Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey, 2018 (CAFVMHS)
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Persons in Household (PHH)
- Military and Demographic Information (MDM)
- General health (GEN)
- General Health 2 (GEN1)
- Chronic Conditions (CCC)
- Type of Cancer - Sub-Block (CCC2)
- Age of Onset - Sub- Block (CCC3)
- Personality Disorders - Sub-Block (CCC4)
- Recall Block (REC)
- Screening Section (SCR)
- Depression (DEP)
- Suicide - sub block (SUI)
- Panic Disorder (PAD)
- Social Phobia (SOP)
- Generalized Anxiety Disorder (GAD)
- Post Traumatic Stress Disorder (PTS)
- Post Traumatic Stress Disorder - Sub block (PTS1)
- Military Sexual Trauma (MST)
- Smoking (SMK)
- Alcohol Use, Abuse and Dependence (AUD)
- Substance Use (SUB)
- Mental Health Services 1 (SR1)
- Mental Health Services 1 - Sub-Block (SR1S)
- Medication Use (MED)
- Perceived Need for Care (PNC)
- Childhood Experiences and Stressors (CES)
- Social support - Affection/ Emotional-Informational (SSM)
- Social Support - Sub- block (SSM2)
- Moral Injury Events Scale (MIES)
- Deployment Experience (DEX)
- Deployment Experience - Sub block (DEX1)
- Stress (STR)
- Employment Status (EMS)
- Work Stress (WST)
- Physical Activity - Short Form (PHS)
- Height and weight - Self-reported (HWT)
- Income (INC)
- Income 2 (INC1)
- Language of Preference (LP)
- HC: De-facto marital status without confirmation - MSNC
- HC: Education Sublock Highest certificate, diploma or degree short version - EHG1
- Record Linkage Statement (RLS)
- Possible future contact (PFC)
Persons in Household (PHH)
Persons in Household (PHH) - Question identifier:PHH_R01
The first couple of questions ask about your household.
Persons in Household (PHH) - Question identifier:PHH_Q01
Including yourself, how many persons usually live in your household?
Min = 1; Max = 20
Persons in Household (PHH) - Question identifier:PHH_Q02
How many of these persons are 18 years or younger?
Min = 0; Max = 20
Military and Demographic Information (MDM)
Military and Demographic Information (MDM) - Question identifier:MDM_R01
The next questions ask about military and general demographic information.
Military and Demographic Information (MDM) - Question identifier:MDM_Q02
Are you currently enrolled in the Canadian Armed Forces (CAF)?
- 1: Yes
- 2: No
Military and Demographic Information (MDM) - Question identifier:MDM_Q03
How old were you when you started serving in the Canadian Armed Forces (CAF)?
Min = 15; Max = 90
Military and Demographic Information (MDM) - Question identifier:MDM_Q04
In which of the following military categories do you currently belong?
- 1: Junior Non-Commissioned Member
e.g., Able Seaman, Corporal, Leading Seaman, Master Corporal, Master Seaman, Private, Aviator, Ordinary Seaman - 2: Senior Non-Commissioned Member
e.g., Sergeant, Petty Officer 2nd class, Warrant Officer, Petty Officer 1st class, Master Warrant Officer, Chief Petty Officer 2nd class, Chief Warrant Officer, Chief Petty Officer 1st class - 3: Junior Officer
e.g., Second Lieutenant, Acting Sub-Lieutenant, Lieutenant, Sub-Lieutenant, Captain, and Lieutenant - 4: Senior Officer
e.g., Major, Lieutenant-Commander, Lieutenant-Colonel, Commander, Colonel, Captain (N), General Officer, Flag Officer - 8: RF
- 9: DK
Military and Demographic Information (MDM) - Question identifier:MDM_Q05
When were you released from the CAF?
Min = 2001; Max = 2018
Military and Demographic Information (MDM) - Question identifier:MDM_Q06
In which of the following military categories did you belong to at the time of your release from the Canadian Armed Forces?
- 1: Junior Non-Commissioned Member
e.g., Able Seaman, Corporal, Leading Seaman, Master Corporal, Master Seaman, Private, Aviator, Ordinary Seaman - 2: Senior Non-Commissioned Member
e.g., Sergeant, Petty Officer 2nd class, Warrant Officer, Petty Officer 1st class, Master Warrant Officer, Chief Petty Officer 2nd class, Chief Warrant Officer, Chief Petty Officer 1st class - 3: Junior Officer
e.g., Second Lieutenant, Acting Sub-Lieutenant, Lieutenant, Sub-Lieutenant, Captain, and Lieutenant - 4: Senior Officer
e.g., Major, Lieutenant-Commander, Lieutenant-Colonel, Commander, Colonel, Captain (N), General Officer, Flag Officer - 8: RF
- 9: DK
Military and Demographic Information (MDM) - Question identifier:MDM_Q07
[Are you currently serving/Did you last serve] with the Regular Force or Reserve Force?
- 1: Regular Force
- 2: Class A Reserve Force
- 3: Class B Reserve Force
- 4: Class C Reserve Force
- 8: RF
- 9: DK
Military and Demographic Information (MDM) - Question identifier:MDM_Q08
For how many years [have you been/were you] a member of the Canadian Armed Forces including time served in either Regular or Reserve Forces?
Min = 1; Max = 60
Military and Demographic Information (MDM) - Question identifier:MDM_Q09
What environmental uniform [do you currently/did you last] wear?
- 1: Air
- 2: Land
- 3: Sea
- 8: RF
- 9: DK
Military and Demographic Information (MDM) - Question identifier:MDM_Q10
[Do you currently/Did you last] report to the Royal Canadian Airforce, the Canadian Army, or the Royal Canadian Navy?
- 1: Royal Canadian Air Force
- 2: Canadian Army
- 3: Royal Canadian Navy
- 4: Purple Trade
- 8: RF
- 9: DK
Military and Demographic Information (MDM) - Question identifier:MDM_Q11
Have you ever been deployed outside of Canada?
(For the purpose of answering the next few questions, "deployment" means having deployed in support of a mission, such as a NATO mission or a UN tour. Please include international disaster relief efforts.
Do not include exercises, sea time, individual or collective training courses, TD (temporary duty), aid to civil power activities or Canadian disaster relief activities.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Military and Demographic Information (MDM) - Question identifier:MDM_Q12
Were you deployed... ?
- 1: before 2002
- 2: after 2002
- 3: before and after 2002
- 8: RF
- 9: DK
Military and Demographic Information (MDM) - Question identifier:MDM_Q13
How many deployments have you had since 2002?
Min = 1; Max = 100
General health (GEN)
General health (GEN) - Question identifier:GEN_R01
This survey deals with various aspects of your health. I'll be asking about such things as physical activity, social relationships and health status. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
General health (GEN) - Question identifier:GEN_Q01
I'll start with a few questions concerning your health in general. In general, would you say your health is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q02A
In general, would you say your physical health is... ?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q02B
In general, would you say your mental health is... ?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q03
Compared to one year ago, how would you say your health is now? Is it...?
- 1: Much better now than 1 year ago
- 2: Somewhat better now (than 1 year ago)
- 3: About the same as 1 year ago
- 4: Somewhat worse now (than 1 year ago)
- 5: Much worse now (than 1 year ago)
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q04
How long do you usually spend sleeping each night?
- 01: Under 2 hours
- 02: 2 hours to less than 3 hours
- 03: 3 hours to less than 4 hours
- 04: 4 hours to less than 5 hours
- 05: 5 hours to less than 6 hours
- 06: 6 hours to less than 7 hours
- 07: 7 hours to less than 8 hours
- 08: 8 hours to less than 9 hours
- 09: 9 hours to less than 10 hours
- 10: 10 hours to less than 11 hours
- 11: 11 hours to less than 12 hours
- 12: 12 hours or more
- 98: RF
- 99: DK
General health (GEN) - Question identifier:GEN_Q05
How often do you have trouble going to sleep or staying asleep?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q10
How would you describe your sense of belonging to your local community? Would you say it is...?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 8: RF
- 9: DK
General Health 2 (GEN1)
General Health 2 (GEN1) - Question identifier:GEN1_Q1
In general, how has the adjustment to civilian life been since you were released from the Canadian Armed Forces?
