 = 1] Did you continue to use marijuana or hashish even though you thought it was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRMJ17 [IF DRUGSCRa = 2] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using marijuana or hashish cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ18 [IF DRUGSCRa = 2] Sometimes people who use marijuana or hashish have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using marijuana or hashish cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRMJ19 [IF DRUGSCRa = 2] During the past 12 months, did you regularly use marijuana or hashish and then do something where using marijuana or hashish might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ20 [IF DRUGSCRa = 2] During the past 12 months, did using marijuana or hashish cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ21 [IF DRUGSCRa = 2] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of marijuana or hashish?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ22 [IF DRMJ21 = 1] Did you continue to use marijuana or hashish even though you thought it caused problems with family or friends?
1 Yes
2 No
DK/REF
DRCC [IF DRUGSCRa = 3 OR 4] Think about your use of cocaine [IF CRK12MON = 1] , including the form of cocaine called ‘crack’ during the past 12 months as you answer these next questions.
Press [ENTER] to continue.
DEFINE COKEFILL:
IF DRUGSCRa = 3 AND DRUGSCRa NE 4, THEN COKEFILL = ‘cocaine’
IF DRUGSCRa = 3 AND DRUGSCRa = 4 THEN COKEFILL = ‘cocaine or ‘crack’
IF DRUGSCRa NE 3 AND DRUGSCRa = 4 THEN COKEFILL = ‘crack’
ELSE COKEFILL = BLANK
DRCC01 [IF DRUGSCRa = 3 OR 4] During the past 12 months, was there a month or more when you spent a lot of your time getting or using [COKEFILL]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC02 [IF DRCC01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the [COKEFILL] you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC04 [IF DRUGSCRa = 3 OR 4] During the past 12 months, did you try to set limits on how often or how much [COKEFILL] you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC05 [IF DRCC04 = 1] Were you able to keep to the limits you set, or did you often use [COKEFILL] more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRCC06 [IF DRUGSCRa = 3 OR 4] During the past 12 months, did you need to use more [COKEFILL] than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC07 [IF DRCC06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of [COKEFILL] had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC08 [IF DRUGSCRa = 3 OR 4] During the past 12 months, did you want to or try to cut down or stop using [COKEFILL]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC09 [IF DRCC08 = 1] During the past 12 months, were you able to cut down or stop using [COKEFILL] every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC10 [IF DRCC8 = 2 OR DK/REF OR DRCC9 = 2 OR DK/REF] During the past 12 months, did you cut down or stop using [COKEFILL] at least one time?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC10a [IF DRCC09 = 1 OR DRCC10 = 1] During the past 12 months, have you felt kind of blue or down when you cut down or stopped using [COKEFILL]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC11 [IF DRCC10a = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms after you cut back or stopped using [COKEFILL]?
• Feeling tired or exhausted
• Having bad dreams
• Having trouble sleeping or sleeping more than you normally do
• Feeling hungry more often
• Feeling either very slowed down or like you couldn’t sit still
1 Yes
2 No
DK/REF
DRCC12 [IF DRCC11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using [COKEFILL]?
• Feeling tired or exhausted
• Having bad dreams
• Having trouble sleeping or sleeping more than you normally do
• Feeling hungry more often
• Feeling either very slowed down or like you couldn’t sit still
1 Yes
2 No
DK/REF
DRCC13 [IF DRUGSCRa = 3 OR 4] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of [COKEFILL]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC14 [IF DRCC13 = 1] Did you continue to use [COKEFILL] even though you thought it was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRCC15 [IF DRCC13 = 2 OR DK/REF OR DRCC14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of [COKEFILL]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC16 [IF DRCC15 = 1] Did you continue to use [COKEFILL] even though you thought it was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRCC17 [IF DRUGSCRa = 3 OR 4] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using [COKEFILL] cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC18 [IF DRUGSCRa = 3 OR 4] Sometimes people who use [COKEFILL] have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using [COKEFILL] cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRCC19 [IF DRUGSCRa = 3 OR 4] During the past 12 months, did you regularly use [COKEFILL] and then do something where using [COKEFILL] might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC20 [IF DRUGSCRa = 3 OR 4] During the past 12 months, did using [COKEFILL] cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC21 [IF DRUGSCRa = 3 OR 4] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of [COKEFILL]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC22 [IF DRCC21 = 1] Did you continue to use [COKEFILL] even though you thought it caused problems with family or friends?
1 Yes
2 No
DK/REF
DRHE [IF DRUGSCRa = 5] Think about your use of heroin during the past 12 months as you answer these next questions.
Click Next to continue.
DRHE01 [IF DRUGSCRa = 5] During the past 12 months, was there a month or more when you spent a lot of your time getting or using heroin?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE02 [IF DRHE01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the heroin you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE04 [IF DRUGSCRa = 5] During the past 12 months, did you try to set limits on how often or how much heroin you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE05 [IF DRHE04 = 1] Were you able to keep to the limits you set, or did you often use heroin more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRHE06 [IF DRUGSCRa = 5] During the past 12 months, did you need to use more heroin than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE07 [IF DRHE06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of heroin had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE08 [IF DRUGSCRa = 5] During the past 12 months, did you want to or try to cut down or stop using heroin?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE09 [IF DRHE08 = 1] During the past 12 months, were you able to cut down or stop using heroin every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE10 [IF DRHE08 = 2 OR DK/REF OR DRHE09 = 2 OR DK/REF] During the past 12 months, did you cut down or stop using heroin at least one time?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE11 [IF DRHE09 = 1 OR DRHE10 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 3 or more of these symptoms after you cut back or stopped using heroin?
• Feeling kind of blue or down
• Vomiting or feeling nauseous
• Having cramps or muscle aches
• Having teary eyes or a runny nose
• Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
• Having diarrhea
• Yawning
• Having a fever
• Having trouble sleeping
1 Yes
2 No
DK/REF
DRHE12 [IF DRHE11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 3 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using heroin?
• Feeling kind of blue or down
• Vomiting or feeling nauseous
• Having cramps or muscle aches
• Having teary eyes or a runny nose
• Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
• Having diarrhea
• Yawning
• Having a fever
• Having trouble sleeping
1 Yes
2 No
DK/REF
DRHE13 [IF DRUGSCRa = 5] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of heroin?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE14 [IF DRHE13 = 1] Did you continue to use heroin even though you thought it was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRHE15 [IF DRHE13 = 2 OR DK/REF OR DRHE14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of heroin?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE16 [IF DRHE15 = 1] Did you continue to use heroin even though you thought it was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRHE17 [IF DRUGSCRa = 5] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using heroin cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE18 [IF DRUGSCRa = 5] Sometimes people who use heroin have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using heroin cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRHE19 [IF DRUGSCRa = 5] During the past 12 months, did you regularly use heroin and then do something where using heroin might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE20 [IF DRUGSCRa = 5] During the past 12 months, did using heroin cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE21 [IF DRUGSCRa = 5] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of heroin?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE22 [IF DRHE21 = 1] Did you continue to use heroin even though you thought it caused problems with family or friends?
1 Yes
2 No
DK/REF
DRLS [IF DRUGSCRb = 1] Think about your use of hallucinogens, such as LSD, ‘acid’, PCP, ‘Ecstasy’ or ‘Molly’, psilocybin or mushrooms, mescaline, or peyote during the past 12 months as you answer these next questions.
Click Next to continue.
DRLS01 [IF DRUGSCRb = 1] During the past 12 months, was there a month or more when you spent a lot of your time getting or using hallucinogens?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS02 [IF DRLS01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the hallucinogens you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS04 [IF DRUGSCRb = 1] During the past 12 months, did you try to set limits on how often or how much hallucinogens you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS05 [IF DRLS04 = 1] Were you able to keep to the limits you set, or did you often use hallucinogens more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRLS06 [IF DRUGSCRb = 1] During the past 12 months, did you need to use more hallucinogens than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS07 IF DRLS06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of hallucinogens had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS08 [IF DRUGSCRb = 1] During the past 12 months, did you want to or try to cut down or stop using hallucinogens?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS09 [IF DRLS08 = 1] During the past 12 months, were you able to cut down or stop using hallucinogens every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS13 [IF DRUGSCRb = 1] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of hallucinogens?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS14 [IF DRLS13 = 1] Did you continue to use hallucinogens even though you thought this was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRLS15 [IF DRLS13 = 2 OR DK/REF OR DRLS14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of hallucinogens?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS16 [IF DRLS15 = 1] Did you continue to use hallucinogens even though you thought this was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRLS17 [IF DRUGSCRb = 1] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using hallucinogens cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS18 [IF DRUGSCRb = 1] Sometimes people who use hallucinogens have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using hallucinogens cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRLS19 [IF DRUGSCRb = 1] During the past 12 months, did you regularly use hallucinogens and then do something where using hallucinogens put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS20 [IF DRUGSCRb = 1] During the past 12 months, did using hallucinogens cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS21 [IF DRUGSCRb = 1] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of hallucinogens?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS22 [IF DRLS21 = 1] Did you continue to use hallucinogens even though you thought this caused problems with family or friends?
1 Yes
2 No
DK/REF
DRIN [IF DRUGSCRc = 1] Think about your use of inhalants, such as amyl nitrite, ‘poppers,’ nitrous oxide, gasoline or lighter fluids, glue, spray paints, or correction fluids during the past 12 months as you answer these next questions.
Click Next to continue.
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN01 [IF DRUGSCRc = 1] During the past 12 months, was there a month or more when you spent a lot of your time getting or using inhalants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN02 [IF DRIN01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the inhalants you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN04 [IF DRUGSCRc = 1] During the past 12 months, did you try to set limits on how often or how much inhalants you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN05 [IF DRIN04 = 1] Were you able to keep to the limits you set, or did you often use inhalants more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRIN06 [IF DRUGSCRc = 1] During the past 12 months, did you need to use more inhalants than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN07 [IF DRIN06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of inhalants had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN08 [IF DRUGSCRc = 1] During the past 12 months, did you want to or try to cut down or stop using inhalants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN09 [IF DRIN08 = 1] During the past 12 months, were you able to cut down or stop using inhalants every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN13 [IF DRUGSCRc = 1] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of inhalants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN14 [IF DRIN13 = 1] Did you continue to use inhalants even though you thought this was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRIN15 [IF DRIN13 = 2 OR DK/REF OR DRIN14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of inhalants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN16 [IF DRIN15 = 1] Did you continue to use inhalants even though you thought this was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRIN17 [IF DRUGSCRc = 1] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using inhalants cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN18 [IF DRUGSCRc = 1] Sometimes people who use inhalants have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using inhalants cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRIN19 [IF DRUGSCRc = 1] During the past 12 months, did you regularly use inhalants and then do something where using inhalants might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN20 [IF DRUGSCRc = 1] During the past 12 months, did using inhalants cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN21 [IF DRUGSCRc = 1] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of inhalants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN22 [IF DRIN21 = 1] Did you continue to use inhalants even though you thought this caused problems with family or friends?
1 Yes
2 No
DK/REF
DRME [IF DRUGSCRa = 6] Think about your use of methamphetamine during the past 12 months as you answer these next questions.
Click Next to continue.
DRME01 [IF DRUGSCRa = 6] During the past 12 months, was there a month or more when you spent a lot of your time getting or using methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME02 [IF DRME01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the methamphetamine you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME04 [IF DRUGSCRa = 6] During the past 12 months, did you try to set limits on how often or how much methamphetamine you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME05 [IF DRME04 = 1] Were you able to keep to the limits you set, or did you often use methamphetamine more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRME06 [IF DRUGSCRa = 6] During the past 12 months, did you need to use more methamphetamine than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME07 [IF DRME06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of methamphetamine had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME08 [IF DRUGSCRa = 6] During the past 12 months, did you want to or try to cut down or stop using methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME09 [IF DRME08 = 1] During the past 12 months, were you able to cut down or stop using methamphetamine every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME10 [IF DRME08 = 2 OR DK/REF OR DRME09 = 2 OR DK/REF] During the past 12 months, did you cut down or stop using methamphetamine at least one time?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME10a [IF DRME09 = 1 OR DRME10 = 1] During the past 12 months, have you felt kind of blue or down when you cut down or stopped using methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME11 [IF DRME10a = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms after you cut back or stopped using methamphetamine?
• Feeling tired or exhausted
• Having bad dreams
• Having trouble sleeping or sleeping more than you normally do
• Feeling hungry more often
• Feeling either very slowed down or like you couldn’t sit still
1 Yes
2 No
DK/REF
DRME12 [IF DRME11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using methamphetamine?
• Feeling tired or exhausted
• Having bad dreams
• Having trouble sleeping or sleeping more than you normally do
• Feeling hungry more often
• Feeling either very slowed down or like you couldn’t sit still
1 Yes
2 No
DK/REF
DRME13 [IF DRUGSCRa = 6] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME14 [IF DRME13 = 1] Did you continue to use methamphetamine even though you thought it was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRME15 [IF DRME13 = 2 OR DK/REF OR DRME14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME16 [IF DRME15 = 1] Did you continue to use methamphetamine even though you thought it was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRME17 [IF DRUGSCRa = 6] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using methamphetamine cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME18 [IF DRUGSCRa = 6] Sometimes people who use methamphetamine have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using methamphetamine cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRME19 [IF DRUGSCRa = 6] During the past 12 months, did you regularly use methamphetamine and then do something where using methamphetamine might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME20 [IF DRUGSCRa = 6] During the past 12 months, did using methamphetamine cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME21 [IF DRUGSCRa = 6] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME22 [IF DRME21 = 1] Did you continue to use methamphetamine even though you thought it caused problems with family or friends?
1 Yes
2 No
DK/REF
DRPR [IF DRUGSCRd NE 95] Think about your use of prescription pain relievers during the past 12 months as you answer these next questions. Remember, we are only interested in prescription pain relievers that you used in any way a doctor did not direct you to.
Earlier the computer recorded that in the past 12 months you used [IF DRUGSCRd = 1 ENTRY, FILL DRUGSCRd WITH DRUG NAME][IF DRUGSCRd>=2 ENTRIES, FILL WITH “the pain relievers listed below” ] in a way a doctor did not direct you to use [it/them].
[IF DRUGSCRd >=2 ENTRIES, FILL WITH DRUG NAMES FROM DRUGSCRd BELOW. USE MULTIPLE COLUMNS AS NEEDED.]
Click Next to continue.
DRPR01 [IF DRUGSCRd NE 95] During the past 12 months, was there a month or more when you spent a lot of your time getting or using prescription pain relievers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR02 [IF DRPR01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the prescription pain relievers you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR04 [IF DRUGSCRd NE 95] During the past 12 months, did you try to set limits on how often or how much prescription pain relievers you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR05 [IF DRPR04 = 1] Were you able to keep to the limits you set, or did you often use prescription pain relievers more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRPR06 [IF DRUGSCRd NE 95] During the past 12 months, did you need to use more prescription pain relievers than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR07 [IF DRPR06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of prescription pain relievers had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR08 [IF DRUGSCRd NE 95] During the past 12 months, did you want to or try to cut down or stop using prescription pain relievers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR09 [IF DRPR08 = 1] During the past 12 months, were you able to cut down or stop using prescription pain relievers every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR10 [IF DRPR08 = 2 OR DK/REF OR DRPR09 = 2 OR DK/REF] During the past 12 months, did you cut down or stop using prescription pain relievers at least one time?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR11 [IF DRPR09 = 1 OR DRPR10 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 3 or more of these symptoms after you cut back or stopped using prescription pain relievers?