- 1: Very difficult
- 2: Moderately difficult
- 3: Neither difficult nor easy
- 4: Moderately easy
- 5: Very easy
- 8: RF
- 9: DK
Chronic Conditions (CCC)
Chronic Conditions (CCC) - Question identifier:CCC_R01
Now I'd like to ask about certain long-term health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic Conditions (CCC) - Question identifier:CCC_Q01
Do you have asthma?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q02
(Do you have:)
...chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q04
(Do you have:)
...arthritis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q05
(Do you have:)
...back problems, excluding arthritis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q07
(Do you have:)
...high cholesterol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q08
(Do you have:)
...high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q09
(Do you have:)
...heart disease?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q10
Do you suffer from the effects of a stroke?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q11
(Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.)
Do you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q12
(Do you have:)
...chronic fatigue syndrome?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q14
(Do you have:)
...intestinal or stomach ulcers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q15
(Do you have:)
... Irritable Bowel Syndrome?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q16
(Do you have:)
... inflammatory bowel disease (Crohn's disease or Ulcerative colitis)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q17
(Do you have:)
...migraine headaches?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q18
(Do you have:)
...effects of a traumatic brain injury (TBI) or concussion?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q19A
(Do you have:)
...cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q19B
Have you ever been diagnosed with cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q20
(Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.)
Do you have epilepsy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q21
(Do you have:)
...multiple sclerosis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q22
(Do you have:)
...chronic liver disease?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q25
(Do you have:)
... attention deficit hyperactivity disorder (ADHD)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q26
(Do you have:)
... obsessive compulsive disorder (OCD)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q27
(Do you have:)
... mania or bipolar disorder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic Conditions (CCC) - Question identifier:CCC_Q30
(Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.)
Do you have a personality disorder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Type of Cancer - Sub-Block (CCC2)
Type of Cancer - Sub-Block (CCC2) - Question identifier:CCC2_Q01
What kind of cancer [did/do] you have?
- 01: Lung and bronchus
- 02: Breast
- 03: Colon and rectal
- 04: Prostate
- 05: Urinary bladder (including in situ)
- 06: Non-Hodgkin's lymphoma
- 07: Melanomas of the skin
- 08: Thyroid
- 09: Endometrial/Uterine/Cervical/Ovarian
- 10: Kidney
- 11: Pancreatic
- 12: Stomach
- 13: Liver
- 14: Bone
- 15: Other - Specify
- 98: RF
- 99: DK
Age of Onset - Sub- Block (CCC3)
Age of Onset - Sub- Block (CCC3) - Question identifier:CCC3_Q01
What age were you when you were first diagnosed with [asthma/chronic bronchitis, emphysema or chronic obstructive pulmonary
disease or COPD/arthritis/back problems, excluding arthritis/high cholesterol/high blood pressure/heart disease/effects of stroke/diabetes/chronic fatigue syndrome/intestinal or stomach ulcers/Irritable Bowel Syndrome/inflammatory bowel disease (Crohn's disease or Ulcerative colitis)/migraine headaches/effects of traumatic brain injury (TBI) or concussion/cancer/cancer/epilepsy/multiple sclerosis/chronic liver disease/attention deficit hyperactivity disorder (ADHD)/obsessive compulsive disorder (OCD)/mania or bipolar disorder/a personality disorder]?
Min = 1; Max = 121
Personality Disorders - Sub-Block (CCC4)
Personality Disorders - Sub-Block (CCC4) - Question identifier:CCC4_Q01
What kind of personality disorder do you have?
- 01: Paranoid
- 02: Schizoid
- 03: Schizotypal
- 04: Antisocial
- 05: Borderline
- 06: Histronic
- 07: Narcissistic
- 08: Avoidant
- 09: Dependent
- 10: Obsessive-Compulsive
- 98: RF
- 99: DK
Recall Block (REC)
Recall Block (REC) - Question identifier:REC_R01
During the summer or fall of 2002, you participated in a Statistics Canada survey about mental health and well-being of the Canadian Armed Forces. Many questions in this survey ask about your experiences since that survey in 2002. The following questions will help you think about your life from that time period.
Recall Block (REC) - Question identifier:REC_Q01
Do you recall where you lived at the time of the interview in 2002?
- 1: Yes
- 2: No
- 9: DK
Recall Block (REC) - Question identifier:REC_Q03
Do you recall your rank and unit at the time of the interview in 2002?
- 1: Yes
- 2: No
- 9: DK
Recall Block (REC) - Question identifier:REC_Q04
Did you own or rent your house in 2002?
- 1: Own
- 2: Rent
- 9: DK
Screening Section (SCR)
Screening Section (SCR) - Question identifier:SCR_R01
The next questions are about your well-being and areas of your life that could affect your physical and emotional health. Take your time to think about each question before answering.
Screening Section (SCR) - Question identifier:SCR_Q01
How satisfied are you with your life in general?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q20A
Since 2002, have you had an attack of fear or panic when all of a sudden you felt very frightened, anxious or uneasy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q20B
Since 2002, have you had an attack when all of a sudden:
- you became very uncomfortable,
- you either became short of breath, dizzy, nauseous or your heart pounded,
- or you thought that you might lose control, die or go crazy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q21
Since 2002, have you had a period lasting several days or longer when most of the day you felt sad, empty or depressed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q22
Since 2002, have you had a period 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
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q23
Since 2002, have you had a period 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
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q26A
Since 2002, did you have a time when you were a "worrier"; that is, when you worried a lot more about things than other people with the same problems as you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q26B
Since 2002, did you have a time when you were much more nervous or anxious than most other people with the same problems as you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q26C
Since 2002, did you have a period lasting 6 months or longer when you were anxious and worried most days?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q29A
Since 2002, was there a time when you felt very afraid or really, really shy with people, for example meeting new people, going to parties, going on a date or using a public bathroom?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q29B
Since 2002, was there a time when you felt very afraid or uncomfortable when you had to do something in front of a group of people, like giving a speech or speaking in class?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q29C
Since 2002, was there a time when you became very upset or nervous DT_SITUATIONSE1?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q29D
Because of your fear, did you stay away from DT_SITUATIONSE2 whenever you could?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Screening Section (SCR) - Question identifier:SCR_Q29E
Do you think your fear was much stronger than it should have been?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP)
Depression (DEP) - Question identifier:DEP_Q01A
Earlier, you mentioned having periods since 2002 that lasted several days or longer when you felt sad, empty or depressed most of the day.
During such episodes, did you feel discouraged about how things were going in your life?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q01A_1
During the episodes of being sad, empty or depressed, did you lose interest in most things like work, hobbies or other things you usually enjoyed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q01B
During the episodes of being sad, empty or depressed, did you lose interest in most things like work, hobbies or other things you usually enjoyed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q02
Earlier, you mentioned having periods since 2002 that lasted several days or longer when you felt discouraged about how things were going in your life.
During such episodes, did you lose interest in most things like work, hobbies or other things you usually enjoy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q09
Earlier, you mentioned having periods since 2002 that lasted several days or longer when you lost interest in most things like work, hobbies or other things you usually enjoy.
Did you have such a period that lasted for most of the day, nearly every day, for 2 weeks or longer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q12
Since 2002, did you have a period of being [sad, discouraged or uninterested in things] that lasted for most of the day, nearly every day, for 2 weeks or longer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q16
Think of periods lasting 2 weeks or longer since 2002 when [these problems/this problem] with your mood [were/was] most severe and frequent. During those periods, did your feelings of being [sad, discouraged or uninterested] usually last ...?
- 1: Less than one hour
- 2: 1 hour to less than 3 hours
- 3: 3 hours to less than 5 hours
- 4: 5 hours or more
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q17
During those periods, how severe was your emotional distress?
- 1: Mild
- 2: Moderate
- 3: Severe
- 4: Very severe
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q18
During those periods, how often was your emotional distress so severe that nothing could cheer you up?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q19
During those periods, how often was your emotional distress so severe that you could not carry out your daily activities?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_R21
(Please refer to page 1 of the booklet.)
People with episodes of being [sad, discouraged or uninterested] often have other problems at the same time. These include things like feelings of low self-worth and changes in sleep, appetite, energy and ability to concentrate and remember.
Depression (DEP) - Question identifier:DEP_Q21
Since 2002, did you have problems like this during one of your episodes of being [sad, discouraged or uninterested]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q22A
Please think of an episode of being [sad, discouraged or uninterested] that lasted 2 weeks or longer when, at the same time, you also had the largest number of these other problems.
Is there one particular episode that stands out as the worst one you had since 2002?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q22A_1
How old were you when that worst episode started?
Min = 0; Max = 130
Depression (DEP) - Question identifier:DEP_Q22B
How long did it last (in terms of days, weeks, months or years)?
Min = 1; Max = 900
Depression (DEP) - Question identifier:DEP_N22C
Was that in days, weeks, months or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Depression (DEP) - Question identifier:DEP_Q23A
Think of the last time you had a bad episode of being [sad, discouraged or uninterested] like this. How old were you when that last episode occurred?
Min = 0; Max = 130
Depression (DEP) - Question identifier:DEP_Q23B
How long did that episode last?
Min = 1; Max = 900
Depression (DEP) - Question identifier:DEP_N23C
Was that in days, weeks, months or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Depression (DEP) - Question identifier:DEP_R24
In answering the next questions, think about the period of 2 weeks or longer occurring since 2002 when your feelings of being [sad, discouraged or uninterested] and other problems were most severe and frequent. During that period, tell me which of the following problems you had for most of the day, nearly every day.
Depression (DEP) - Question identifier:DEP_Q24A
Did you feel sad, empty or depressed most of the day, nearly every day, during that period of 2 weeks or longer?
- 1: Yes (KEY_PHRASE = feeling sad, empty or depressed)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q24B
Nearly every day, did you feel so sad that nothing could cheer you up?
- 1: Yes (KEY_PHRASE = feeling that nothing could cheer you up)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q24C
During that period of 2 weeks or longer, did you feel discouraged most of the day, nearly every day, about how things were going in your life?
- 1: Yes (KEY_PHRASE = feeling discouraged about things in your life)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q24D
Did you feel hopeless about the future nearly every day?
- 1: Yes (KEY_PHRASE = feeling hopeless about the future)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q24E
During that period of 2 weeks or longer, did you lose interest in almost all things like work, hobbies and things you like to do for fun?
- 1: Yes (KEY_PHRASE = losing interest in almost all things)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q24F
Did you feel like nothing was fun even when good things were happening?
- 1: Yes (KEY_PHRASE = feeling that nothing was fun)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26A
During that period of 2 weeks or longer, did you, nearly every day, have a much smaller appetite than usual?
- 1: Yes (KEY_PHRASE = having a much smaller
appetite) - 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26B
Did you have a much larger appetite than usual nearly every day?
- 1: Yes (KEY_PHRASE = having a much larger appetite)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26C
During that period of 2 weeks or longer, did you gain weight without trying to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26C_1
Was this weight gain due to a physical growth[or pregnancy]?
- 1: Yes
- 2: No (KEY_PHRASE = gaining weight without trying to)
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26D
How much did you gain?
Min = 1; Max = 300
Depression (DEP) - Question identifier:DEP_N26D
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Depression (DEP) - Question identifier:DEP_Q26E
Did you lose weight without trying to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26E_1
Was this weight loss a result of a diet or a physical illness?
- 1: Yes
- 2: No (KEY_PHRASE = losing weight without trying to)
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26F
How much did you lose?
Min = 1; Max = 300
Depression (DEP) - Question identifier:DEP_N26F
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Depression (DEP) - Question identifier:DEP_Q26G
During that period of 2 weeks or longer, did you have a lot more trouble than usual either falling asleep, staying asleep or waking up too early nearly every night?
- 1: Yes (KEY_PHRASE = having trouble falling
or staying asleep or waking up too early) - 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26H
During that period of 2 weeks or longer, did you sleep a lot more than usual nearly every night?
- 1: Yes (KEY_PHRASE = sleeping a lot more
than usual) - 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26I
Did you sleep much less than usual and still not feel tired or sleepy?
- 1: Yes (KEY_PHRASE = sleeping much less than usual)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26J
During that period of 2 weeks or longer, did you feel tired or low in energy nearly every day, even when you had not been working very hard?
- 1: Yes (KEY_PHRASE = feeling tired or low in
energy) - 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26K
During that period of 2 weeks or longer, did you have a lot more energy than usual nearly every day?
- 1: Yes (KEY_PHRASE = having a lot more
energy than usual) - 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26L
Did you talk or move more slowly than is normal for you nearly every day?
- 1: Yes (KEY_PHRASE = talking or moving more slowly than normal)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26M
Did anyone else notice that you were talking or moving slowly?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26N
Were you so restless or jittery nearly every day that you paced up and down or couldn't sit still?
- 1: Yes (KEY_PHRASE = feeling restless or jittery, or couldn't sit still)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26O
Did anyone else notice that you were restless?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26P
During that period of 2 weeks or longer, did your thoughts come much more slowly than usual or seem mixed up nearly every day?
- 1: Yes (KEY_PHRASE = thinking much more
slowly than usual) - 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26Q
Did your thoughts seem to jump from one thing to another or race through your head so fast you couldn't keep track of them?
- 1: Yes (KEY_PHRASE = having thoughts race through your head)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26R
Nearly every day, did you have a lot more trouble concentrating than is normal for you?
- 1: Yes (KEY_PHRASE = having more trouble concentrating)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26S
Were you unable to make up your mind about things you ordinarily have no trouble deciding about?
- 1: Yes (KEY_PHRASE = being unable to make your mind about things)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26T
Did you lose your self-confidence?
- 1: Yes (KEY_PHRASE = losing your self-confidence)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26U
Nearly every day, did you feel that you were not as good as other people?
- 1: Yes (KEY_PHRASE = feeling not as good as other people)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26V
Did you feel totally worthless nearly every day?
- 1: Yes (KEY_PHRASE = feeling worthless)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26W
Did you feel guilty nearly every day?
- 1: Yes (KEY_PHRASE = feeling guilty every day)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26X
Did you feel irritable, grouchy or in a bad mood nearly every day?
- 1: Yes (KEY_PHRASE = feeling grouchy)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26Y
Did you feel nervous or anxious most days?
- 1: Yes (KEY_PHRASE = feeling nervous or anxious)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26Z
During that period of 2 weeks or longer, did you have any sudden attacks of intense fear or panic?
- 1: Yes (KEY_PHRASE = having attacks of fear or panic)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26ZFF
Did you feel that you could not cope with your everyday responsibilities?
- 1: Yes (KEY_PHRASE = feeling you couldn't cope with your responsibilities)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26ZGG
Did you feel like you wanted to be alone rather than spend time with friends or relatives?
- 1: Yes (KEY_PHRASE = wanting to be alone)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26ZHH
Did you feel less talkative than usual?
- 1: Yes (KEY_PHRASE = feeling less talkative)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26ZII
Were you often in tears?
- 1: Yes (KEY_PHRASE = being often in tears)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26AA
Did you often think a lot about death, either your own, someone else's or death in general?
- 1: Yes (KEY_PHRASE = thinking about death)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q26BB
During that period, did you think that it would be better if you were dead?
- 1: Yes (KEY_PHRASE = thinking you were better dead)
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q28A
You mentioned having a number of the problems that I just asked you about.
During that episode that occurred since 2002, how much did your feelings of being [sad, discouraged or uninterested] and having these other problems interfere with either your work, your social life or your personal relationships?
- 1: Not at all
- 2: A little
- 3: Some
- 4: A lot
- 5: Extremely
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q28B
Earlier, you mentioned having a number of problems during the period of 2 weeks or longer that occurred since 2002 when your feelings of being [sad, discouraged or uninterested] were most frequent and severe. During that episode, how much did your feelings of being [sad, discouraged or uninterested] and having these other problems interfere with either your work, your social life or your personal relationships?
- 1: Not at all
- 2: A little
- 3: Some
- 4: A lot
- 5: Extremely
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q28C
During that episode, how often were you unable to carry out your daily activities because of your feelings of being [sad, discouraged or uninterested]?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q29A
Episodes of this sort sometimes occur as a result of a physical illness or injury or the use of medication, drugs or alcohol. Do you think your episodes of feeling [sad, discouraged or uninterested] since 2002 occurred as the result of physical causes, medication, drugs or alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q29B
Do you think your episodes were always the result of physical causes, medication, drugs or alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q29C
What were the causes?