• Feeling kind of blue or down
• Vomiting or feeling nauseous
• Having cramps or muscle aches
• Having teary eyes or a runny nose
• Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
• Having diarrhea
• Yawning
• Having a fever
• Having trouble sleeping
1 Yes
2 No
DK/REF
DRPR12 [IF DRPR11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 3 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using prescription pain relievers?
• Feeling kind of blue or down
• Vomiting or feeling nauseous
• Having cramps or muscle aches
• Having teary eyes or a runny nose
• Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
• Having diarrhea
• Yawning
• Having a fever
• Having trouble sleeping
1 Yes
2 No
DK/REF
DRPR13 [IF DRUGSCRd NE 95] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of prescription pain relievers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR14 [IF DRPR13 = 1] Did you continue to use prescription pain relievers even though you thought this was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRPR15 [IF DRPR13 = 2 OR DK/REF OR DRPR14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of prescription pain relievers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR16 [IF DRPR15 = 1] Did you continue to use prescription pain relievers even though you thought this was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRPR17 [IF DRUGSCRd NE 95] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription pain relievers cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR18 [IF DRUGSCRd NE 95] Sometimes people who use prescription pain relievers have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using prescription pain relievers cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRPR19 [IF DRUGSCRd NE 95] During the past 12 months, did you regularly use prescription pain relievers and then do something where using prescription pain relievers might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR20 [IF DRUGSCRd NE 95] During the past 12 months, did using prescription pain relievers cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR21 [IF DRUGSCRd NE 95] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of prescription pain relievers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR22 [IF DRPR21 = 1] Did you continue to use prescription pain relievers even though you thought this caused problems with family or friends?
1 Yes
2 No
DK/REF
DRTR [IF DRUGSCRe NE 95] Think about your use of prescription tranquilizers during the past 12 months as you answer these next questions. Remember, we are only interested in prescription tranquilizers that you used in any way a doctor did not direct you to.
Earlier the computer recorded that in the past 12 months you used [IF DRUGSCRe=1 ENTRY, FILL WITH DRUGSCRe DRUG NAME][IF DRUGSCRe >=2 ENTRIES, FILL WITH “the tranquilizers listed below” ] in a way a doctor did not direct you to use [it/them].
[IF DRUGSCRe>=2 ENTRIES, FILL WITH DRUG NAMES FROM DRUGSCRe BELOW. USE MULTIPLE COLUMNS AS NEEDED.]
Click Next to continue.
DRTR01 [IF DRUGSCRe NE 95] During the past 12 months, was there a month or more when you spent a lot of your time getting or using prescription tranquilizers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR02 [IF DRTR01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the prescription tranquilizers you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR04 [IF DRUGSCRe NE 95] During the past 12 months, did you try to set limits on how often or how much prescription tranquilizers you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR05 [IF DRTR04 = 1] Were you able to keep to the limits you set, or did you often use prescription tranquilizers more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRTR06 [IF DRUGSCRe NE 95] During the past 12 months, did you need to use more prescription tranquilizers than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR07 [IF DRTR06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of prescription tranquilizers had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR08 [IF DRUGSCRe NE 95] During the past 12 months, did you want to or try to cut down or stop using prescription tranquilizers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR09 [IF DRTR08 = 1] During the past 12 months, were you able to cut down or stop using prescription tranquilizers every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR13 [IF DRUGSCRe NE 95] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of prescription tranquilizers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR14 [IF DRTR13 = 1] Did you continue to use prescription tranquilizers even though you thought this was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRTR15 [IF DRTR13 = 2 OR DK/REF OR DRTR14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of prescription tranquilizers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR16 [IF DRTR15 = 1] Did you continue to use prescription tranquilizers even though you thought this was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRTR17 [IF DRUGSCRe NE 95] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription tranquilizers cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR18 [IF DRUGSCRe NE 95] Sometimes people who use prescription tranquilizers have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using prescription tranquilizers cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRTR19 [IF DRUGSCRe NE 95] During the past 12 months, did you regularly use prescription tranquilizers and then do something where using prescription tranquilizers might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR20 [IF DRUGSCRe NE 95] During the past 12 months, did using prescription tranquilizers cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR21 [IF DRUGSCRe NE 95] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of prescription tranquilizers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR22 [IF DRTR21 = 1] Did you continue to use prescription tranquilizers even though you thought this caused problems with family or friends?
1 Yes
2 No
DK/REF
DRST [IF DRUGSCRf NE 95] Think about your use of prescription stimulants during the past 12 months as you answer these next questions. Remember, we are only interested in prescription stimulants that you used in any way a doctor did not direct you to.
Earlier the computer recorded that in the past 12 months you used [IF DRUGSCRf=1 ENTRY, FILL WITH DRUG NAME][IF DRUGSCRf >=2 ENTRIES FILL WITH “the stimulants listed below” ] in a way a doctor did not direct you to use [it/them].
[IF DRUGSCRf > =2 ENTRIES, FILL WITH DRUG NAMES FROM DRUGSCRf BELOW. USE MULTIPLE COLUMNS AS NEEDED]
Click Next to continue.
DRST01 [IF DRUGSCRf NE 95] During the past 12 months, was there a month or more when you spent a lot of your time getting or using prescription stimulants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST02 [IF DRST01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the prescription stimulants you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST04 [IF DRUGSCRf NE 95] During the past 12 months, did you try to set limits on how often or how much prescription stimulants you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST05 [IF DRST04 = 1] Were you able to keep to the limits you set, or did you often use prescription stimulants more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRST06 [IF DRUGSCRf NE 95] During the past 12 months, did you need to use more prescription stimulants than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST07 [IF DRST06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of prescription stimulants had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST08 [IF DRUGSCRf NE 95] During the past 12 months, did you want to or try to cut down or stop using prescription stimulants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST09 [IF DRST08 = 1] During the past 12 months, were you able to cut down or stop using prescription stimulants every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST10 [IF DRST08 = 2 OR DK/REF OR DRST09 = 2 OR DK/REF] During the past 12 months, did you cut down or stop using prescription stimulants at least one time?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST10a [IF DRST09 = 1 OR DRST10 = 1] During the past 12 months, have you felt kind of blue or down when you cut down or stopped using prescription stimulants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST11 [IF DRST10a = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms after you cut back or stopped using prescription stimulants?
• Feeling tired or exhausted
• Having bad dreams
• Having trouble sleeping or sleeping more than you normally do
• Feeling hungry more often
• Feeling either very slowed down or like you couldn’t sit still
1 Yes
2 No
DK/REF
DRST12 [IF DRST11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using prescription stimulants?
• Feeling tired or exhausted
• Having bad dreams
• Having trouble sleeping or sleeping more than you normally do
• Feeling hungry more often
• Feeling either very slowed down or like you couldn’t sit still
1 Yes
2 No
DK/REF
DRST13 [IF DRUGSCRf NE 95] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of prescription stimulants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST14 [IF DRST13 = 1] Did you continue to use prescription stimulants even though you thought this was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRST15 [IF DRST13 = 2 OR DK/REF OR DRST14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of prescription stimulants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST16 [IF DRST15 = 1] Did you continue to use prescription stimulants even though this was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRST17 [IF DRUGSCRf NE 95] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription stimulants cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST18 [IF DRUGSCRf NE 95] Sometimes people who use prescription stimulants have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using prescription stimulants cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRST19 [IF DRUGSCRf NE 95] During the past 12 months, did you regularly use prescription stimulants and then do something where using prescription stimulants might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST20 [IF DRUGSCRf NE 95] During the past 12 months, did using prescription stimulants cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST21 [IF DRUGSCRf NE 95] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of prescription stimulants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST22 [IF DRST21 = 1] Did you continue to use prescription stimulants even though you thought this caused problems with family or friends?
1 Yes
2 No
DK/REF
DRSV [IF DRUGSCRg NE 95] Think about your use of prescription sedatives during the past 12 months as you answer these next questions. Remember, we are only interested in prescription sedatives that you used in any way a doctor did not direct you to.
Earlier the computer recorded that in the past 12 months you used [IF DRUGSCRg=1 ENTRY, FILL WITH DRUG NAME][IF DRUGSCRg >=2 ENTRIES, FILL WITH “the sedatives listed below” ] in a way a doctor did not direct you to use [it/them].
[IF DRUGSCRg>= 2 ENTRIES FILL WITH DRUG NAMES FROM DRUGSCRg BELOW. USE MULTIPLE COLUMNS AS NEEDED.]
Click Next to continue.
DRSV01 [IF DRUGSCRg NE 95] During the past 12 months, was there a month or more when you spent a lot of your time getting or using prescription sedatives?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV02 [IF DRSV01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of your time getting over the effects of the prescription sedatives you used?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV04 [IF DRUGSCRg NE 95] During the past 12 months, did you try to set limits on how often or how much prescription sedatives you would use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV05 [IF DRSV04 = 1] Were you able to keep to the limits you set, or did you often use prescription sedatives more than you intended to?
1 Usually kept to the limits set
2 Often used more than intended
DK/REF
DRSV06 [IF DRUGSCRg NE 95] During the past 12 months, did you need to use more prescription sedatives than you used to in order to get the effect you wanted?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV07 [IF DRSV06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of prescription sedatives had less effect on you than it used to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV08 [IF DRUGSCRg NE 95] During the past 12 months, did you want to or try to cut down or stop using prescription sedatives?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV09 [IF DRSV08 = 1] During the past 12 months, were you able to cut down or stop using prescription sedatives every time you wanted to or tried to?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV10 [IF DRSV08 = 2 OR DK/REF OR DRSV09 = 2 OR DK/REF] During the past 12 months, did you cut down or stop using prescription sedatives at least one time?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV11 [IF DRSV09 = 1 OR DRSV10 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms after you cut back or stopped using prescription sedatives?
• Sweating or feeling that your heart was beating fast
• Having your hands tremble
• Having trouble sleeping or sleeping more than you normally do
• Vomiting or feeling nauseous
• Seeing, hearing, or feeling things that weren’t really there
• Feeling like you couldn’t sit still
• Feeling anxious
• Having seizures or fits
1 Yes
2 No
DK/REF
DRSV12 [IF DRSV11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using prescription sedatives?
• Sweating or feeling that your heart was beating fast
• Having your hands tremble
• Having trouble sleeping or sleeping more than you normally do
• Vomiting or feeling nauseous
• Seeing, hearing, or feeling things that weren’t really there
• Feeling like you couldn’t sit still
• Feeling anxious
• Having seizures or fits
1 Yes
2 No
DK/REF
DRSV13 [IF DRUGSCRg NE 95] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by your use of prescription sedatives?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV14 [IF DRSV13 = 1] Did you continue to use prescription sedatives even though you thought this was causing you to have problems with your emotions, nerves, or mental health?
1 Yes
2 No
DK/REF
DRSV15 [IF DRSV13 = 2 OR DK/REF OR DRSV14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by your use of prescription sedatives?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV16 [IF DRSV15 = 1] Did you continue to use prescription sedatives even though you thought this was causing you to have physical problems?
1 Yes
2 No
DK/REF
DRSV17 [IF DRUGSCRg NE 95] This question is about important activities such as working, going to school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription sedatives cause you to give up or spend less time doing these types of important activities?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV18 [IF DRUGSCRg NE 95] Sometimes people who use prescription sedatives have serious problems at home, work or school — such as:
• neglecting their children
• missing work or school
• doing a poor job at work or school
• losing a job or dropping out of school
During the past 12 months, did using prescription sedatives cause you to have serious problems like this either at home, work, or school?
1 Yes
2 No
DK/REF
DRSV19 [IF DRUGSCRg NE 95] During the past 12 months, did you regularly use prescription sedatives and then do something where using prescription sedatives might have put you in physical danger?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV20 [IF DRUGSCRg NE 95] During the past 12 months, did using prescription sedatives cause you to do things that repeatedly got you in trouble with the law?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV21 [IF DRUGSCRg NE 95] During the past 12 months, did you have any problems with family or friends that were probably caused by your use of prescription sedatives?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV22 [IF DRSV21 = 1] Did you continue to use prescription sedatives even though you thought this caused problems with family or friends?
1 Yes
2 No
DK/REF
Drug Treatment
INTROTX These next questions deal with treatment for alcohol and drug problems, not including cigarettes. Please report treatment or counseling designed to help you reduce or stop your alcohol or drug use. Please include detoxification and any other treatment for medical problems associated with your alcohol or drug use.
Click Next to continue.
TX01 Have you ever received treatment or counseling for your use of alcohol or any drug, not counting cigarettes?
1 Yes
2 No
DK/REF
TX02 [IF TX01 = 1] During the past 12 months, that is, since [DATEFILL], have you received treatment or counseling for your use of alcohol or any drug, not counting cigarettes?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX03 [IF TX02 = 1] During the past 12 months when you received treatment, was the treatment for alcohol use only, drug use only, or both alcohol and drug use?
1 Alcohol use only
2 Drug use only
3 Both alcohol and drug use
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE TXFILL1:
IF TX03 = 1, TXFILL1 = alcohol use
IF TX03 = 2, TXFILL1 = drug use
IF TX03 = 3 OR DK/REF, TXFILL1 = alcohol or drug use
ELSE, TXFILL1 = BLANK
TX04a [IF TX03 NE BLANK ] During the past 12 months, have you received treatment for your [TXFILL1] in a hospital overnight as an inpatient?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04a1 [IF TX03 = 3 AND TX04a = 1] Was the treatment you received in a hospital overnight as an inpatient for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04b [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a residential drug or alcohol rehabilitation facility where you stayed overnight?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04b1 [IF TX03 = 3 AND TX04b = 1] Was the treatment you received in a residential drug or alcohol rehabilitation facility where you stayed overnight for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04c [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a drug or alcohol rehabilitation facility as an outpatient?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04c1 [IF TX03 = 3 AND TX04c = 1] Was the treatment you received in a drug or alcohol rehabilitation facility as an outpatient for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04d [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a mental health center or facility as an outpatient?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04d1 [IF TX03 = 3 AND TX04d = 1] Was the treatment you received in a mental health center or facility as an outpatient for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04e [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in an emergency room?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04e1 [IF TX03 = 3 AND TX04e = 1] Was the treatment you received in an emergency room for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04f [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a private doctor’s office?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04f1 [IF TX03 = 3 AND TX04f = 1] Was the treatment you received in a private doctor’s office for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04g [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a prison or jail?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04g1 [IF TX03 = 3 AND TX04g = 1] Was the treatment you received in a prison or jail for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04h [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a self-help group such as Alcoholics Anonymous or Narcotics Anonymous?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04h1 [IF TX03 = 3 AND TX04h = 1] Was the treatment you received in a self-help group for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX04i [IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in some other place besides these that have been listed?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04iSP [IF TX04i = 1] Please type in a description of the place where you received treatment or counseling for your [TXFILL1] other than the places just mentioned. When you have finished typing your answer, click Next to go to the next question.
_______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX04iSP.
TX04i1 [IF TX03 = 3 AND TX04i = 1] Was the treatment you received in this other place for your alcohol use, your drug use, or both?
1 Alcohol use
2 Drug use
3 Both alcohol and drug use
DK/REF
TX05 [IF (TX03 = 2 OR 3) AND ME01 = 1] During the past 12 months, that is, since [DATEFILL], did you visit a hospital emergency room to receive treatment for your use of methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX06 [IF TX05 = 1] During the past 12 months, how many times did you visit a hospital emergency room to receive treatment for your use of methamphetamine?
# OF TIMES: [RANGE: 1 - 90]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX07 [IF TX02 = 1 OR DK/REF] Are you currently receiving treatment or counseling for your [TXFILL1]?
1 Yes
2 No
DK/REF
TX08 [IF (TX01 = 2 OR DK/REF) OR ((TX02 =2 OR DK/REF) AND TX07 NE 1)] During the past 12 months, did you need treatment or counseling for your alcohol or drug use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX09 [IF TX02 = 1 AND TX07 NE 1] During the past 12 months, did you need additional treatment or counseling for your alcohol or drug use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX10 [IF TX09 = 1] During the past 12 months, for which of the following drugs did you need additional treatment or counseling?
Select all that apply
Alcohol
Marijuana or hashish
Cocaine or ‘crack’
Heroin
Hallucinogens
Inhalants
Methamphetamine
Prescription pain relievers
Prescription tranquilizers
Prescription stimulants
Prescription sedatives
Some other drug
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX11 [IF DRUGSCRa=1 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of alcohol?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX12 [IF DRUGSCRa=2 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of marijuana or hashish?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX13 [IF (DRUGSCRa = 3 OR 4) AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of cocaine or ‘crack’?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX14 [IF DRUGSCRa= 5 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of heroin?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX15 [IF DRUGSCRb=1 AND TX08 =1] During the past 12 months, did you need treatment or counseling for your use of hallucinogens?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX16 [IF DRUGSCRc=1 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of inhalants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX16a [IF DRUGSCRa=6 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of methamphetamine?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX17 [IF DRUGSCRd = 1 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of prescription pain relievers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX18 [IF DRUGSCRe=1 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of prescription tranquilizers?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX19 [IF DRUGSCRf=1 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of prescription stimulants?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX20 [IF DRUGSCRg=1 AND TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of prescription sedatives?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX21 [IF TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of some other drug besides the ones just listed?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX21SP1 [IF TX21 = 1] Please type in the name of one of the other drugs you needed treatment or counseling for during the past 12 months. If you’re not sure how to spell the drug name, just make your best guess. When you have finished typing your answer, click Next to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX21SP1.
TX21SP2 [IF TX21SP1 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment or counseling for during the past 12 months other than those you have already mentioned. If you have not needed treatment or counseling for your use of any other drugs, click Next to go to the next question.
____________
DK/REF
TX21SP3 [IF TX21SP2 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment or counseling for during the past 12 months other than those you have already mentioned. If you have not needed treatment or counseling for your use of any other drugs, click Next to go to the next question.
____________
DK/REF
TX21SP4 [IF TX21SP3 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment or counseling for during the past 12 months other than those you have already mentioned. If you have not needed treatment or counseling for your use of any other drugs, click Next to go to the next question.
____________
DK/REF
TX21SP5 [IF TX21SP4 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment or counseling for during the past 12 months other than those you have already mentioned. If you have not needed treatment or counseling for your use of any other drugs, click Next to go to the next question.
____________
DK/REF
DEFINE TXFILL2:
IF TX11 = 1 AND ALL OF TX12 - TX21 = 2 OR DK/REF, TXFILL2 = alcohol
IF TX11 = 2 OR DK/REF, AND ANY IN TX12 - TX21 = 1, TXFILL2 = any drug
ELSE, TXFILL2 = alcohol or any other drug
TX22 [IF TX08 = 1] During the past 12 months, did you make an effort to get treatment or counseling for your use of [TXFILL2]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX22A [IF TX22 IS NOT BLANK] Which of these statements explain why you did not get the treatment or counseling you needed for your use of [TXFILL2]?
Select all that apply.
1 You had no health care coverage, and you couldn’t afford the cost.
2 You did have health care coverage, but it didn’t cover treatment for [TXFILL2], or didn’t cover the full cost.
3 You had no transportation to a program, or the programs were too far away, or the hours were not convenient.
4 You didn’t find a program that offered the type of treatment or counseling you wanted.
5 You were not ready to stop using [TXFILL2].
6 There were no openings in the programs.
7 You did not know where to go to get treatment.
8 You were concerned that getting treatment or counseling might cause your neighbors or community to have a negative opinion of you.
9 You were concerned that getting treatment or counseling might have a negative effect on your job.
10 Some other reason or reasons.
DK/REF
TX22B [IF ANY ENTRY IN TX22A = 10] Which of these statements explain why you did not get the treatment or counseling you needed for your use of [TXFILL2]?
Select all that apply.
1 You didn't think you needed treatment at the time.
2 You thought you could handle the problem without treatment.
3 You didn't think treatment would help.
4 You didn't have time (because of job, childcare, or other commitments).
5 You didn't want others to find out that you needed treatment.
6 Some other reason or reasons.
DK/REF
TX22SP [IF ANY ENTRY IN TX22B = 6 ] Please type in the most important other reason you did not get the treatment you needed. When you have finished typing your answer, click Next to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX22SP.
TX23 [IF TX09 = 1] During the past 12 months, did you make an effort to get additional treatment or counseling for your use of alcohol or any other drug?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX23A [IF TX23 IS NOT BLANK] Which of these statements explain why you did not get the additional treatment or counseling you needed for your use of alcohol or drugs?
Select all that apply.
1 You had no health care coverage, and you couldn’t afford the cost.
2 You did have health care coverage, but it didn’t cover treatment for alcohol or drugs, or didn’t cover the full cost.
3 You had no transportation to a program, or the programs were too far away, or the hours were not convenient.
4 You didn’t find a program that offered the type of treatment or counseling you wanted.
5 You were not ready to stop using alcohol or drugs.
6 There were no openings in the programs.
7 You did not know where to go to get treatment.
8 You were concerned that getting treatment or counseling might cause your neighbors or community to have a negative opinion of you.
9 You were concerned that getting treatment or counseling might have a negative effect on your job.
10 Some other reason or reasons.
DK/REF
TX23B [IF ANY ENTRY IN TX23A = 10] Which of these statements explain why you did not get the additional treatment or counseling you needed for your use of alcohol or drugs?
Select all that apply.
1 You didn't think you needed treatment at the time.
2 You thought you could handle the problem without treatment.
3 You didn't think treatment would help.
4 You didn't have time (because of job, childcare, or other commitments).
5 You didn't want others to find out that you needed treatment.
6 Some other reason or reasons.
DK/REF
TX23SP [IF ANY ENTRY IN TX23B = 6] Please type in the most important other reason you did not get the treatment you needed. When you have finished typing your answer, press the [ENTER] key to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX23SP.
TX24 [IF TX07 NE 1] How long has it been since you were last in treatment or counseling for your alcohol or drug use, not counting cigarettes?
1 Within the past 30 days -- that is, since [DATEFILL]
2 More than 30 days ago but within the past 12 months
3 More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX25 [IF TX01 = 1 AND TX07 NE 1 OR BLANK] What was the main place where you received treatment the last time you started treatment for your alcohol or other drug use, not counting cigarettes?
[IF TX01 = 1 AND TX07 = 1] What is the main place where you are currently receiving treatment for your alcohol or other drug use, not counting cigarettes?
1 A hospital overnight as an inpatient
2 A residential drug or alcohol rehabilitation facility where you stay at night
3 A drug or alcohol rehabilitation facility as an outpatient where you do not stay at night
4 A mental health center or facility as an outpatient
5 An emergency room
6 A private doctor’s office
7 A prison or jail
8 A self-help group
9 Some other place
DK/REF
TX25SP [IF TX01 = 1 AND TX07 NE BLANK AND TX25 = 9] Please type in a description of the place where you received treatment or counseling for your drug use other than the places just mentioned. When you have finished typing your answer, click Next to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX25SP.
TX26 [IF DRUGSCRa=1 AND TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of alcohol?
[IF DRUGSCRa=1 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of alcohol?
1 Yes
2 No
DK/REF
TX27 [IF DRUGSCRa=2 AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of marijuana or hashish?
[IF DRUGSCRa=2 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of marijuana or hashish?
1 Yes
2 No
DK/REF
TX28 [IF DRUGSCRa=3 OR 4) AND TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of cocaine or ‘crack’?
[IF (DRUGSCRa=3 OR 4) AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of cocaine or ‘crack’?
1 Yes
2 No
DK/REF
TX29 [IF DRUGSCRa=5 AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of heroin?
[IF DRUGSCRa=5 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of heroin?
1 Yes
2 No
DK/REF
TX30 [IF DRUGSCRb = 1 AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of hallucinogens?
[IF DRUGSCRb=1 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of hallucinogens?
1 Yes
2 No
DK/REF
TX31 [IF DRUGSCRc=1 AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of inhalants?
[IF DRUGSCRc = 1 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of inhalants?
1 Yes
2 No
DK/REF
TX31a [IF DRUGSCRa=6 AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of methamphetamine?
[IF DRUGSCRa=5 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of methamphetamine?
1 Yes
2 No
DK/REF
TX32 [IF DRUGSCRd=1 AND TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of fentanyl?
[IF DRUGSCRd=1 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of fentanyl?
1 Yes
2 No
DK/REF
TX33 [IF DRUGSCRe=1 AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of prescription tranquilizers?
[IF DRUGSCRe=1 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of prescription tranquilizers?
1 Yes
2 No
DK/REF
TX34 [IF DRUGSCRf=1 AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of prescription stimulants?
[IF DRUGSCRf=1 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of prescription stimulants?
1 Yes
2 No
DK/REF
TX35 [IF DRUGSCRg=1 AND TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of prescription sedatives?
[IF DRUGSCRg=1 AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of prescription sedatives?
1 Yes
2 No
DK/REF
TX36 [IF TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of any other drug?
[IF TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of any other drug?
1 Yes
2 No
DK/REF
TX36SP1 [IF TX36 = 1 AND TX07 NE 1 OR BLANK] Please type in the name of one of the drugs you received treatment for the last time. If you’re not sure how to spell the name of the drug, just make your best guess.
When you have finished typing your answer, click Next to go to the next question.
[IF TX36 = 1 AND TX07 = 1] Please type in the name of one of the drugs for which you are currently being treated. If you’re not sure how to spell the name of the drug, just make your best guess.
When you have finished typing your answer, click Next to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX36SP1.
TX36SP2 [IF TX36SP1 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are no other drugs you received treatment or counseling for the last time, other than those you already mentioned, click Next to go to the next question.
[IF TX36SP1 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving treatment or counseling for, other than those you already mentioned, click Next to go to the next question.
_____________
DK/REF
TX36SP3 [IF TX36SP2 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are no other drugs you received treatment or counseling for the last time, other than those you already mentioned, click Next to go to the next question.
[IF TX36SP2 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving treatment or counseling for, other than those you already mentioned, click Next to go to the next question.
_____________
DK/REF
TX36SP4 [IF TX36SP3 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are no other drugs you received treatment or counseling for the last time, other than those you already mentioned, click Next to go to the next question.
[IF TX36SP3 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving treatment or counseling for, other than those you already mentioned, click Next to go to the next question.
_____________
DK/REF
TX36SP5 [IF TX36SP4 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are no other drugs you received treatment or counseling for the last time, other than those you already mentioned, click Next to go to the next question.
[IF TX36SP4 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving treatment or counseling for, other than those you already mentioned, click Next to go to the next question.
_____________
DK/REF
TX37 [IF MORE THAN 1 ITEM IN THE TX26 - TX36 SERIES = 1 OR DK/REF AND TX07 NE 1 OR BLANK] What was the main drug you entered treatment for the last time you were treated?
[IF MORE THAN 1 ITEM IN THE TX26 - TX36 SERIES = 1 OR DK/REF AND TX07 = 1] What is the main drug for which you are currently receiving treatment or counseling?
Alcohol
Marijuana or hashish
Cocaine or ‘crack’
Heroin
Hallucinogens
Inhalants
Methamphetamine
Prescription pain relievers
Prescription tranquilizers
Prescription stimulants
Prescription sedatives
Some other drug
DK/REF
TX38 [IF TX25 = 1 - 8 AND TX07 NE 1 OR BLANK] What was the outcome of the treatment or counseling you last received at [FILL IN ANSWER FROM TX25]?
[IF TX25 = DK/REF OR TX25 = 9 AND TX07 NE 1 OR BLANK] What was the outcome of the treatment or counseling you last received?
1 You are still in treatment
2 You successfully completed treatment
3 You left because you had a problem with the program
4 You left because you couldn’t afford to continue treatment
5 You left because your family needed you
6 You left because you began using drugs again
7 Your last treatment had some other outcome
DK/REF
TX38SP [IF TX38 = 7] Please type in a description of the outcome of your last treatment or counseling for drug use. You do not need to give a detailed description — just a few words will be sufficient.
When you have finished typing your answer, click Next to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX38SP.
TX39 [IF TX25 = 1- 8 AND TX38 = 2 - 7 OR DK/REF] How long did you stay in treatment for your alcohol or drug use during your last treatment at [FILL IN ANSWER FROM TX25]?
[IF (TX25 = 1 - 8 AND TX38 = 1) OR (TX07 = 1 AND TX25 = 1 - 8)] How long have you been in treatment for your alcohol or drug use at [FILL IN ANSWER FROM TX17]?
[IF TX25 = 9 OR DK/REF AND TX38 = 2 - 7 OR DK/REF] How long did you stay in treatment for your alcohol or drug use during your last treatment?
[IF (TX25 = 9 OR DK/REF AND TX38 = 1) OR TX07 = 1 AND TX25 = 9)] How long have you been in treatment for your alcohol or drug use so far?
Please indicate whether you want to give your answer in days, months, or years.
1 Days
2 Months
3 Years
DK/REF
TX40DAY1 [IF (TX38 = 1 OR TX07 = 1) AND TX39 = 1 OR DK/REF] How many days have you been in treatment for your alcohol or drug use so far?
# OF DAYS: [RANGE: 1 - 366]
DK/REF
TX40DAY2 [IF TX38 = 2 - 7 OR DK/REF AND TX39 = 1 OR DK/REF] How many days did you stay in treatment for your alcohol or drug use the last time?
# OF DAYS: [RANGE: 1 - 366]
DK/REF
TX41MON1 [IF (TX38 = 1 OR TX07 = 1) AND TX39 = 2] How many months have you been in treatment for your alcohol or drug use so far?
# OF MONTHS: [RANGE: 1 - 400]
DK/REF
TX41MON2 [IF TX38 = 2 - 7 OR DK/REF AND TX39 = 2] How many months did you stay in treatment for your alcohol or drug use the last time?
# OF MONTHS: [RANGE: 1 - 400]
DK/REF
TX41YR1 [IF (TX38 = 1 OR TX07 = 1) AND TX39 = 3] How many years have you been in treatment for your alcohol or drug use so far?