- 01: Exhaustion
- 02: Hyperventilation
- 03: Hypochondria
- 04: Menstrual cycle
- 05: Pregnancy / postpartum
- 06: Thyroid disease
- 07: Cancer
- 08: Overweight
- 09: Medication (excluding illicit drugs)
- 10: Illicit drugs
- 11: Alcohol
- 12: Chemical Imbalance / Serotonin Imbalance
- 13: Chronic Pain
- 14: Caffeine
- 15: No specific diagnosis
- 16: Accident / Injury
- 17: Emotional, social or economic reason
- 18: Other - Specify
- 98: RF
- 99: DK
Depression (DEP) - Question identifier:DEP_Q30A
Since 2002, did your episodes of feeling [sad, discouraged or uninterested] occur just after someone close to you died?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q30B
Did your episodes of feeling [sad, discouraged or uninterested] since 2002 always occur just after someone close to you died?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_R31
In the next questions, the word "episode" means a period lasting 2 weeks or longer that occurred at some point since 2002, when, nearly every day, you were [sad, discouraged or uninterested] and you also had some of the other problems we just mentioned. The end of an episode is when you no longer have the problems for two weeks in a row.
Depression (DEP) - Question identifier:DEP_Q31
Since 2002, how many episodes of feeling [sad, discouraged or uninterested] with some other problems lasting two weeks or longer have you had?
Min = 1; Max = 901
Depression (DEP) - Question identifier:DEP_Q37E
Was that episode brought on by some stressful experience or did it happen out of the blue?
- 1: Brought on by stress
- 2: Out of the blue
- 3: Don't remember
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q38A
At any time in the past 12 months, did you have an episode lasting 2 weeks or longer when you felt [sad, discouraged or uninterested] and also had some of the other problems already mentioned?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q38A_1
How recently was it?
- 1: During the past month
- 2: Between 1 and 6 months ago
- 3: More than 6 months ago
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q38B
During the past 12 months, about how many days out of 365 were you in such an episode? (You may use any number between 1 and 365 to answer.)
Min = 1; Max = 365
Depression (DEP) - Question identifier:DEP_Q38C
How old were you the last time you had one of these episodes?
Min = 0; Max = 130
Depression (DEP) - Question identifier:DEP_Q39
What is the longest episode you had since 2002 when, most of the day, nearly everyday, you were feeling [sad, discouraged or uninterested] and you also had some of the other problems we just mentioned?
Min = 1; Max = 900
Depression (DEP) - Question identifier:DEP_N39_1
Was that in days, weeks, months or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Depression (DEP) - Question identifier:DEP_Q53
Earlier, you mentioned that you had [^DEP_Q31/several] episode(s) of feeling [sad, discouraged or uninterested] with some other problems lasting 2 weeks or longer since 2002.
How many of these episodes were brought on by some stressful experience?
Min = 0; Max = 901
Depression (DEP) - Question identifier:DEP_R64A
For the next questions, think about the period of 2 weeks or longer during the past 12 months when your feelings of being [sad, discouraged or uninterested] were most severe and frequent.
Depression (DEP) - Question identifier:DEP_Q64A
During this period, how often did you feel cheerful?
- 1: Often
- 2: Sometimes
- 3: Occasionally
- 4: Never
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q64B
How often did you feel as if you were slowed down?
- 1: Often
- 2: Sometimes
- 3: Occasionally
- 4: Never
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q64C
How often could you enjoy a good book or radio or TV program?
- 1: Often
- 2: Sometimes
- 3: Occasionally
- 4: Never
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q65A
During this period, how often did you still enjoy the things you used to enjoy?
- 1: As much as usual
- 2: Not quite as much as usual
- 3: Only a little
- 4: Not at all
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q65B
How often could you laugh and see the bright side of things?
- 1: As much as usual
- 2: Not quite as much as usual
- 3: Only a little
- 4: Not at all
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q65C
How often did you take interest in your physical appearance?
- 1: As much as usual
- 2: Not quite as much as usual
- 3: Only a little
- 4: Not at all
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q65D
How often did you look forward to enjoying things?
- 1: As much as usual
- 2: Not quite as much as usual
- 3: Only a little
- 4: Not at all
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_R66
(Please refer to page 2 of the booklet.)
Think about the period of time that lasted one month or longer when your feelings of being [sad, discouraged or uninterested in things] were most severe in the past 12 months. Please tell me what number best describes how much these feelings interfered with each of the following activities. For each activity, answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference".
Depression (DEP) - Question identifier:DEP_Q66A
In the past 12 months, how much did your feelings of being [sad, discouraged or uninterested in things] interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Depression (DEP) - Question identifier:DEP_Q66B_1
How much did your feelings interfere with your ability to attend school?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Depression (DEP) - Question identifier:DEP_Q66B_2
How much did they interfere with your ability to work at a job?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Depression (DEP) - Question identifier:DEP_Q66C
Again thinking about that period of time lasting one month or longer during the past 12 months when your feelings of being [sad, discouraged or uninterested in things] were most severe, how much did they interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 "very severe interference".)
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Depression (DEP) - Question identifier:DEP_Q66D
How much did they interfere with your social life?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Depression (DEP) - Question identifier:DEP_Q68
In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your feelings of being [sad, discouraged or uninterested in things]? (You may use any number between 0 and 365 to answer.)
Min = 0; Max = 365
Depression (DEP) - Question identifier:DEP_Q72A
Since 2002, did you talk to a medical doctor or other professional about your feelings of being [sad, discouraged or uninterested in things]? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q86
During the past 12 months, did you receive professional treatment for your feelings of being [sad, discouraged or uninterested in things]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q87
Since 2002, were you hospitalized overnight for your feelings of being [sad, discouraged or uninterested in things]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI)
Suicide - sub block (SUI) - Question identifier:SUI_R01
(Please refer to page 3 of the booklet.)
Three experiences are listed, EXPERIENCE A, B and C.
Suicide - sub block (SUI) - Question identifier:SUI_Q01
Think of the period of 2 weeks or longer since 2002 when your feelings of being ^DT_KEYPHRASE3 and other problems were most severe and frequent. During that time, did EXPERIENCE A happen to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_R02
(Please refer to page 3 of the booklet.)
The following questions may be sensitive to some people, but we have to ask the same questions of everyone. Three experiences are listed, EXPERIENCE A, B and C.
Suicide - sub block (SUI) - Question identifier:SUI_Q02
Has EXPERIENCE A ever happened to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q03
In the past 12 months, did EXPERIENCE A happen to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q03_1
How old were you the last time this experience happened to you?
Min = 6; Max = 129
Suicide - sub block (SUI) - Question identifier:SUI_Q04A
Now look at the second experience on the list, EXPERIENCE B. During that period of 2 weeks or longer, did EXPERIENCE B happen to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q04B
[Now look at the second of the three experiences on the list, EXPERIENCE B.] Did EXPERIENCE B ever happen to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q05
Did EXPERIENCE B happen to you at any time in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q05_1
How old were you the last time EXPERIENCE B happened to you?
Min = 6; Max = 129
Suicide - sub block (SUI) - Question identifier:SUI_Q06A
Now, look at the third experience on the list, EXPERIENCE C. During that period of 2 weeks or longer, did EXPERIENCE C happen to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q06B
[Now look at the third of the three experiences on the list, EXPERIENCE C.] Has EXPERIENCE C ever happened to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q06C
How many times did EXPERIENCE C ever happen to you in your lifetime?
Min = 1; Max = 901
Suicide - sub block (SUI) - Question identifier:SUI_Q09
(Please refer to page 4 of the booklet)
There are three statements numbered 1, 2, and 3 on page 4 in your booklet. Which of these three statements best describes your situation when EXPERIENCE C happened to you the first time -- 1, 2, or 3?
- 1: I made a serious attempt to kill myself and it was only luck that I did not succeed
- 2: I tried to kill myself, but knew that the method was not fool-proof
- 3: My attempt was a cry for help. I did not intend to die.
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q10
During the last 12 months, did EXPERIENCE C happen to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q10_1
How old were you [when/the last time] EXPERIENCE C happened to you?
Min = 6; Max = 129
Suicide - sub block (SUI) - Question identifier:SUI_Q11
Did it result in an injury or poisoning?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q12
Did it require medical attention (following the most recent time EXPERIENCE C happened to you)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q13
Were you hospitalized overnight or longer (following this most recent time since EXPERIENCE C happened to you)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q14
Looking at page 4 in your booklet, which of the three statements best describes your situation [when/the last time] EXPERIENCE C happened to you - 1, 2, or 3?
- 1: I made a serious attempt to kill myself and it was only luck that I did not succeed
- 2: I tried to kill myself, but knew that the method was not fool-proof
- 3: My attempt was a cry for help. I did not intend to die.