# OF YEARS: [RANGE: 1 - 60]
DK/REF
TX41YR2 [IF TX38 = 2 - 7 OR DK/REF AND TX39 = 3] How many years did you stay in treatment for your alcohol or drug use the last time?
# OF YEARS: [RANGE: 1 - 60]
DK/REF
TX42A [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did private health insurance pay for the last treatment you received, even if it paid only part of the cost?
[IF TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will private health insurance pay for the treatment you are currently receiving, even if it pays only part of the cost?
1 Yes
2 No
DK/REF
TX42B [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did Medicare pay for the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will Medicare pay for the treatment you are currently receiving, even if it pays only part of the cost?
1 Yes
2 No
DK/REF
TX42C [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did Medicaid pay for the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will Medicaid pay for the treatment you are currently receiving, even if it pays only part of the cost?
1 Yes
2 No
DK/REF
TX42D [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did a public assistance program other than Medicaid pay for the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will a public assistance program other than Medicaid pay for the treatment you are currently receiving, even if it pays only part of the cost?
1 Yes
2 No
DK/REF
TX42E [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did you use your own savings or earnings to pay for the last treatment you received, even if you paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will you use your own savings or earnings to pay for the treatment you are currently receiving, even if you pay only part of the cost?
1 Yes
2 No
DK/REF
TX42F [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did family members pay for the last treatment you received, even if they paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will family members pay for the treatment you are currently receiving, even if they pay only part of the cost?
1 Yes
2 No
DK/REF
TX42G [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did the courts pay for the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will the courts pay for the treatment you are currently receiving, even if it pays only part of the cost?
1 Yes
2 No
DK/REF
TX42H [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did CHAMPUS or TRICARE, CHAMPVA, the VA, or some other military health care pay for the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will CHAMPUS or TRICARE, CHAMPVA, the VA, or some other military health care pay for the treatment you are currently receiving, even if it pays only part of the cost?
1 Yes
2 No
DK/REF
TX42I [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did your employer pay for the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will your employer pay for the treatment you are currently receiving, even if it pays only part of the cost?
1 Yes
2 No
DK/REF
TX42J [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Was your last treatment paid for by some other source besides those that have been listed?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will the treatment you are currently receiving be paid for by some other source besides those that have been listed?
1 Yes
2 No
DK/REF
TX42JSP [IF TX42J = 1 AND TX07 NE 1 OR BLANK] Please type in a description of the source that paid for your last treatment or counseling for alcohol or drug use. You do not need to give a detailed description — just a few words will be sufficient. When you have finished typing your answer, press the [ENTER] key to go to the next question.
[IF TX42J = 1 AND (TX07 = 1 OR TX38 = 1)] Please type in a description of the source that will pay for your current treatment or counseling for alcohol or drug use. You do not need to give a detailed description — just a few words will be sufficient. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX42JSP.
TX42K [IF TX42A - TX42J = 2 AND TX07 NE 1 OR BLANK] Was the last treatment you received free?
[IF TX42A - TX42J = 2 AND (TX07 = 1 OR TX38 = 1)] Is the treatment you are currently receiving free?
1 Yes
2 No
DK/REF
TX43 [IF TX01 = 1] Were you enrolled in a treatment program for your alcohol or drug use on October 1, [CURRENT YEAR – 1]?
For this question, please include only treatment you received at a hospital, drug rehabilitation facility, or mental health center.
1 Yes
2 No
DK/REF
TX44 [IF TX03 NE BLANK] Think about all the treatment or counseling you received for your [TXFILL1] during the past 12 months. Was detoxification the only [TXFILL1] treatment you received during the past 12 months?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX52 [IF (TX01 NE BLANK) AND (TX04h NE 1)] The next question is about self-help groups. Some examples of self-help groups for alcohol or drug use are AA or Alcoholics Anonymous, NA or Narcotics Anonymous, CA or Cocaine Anonymous, and CMA or Crystal Meth Anonymous.
During the past 12 months, did you go to any self-help group meetings or 12-step programs to receive help for your own use of alcohol or any drug, not counting cigarettes?
Yes
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX53 [IF TX52 = 1] Did you go to the self-help group because of your alcohol use only, your drug use only, or because of both alcohol and drug use?
Alcohol use only
Drug use only
Both alcohol and drug use
DK/REF
Adult Mental Health Service Utilization
(Questions Administered only to respondents 18 or older)
ADINTRO [IF CURNTAGE = 18 OR OLDER] These next questions are about treatment and counseling for problems with emotions, nerves or mental health. [IF TX01 = 1 OR DK/REF] Please do not include treatment for alcohol or drug use.
Click Next to continue.
ADMT01 [IF CURNTAGE = 18 OR OLDER] During the past 12 months, have you stayed overnight or longer in a hospital or other facility to receive treatment or counseling for any problem you were having with your emotions, nerves, or mental health? [IF TX01 = 1 OR DK/REF] Please do not include treatment for alcohol or drug use.
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMTREF1 [IF ADMT01 = REF] The answers that people give us about mental health treatment are important to this study’s success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: During the past 12 months, have you stayed overnight or longer in a hospital or other facility to receive treatment or counseling for any problem you were having with your emotions, nerves, or mental health? [IF TX01 = 1 OR DK/REF] Please do not include treatment for alcohol or drug use.
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT02 [IF ADMT01 = 1 OR ADMTREF1 = 1] Where did you stay overnight or longer to receive mental health treatment or counseling during the past 12 months?
Select all that apply.
1 A private or public psychiatric hospital
2 A psychiatric unit of a general hospital
3 A medical unit of a general hospital
4 Another type of hospital
5 A residential treatment center
6 Some other type of facility
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT04 [IF ADMT02 = 1] During the past 12 months, how many nights did you spend in a private or public psychiatric hospital for mental health care?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT05 [IF ADMT02 = 2] During the past 12 months, how many nights did you spend in the psychiatric unit of a general hospital for mental health care?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT06 [IF ADMT02 = 3] During the past 12 months, how many nights did you spend in the medical unit of a general hospital for mental health care?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT07 [IF ADMT02 = 4] During the past 12 months, how many nights did you spend in some other type of hospital for mental health care?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT08 [IF ADMT02 = 5] During the past 12 months, how many nights did you spend in a residential treatment center for mental health care?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT09 [IF ADMT02 = 6] During the past 12 months, how many nights did you spend in some other type of facility for mental health care?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT10 [IF ADMT02 NE BLANK] Who paid or will pay for the inpatient mental health care you received during the past 12 months?
Select all that apply.
1 Self or a family member living with you
2 A family member who does not live with you
3 Private health insurance
4 Medicare
5 Medicaid
6 Rehabilitation program
7 Employer
8 VA or other military program
9 Other public source
10 Other private source
11 No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT11 [IF MORE THAN 1 RESPONSE SELECTED IN ADMT10 AND ADMT02 NE DK/REF] Who paid or will pay most of the cost for the inpatient mental health care you received during the past 12 months?
Please select only one answer from those that are shown in blue below.
[NOTE TO PROGRAMMERS: RESPONSES CHOSEN IN ADMT10 SHOULD BE SHOWN IN BLUE. IMPLEMENT AN ERROR MESSAGE IF THE RESPONDENT SELECTS ONE OF THE OTHER RESPONSES.]
1 Self or a family member living with you
2 A family member who does not live with you
3 Private health insurance
4 Medicare
5 Medicaid
6 Rehabilitation program
7 Employer
8 VA or other military program
9 Other public source
10 Other private source
11 No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT12 [IF ADMT10 = 1 AND ADMT02 NE DK/REF] How much did you or your family pay for the inpatient mental health care you received during the past 12 months? Do not count any money that has been or will be reimbursed by insurance or any other source.
[IF ADMT10 = 2 AND NE 1 AND ADMT02 NE DK/REF] How much did your family pay for the inpatient mental health care you received during the past 12 months? Do not count any money that has been or will be reimbursed by insurance or any other source.
1 Less than $100
2 $100 to $200
3 $201 to $500
4 $501 to $900
5 $901 to $1,500
6 $1,501 to $2,000
7 $2,001 to $5,000
8 $5,001 to $7,500
9 $7,501 to $10,000
10 More than $10,000
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT13 [IF CURNTAGE = 18 OR OLDER] The list below includes some of the places where people can get outpatient treatment or counseling for problems with their emotions, nerves, or mental health.
During the past 12 months, did you receive any outpatient treatment or counseling for any problem you were having with your emotions, nerves, or mental health at any of the places listed below? [IF TX01 = 1 OR DK/REF] Please do not include treatment for alcohol or drug use.
• An outpatient mental health clinic or center
• The office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not part of a clinic
• A doctor’s office that was not part of a clinic
• An outpatient medical clinic
• A partial day hospital or day treatment program
• Some other place
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMTREF13 [IF ADMT13 = REF] The answers that people give us about mental health treatment are important to this study’s success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: During the past 12 months, did you receive any outpatient treatment or counseling for any problem you were having with your emotions, nerves, or mental health at any of the places listed below? [IF TX01 = 1 OR DK/REF] Please do not include treatment for alcohol or drug use.
• An outpatient mental health clinic or center
• The office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not part of a clinic
• A doctor’s office that was not part of a clinic
• An outpatient medical clinic
• A partial day hospital or day treatment program
• Some other place
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT14 [IF ADMT13 = 1 OR ADMTREF13 = 1] Where did you receive outpatient mental health treatment or counseling during the past 12 months?
Select all that apply.
1 An outpatient mental health clinic or center
2 The office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not part of a clinic
3 A doctor’s office that was not part of a clinic
4 An outpatient medical clinic
5 A partial day hospital or day treatment program
6 Some other place
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT15 [IF ADMT14 = 6] Please type in a description of this other place where you received outpatient mental health treatment or counseling. When you have finished, press the [ENTER] key to go to the next question.
________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN ADMT15.
ADMT16 [IF ADMT14 = 1] During the past 12 months, how many visits did you make to an outpatient mental health clinic or center for mental health care?
# OF VISITS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT17 [IF ADMT14 = 2] During the past 12 months, how many outpatient visits did you make to a private therapist, psychologist, psychiatrist, social worker, or counselor for mental health care?
# OF VISITS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT18 [IF ADMT14 = 3] During the past 12 months, how many outpatient visits did you make to a doctor’s office for mental health care?
# OF VISITS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT19 [IF ADMT14 = 4] During the past 12 months, how many outpatient visits did you make to an outpatient medical clinic for mental health care?
# OF VISITS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT20 [IF ADMT14 = 5] During the past 12 months, how many outpatient visits did you make to a partial day hospital or day treatment program for mental health care?
# OF VISITS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT21 [IF ADMT14 = 6] During the past 12 months, how many outpatient visits did you make to some other type of facility for mental health care?
# OF VISITS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT22 [IF ADMT14 NE BLANK] Who paid or will pay for the outpatient mental health care you received during the past 12 months?
Select all that apply.
1 Self or a family member living with you
2 A family member who does not live with you
3 Private health insurance
4 Medicare
5 Medicaid
6 Rehabilitation program
7 Employer
8 VA or other military program
9 Other public source
10 Other private source
11 No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT23 [IF MORE THAN 1 RESPONSE SELECTED IN ADMT22 AND ADMT14 NE DK/REF] Who paid or will pay most of the cost for the outpatient mental health care you received during the past 12 months?
Please select only one answer from those that are shown in blue below.
[NOTE TO PROGRAMMERS: RESPONSES CHOSEN IN ADMT22 SHOULD BE SHOWN IN BLUE. IMPLEMENT AN ERROR MESSAGE IF THE RESPONDENT SELECTS ONE OF THE OTHER RESPONSES.]
1 Self or a family member living with you
2 A family member who does not live with you
3 Private health insurance
4 Medicare
5 Medicaid
6 Rehabilitation program
7 Employer
8 VA or other military program
9 Other public source
10 Other private source
11 No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT24 [IF ADMT22 = 1 AND ADMT14 NE DK/REF] How much did you or your family pay for the outpatient mental health care you received during the past 12 months? Do not count any money that has been or will be reimbursed by insurance or any other source.
[IF ADMT22 = 2 AND NE 1 AND ADMT14 NE DK/REF] How much did your family pay for the outpatient mental health care you received during the past 12 months? Do not count any money that has been or will be reimbursed by insurance or any other source.
1 Less than $100
2 $100 to $200
3 $201 to $500
4 $501 to $900
5 $901 to $1,500
6 $1,501 to $2,000
7 $2,001 to $5,000
8 More than $5,000
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT25 [IF CURNTAGE = 18 OR OLDER] During the past 12 months, did you take any prescription medication that was prescribed for you to treat a mental or emotional condition?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMTREF25 [IF ADMT25 = REF] The answers that people give us about their use of prescription medications are important to this study’s success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: During the past 12 months, did you take any prescription medication that was prescribed for you to treat a mental or emotional condition?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT26 [IF CURNTAGE = 18 OR OLDER] During the past 12 months, was there any time when you needed mental health treatment or counseling for yourself but didn’t get it?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT27 [IF ADMT26 = 1] Which of these statements explain why you did not get the mental health treatment or counseling you needed?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press [ENTER].
1 You couldn’t afford the cost.
2 You were concerned that getting mental health treatment or counseling might cause your neighbors or community to have a negative opinion of you.
3 You were concerned that getting mental health treatment or counseling might have a negative effect on your job.
4 Your health insurance does not cover any mental health treatment or counseling.
5 Your health insurance does not pay enough for mental health treatment or counseling.
6 You did not know where to go to get services.
7 You were concerned that the information you gave the counselor might not be kept confidential.
8 You were concerned that you might be committed to a psychiatric hospital or might have to take medicine.
9 Some other reason or reasons.
DK/REF
ADMT27A [IF ANY ENTRY IN ADMT27 = 9] Which of these statements explain why you did not get the mental health treatment or counseling you needed?
Select all that apply.
1 You didn't think you needed treatment at the time.
2 You thought you could handle the problem without treatment.
3 You didn't think treatment would help.
4 You didn't have time (because of job, childcare, or other commitments).
5 You didn't want others to find out that you needed treatment.
6 You had no transportation, or treatment was too far away, or the hours were not convenient.
7 Some other reason or reasons.
DK/REF
ADMT27SP [IF ADMT27A = 7] Please type in the most important other reason you did not get the mental health treatment or counseling you needed. When you have finished, click Next to go to the next question.
__________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN ADMT27SP.
ADMT29a [IF CURNTAGE = 18 OR OLDER] Earlier, we asked whether you have received prescription medicines, inpatient treatment or outpatient treatment for your emotions, nerves or mental health. The list below contains possible sources of treatment, counseling or support that were not mentioned before.
Acupuncturist or acupressurist
Chiropractor
Herbalist
In-person support group or self-help group
Internet support group or chat room
Spiritual or religious advisor, such as a pastor, priest, rabbi
Telephone hotline
Massage therapist
Did you receive treatment, counseling or support from any other sources such as these during the past 12 months?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT29b [IF ADMT29a = 1] From what source did you receive other treatment, counseling or support for problems with your emotions, nerves or mental health in the past 12 months?
Select all that apply.
1 Acupuncturist or acupressurist
2 Chiropractor
3 Herbalist
4 In-person support group or self-help group
5 Internet support group or chat room
6 Spiritual or religious advisor, such as a pastor, priest, rabbi
7 Telephone hotline
8 Massage therapist
9 Other (specify)
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT29bSP [IF ADMT29b = 9] Please type in the source of the other treatment, counseling or support you received. When you have finished, click Next to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN ADMT29bSP.
ADMT30 [IF ADMT01 = 1 OR ADMTREF1 = 1 OR ADMT13 = 1 OR ADMTREF13 = 1 OR ADMT25 = 1 OR ADMTREF25 = 1 OR ADMT29a=1] Please think about the mental health treatment or counseling you received during the past 12 months. Which of these statements best describes how you were prompted to get treatment?
I decided on my own to get treatment
I got treatment mainly because someone else thought I should
I was ordered to get treatment
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
Mental Health
(Questions administered only to respondents 18 or older.)
DIINTRO [IF CURNTAGE = 18 OR OLDER] These questions ask how you have been feeling during the past 30 days.
Click Next to continue.
NERVE30 [IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel nervous?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
HOPE30 [IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel hopeless?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
FIDG30 [IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel restless or fidgety?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
NOCHR30 [IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel so sad or depressed that nothing could cheer you up?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
EFFORT30 [IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel that everything was an effort?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DOWN30 [IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel down on yourself, no good or worthless?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
WORST30 The last questions asked about how you have been feeling during the past 30 days. Now think about the past 12 months. Was there a month in the past 12 months when you felt more depressed, anxious, or emotionally stressed than you felt during the past 30 days?
1 Yes
2 No
PROGRAMMER: SHOW 12 MONTH CALENDAR
DSNERV1 [IF CURNTAGE = 18 OR OLDER AND WORST30=1] Think of one month in the past 12 months when you were the most depressed, anxious, or emotionally stressed.
During that month, how often did you feel nervous?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DSHOPE [IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your worst emotionally . . .
how often did you feel hopeless?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
DSFIDG [IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your worst emotionally . . .
how often did you feel restless or fidgety?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
DSNOCHR [IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your worst emotionally . . .
how often did you feel so sad or depressed that nothing could cheer you up?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
DSEFFORT [IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your worst emotionally . . .
how often did you feel that everything was an effort?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
DSDOWN [IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your worst emotionally . . .
how often did you feel down on yourself, no good, or worthless?
1 All of the time
2 Most of the time
3 Some of the time
4 A little of the time
5 None of the time
DK/REF
DEFINE DISTRESS:
IF NERVE30 = 1-4 OR HOPE30 = 1-4 OR FIDG30 = 1-4, OR NOCHR30 = 1-4 OR EFFORT30= 1-4 OR DOWN30 = 1-4, OR DSNERV1 = 1-4 OR DSHOPE = 1-4 OR DSFIDG = 1-4 ORDSNOCHR = 1-4 OR DSEFFORT= 1-4 OR DSDOWN = 1-4, THEN DISTRESS = 1
ELSE, DISTRESS = 2
LIKERT [IF DISTRESS=1] The next questions are about how much your emotions, nerves, or mental health caused you to have difficulties in daily activities.
In answering, think of the one month in the past 12 months when your emotions, nerves, or mental health interfered most with your daily activities.
Click Next to continue.
LIREMEM [IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have remembering to do things you needed to do?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
DK/REF
LICONCEN [IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have concentrating on doing something important when other things were going on around you?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
DK/REF
LIGOOUT1 [IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have going out of the house and getting around on your own?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
5 You didn’t leave the house on your own
DK/REF
LIGOOUT2 [IF LIGOOUT1 = 5] Did problems with your emotions, nerves, or mental health keep you from leaving the house on your own?
1 Yes
2 No
DK/REF
LISTRAN1 [IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have dealing with people you did not know well?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
5 You didn’t deal with people you did not know well
DK/REF
LISTRAN2 [IF LISTRAN1 = 5] Did problems with your emotions, nerves, or mental health keep you from dealing with people you did not know well?
1 Yes
2 No
DK/REF
LISOC1 [IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have participating in social activities, like visiting friends or going to parties?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
5 You didn’t participate in social activities
DK/REF
LISOC2 [IF LISOC1=5] Did problems with your emotions, nerves, or mental health keep you from participating in social activities?
1 Yes
2 No
DK/REF
LIHHRES1 [IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have taking care of household responsibilities?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
5 You didn’t take care of household responsibilities
DK/REF
LIHHRES2 [IF LIHHRES1=5] Did problems with your emotions, nerves, or mental health keep you from taking care of household responsibilities?
1 Yes
2 No
DK/REF
LIWKRES1 [IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have taking care of your daily responsibilities at work or school?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
5 You didn’t work or go to school
DK/REF
LIWKRES2 [IF LIWKRES1=5] Did problems with your emotions, nerves, or mental health keep you from working or going to school?
1 Yes
2 No
DK/REF
LIWKQUIC [IF DISTRESS =1 AND LIWKRES1 NE 5] During that one month when your emotions, nerves or mental health interfered most with your daily activities . . .
how much difficulty did you have getting your daily work done as quickly as needed?
1 No difficulty
2 Mild difficulty
3 Moderate difficulty
4 Severe difficulty
DK/REF
IMWEEK1 [IF LIREMEM = 2 - 4 OR LICONCEN = 2 - 4 OR LIGOOUT1 = 2 - 4 OR LIGOOUT2 = 1 OR LISTRAN1 = 2 - 4 OR LISTRAN2 = 1 OR LISOC1 = 2 - 4 OR LISOC2 = 1 OR LIHHRES1 = 2 - 4 OR LIHHRES2 = 1 OR LIWKRES1 = 2 - 4 OR LIWKRES2 = 1 OR LIWKQUIC = 2 - 4] You mentioned having difficulty with or being unable to do such things as [FILL WITH BOLDED TEXT FROM UP TO ALL ITEMS WHERE LIREMEM = 2 - 4 OR LICONCEN = 2 - 4 OR LIGOOUT1 = 2 - 4 OR LISTRAN1 = 2 - 4 OR LISOC1 = 2 - 4 OR LIHHRES1 = 2 - 4 OR LIWKRES1 = 2 - 4 OR LIWKQUIC = 2 - 4].
[Note to Programmers: Bolded text fills should appear in bold lower case and be separated by semicolons. The last fill should be preceded by the word “and.”
IF LIREMEM = 2 – 4 THEN FILL = “remembering to do things you needed to do”
IF LICONCEN = 2 – 4 THEN FILL = “concentrating on doing something important when other things were going on around you”
IF LIGOOUT1 = 2 – 4 THEN FILL = “going out of the house and getting around on your own”
IF LISTRAN1 = 2 – 4 THEN FILL = “dealing with people you did not know well”
IF LISOC1 = 2 – 4 THEN FILL = “participating in social activities, like visiting friends or going to parties”
IF LIHHRES1 = 2 – 4 THEN FILL = “taking care of your household responsibilities”
IF LIWKRES1 = 2 – 4 THEN FILL = “taking care of your daily responsibilities at work or school”
IF LIWKQUIC = 2 – 4 THEN FILL = “getting your daily work done as quickly as needed”
Further IMWEEK1 Fill Specifications:
IF LIGOOUT2=1 USE FILL FOR LIGOOUT1.
IF LISTRAN2=1 USE FILL FOR LISTRAN1.
IF LISOC2=1 USE FILL FOR LISOC1.
IF LIHHRES2=1 USE FILL FOR LIHHRES1.
IF LIWKRES2=1 USE FILL FOR LIWKRES1.]
During the past 12 months, about how many weeks did you have any of these difficulties because of your emotions, nerves, or mental health? If you can’t remember the exact number, just give your best estimate.
# OF WEEKS: [RANGE: 1 - 52]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CREATE IMWEEK1 FILL.
IMDAYS [IF IMWEEK1 =1-52] During (that [IMWEEK1FILL] week/those [IMWEEK1 FILL] weeks), did you have these kinds of difficulties every day, most days, or only one or two days a week?
1 Every day
2 Most days
3 Only one or two days a week
DK/REF
LIAD68 [IF LIREMEM = 2 – 4, OR LICONCEN = 2 - 4, OR LIGOOUT1 = 2 - 4 , OR LIGOOUT2 = 1, OR LISTRAN1 = 2 – 4, OR LISTRAN2 = 1, OR LISOC1 = 2 - 4, OR LISOC2 = 1, OR LIHHRES1 = 2 - 4, OR LIHHRES2 = 1, OR LIWKRES1 = 2 - 4, OR LIWKQUIC = 2 - 4] About how many days out of 365 in the past 12 months were you totally unable to work or carry out your normal activities because of your emotions, nerves or mental health?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
Adult Depression
[Questions administered only to respondents 18 years of age and older]
ASC21 [IF CURNTAGE = 18 OR OLDER] Have you ever in your life had a period of time lasting several days or longer when most of the day you felt sad, empty or depressed?
1 Yes
2 No
DK/REF
ASC22 [IF ASC21 = 2 OR DK/REF] Have you ever had a period of time lasting several days or longer when most of the day you were very discouraged about how things were going in your life?
1 Yes
2 No
DK/REF
ASC23 [IF ASC22 = 2 or DK/REF] Have you ever had a period of time lasting several days or longer when you lost interest in most things you usually enjoy like work, hobbies, and personal relationships?
1 Yes
2 No
DK/REF
AD01 [IF ASC21 =1] During times when you felt sad, empty, or depressed most of the day, did you ever feel discouraged about how things were going in your life?
1 Yes
2 No
DK/REF
AD01a [IF AD01 = 1] During the times when you felt sad, empty, or depressed, did you ever lose interest in most things like work, hobbies, and other things you usually enjoy?
1 Yes
2 No
DK/REF
AD01b [IF AD01 = 2 OR DK/REF] During the times when you felt sad, empty, or depressed, did you ever lose interest in most things like work, hobbies, and other things you usually enjoy?
1 Yes
2 No
DK/REF
AD02 [IF ASC22 = 1] During times when you felt discouraged about how things were going in your life, did you ever lose interest in most things like work, hobbies, and other things you usually enjoy?
1 Yes
2 No
DK/REF
AD09 [IF ASC23= 1] Did you ever have a period of time like this that lasted most of the day nearly every day for two weeks or longer?
1 Yes
2 No
DK/REF
DEFINE FEELFILL:
IF (AD01a = 1), THEN FEELFILL = “were sad, discouraged, or lost interest in most things”
IF (AD01a = 2 OR DK/REF), THEN FEELFILL = “were sad or discouraged”
IF (AD01b = 1), THEN FEELFILL = “were sad or lost interest in most things”
IF (AD01b = 2 OR DK/REF) THEN FEELFILL = “were sad”
IF (AD02 = 1), THEN FEELFILL = “were discouraged or lost interest in most things”
IF (AD02 = 2 OR DK/REF), THEN FEELFILL = “were discouraged about the way things were going in your life”
IF (AD09 = 1), THEN FEELFILL = “lost interest in most things”
ELSE, FEELFILL = BLANK
DEFINE FEELNOUN:
IF (AD01a = 1), THEN FEELNOUN = “sadness, discouragement, or lack of interest”
IF (AD01a = 2 OR DK/REF), THEN FEELNOUN = “sadness or discouragement”
IF (AD01b = 1), THEN FEELNOUN = “sadness or lack of interest”
IF (AD01b = 2 OR DK/REF), THEN FEELNOUN = “sadness”
IF (AD02 = 1), THEN FEELNOUN = “discouragement or lack of interest”
IF (AD02 = 2 OR DK/REF), THEN FEELNOUN = “discouragement”
IF (AD09 = 1), THEN FEELNOUN = “lack of interest in most things”
ELSE FEELNOUN = BLANK
DEFINE NUMPROBS
IF AD01a NE BLANK OR AD01b = 1 OR AD02 = 1, THEN NUMPROBS = “these problems”
IF AD01b = (2 OR DK/REF) OR AD02 = (2 OR DK/REF) OR AD09 = 1, THEN NUMPROBS = “this problem”
ELSE NUMPROBS = BLANK
DEFINE WASWERE:
IF AD01a NE BLANK OR AD01b = 1 OR AD02 = 1, THEN WASWERE = “were”
IF AD01b = (2 OR DK/REF) OR AD02 = (2 OR DK/REF) OR AD09 = 1, THEN WASWERE = “was”
ELSE WASWERE = BLANK
AD12 [IF AD01a NE BLANK OR AD01b NE BLANK OR AD02 NE BLANK] Think about the times when you [FEELFILL]. Did you ever have a period of time like this that lasted most of the day, nearly every day, for two weeks or longer?
1 Yes
2 No
DK/REF
AD16 [IF AD09 = 1 OR AD12 = 1] Think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent. During those times, how long did your [FEELNOUN] usually last?
1 Less than 1 hour
2 At least 1 hour but no more than 3 hours
3 At least 3 hours but no more than 5 hours
4 5 hours or more
DK/REF
AD17 [IF AD16 = 2, 3, 4, OR DK/REF] Still thinking of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent, how severe was your emotional distress during those times?
1 Mild
2 Moderate
3 Severe
4 Very severe
DK/REF
AD18 [IF AD16 = 2, 3, 4, OR DK/REF] Again, think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent.
How often, during those times, was your emotional distress so severe that nothing could cheer you up?
1 Often
2 Sometimes
3 Rarely
4 Never
DK/REF
AD19 [IF AD16 = 2, 3, 4, OR DK/REF] Once again, please think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE]most severe and frequent.
How often, during those times, was your emotional distress so severe that you could not carry out your daily activities?
1 Often
2 Sometimes
3 Rarely
4 Never
DK/REF
AD21 [IF AD16 = (2, 3, 4 OR DK/REF) AND NOT (AD17 = 1 AND AD18 = 4 AND AD19 = 4) AND (ASC21=1 OR ASC22=1 OR ASC23=1) AND AD09 NE (2 OR DK/REF)] People who have problems with their mood often have other problems at the same time. These problems may include things like changes in:
sleep
appetite
energy
the ability to concentrate and remember
feelings of low self-worth
Did you ever have any of these problems during a period of time when you [FEELFILL] for two weeks or longer?
1 Yes
2 No
DK/REF
AD22 [IF AD21 = 1] Think again about these other problems we just mentioned. They include things like changes in
sleep
appetite
energy
the ability to concentrate and remember
feelings of low self-worth
Please think of a time when you [FEELFILL] for two weeks or longer and you also had the largest number of these other problems at the same time.
Is there one particular time like this that stands out in your mind as the worst one you ever had?
1 Yes
2 No
DK/REF
AD22a [IF AD22 = 1] How old were you when that worst period of time started?
__________ YEARS OLD [RANGE: 1-110]
DK/REF
AD22c [IF AD22 = 2 OR DK/REF] Then think of the most recent time when you [FEELFILL] for two weeks or longer and you also had the largest number of these other problems at the same time.
How old were you when that time started?
__________ YEARS OLD
DK/REF
DEFINE TIMEFILL:
IF AD22a NE BLANK, THEN TIMEFILL = ‘worst’
IF AD22c NE BLANK, THEN TIMEFILL = ‘most recent’
AD24a [IF AD22a NE BLANK] In answering the next questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] In answering the next questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
During that time, did you feel sad, empty, or depressed most of the day nearly every day?
1 Yes
2 No
DK/REF
AD24c [IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL] period of time, did you feel discouraged about how things were going in your life most of the day nearly every day?