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q16
During the past 12 months, have you talked to a professional about EXPERIENCE A?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicide - sub block (SUI) - Question identifier:SUI_Q19
During the past 12 months, have you talked to a professional about EXPERIENCE A or EXPERIENCE C?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD)
Panic Disorder (PAD) - Question identifier:PAD_R01A
Earlier, you mentioned having attacks of fear or panic when all of a sudden you felt very frightened, anxious or uneasy. Think of a bad attack like that since 2002. During that attack, tell me which of the following problems you had.
Panic Disorder (PAD) - Question identifier:PAD_R01B
Earlier you mentioned having attacks when all of a sudden you had problems like being short of breath, feeling dizzy, your heart pounding or being afraid you would die or go crazy. Think of a bad attack like that since 2002. During that attack, tell me which of the following problems you had.
Panic Disorder (PAD) - Question identifier:PAD_Q02A
Did your heart pound or race?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02B
Were you short of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02C
Did you feel nauseous or sick to your stomach?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02D
Did you feel dizzy or faint?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02E
Did you sweat?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02F
Did you tremble or shake?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02G
Did you have a dry mouth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02H
Did you feel like you were choking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02I
Did you have pain or discomfort in your chest?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02J
Were you afraid that you might lose control of yourself or go crazy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02K
Did you feel that you were "not really there", like you were watching a movie of yourself?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02L
Did you feel that things around you were not real or like a dream?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02M
Were you afraid that you might pass out?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02N
Were you afraid that you might die?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02O
Did you have hot flushes or chills?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q02P
Did you feel numbness or have tingling sensations?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q04
During your attacks in the years since 2002, did the problems like:
[List of problems]
begin suddenly and reach their peak within 10 minutes after the attacks began?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q05
About how many of these sudden attacks have you had since 2002?
Min = 1; Max = 901
Panic Disorder (PAD) - Question identifier:PAD_Q06
When did the attack occur? Was it... ?
- 1: During the past month
- 2: 1 month to less than 6 months ago
- 3: 6 months to 12 months ago
- 4: More than 12 months ago
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_R08
(Please refer to page 5 of the booklet.)
Attacks of this sort can occur in 3 different situations.
- In the first situation, the attacks occur unexpectedly, "out of the blue".
- In the second situation, a person has an unreasonably strong fear. For example, some people have a terrible fear of bugs or of heights or of being in a crowd.
- In the third situation, a person is in real danger, like a car accident or a bank robbery.
Panic Disorder (PAD) - Question identifier:PAD_Q08
Which of these 3 situations describes your attack? Did it occur...?
- 1: Unexpectedly, "out of the blue"
- 2: In a situation where you had a strong fear
- 3: In a situation of real danger
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q10A
At any time in the past 12 months, did you have one of these attacks?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q10B
How recently was it?
- 1: During the past month
- 2: Between 1 and 6 months ago
- 3: More than 6 months ago
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q10C
How old were you the last time you had one of these attacks?
Min = 0; Max = 130
Panic Disorder (PAD) - Question identifier:PAD_R13A
After one of these attacks, tell me if you had any of the following experiences since 2002.
Panic Disorder (PAD) - Question identifier:PAD_Q13A
A month or more when you often worried that you might have another attack?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q13B
A month or more when you worried that something terrible might happen because of the attacks, like having a car accident, having a heart attack or losing control?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q13C
A month or more when you changed your everyday activities because of the attacks?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q13D
A month or more when you avoided certain situations because of fear about having another attack?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q16
Did you have a month of worry or change in activity like that in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_R17A
(Please refer to page 5 of the booklet.)
Attacks of this sort can occur in 3 different situations.
- In the first situation, the attacks occur unexpectedly, "out of the blue".
- In the second situation, a person has an unreasonably strong fear. For example, some people have a terrible fear of bugs or of heights or of being in a crowd.
- In the third situation, a person is in real danger, like a car accident or a bank robbery.
Panic Disorder (PAD) - Question identifier:PAD_Q17A
The next questions are about how many of your attacks occurred in each of these 3 kinds of situations.
Since 2002, did you have an attack that occurred unexpectedly, "out of the blue"?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q17B
Since 2002, about how many attacks occurred unexpectedly, "out of the blue"?
Min = 1; Max = 901
Panic Disorder (PAD) - Question identifier:PAD_Q17C
Since 2002, did you have 4 or more attacks that occurred unexpectedly, "out of the blue"?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q18
Since 2002, about how many attacks occurred in situations where you were not in real danger, but where you had an unreasonably strong fear of the situations?
Min = 0; Max = 901
Panic Disorder (PAD) - Question identifier:PAD_Q19
Since 2002, about how many attacks occurred in situations where you were in real danger?
Min = 0; Max = 901
Panic Disorder (PAD) - Question identifier:PAD_Q22
How much did [this/these] unexpected, "out of the blue" [attack/attacks] or worry about having another attack interfere with either your work, your social life or your personal relationships since 2002?
- 1: Not at all
- 2: A little
- 3: Some
- 4: A lot
- 5: Extremely
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q25A
Unexpected attacks sometimes occur as a result of a physical illness or injury or the use of medication, drugs or alcohol.
Do you think any of your attacks since 2002 occurred as the result of physical causes, medication, drugs or alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q25B
Do you think all of your attacks (since 2002) were the result of physical causes, medication, drugs or alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q25C
What were the causes?
- 01: Exhaustion
- 02: Hyperventilation
- 03: Hypochondria
- 04: Menstrual cycle
- 05: Pregnancy / postpartum
- 06: Thyroid disease
- 07: Cancer
- 08: Overweight
- 09: Medication (excluding illicit drugs)
- 10: Illicit drugs
- 11: Alcohol
- 12: Chemical Imbalance / Serotonin Imbalance
- 13: Chronic pain
- 14: Caffeine
- 15: No specific diagnosis
- 16: Other - Specify
- 17: Other - Physical causes, etc.
- 98: RF
- 99: DK
Panic Disorder (PAD) - Question identifier:PAD_Q36
In the past 12 months, how many unexpected, "out of the blue" attacks did you have?
Min = 0; Max = 901
Panic Disorder (PAD) - Question identifier:PAD_Q37A
How old were you the last time you had an unexpected, "out of the blue" attack?
Min = 0; Max = 130
Panic Disorder (PAD) - Question identifier:PAD_Q40
Think about an attack during the past 12 months. How much emotional distress did you have during this attack?
- 1: None
- 2: Mild
- 3: Moderate
- 4: Severe
- 5: Very severe
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_R41
Sometimes people with attacks get upset by physical sensations that remind them of the attacks. Examples include being out of breath after physical exercise, feeling speeded up after drinking coffee or beverages containing caffeine, feeling out of control after using alcohol or drugs, and feeling tingly while watching a scary movie or television show.
Panic Disorder (PAD) - Question identifier:PAD_Q41
In the past 12 months, did you get upset by any physical sensations that reminded you of your attacks?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q42
In the past 12 months, how often did you avoid situations or activities that might cause these physical sensations?
- 1: All the time
- 2: Most of the time
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_R44A
(Please refer to page 2 of the booklet.)
Think about the period of time lasting one month or longer when your attacks or worry about the attacks were most severe in the past 12 months. Please tell me what number best describes how much the attacks or worry about the attacks interfered with each of the following activities. For each activity, answer with a number between 0 and 10; 0 means "no interference", while 10 means "very severe interference".
Panic Disorder (PAD) - Question identifier:PAD_Q44A
How much did your attacks or worry about the attacks interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Panic Disorder (PAD) - Question identifier:PAD_Q44B_1
How much did it interfere with your ability to attend school?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Panic Disorder (PAD) - Question identifier:PAD_Q44B_2
How much did it interfere with your ability to work at a job?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Panic Disorder (PAD) - Question identifier:PAD_Q44C
Again thinking about the period of time that lasted one month or longer when your attacks or worry about the attacks were most severe, how much did they interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference".)
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Panic Disorder (PAD) - Question identifier:PAD_Q44D
How much did it interfere with your social life?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Panic Disorder (PAD) - Question identifier:PAD_Q46
In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your attacks or the worry about the attacks? (You may use any number between 0 and 365 to answer.)
Min = 0; Max = 365
Panic Disorder (PAD) - Question identifier:PAD_Q50
Since 2002, did you talk to a medical doctor or other professional about your attacks? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q64
During the past 12 months, did you receive professional treatment for your attacks?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Panic Disorder (PAD) - Question identifier:PAD_Q65
Since 2002, were you hospitalized overnight for your attacks?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP)
Social Phobia (SOP) - Question identifier:SOP_R01
Earlier, you mentioned having a time since 2002 when you felt very shy, afraid or uncomfortable with other people or in social situations. The next questions are about which of these situations made you feel this way. Please tell me if there was a time since 2002 when you felt very shy, afraid or uncomfortable with the following situations.
Social Phobia (SOP) - Question identifier:SOP_Q01A
Meeting new people?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01B
Talking to people in authority?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01C
Speaking up in a meeting or class?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01D
Going to parties or other social gatherings?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01E
Since 2002, have you felt very shy, afraid or uncomfortable when you were performing or giving a talk in front of an audience?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01F
Taking an important exam or interviewing for a job, even though you were well prepared?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01G
Working while someone watches you?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01H
Entering a room when others are already present?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01I
Talking with people you don't know very well?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01J
Expressing disagreement to people you don't know very well?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01K
Writing, eating or drinking while someone watches?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01L
Since 2002, have you felt very shy, afraid or uncomfortable when using a public bathroom or a bathroom away from home?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01M
When going on a date?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q01N
In any other social or performance situation where you could be the centre of attention or where something embarrassing might happen?
- 1: Yes
- 2: No
- 3: Not applicable
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_R08
Think of the time since 2002 when your fear or avoidance of [this situation/these situations] was most severe. When you were faced with [this situation/these situations], or thought you would have to be, did you have any of the following experiences?
Social Phobia (SOP) - Question identifier:SOP_Q08A
Did you blush or shake?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q08B
Did you fear that you might lose control of your bowels or bladder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q08C
Did you fear that you might vomit?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_R09A
When you were faced with [situations similar to those that we just mentioned/DT_KEYPHRASE1A, DT_KEYPHRASE1B, DT_KEYPHRASE1C, DT_KEYPHRASE1D, DT_KEYPHRASE1E, DT_KEYPHRASE1F, DT_KEYPHRASE1G, DT_KEYPHRASE1H, DT_KEYPHRASE1I, DT_KEYPHRASE1J, DT_KEYPHRASE1K, DT_KEYPHRASE1L, DT_KEYPHRASE1M, DT_KEYPHRASE1N/these situations], please tell me if you had any of the following reactions since 2002.
Social Phobia (SOP) - Question identifier:SOP_Q09A
Did your heart pound or race?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09B
Did you sweat?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09C
Did you tremble?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09D
Did you feel sick to your stomach?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09E
Did you have a dry mouth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09F
Did you have hot flushes or chills?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09G
Did you feel numbness or have tingling sensations?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09H
Did you have trouble breathing normally?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09I
Since 2002, did you feel like you were choking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09J
Did you have pain or discomfort in your chest?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09K
Did you feel dizzy or faint?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09L
Were you afraid that you might die?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09M
When you were faced with [situations similar to those that we just mentioned/DT_KEYPHRASE1A, DT_KEYPHRASE1B, DT_KEYPHRASE1C, DT_KEYPHRASE1D, DT_KEYPHRASE1E, DT_KEYPHRASE1F, DT_KEYPHRASE1G, DT_KEYPHRASE1H, DT_KEYPHRASE1I, DT_KEYPHRASE1J, DT_KEYPHRASE1K, DT_KEYPHRASE1L, DT_KEYPHRASE1M, DT_KEYPHRASE1N/these situations] since 2002, did you fear that you might lose control, go crazy or pass out?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09N
Did you feel like you were "not really there", like you were watching a movie of yourself?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q09O
Did you feel that things around you were not real or like a dream?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q10A
When you were in [this situation/these situations] since 2002, were you afraid that you might have a panic attack?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q10B
Did you have a panic attack in [this situation/these situations] since 2002?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q11
Were you afraid that you might be trapped or unable to escape?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q12A
When you were in [this situation/these situations] since 2002, were you afraid that you might do something embarrassing or humiliating?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q12B
Were you afraid that you might embarrass other people?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q13
Were you afraid that people might look at you, talk about you or think negative things about you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q14A
Were you afraid that you might be the focus of attention?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q14B
There are several reasons why people are afraid when faced with different situations. Tell me, what was it you feared most about [facing situations similar to those we just mentioned/DT_KEYPHRASE1A, DT_KEYPHRASE1B, DT_KEYPHRASE1C, DT_KEYPHRASE1D, DT_KEYPHRASE1E, DT_KEYPHRASE1F, DT_KEYPHRASE1G, DT_KEYPHRASE1H, DT_KEYPHRASE1I, DT_KEYPHRASE1J, DT_KEYPHRASE1K, DT_KEYPHRASE1L, DT_KEYPHRASE1M, DT_KEYPHRASE1N/these situations] since 2002? Did you think it was...?
- 1: a real danger, like the danger associated with a car accident or a bank robbery?
- 2: or another reason?
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q14C
What was this danger?
Long Answer Length = 50
Social Phobia (SOP) - Question identifier:SOP_Q14D
What was this reason?
Long Answer Length = 50
Social Phobia (SOP) - Question identifier:SOP_Q15A
Was your fear related to embarrassment about having a physical, emotional or mental health problem or condition?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q15B
(Please refer to page 6 of the booklet.)
What was the problem or condition?
- 01: Emotional or mental health problem or condition
- 02: Alcohol or drug problem
- 03: Speech, vision or hearing problem
- 04: Movement or coordination problem
- 05: Facial or body disfigurement, weight or body image problem
- 06: Bad odour or sweating
- 07: Other physical health problem
- 08: Pregnancy
- 98: RF
- 99: DK
Social Phobia (SOP) - Question identifier:SOP_Q16
Since 2002, how much did your fear or avoidance of [this situation/these situations] interfere with either your work, your social life or your personal relationships?
- 1: Not at all
- 2: A little
- 3: Some
- 4: A lot
- 5: Extremely
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q17
Was there a time since 2002 when you felt emotionally upset, worried or disappointed with yourself because of your fear or avoidance of [this situation/these situations]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q18A
When was the last time you either strongly feared or avoided [this situation/any of these situations]? Was it:
- 1: During the past month?
- 2: Between 1 and 6 months ago?
- 3: Between 7 and 12 months ago?
- 4: More than 12 months ago?
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q18B
How old were you the last time you either strongly feared or avoided [this situation/any of these situations]?
Min = 0; Max = 130
Social Phobia (SOP) - Question identifier:SOP_Q19
What if you were faced with [this situation/one of these situations] today? How strong would your fear be?
- 1: No fear
- 2: Mild
- 3: Moderate
- 4: Severe
- 5: Very severe
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q20
During the past 12 months, how often did you avoid [situations similar to those we just mentioned/situations like DT_KEYPHRASE1A, DT_KEYPHRASE1B, DT_KEYPHRASE1C, DT_KEYPHRASE1D, DT_KEYPHRASE1E, DT_KEYPHRASE1F, DT_KEYPHRASE1G, DT_KEYPHRASE1H, DT_KEYPHRASE1I, DT_KEYPHRASE1J, DT_KEYPHRASE1K, DT_KEYPHRASE1L, DT_KEYPHRASE1M, DT_KEYPHRASE1N/any of these situations]?
- 1: All of the time
- 2: Most of the time
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_R21
(Please refer to page 2 in the booklet.)
Think about the period of time that lasted one month or longer when your fear or avoidance of social and performance situations was most severe in the past 12 months. Please tell me what number best describes how much your fear or avoidance of situations interfered with each of the following activities. For each activity, please answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference".
Social Phobia (SOP) - Question identifier:SOP_Q21A
In the past 12 months, how much did your fear or avoidance of social and performance situations interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: I
- 10: Very severe interference
- 98: RF
- 99: DK
Social Phobia (SOP) - Question identifier:SOP_Q21B_1
How much did it interfere with your ability to attend school?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: I
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Social Phobia (SOP) - Question identifier:SOP_Q21B_2
How much did it interfere with your ability to work at a job?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: I
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Social Phobia (SOP) - Question identifier:SOP_Q21C
Again, thinking about that period lasting one month or longer during the past 12 months when your fear or avoidance of social or performance situations was most severe, how much did this fear or avoidance interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference".)
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: I
- 10: Very severe interference
- 98: RF
- 99: DK
Social Phobia (SOP) - Question identifier:SOP_Q21D
How much did it interfere with your social life?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: I
- 10: Very severe interference
- 98: RF
- 99: DK
Social Phobia (SOP) - Question identifier:SOP_Q23
In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your fear or avoidance of situations? (You may use any number between 0 and 365 to answer.)