1 Yes
2 No
DK/REF
AD24e [IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL] period of time, did you lose interest in almost all things like work and hobbies and things you like to do for fun?
1 Yes
2 No
DK/REF
AD24f [IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL] period of time, did you lose the ability to take pleasure in having good things happen to you, like winning something or being praised or complimented?
1 Yes
2 No
DK/REF
AD26a [IF ANY AD24a – AD24f = 1] The next questions are about changes in appetite and weight.
[IF AD22a NE BLANK] In answering the next questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] In answering the next questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
Did you have a much smaller appetite than usual nearly every day during that time?
1 Yes
2 No
DK/REF
AD26b [IF AD26a = 2 OR DK/REF] Did you have a much larger appetite than usual nearly every day?
1 Yes
2 No
DK/REF
AD26c [IF AD26a = 2 OR DK/REF] Did you gain weight without trying to during that [TIMEFILL] period of time?
1 Yes
2 No
DK/REF
AD26c1 [IF AD26c = 1 AND (AD22a ≤ 21 OR AD22c ≤ 21)] Did you gain weight without trying to because you were growing?
Yes
No
DK/REF
AD26c2 [IF AD26c = 1 AND AD26c1 NE YES AND QD01 = 9] Did you gain weight without trying to because you were pregnant?
Yes
No
DK/REF
AD26d [IF AD26c = 1 AND AD26c1 NE YES AND AD26c2 NE YES] How many pounds did you gain?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF
AD26e [IF (AD26a = 1 OR AD26c=(2 OR DK/REF)] Did you lose weight without trying to?
1 Yes
2 No
DK/REF
AD26e1 [IF AD26e = 1] Did you lose weight without trying to because you were sick or on a diet?
Yes
No
DK/REF
AD26f [IF AD26e1 = 2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF
AD26g [IF AD26a NE BLANK]
[IF AD22a NE BLANK] Again, please think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, please think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
Did you have a lot more trouble than usual falling asleep, staying asleep, or waking too early nearly every night during that [TIMEFILL] period of time?
1 Yes
2 No
DK/REF
AD26h [IF AD26g = 2 OR DK/REF] During that [TIMEFILL] period of time, did you sleep a lot more than usual nearly every night?
1 Yes
2 No
DK/REF
AD26j [IF AD26a NE BLANK] During that [TIMEFILL] period of time, did you feel tired or low in energy nearly every day, even when you had not been working very hard?
1 Yes
2 No
DK/REF
AD26l [IF AD26a NE BLANK] Did you talk or move more slowly than is normal for you nearly every day?
1 Yes
2 No
DK/REF
AD26m [IF AD26l = 1] Did anyone else notice that you were talking or moving slowly?
1 Yes
2 No
DK/REF
AD26n [IF AD26l = 2 OR DK/REF] Were you so restless or jittery nearly every day that you paced up and down or couldn't sit still?
1 Yes
2 No
DK/REF
AD26o [AD26n = 1] Did anyone else notice that you were restless?
1 Yes
2 No
DK/REF
AD26p [IF AD26a NE BLANK] The next questions are about changes in your ability to concentrate, and your feelings about yourself.
[IF AD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
During that [TIMEFILL] time, did your thoughts come much more slowly than usual or seem confused nearly every day?
1 Yes
2 No
DK/REF
AD26r [IF AD26a NE BLANK] Did you have a lot more trouble concentrating than usual nearly every day?
1 Yes
2 No
DK/REF
AD26s [IF AD26a NE BLANK] Were you unable to make decisions about things you ordinarily have no trouble deciding about?
1 Yes
2 No
DK/REF
AD26u [IF AD26a NE BLANK] Did you feel that you were not as good as other people nearly every day?
1 Yes
2 No
DK/REF
AD26v [IF AD26u = 1] Did you feel totally worthless nearly every day?
1 Yes
2 No
DK/REF
AD26aa [IF AD26a NE BLANK] The next questions are about thoughts of death or suicide.
[IF AD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
Did you often think a lot about death, either your own, someone else’s, or death in general?
1 Yes
2 No
DK/REF
AD26bb [IF AD26a NE BLANK] During that period, did you ever think that it would be better if you were dead?
1 Yes
2 No
DK/REF
AD26cc [IF AD26a NE BLANK] Did you think about committing suicide?
1 Yes
2 No
DK/REF
AD26dd [IF AD26cc = 1] Did you make a suicide plan?
1 Yes
2 No
DK/REF
AD26ee [IF AD26cc = 1] Did you make a suicide attempt?
1 Yes
2 No
DK/REF
DEFINE D_MDEA1:
IF AD24A = 1 OR AD24C = 1, THEN D_MDEA1= 1
ELSE IF AD24A = 2 AND AD24C = 2, THEN D_MDEA1= 2
ELSE IF AD24A = DK OR AD24C = DK, THEN D_MDEA1= DK
ELSE IF AD24A = REF OR AD24C = REF, THEN D_MDEA1= REF
ELSE D_MDEA1= BLANK
DEFINE D_MDEA2:
IF AD24E = 1 OR AD24F = 1, THEN D_MDEA2= 1
ELSE IF AD24E = 2 AND AD24F = 2, THEN D_MDEA2= 2
ELSE IF AD24E = DK OR AD24F = DK, THEN D_MDEA2= DK
ELSE IF AD24E = REF OR AD24F = REF, THEN D_MDEA2= REF
ELSE D_MDEA2= BLANK
DEFINE D_MDEA3:
IF AD26A = 1 OR AD26B = 1 OR AD26D ≥10 OR AD26F ≥10, THEN D_MDEA3= 1
ELSE IF AD26A = 2 AND AD26B = 2 AND ((AD26D < 10 OR AD26F < 10) OR (AD26C = (2 OR BLANK) AND AD26E = (2 OR BLANK)) OR (AD26C = 1 AND (AD26C1 = 1 OR AD26C2 = 1)) OR (AD26E = 1 AND AD26E1 = 1)), THEN D_MDEA3= 2
ELSE IF AD26A = DK OR AD26B = DK OR AD26C = DK OR AD26D = DK OR AD26E = DK OR AD26F = DK, THEN D_MDEA3= DK
ELSE IF AD26A = REF OR AD26B = REF OR AD26C = REF OR AD26D = REF OR AD26E = REF OR AD26F = REF, THEN D_MDEA3= REF
ELSE D_MDEA3= BLANK
DEFINE D_MDEA4:
IF AD26G = 1 OR AD26H = 1, THEN D_MDEA4= 1
ELSE IF AD26G = 2 AND AD26H = 2, THEN D_MDEA4= 2
ELSE IF AD26G = DK OR AD26H = DK, THEN D_MDEA4= DK
ELSE IF AD26G = REF OR AD26H = REF, THEN D_MDEA4= REF
ELSE D_MDEA4= BLANK
DEFINE D_MDEA5:
IF AD26M = 1 OR AD26O = 1, THEN D_MDEA5= 1
ELSE IF (AD26L = (2 OR DK/REF) AND (AD26N = (2 OR DK/REF) OR AD26O = 2)) OR AD26M = 2, THEN D_MDEA5= 2
ELSE IF AD26L = DK OR AD26M = DK OR AD26N = DK OR AD26O = DK, THEN D_MDEA5= DK
ELSE IF AD26L = REF OR AD26M = REF OR AD26N = REF OR AD26O = REF, THEN D_MDEA5= REF
ELSE D_MDEA5= BLANK
DEFINE D_MDEA6:
D_MDEA6= AD26J
DEFINE D_MDEA7:
IF AD26V = 1, THEN D_MDEA7= 1
ELSE IF AD26U = (2 OR DK/REF) OR AD26V = 2, THEN D_MDEA7= 2
ELSE D_MDEA7=AD26V
ELSE D_MDEA7= BLANK
DEFINE D_MDEA8:
IF AD26P = 1 OR AD26R = 1 OR AD26S = 1, THEN D_MDEA8= 1
ELSE IF AD26P = 2 AND AD26R = 2 AND AD26S = 2, THEN D_MDEA8= 2
ELSE IF AD26P = DK OR AD26R = DK OR AD26S = DK, THEN D_MDEA8= DK
ELSE IF AD26P = REF OR AD26R = REF OR AD26S = REF, THEN D_MDEA8= REF
ELSE D_MDEA8= BLANK
DEFINE D_MDEA9:
IF AD26AA = 1 OR D26BB = 1 OR AD26CC = 1 OR AD26DD = 1 OR AD26EE = 1, THEN D_MDEA9= 1
ELSE IF AD26AA = 2 AND AD26BB = 2 AND AD26CC = 2, THEN D_MDEA9= 2
ELSE IF AD26AA = DK OR AD26BB = DK OR AD26CC = DK OR AD26DD = DK OR AD26EE = DK, THEN D_MDEA9= DK
ELSE IF AD26AA = REF OR AD26BB = REF OR AD26CC = REF OR AD26DD = REF OR AD26EE = REF, THEN D_MDEA9= REF
ELSE D_MDEA9= BLANK
DEFINE DSMMDEA2:
IF SUM (D_MDEA1 = 1, D_MDEA2 = 1, D_MDEA3 = 1, D_MDEA4 = 1, D_MDEA5 = 1, D_MDEA6 = 1, D_MDEA7 = 1, D_MDEA8 = 1, D_MDEA9 = 1) ≥ 5, THEN DSMMDEA2 = 1
ELSE IF SUM (D_MDEA1 = (1 OR DK/REF), D_MDEA2 = (1 OR DK/REF), D_MDEA3 = (1 OR DK/REF), D_MDEA4 = (1 OR DK/REF), D_MDEA5 = (1 OR DK/REF), D_MDEA6 = (1 OR DK/REF), D_MDEA7 = (1 OR DK/REF), D_MDEA8 = (1 OR DK/REF), D_MDEA9 = (1 OR DK/REF)) < 5 AND N(OF D_MDEA1-D_MDEA9) > 0, THEN DSMMDEA2 = 2
ELSE IF D_MDEA1 = DK OR D_MDEA2 = DK OR D_MDEA3 = DK OR D_MDEA4 = DK OR D_MDEA5 = DK OR D_MDEA6 = DK OR D_MDEA7 = DK OR D_MDEA8 = DK OR D_MDEA9 = DK, THEN DSMMDEA2 = DK
ELSE IF D_MDEA1 = REF OR D_MDEA2 = REF OR D_MDEA3 = REF OR D_MDEA4 = REF OR D_MDEA5 = REF OR D_MDEA6 = REF OR D_MDEA7 = REF OR D_MDEA8 = REF OR D_MDEA9 = REF, THEN DSMMDEA2 = REF
AD28 [IF D_MDEA9 = 1 OR DSMMDEA2 = 1] You mentioned having some of the problems I just asked you about.
During that [TIMEFILL] period of time, how much did your [FEELNOUN]
and these other problems interfere with your work, your social life, or your personal relationships?
1 Not at all
2 A little
3 Some
4 A lot
5 Extremely
DK/REF
AD28a [IF AD28 NE (BLANK OR 1)] During that [TIMEFILL] period of time, how often were you unable to carry out your daily activities because of these problems with your mood?
1 Often
2 Sometimes
3 Rarely
4 Never
DK/REF
AD37 [IF AD28 NE BLANK] Think of the very first period of time in your life lasting two weeks or longer when you [FEELFILL] for most of the day nearly every day and also had some of the other problems we just asked about.
Can you remember your exact age?
1 Yes
2 No
DK/REF
AD37a [IF AD37 = 1] How old were you?
__________ YEARS OLD [RANGE: 1-110]
DK/REF
AD37b [IF AD37 = 2 OR DK] About how old were you when you first had a period of time like this?
AGE:__________ [RANGE: 1-110]
DK/REF
AD52 [IF AD28 NE BLANK] In your entire life, how many times did you feel [FEELNOUN] for two weeks or longer while also having some of the other problems we asked about?
If you are not sure of your answer, just make your best guess.
______________ NUMBER [RANGE: 1-1000]
DK/REF
AD38 [IF AD28 NE BLANK ] In the past 12 months, did you have a period of time when you felt [FEELNOUN] for two weeks or longer while also having some of the other problems we asked about?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD66a [IF AD38 = 1] Think about the time in the past 12 months when [NUMPROBS] with your mood [WASWERE] most severe.
Using the 0 to 10 scale shown below, where 0 means no interference and 10 means very severe interference, select the number that describes how much [NUMPROBS] interfered with your ability to do each of the following activities during that period. You can use any number between 0 and 10 to answer.
How much did your [FEELNOUN] interfere with your ability to do home management tasks, like cleaning, shopping, and working around the house, apartment, or yard?
No Very Severe Interference Mild Moderate Severe Interference
│
│
0 1 2 3 4 5 6 7 8 9 10
DK/REF
AD66b [IF AD38 = 1] During that time in the past 12 months when your [FEELNOUN] was most severe, how much did this interfere with your ability to work?
You can use any number between 0 and 10 to answer.
No Very Severe Interference Mild Moderate Severe Interference
│
│
0 1 2 3 4 5 6 7 8 9 10
DK/REF
AD66c [IF AD38 = 1]How much did your [FEELNOUN] interfere with your ability to form and maintain close relationships with other people during that period of time?
You can use any number between 0 and 10 to answer.
No Very Severe Interference Mild Moderate Severe Interference
│
│
0 1 2 3 4 5 6 7 8 9 10
DK/REF
AD66d [IF AD38 = 1] How much did [NUMPROBS] interfere with your ability to have a social life during that period of time?
You can use any number between 0 and 10 to answer.
No Very Severe Interference Mild Moderate Severe Interference
│
│
0 1 2 3 4 5 6 7 8 9 10
DK/REF
AD68 [IF ANY RESPONSES TO AD66a – AD66d = 1-10] About how many days out of 365 in the past 12 months were you totally unable to work or carry out your normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86 [IF AD38 NE BLANK] Here is a list of professionals some people talk to about the problems we have been asking about:
General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
Another healer, like an herbalist, chiropractor, acupuncturist, or massage therapist
At any time in the past 12 months, did you see or talk to a medical doctor or other professional about your [FEELNOUN]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86a [IF AD86 = 1] During the past 12 months, which professionals did you see or talk to about [NUMPROBS] with your mood?
Select all that apply from the categories shown below. To select more than one answer from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 General practitioner or family doctor
2 Other medical doctor like a cardiologist, gynecologist, urologist
3 Psychologist
4 Psychiatrist or psychotherapist
5 Social Worker
6 Counselor
7 Other mental health professional, like a mental health nurse
8 A nurse, occupational therapist, or other health professional
9 A religious or spiritual advisor like a minister, priest, or rabbi
10 An herbalist, chiropractor, acupuncturist, or massage therapist
11 Another type of helping professional
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86aSP [IF AD86a = 11]Please type in the other type of professional you saw or talked to during the past 12 months about your [FEELNOUN]. When you have finished typing in your answer, press the [ENTER] key to go to the next question.
______________[RANGE: 50 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN AD86aSP.
AD86b [IF AD86 = 1] Are you currently receiving professional treatment or counseling for [NUMPROBS] with your mood?
1 Yes
2 No
DK/REF
AD86c [IF AD38 NE BLANK] During the past 12 months, did you take prescription medication that was prescribed for [NUMPROBS]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86d [IF AD86c = 1] Are you currently taking prescription medication that was prescribed for [NUMPROBS]?