Min = 0; Max = 365
Social Phobia (SOP) - Question identifier:SOP_Q25A
Since 2002, did you talk to a medical doctor or other professional about your fear or avoidance [of situations similar to those we just mentioned/of a situation like DT_KEYPHRASE1A, DT_KEYPHRASE1B, DT_KEYPHRASE1C, DT_KEYPHRASE1D, DT_KEYPHRASE1E, DT_KEYPHRASE1F, DT_KEYPHRASE1G, DT_KEYPHRASE1H, DT_KEYPHRASE1I, DT_KEYPHRASE1J, DT_KEYPHRASE1K, DT_KEYPHRASE1L, DT_KEYPHRASE1M, DT_KEYPHRASE1N/of these situations]? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q38
During the past 12 months, did you receive professional treatment for your fear?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Phobia (SOP) - Question identifier:SOP_Q39A
Since 2002, were you hospitalized overnight for your fear?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD)
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R01A
Earlier, you mentioned having a time since 2002 when you were "a worrier". The next questions are about that time. Please turn to page 7 of the booklet where we list several things which you could have been worried, nervous or anxious about during that time.
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R01B
Earlier, you mentioned having a time since 2002 when you were much more nervous or anxious than most other people. The next questions are about that time. Please turn to page 7 of the booklet where we list several things which you could have been nervous or anxious about during that time.
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R01C
Earlier, you mentioned having a period of time since 2002 lasting 6 months or longer when you were anxious or worried most days. The next questions are about that time. Please turn to page 7 of the booklet where we list several things which you could have been anxious or worried about during that time.
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q01
Now, tell me which of these things were you [worried, nervous or anxious/nervous or anxious/anxious or worried] about during that time?
- 01: Worrying about everything
- 02: Worrying about nothing in particular
- 03: Finances
- 04: Success at school or work
- 05: Social life
- 06: Love life
- 07: Relationships at school or work
- 08: Relationships with family
- 09: Physical appearance
- 10: Own physical health
- 11: Own mental health
- 12: Alcohol or drug use
- 13: Being away from home or apart from loved ones
- 14: The health or welfare of loved ones
- 15: Social phobias (e.g., meeting people)
- 16: Agoraphobia (e.g., leaving home alone)
- 17: Specific phobias (e.g., fears of bugs, heights or closed spaces)
- 18: Obsessions (e.g., worry about germs)
- 19: Compulsions (e.g., repetitive hand washing)
- 20: Crime / violence
- 21: Economy
- 22: Environment (e.g., global warming, pollution)
- 23: Moral decline of society (e.g., capitalism, decline of the family)
- 24: War / revolution
- 25: Other - Specify
- 98: RF
- 99: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q02A
Is there anything else which you were [worried, nervous or anxious/nervous or anxious/anxious or worried] about during that time?
- 1: Yes - Specify
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q02B
Is there anything else which you were [worried, nervous or anxious/nervous or anxious/anxious or worried] about during that time?
- 1: Yes - Specify
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q03
Do you think your feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried] since 2002 were excessive, unreasonable, or a lot stronger than they should have been?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q04
How often did you find it difficult to control your [worry, nervousness or anxiety/nervousness or anxiety/anxiety or worry]?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q04_1
How often were you so nervous or worried that you could not think about anything else, no matter how hard you tried?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q05
Since 2002, what is the longest period of months or years in a row when you were feeling [worried, nervous or anxious/nervous or anxious/anxious or worried] most days?
Min = 0; Max = 130
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_N05_1
Was that in months or years?
- 1: Months
- 2: Years
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q05_3
Since 2002, did you have a period that lasted 6 months or longer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R09
Think of your worst period lasting 6 months or longer when you were [worried, nervous or anxious/nervous or anxious/anxious or worried] since 2002. During that episode, tell me if you had any of the following problems.
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09A
Did you often feel restless, keyed up or on edge?
- 1: Yes (KEY_PHRASE = feeling restless or on edge)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09B
Did you often get tired easily?
- 1: Yes (KEY_PHRASE = feeling tired easily)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09C
Were you often more irritable than usual?
- 1: Yes (KEY_PHRASE = feeling more irritable than usual)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09D
Did you often have difficulty concentrating or keeping your mind on what you were doing?
- 1: Yes (KEY_PHRASE = having difficulty concentrating)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09E
Did you often have tense, sore or aching muscles?
- 1: Yes (KEY_PHRASE = having tense or aching muscles)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09F
(During this worst episode lasting 6 months or longer since 2002,) did you often have trouble falling or staying asleep?
- 1: Yes (KEY_PHRASE = having difficulty falling or staying asleep)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10A
Did your heart often pound or race?
- 1: Yes (KEY_PHRASE = having your heart pound)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10B
Did you often sweat?
- 1: Yes (KEY_PHRASE = sweating)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10C
Did you often tremble or shake?
- 1: Yes (KEY_PHRASE = trembling)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10D
Did you often have a dry mouth?
- 1: Yes (KEY_PHRASE = having a dry mouth)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10E
Were you sad or depressed most of the time?
- 1: Yes (KEY_PHRASE = feeling sad)
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13A
(During this episode lasting 6 months or longer since 2002,) did you often feel dizzy or lightheaded?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13B
Were you often short of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13C
Did you often feel like you were choking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13D
Did you often have pain or discomfort in your chest?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13E
Did you often have pain or discomfort in your stomach?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13F
(During this episode lasting 6 months or longer since 2002,) did you often have nausea?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13G
Did you often feel that you were unreal?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13H
Did you often feel that things around you were unreal?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13I
Were you often afraid that you might lose control or go crazy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13J
Were you often afraid that you might pass out?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13K
(During this episode lasting 6 months or longer since 2002,) were you often afraid that you might die?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13L
Did you often have hot flushes or chills?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13M
Did you often have numbness or tingling sensations?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13N
Did you often feel like you had a lump in your throat?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13O
Were you easily startled?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q15
Since 2002, how much emotional distress did you experience because you felt [worried, nervous or anxious/nervous or anxious/anxious or worried]?
- 1: None
- 2: Mild
- 3: Moderate
- 4: Severe
- 5: Very severe
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q17
Since 2002, how much did your feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried] interfere with either your work, your social life or your personal relationships?
- 1: Not at all
- 2: A little
- 3: Some
- 4: A lot
- 5: Extremely
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q17_1
(Since 2002), how often were you unable to carry out your daily activities because you felt [worried, nervous or anxious/nervous or anxious/anxious or worried]?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q18A
Feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried] sometimes occur as a result of a physical illness or injury or the use of medication, drugs or alcohol. Do you think these feelings occurred as the result of physical causes, medication, drugs or alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q18B
Do you think your [worry, nervousness or anxiety/nervousness or anxiety/anxiety or worry] since 2002 was always the result of physical causes, medication, drugs, or alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q18C
What were the causes?
- 01: Exhaustion
- 02: Hyperventilation
- 03: Hypochondria
- 04: Menstrual cycle
- 05: Pregnancy / postpartum
- 06: Thyroid disease
- 07: Cancer
- 08: Overweight
- 09: Medication (excluding illicit drugs)
- 10: Illicit drugs
- 11: Alcohol
- 12: Chemical Imbalance / Serotonin Imbalance
- 13: Chronic Pain
- 14: Caffeine
- 15: No specific diagnosis
- 16: Other - Specify
- 98: RF
- 99: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R26
In the next questions, the word "episode" means a period lasting 6 months or longer when, nearly every day, you were [worried, nervous or anxious/nervous or anxious/anxious or worried], and you also had some of the other problems we just mentioned. The end of an episode is when you no longer have these feelings for a full month.
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q26D
Since 2002, how many episodes lasting 6 months or longer have you had when you felt [worried, nervous or anxious/nervous or anxious/anxious or worried]?
Min = 1; Max = 260
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q27
During the past 12 months, did you have an episode of being [worried, nervous or anxious/nervous or anxious/anxious or worried] that lasted at least six months or longer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q27_1
How recently was it?
- 1: During the past month
- 2: Between 1 and 6 months ago
- 3: More than 6 months ago
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q27_2
How old were you [the last time you had one of these episodes/when you had this episode]?
Min = 0; Max = 130
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q31
How many of these episodes were brought on by some stressful experience?