1 Yes
2 No
DK/REF
AD86e [IF AD86c = 1] During the past 12 months, how much has this prescription medication helped you?
1 Not at all
2 A little
3 Some
4 A lot
5 Extremely
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86f [IF AD86 = 1] During the past 12 months, how much has treatment or counseling helped you?
1 Not at all
2 A little
3 Some
4 A lot
5 Extremely
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
Youth Mental Health Service Utilization
(Section Administered to 12 - 17 Year Old Respondents Only)
INTROYSU [IF CURNTAGE = 12 - 17] These next questions are about treatment and counseling for problems with your behaviors or emotions that were not caused by alcohol or drugs.
Click Next to continue.
YSU01 [IF CURNTAGE = 12 - 17] During the past 12 months, have you stayed overnight or longer in any type of hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU02 [IF YSU01 = 1] During the past 12 months, how many nights altogether did you stay in a hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU03 [IF YSU01 = 1] Think about the last time you stayed overnight or longer in a hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason you were admitted there?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, click Next to go to the next question.
1 You thought about killing yourself or tried to kill yourself
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU03a [IF ANY ENTRY IN YSU03 = 6] What was the other emotional or behavioral problem for which you last stayed overnight in a hospital?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU03SP [IF ANY ENTRY IN YSU03a = 7] Please type in the most important other reason for your last overnight stay in a hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU03SP.
YSU04 [IF CURNTAGE = 12 - 17] During the past 12 months, did you stay overnight or longer in a residential treatment center to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU05 [IF YSU04=1] During the past 12 months, how many nights altogether did you stay in a residential treatment center to receive treatment for emotional or behavioral problems that were not caused by alcohol or drugs?
# OF NIGHTS: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU06 [IF YSU04=1] Think about the last time you stayed overnight or longer in a residential treatment center to receive treatment for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason you were admitted there?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU06a [IF ANY ENTRY IN YSU06 = 6] What was the other emotional or behavioral problem for which you last stayed overnight in a residential treatment center?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU06SP [IF ANY ENTRY IN YSU06a=7] Please type in the most important other reason for your last overnight stay in a residential treatment center to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU06SP.
YSU07 [IF CURNTAGE = 12 - 17] During the past 12 months, did you stay overnight or longer in foster care or in a therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU08 [IF YSU07 = 1] During the past 12 months, how many nights altogether did you stay in foster care or in a therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs?
# OF NIGHTS: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU09 [IF YSU07=1] Think about the last time you stayed overnight or longer in foster care or in a therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason you were placed there?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU09a [IF ANY ENTRY IN YSU09 = 6] What was the other emotional or behavioral problem for which you last stayed overnight or longer in foster care or a therapeutic foster care home?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU09SP [IF ANY ENTRY IN YSU09a =7] Please type in the most important other reason for your last overnight stay in foster care or in a therapeutic foster care home to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU09SP.
YSU10 [IF CURNTAGE = 12 - 17] During the past 12 months, did you receive treatment or counseling at a partial day hospital or day treatment program because you had problems with your behavior or emotions that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU11 [IF YSU10 = 1] During the past 12 months, how many times did you visit a partial day hospital or day treatment program because you had emotional or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU12 [IF YSU10 =1] Think about the last time you visited a partial day hospital or day treatment program because you had emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU12a [IF ANY ENTRY IN YSU12 = 6] What was the other emotional or behavioral problem for which you last visited a partial day hospital or day treatment program?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU12SP [IF ANY ENTRY IN YSU12a =7] Please type in the most important other reason for your last visit to a partial day hospital or day treatment program to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU12SP.
YSU13 [IF CURNTAGE = 12 - 17] During the past 12 months, did you receive treatment or counseling at a mental health clinic or center because you had problems with your behavior or emotions that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU14 [IF YSU13 = 1] During the past 12 months, how many times did you visit a mental health clinic or center to receive treatment or counseling because you had emotional or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU15 [IF YSU13 =1] Think about the last time you visited a mental health clinic or center to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU15a [IF ANY ENTRY IN YSU15 = 6] What was the other emotional or behavioral problem for which you last visited a mental health clinic or center?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU15SP [IF ANY ENTRY IN YSU15a =7] Please type in the most important other reason for your last visit to a mental health clinic or center to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU15SP.
YSU16 [IF CURNTAGE = 12 - 17] During the past 12 months, did you receive treatment or counseling from a private therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU17 [IF YSU16 = 1] During the past 12 months, how many times did you receive treatment or counseling from a private therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU18 [IF YSU16 = 1] Think about the last time you visited a private therapist, psychologist, psychiatrist, social worker, or counselor to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU18a [IF ANY ENTRY IN YSU18 = 6] What was the other emotional or behavioral problem for which you last visited a private therapist, psychologist, psychiatrist, social worker or counselor?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU18SP [IF ANY ENTRY IN YSU18a =7] Please type in the most important other reason for your last visit to a private therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU18SP.
YSU19 [IF CURNTAGE = 12 -17] During the past 12 months, did you receive treatment or counseling from an in-home therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU20 [IF YSU19 = 1] During the past 12 months, how many times did you receive treatment or counseling from an in-home therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU21 [IF YSU19 = 1] Think about the last time you saw an in-home therapist, counselor, or family preservation worker to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for this visit?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU21a [IF ANY ENTRY IN YSU21 = 6] What was the other emotional or behavioral problem for which you last saw an in-home therapist, counselor, or family preservation worker?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU21SP [IF ANY ENTRY IN YSU21a=7] Please type in the most important other reason you last saw an in-home therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU21SP.
YSU22 [IF CURNTAGE = 12 -17] During the past 12 months, did you receive treatment or counseling from a pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU23 [IF YSU22 = 1] During the past 12 months, how many times did you receive treatment or counseling from a pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU24 [IF YSU22 = 1] Think about the last time you visited a pediatrician or other family doctor to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your visit?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU24a [IF ANY ENTRY IN YSU24 = 6] What was the other emotional or behavioral problem for which you last visited a pediatrician or other family doctor?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU24SP [IF ANY ENTRY IN YSU24a=7] Please type in the most important other reason for your last visit to a pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU24SP.
YSU30 [IF CURNTAGE = 12 – 17] Sometimes students get treatment or counseling through the school system. This counseling is often provided by school social workers, school psychologists or school counselors.
During the past 12 months, that is, since [DATEFILL], did you receive any treatment or counseling from a school social worker, a school psychologist, or a school counselor for emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU31 [IF YSU30 = 1] Think about the last time you talked with a school social worker, school psychologist, or school counselor about emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your talk?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You thought about killing yourself or tried to kill yourself.
2 You felt depressed
3 You felt very afraid and tense
4 You were breaking rules and “acting out”
5 You had eating problems
6 Some other reason
DK/REF
YSU31a [IF ANY ENTRY IN YSU31 = 6] What was the other reason for your last talk with a school social worker, school psychologist or school counselor ?
To select more than one reason from the list, press the space bar between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 You had trouble controlling your anger
2 You had gotten into physical fights
3 You had problems at home or in your family
4 You had problems with your friends
5 You had problems with people other than your friends or family
6 You had problems at school
7 Some other reason
DK/REF
YSU31SP [IF ANY ENTRY IN YSU31a=7] Please type in the most important other reason for your last talk with a school social worker, school psychologist or school counselor. You do not need to give a detailed description — just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU31SP.
YSU32 [IF CURNTAGE = 12 – 17 AND YE09=1] At any time during the past 12 months, that is since [DATEFILL], did you attend a school for students with emotional or behavioral problems?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU33 [IF CURNTAGE = 12 – 17 and YSU32=2 or DK/ref] Regular schools sometimes provide programs for students with emotional or behavioral problems.
At any time during the past 12 months, did you participate in a school program that was just for students with emotional or behavioral problems?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU34 [IF CURNTAGE = 12 – 17 ] These next questions are about experiences with the justice system.
During the past 12 months, that is, since [DATEFILL], did you stay overnight or longer in any type of juvenile detention center, sometimes called “juvie”, prison, or jail?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU35 [IF YSU34=1] During the past 12 months, how many nights altogether did you stay in any type of juvenile detention center, prison or jail?
# OF NIGHTS: [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU36 [IF YSU34 = 1] Sometimes, the court system provides treatment or counseling in juvenile detention centers, prisons or jails. These services are often provided by psychiatrists, psychologists, social workers or counselors who work for the court system.
While you were in a juvenile detention center, prison or jail during the past 12 months, did you receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
Adolescent Depression
YDS21 [IF CURNTAGE = 12-17] Have you ever in your life had a period of time lasting several days or longer when most of the day you felt sad, empty, or depressed?
1 Yes
2 No
DK/REF
YDS22 [IF YDS21 = 2 OR DK/REF] Have you ever had a period of time lasting several days or longer when most of the day you felt very discouraged or hopeless about how things were going in your life?
1 Yes
2 No
DK/REF
YDS23 [IF YDS22 = 2 OR DK/REF] Have you ever had a period of time lasting several days or longer when you lost interest and became bored with most things you usually enjoy, like work, hobbies, and personal relationships?
1 Yes
2 No
DK/REF
YD01 [IF YDS21 = 1] During times when you felt sad, empty, or depressed most of the day, did you ever feel discouraged about how things were going in your life?
1 Yes
2 No
DK/REF
YD01a [IF YD01 = 1] During the times when you felt sad, empty, or depressed, did you ever lose interest and become really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to music, watching TV, movies, or sports, playing computer games, or going out with friends?
1 Yes
2 No
DK/REF
YD01b [YD01 = 2 OR DK/REF] During times when you felt sad, empty, or depressed, did you ever lose interest and become really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to music, watching TV, movies, or sports, playing computer games, or going out with friends?
1 Yes
2 No
DK/REF
YD02 [IF YDS22 = 1] During times when you felt discouraged about how things were going in your life, did you ever lose interest and become really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to music, watching TV, movies, or sports, playing computer games, or going out with friends?
1 Yes
2 No
DK/REF
YD09 [IF YDS23 = 1] Did you ever have a period of time like this that lasted most of the day almost every day for two weeks or longer?
1 Yes
2 No
DK/REF
DEFINE FEELFILL:
IF (YD01a = 1), THEN FEELFILL = “were sad, discouraged, or really bored”
IF (YD01a = 2 OR DK/REF), THEN FEELFILL = “were sad or discouraged”
IF (YD01b = 1), THEN FEELFILL = “were sad or really bored”
IF (YD01b = 2 OR DK/REF) THEN FEELFILL = “were sad”
IF (YD02 = 1), THEN FEELFILL = “were discouraged or really bored”
IF (YD02 = 2 OR DK/REF), THEN FEELFILL = “were discouraged about the way things were going in your life”
IF (YD09 = 1), THEN FEELFILL = “were really bored”
ELSE, FEELFILL = BLANK
DEFINE FEELNOUN:
IF (YD01a = 1), THEN FEELNOUN = “sadness, discouragement, or boredom”
IF (YD01a = 2 OR DK/REF), THEN FEELNOUN = “sadness or discouragement”
IF (YD01b = 1), THEN FEELNOUN = “sadness or boredom”
IF (YD01b = 2 OR DK/REF), THEN FEELNOUN = “sadness”
IF (YD02 = 1), THEN FEELNOUN = “discouragement or boredom”
IF (YD02 = 2 OR DK/REF), THEN FEELNOUN = “discouragement”
IF (YD09 = 1), THEN FEELNOUN = “boredom”
ELSE FEELNOUN = BLANK
DEFINE NUMPROBS
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN NUMPROBS = these problems
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN NUMPROBS = this problem
ELSE NUMPROBS = BLANK
DEFINE WASWERE:
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN WASWERE = “were”
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN WASWERE = “was”
ELSE WASWERE = BLANK
YD12 [IF YD01a NE BLANK OR YD01b NE BLANK OR YD02 NE BLANK] Think about the times when you [FEELFILL]. Did you ever have a period of time like this that lasted most of the day, almost every day, for two weeks or longer?
1 Yes
2 No
DK/REF
YD16 [IF YD09 = 1 OR YD12 = 1] Think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent. During those times, how long did your [FEELNOUN] usually last?
1 Less than 1 hour
2 At least 1 hour but less than 3 hours
3 At least 3 hours but less than 5 hours
4 5 hours or more
DK/REF
YD17 [IF YD16 = 2, 3, 4, OR DK/REF] Still thinking of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent, how strong were your bad feelings during those times?
1 Mild
2 Moderate
3 Severe
4 Very severe
DK/REF
YD18 [IF YD16 = 2, 3, 4, OR DK/REF] Again, think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent.
How often, during those times, did you feel so bad that nothing could cheer you up?
1 Often
2 Sometimes
3 Not very often
4 Never
DK/REF
YD19 [IF YD16 = 2, 3, 4, OR DK/REF] Once again, please think of times lasting two weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe and frequent.
How often, during those times, did you feel so bad that you could not carry out your daily activities?
1 Often
2 Sometimes
3 Not very often
4 Never
DK/REF
YD21 [IF YD16 = (2, 3, 4 OR DK/REF) AND NOT (YD17 = 1 AND YD18 = 4 AND YD19 = 4) AND (YDS21=1 OR YDS22=1 OR YDS23=1) AND YD09 NE (2 OR DK/REF)] People who have problems with their mood often have other problems at the same time. These problems may include things like changes in:
sleep
eating
energy
the ability to keep their mind on things
feeling badly about themselves
Did you ever have any of these problems during a period of time when you [FEELFILL] for two weeks or longer?
1 Yes
2 No
DK/REF
YD22 [IF YD21=1] Think again about these other problems we just mentioned. They include things like changes in:
sleep
eating
energy
the ability to keep their mind on things
feeling badly about themselves
Can you think of the worst time when you [FEELFILL] for two weeks or longer and also had these other problems at the same time?
1 Yes
2 No
DK/REF
YD22a [IF YD22 = 1] How old were you when that worst period of time started?
AGE: __________ [RANGE: 1-17]
DK/REF
YD22c [IF YD22 = 2 OR DK/REF] Then think of the most recent time you [FEELFILL] for two weeks or longer and you had these other problems at the same time.
How old were you when that time started?
AGE: __________ [RANGE: 1-17]
DK/REF
DEFINE TIMEFILL:
IF YD22a NE BLANK, THEN TIMEFILL = ‘worst’
IF YD22c NE BLANK, THEN TIMEFILL = ‘most recent’
YD24a [IF YD22a NE BLANK] In answering the next questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] In answering the next questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
During that time, did you feel sad, empty, or depressed for most of the day nearly every day?
1 Yes
2 No
DK/REF
YD24c [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of time, did you feel discouraged about how things were going in your life most of the day nearly every day?
1 Yes
2 No
DK/REF
YD24e [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of time, did you become bored with almost everything like school, work, hobbies, and things you like to do for fun?
1 Yes
2 No
DK/REF
YD24f [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of time, did you feel like nothing was fun even when good things were happening?
1 Yes
2 No
DK/REF
YD26a [IF ANY YD24a - YD24f = 1] The next questions are about changes in appetite and weight.
[IF YD22a NE BLANK] In answering these questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] In answering these questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
Did you eat much less than usual almost every day during that time?
1 Yes
2 No
DK/REF
YD26b [IF YD26a = 2 OR DK/REF] Did you eat much more than usual almost every day?
1 Yes
2 No
DK/REF
YD26c [IF YD26a = 2 OR DK/REF]Did you gain weight without trying to during that [TIMEFILL] period of time?
1 Yes
2 No
DK/REF
YD26c1 [IF YD26c = 1] Did you gain weight without trying to because you were growing?
1 Yes
2 No
DK/REF
YD26c2 [IF YD26c1 = (2 OR DK/REF) AND QD01 = 9] Did you gain weight without trying to because you were pregnant?
1 Yes
2 No
DK/REF
YD26d [IF (YD26c1=(2 OR DK/REF) AND YD26c2=BLANK, 2 OR DK/REF] How many pounds did you gain?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF
YD26e [IF YD26a = 1 OR YD26c = (2 OR DK/REF)] Did you lose weight without trying to?
1 Yes
2 No
DK/REF
YD26e1 [IF YD26e = 1] Did you lose weight without trying to because you were sick or on a diet?
1 Yes
2 No
DK/REF
YD26f [IF YD26e1=2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF
YD26g [IF YD26a NE BLANK]
[IF YD22a NE BLANK] Again, please think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] Again, please think about the most recent period of time when you [FEELFILL]and had other problems at the same time.
Did you have a lot more trouble than usual falling asleep or staying asleep most nights or waking too early most mornings during that [TIMEFILL] time?
1 Yes
2 No
DK/REF
YD26h [IF YD26g=2 OR DK/REF]During that [TIMEFILL] period of time, did you sleep a lot more than usual?
1 Yes
2 No
DK/REF
YD26j [IF YD26a NE BLANK] On most days during that [TIMEFILL] period of time, did you feel that you didn’t have much energy?
1 Yes
2 No
DK/REF
YD26l [IF YD26a NE BLANK] Did you feel as though you were talking or moving more slowly than usual on most days during that [TIMEFILL] period of time?
1 Yes
2 No
DK/REF
YD26m [IF YD26l = 1] Did anyone else notice that you were talking or moving more slowly than usual?
1 Yes
2 No
DK/REF
YD26n [IF YD26l = 2 OR DK/REF] Were you so restless or jittery that you walked up or down or couldn't sit still?
1 Yes
2 No
DK/REF
YD26o [IF YD26n = 1] Did anyone else notice that you couldn’t sit still?
1 Yes
2 No
DK/REF
YD26p [IF YD26a NE BLANK] The next questions are about changes in your ability to concentrate, and your feelings about yourself.
[IF YD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
On most days during that [TIMEFILL] time, did your thinking seem slower than usual or seem mixed up?
1 Yes
2 No
DK/REF
YD26r [IF YD26a NE BLANK] On most days, did you have a lot more trouble than usual keeping your mind on things?
1 Yes
2 No
DK/REF
YD26s [IF YD26a NE BLANK] Were you unable to make up your mind about things you ordinarily have no trouble deciding about?
1 Yes
2 No
DK/REF
YD26u [IF YD26a NE BLANK] Did you feel that you were not as good as other people nearly every day?
1 Yes
2 No
DK/REF
YD26v [IF YD26u = 1] Did you feel totally worthless nearly every day?
1 Yes
2 No
DK/REF
YD26aa [IF YD26a NE BLANK] The next questions are about thoughts of death or suicide.
[IF YD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you [FEELFILL] and had other problems at the same time.
Did you often think a lot about death, either your own, someone else’s, or death in general?
1 Yes
2 No
DK/REF
YD26bb [IF YD26a NE BLANK] During that time, did you ever think that it would be better if you were dead?
1 Yes
2 No
DK/REF
YD26cc [IF YD26a NE BLANK] Did you think about killing yourself?
1 Yes
2 No
DK/REF
YD26dd [IF YD26cc = 1] Did you make a plan to kill yourself?
1 Yes
2 No
DK/REF
YD26ee [IF YD26cc = 1] Did you make a suicide attempt or try to kill yourself?
1 Yes
2 No
DK/REF
DEFINE D_MDEA1Y:
IF YD24A = 1 OR YD24C = 1, THEN D_MDEA1Y= 1
ELSE IF YD24A = 2 AND YD24C = 2, THEN D_MDEA1Y= 2
ELSE IF YD24A = DK OR YD24C = DK, THEN D_MDEA1Y= DK
ELSE IF YD24A = REF OR YD24C = REF, THEN D_MDEA1Y= REF
ELSE D_MDEA1Y= BLANK
DEFINE D_MDEA2Y:
IF YD09 = 1 OR YD24E = 1 OR YD24F = 1 THEN D_MDEA2Y = 1
ELSE IF (YDS21 = 1 OR YDS22 = 1 OR YD09 = 2) AND YD24E = 2 AND YD24F = 2 THEN D_MDEA2Y = 2
ELSE IF YD09 = DK OR YD24E = DK OR YD24F = DK THEN D_MDEA2Y = DK
ELSE IF YD09 = REF OR YD24E = REF OR YD24F = REF THEN D_MDEA2Y = REF
ELSE D_MDEA2Y=BLANK
DEFINE D_MDEA3Y:
IF YD26A = 1 OR YD26B = 1 OR YD26D ≥10 OR YD26F ≥10, THEN D_MDEA3Y= 1
ELSE IF YD26A = 2 AND YD26B = 2 AND ((YD26D < 10 OR YD26F < 10) OR (YD26C = (2 OR BLANK) AND YD26E = (2 OR BLANK)) OR (YD26C = 1 AND (YD26C1 = 1 OR YD26C2 = 1)) OR (YD26E = 1 AND YD26E1 = 1)), THEN D_MDEA3Y= 2
ELSE IF YD26A = DK OR YD26B = DK OR YD26C = DK OR YD26D = DK OR YD26E = DK OR YD26F = DK, THEN D_MDEA3Y= DK
ELSE IF YD26A = REF OR YD26B = REF OR YD26C = REF OR YD26D = REF OR YD26E = REF OR YD26F = REF, THEN D_MDEA3Y= REF
ELSE D_MDEA3Y= BLANK
DEFINE D_MDEA4Y:
IF YD26G = 1 OR YD26H = 1, THEN D_MDEA4Y= 1
ELSE IF YD26G = 2 AND YD26H = 2, THEN D_MDEA4Y= 2
ELSE IF YD26G = DK OR YD26H = DK, THEN D_MDEA4Y= DK
ELSE IF YD26G = REF OR YD26H = REF, THEN D_MDEA4Y= REF
ELSE D_MDEA4Y= BLANK
DEFINE D_MDEA5Y:
IF YD26M = 1 OR YD26O = 1, THEN D_MDEA5Y= 1
ELSE IF (YD26L = (2 OR DK/REF) AND (YD26N = (2 OR DK/REF) OR YD26O = 2)) OR YD26M = 2, THEN D_MDEA5Y= 2
ELSE IF YD26L = DK OR YD26M = DK OR YD26N = DK OR YD26O = DK, THEN D_MDEA5Y= DK
ELSE IF YD26L = REF OR YD26M = REF OR YD26N = REF OR YD26O = REF, THEN D_MDEA5Y= REF
ELSE D_MDEA5Y= BLANK
DEFINE D_MDEA6Y:
D_MDEA6Y= YD26J
DEFINE D_MDEA7Y:
IF YD26V = 1, THEN D_MDEA7Y= 1
ELSE IF YD26U = (2 OR DK/REF) OR YD26V = 2, THEN D_MDEA7Y= 2
ELSE D_MDEA7Y=YD26V
ELSE D_MDEA7Y= BLANK
DEFINE D_MDEA8Y:
IF YD26P = 1 OR YD26R = 1 OR YD26S = 1, THEN D_MDEA8Y= 1
ELSE IF YD26P = 2 AND YD26R = 2 AND YD26S = 2, THEN D_MDEA8Y= 2
ELSE IF YD26P = DK OR YD26R = DK OR YD26S = DK, THEN D_MDEA8Y= DK
ELSE IF YD26P = REF OR YD26R = REF OR YD26S = REF, THEN D_MDEA8Y= REF
ELSE D_MDEA8Y= BLANK
DEFINE D_MDEA9Y:
IF YD26AA = 1 OR D26BB = 1 OR YD26CC = 1 OR YD26DD = 1 OR YD26EE = 1, THEN D_MDEA9Y= 1
ELSE IF YD26AA = 2 AND YD26BB = 2 AND YD26CC = 2, THEN D_MDEA9Y= 2
ELSE IF YD26AA = DK OR YD26BB = DK OR YD26CC = DK OR YD26DD = DK OR YD26EE = DK, THEN D_MDEA9Y= DK
ELSE IF YD26AA = REF OR YD26BB = REF OR YD26CC = REF OR YD26DD = REF OR YD26EE = REF, THEN D_MDEA9Y= REF
ELSE D_MDEA9Y= BLANK
DEFINE DSMMDEAY:
IF SUM (D_MDEA1Y = 1, D_MDEA2Y = 1, D_MDEA3Y = 1, D_MDEA4Y = 1, D_MDEA5Y = 1, D_MDEA6Y = 1, D_MDEA7Y = 1, D_MDEA8Y = 1, D_MDEA9Y = 1) ≥ 5, THEN DSMMDEAY = 1
ELSE IF SUM (D_MDEA1Y = (1 OR DK/REF), D_MDEA2Y = (1 OR DK/REF), D_MDEA3Y = (1 OR DK/REF), D_MDEA4Y = (1 OR DK/REF), D_MDEA5Y = (1 OR DK/REF), D_MDEA6Y = (1 OR DK/REF), D_MDEA7Y = (1 OR DK/REF), D_MDEA8Y = (1 OR DK/REF), D_MDEA9Y = (1 OR DK/REF)) < 5 AND N(OF D_MDEA1Y-D_MDEA9Y) > 0, THEN DSMMDEAY = 2
ELSE IF D_MDEA1Y = DK OR D_MDEA2Y = DK OR D_MDEA3Y = DK OR D_MDEA4Y = DK OR D_MDEA5 = DK OR D_MDEA6Y = DK OR D_MDEA7Y = DK OR D_MDEA8Y = DK OR D_MDEA9Y = DK, THEN DSMMDEAY = DK
ELSE IF D_MDEA1Y = REF OR D_MDEA2Y = REF OR D_MDEA3Y = REF OR D_MDEA4Y = REF OR D_MDEA5Y = REF OR D_MDEA6Y = REF OR D_MDEA7Y = REF OR D_MDEA8Y = REF OR D_MDEA9Y = REF, THEN DSMMDEAY = REF
YD28 [IF D_MDEA9Y = 1 OR DSMMDEAY = 1] You mentioned having some of the problems I just asked you about.
During that [TIMEFILL] period of time, how much did your [FEELNOUN]
interfere or cause problems with your school work, your job, or your relationships with family and friends?
1 Not at all
2 A little
3 Some
4 A lot
5 Extremely
DK/REF
YD28a [IF YD28 = 2, 3, 4, 5 OR DK/REF] During that [TIMEFILL] period of time, how often were you unable to carry out your daily activities or to take care of yourself because of these problems with your mood?
1 Often
2 Sometimes
3 Not very often
4 Never
DK/REF
YD37 [IF YD28 NE BLANK] Think of the very first period of time in your life lasting two weeks or longer when you [FEELFILL] and also had some of the other problems we just asked about.
Can you remember your exact age?
1 Yes
2 No
DK/REF
YD37a [IF YD37 = 1] How old were you?
AGE:__________ [RANGE: 1-17]
DK/REF
YD37b [IF YD37 = 2 OR DK] About how old were you when you first had a period of time like this?
AGE:__________ [RANGE: 1-17]
DK/REF
YD52 [IF YD28 NE BLANK] In your entire life, how many times did you feel [FEELNOUN] for two weeks or longer while also having some of the other problems we asked about?
If you are not sure of your answer, just make your best guess.
# OF EPISODES______________ [RANGE: 1-1000]
DK/REF
YD38 [IF YD28 NE BLANK] In the past 12 months, did you have a period of time when you felt [FEELNOUN] for two weeks or longer while also having some of the other problems we asked about?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD66a [IF YD38 = 1] Think about the time in the past 12 months when [NUMPROBS] with your mood [WASWERE] the worst.
Using the 0 to 10 scale shown below, where 0 means no problems and 10 means very severe problems, select the number that describes how much your [FEELNOUN] caused problems with your ability to do each of the following activities during that time. You can use any number between 0 and 10 to answer.
How much did your [FEELNOUN] cause problems with your chores at home?
No Very Severe
Problems Mild Moderate Severe Problems
│ │
NUMBER: ______________[RANGE: 0-10]
DK/REF
YD66b [IF YD38 = 1] During that time in the past 12 months when your [FEELNOUN] was worst, how much did this cause problems with your ability to do well at school or work?
You can use any number between 0 and 10 to answer.
No Very Severe
Problems Mild Moderate Severe Problems
│ │
0 1 2 3 4 5 6 7 8 9 10
NUMBER: ______________[RANGE: 0-10]
DK/REF
YD66c [IF YD38 = 1] How much did your [FEELNOUN] cause problems with your ability to get along with your family during that time?
You can use any number between 0 and 10 to answer.
No Very Severe
Problems Mild Moderate Severe Problems
│ │
0 1 2 3 4 5 6 7 8 9 10
NUMBER: ______________[RANGE: 0-10]
DK/REF
YD66d [IF YD38 = 1] How much did your [FEELNOUN] cause problems with your ability to have a social life during that time?
You can use any number between 0 and 10 to answer.
No Very Severe
Problems Mild Moderate Severe Problems
│ │
0 1 2 3 4 5 6 7 8 9 10
NUMBER: ______________[RANGE: 0-10]
DK/REF
YD68 [IF ANY RESPONSES TO YD66a – YD66d = 1-10] About how many days out of 365 in the past 12 months were you totally unable to go to school or work or carry out your normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD86 [IF YD38 NE BLANK] Here is a list of professionals some people talk to about the problems we have been asking about:
General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
Another healer, like an herbalist, chiropractor, acupuncturist, or massage therapist
At any time in the past 12 months, did you see or talk to a medical doctor or other professional about your [FEELNOUN]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD86a [IF YD86 = 1] During the past 12 months, which professionals did you see or talk to about [NUMPROBS] with your mood?
Select all that apply
General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
An herbalist, chiropractor, acupuncturist, or massage therapist
Another type of helping professional
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD86aSP [IF ANY RESPONSE IN YD86a =11] Please type in the type of other professional you saw or talked to during the past 12 months about your [FEELNOUN]. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________ [RANGE: 50 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YD86aSP.
YD86b [IF YD86= 1] Are you currently receiving treatment or counseling for [NUMPROBS] with your mood?
1 Yes
2 No
DK/REF
YD86c [IF YD38 NE BLANK] During the past 12 months, did you take prescription medication that was prescribed for[NUMPROBS]?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
END Thank you for helping us out with these questions! Please click Finish to submit your answers, and you will receive your [INCENTIVE] within [INCENTIVE DISPERSAL TIME PERIOD].
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Grace Medley |
| File Modified | 0000-00-00 |
| File Created | 2022-05-08 |
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