Min = 0; Max = 260
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q32
Was this episode brought on by some stressful experience or did it happen out of the blue?
- 1: Brought on by stress
- 2: Out of the blue
- 3: Don't remember
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R38
(Please refer to page 2 of the booklet.)
Think about the period of time lasting one month or longer when your feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried] were most severe in the past 12 months. Please tell me what number best describes how much these feelings interfered with each of the following activities. For each activity, please answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference".
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38A
In the past 12 months, how much did your feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried] interfere with your home responsibilities, like cleaning, shopping, and taking care of the house or apartment?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38B_1
How much did these feelings interfere with your ability to attend school?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38B_2
How much did these feelings interfere with your ability to work at a job?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38C
Again, thinking about the period of time that lasted one month or longer when your feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried] were most severe, how much did these feelings interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference").
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38D
How much did these feelings interfere with your social life?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q40
In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried]? (You may use any number between 0 and 365 to answer.)
Min = 0; Max = 365
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q44
Since 2002, did you talk to a medical doctor or other professional about your feelings of being [worried, nervous or anxious/nervous or anxious/anxious or worried]? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q58
During the past 12 months, did you receive professional treatment for being [worried, nervous or anxious/nervous or anxious/anxious or worried]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q59
Since 2002, were you hospitalized overnight for being [worried, nervous or anxious/nervous or anxious/anxious or worried]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS)
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_R001
(Please refer to reference card 1.)
In this next part of the interview, we ask about how people react to very stressful events that might have happened anytime during their life. Some questions might be a little more sensitive than others.
This card is provided to help you keep track of these events and you may take it with you at the end of the interview.
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_R005
(Please refer to page 8 of the booklet)
During experiences like these, people often have feelings like being very frightened or terrified, feeling helpless, feeling shocked or horrified, or feeling emotionally numb.
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q005A
Did you have any of these feelings during [this experience/any of these traumatic experiences] you went through anytime during your life?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q005B
Did you have any of these feelings during [this experience/any of these traumatic experiences] you went through since 2002?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q005C
(Please refer to page 9 of the booklet.)
Did [an experience like this/experiences like these] ever cause you to have reactions such as upsetting memories or dreams, feeling emotionally distant or depressed, trouble sleeping or concentrating, or feeling jumpy or easily startled?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q005D
Since 2002, did you have any of these reactions?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q006
Did you have reactions like this at least once a week for one month or longer since 2002?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q064A
Which traumatic events caused you to have upsetting reactions since 2002?
- 01: 01
- 02: 02
- 03: 03
- 04: 04
- 05: 05
- 06: 06
- 07: 07
- 08: 08
- 09: 09
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 98: RF
- 99: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q068
In the weeks, months or years since 2002 when these reactions were the worst, did you try not to think about what happened?
- 1: Yes (KEY_PHRASE = trying not to think about it)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q069
Did you purposely stay away from places, people or activities that reminded you of the [traumatic experience/traumatic experiences]?
- 1: Yes (KEY_PHRASE = staying away from reminders of it)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q070
Were you unable to remember some important parts of what happened?
- 1: Yes (KEY_PHRASE = being unable to remember part(s) of it)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q071
Did you lose interest in doing things you used to enjoy?
- 1: Yes (KEY_PHRASE = losing interest in things you used to enjoy)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q072
Did you feel emotionally distant or cut off from other people?
- 1: Yes (KEY_PHRASE = feeling distant from other people)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q073
Did you have trouble feeling normal feelings like love, happiness or warmth toward other people?
- 1: Yes (KEY_PHRASE = having trouble feeling normal feelings)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q074
Did you feel you had no reason to plan for the future because you thought it would be cut short?
- 1: Yes (KEY_PHRASE = feeling you had no reason to plan for the future)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q086
Since 2002, did you have repeated unwanted memories of the [traumatic experience/traumatic experiences], that is, you kept remembering [it/them] even when you didn't want to?
- 1: Yes (KEY_PHRASE = having unwanted memories)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q087
Did you have repeated unpleasant dreams about the [traumatic experience/traumatic experiences]?
- 1: Yes (KEY_PHRASE = having unpleasant dreams)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q088
Did you have flashbacks, that is, suddenly act or feel as if the [traumatic experience/traumatic experiences] [was/were] happening all over again?
- 1: Yes (KEY_PHRASE = having flashbacks)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q089
Did you get very upset when you were reminded of the [traumatic experience/traumatic experiences]?
- 1: Yes (KEY_PHRASE = getting really upset when reminded of it)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q090
When you were reminded of the [traumatic experience/traumatic experiences], did you have physical reactions like sweating, your heart racing or feeling shaky?
- 1: Yes (KEY_PHRASE = having physical reactions)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q102
During the time the [traumatic experience/traumatic experiences] affected you most since 2002, did you have trouble falling or staying asleep?
- 1: Yes (KEY_PHRASE = having sleep problems)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q103
Were you more irritable or short-tempered than you usually are?
- 1: Yes (KEY_PHRASE = being irritable)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q104
Did you have more trouble concentrating or keeping your mind on what you were doing?
- 1: Yes (KEY_PHRASE = having trouble concentrating)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q105
Were you much more alert or watchful, even when there was no real need to be?
- 1: (KEY_PHRASE = being more alert or watchful)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q106
Were you more jumpy or easily startled by ordinary noises?
- 1: Yes (KEY_PHRASE = being jumpy or easily startled)
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_R110A
You had quite a few reactions such as [trying not to think about it/staying away from reminders of it/being unable to remember part(s) of it/losing interest in things you used to enjoy)/feeling distant from other people/having trouble feeling normal feelings/feeling you had no reason to plan for the future], [having unwanted memories/having unpleasant dreams/having flashbacks/getting really upset when reminded of it/having physical reactions] and [having sleep problems/being irritable/having trouble concentrating/being more alert or watchful/being jumpy or easily startled].
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q110A
What was the longest amount of time since 2002 when you had some of these reactions at least once a week?
Min = 0; Max = 901
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_N110A
Was that days, weeks, months, or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q111
Did any of these reactions last at least one month?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_R113
Think of the time since 2002 when these reactions were most frequent and intense.
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q113
How often did these reactions occur?
- 1: Less than once a month
- 2: One to two times a month
- 3: Three to five times a month
- 4: Six to ten times a month
- 5: More than ten times a month
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q114
How much distress did these reactions cause you?
- 1: None
- 2: Mild
- 3: Moderate
- 4: Severe
- 5: Very severe
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q115
How much did these reactions disrupt or interfere with your normal life?
- 1: Not at all
- 2: A little
- 3: Some
- 4: A lot
- 5: Extremely
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q119
Did you have any of these reactions at any time in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q262
When was the last time you had any of these reactions?
- 1: During the past month
- 2: Between 1 and 6 months ago
- 3: More than 6 months ago
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q263
In the past 12 months, how many weeks altogether did you have any of these reactions?
Min = 1; Max = 52
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_R269
For the next few questions, think of the 30-day period in the past 12 months when your reactions to the [traumatic experience/traumatic experiences] were most frequent and intense.
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q269
During this 30-day period, did you lose interest in doing things you used to enjoy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q270
(During this 30-day period,) did you feel emotionally distant or cut off from other people?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q271
(During this 30-day period,) did you have trouble feeling normal feelings like love, happiness or warmth toward other people?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q272
(During this 30-day period,) did you feel you had no reason to plan for the future because you thought it would be cut short?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q273
During this 30-day period, did you have any trouble falling or staying asleep?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q274
(During this 30-day period,) were you more jumpy or more easily startled by ordinary noises?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q275
(During this 30-day period,) did you purposely stay away from places, people or activities that reminded you of the [traumatic experience/traumatic experiences]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_R278
(Please refer to page 2 of the booklet.)
In the past 12 months, think about the period of time that lasted one month or longer when your reactions to the [traumatic experience/traumatic experiences] were most severe. Please tell me what number best describes how much these reactions interfered with each of the following activities. For each activity, please answer with a number between 0 and 10; 0 means "no interference", while 10 means "very severe interference".
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q278A
In the past 12 months, how much did your reactions interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q278BA
How much did they interfere with your ability to attend school?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q278BB
How much did they interfere with your ability to work at a job?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q278C
Again think about that period of time lasting one month or longer when your reactions to the [traumatic experience/traumatic experiences] were most severe, how much did they interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference".)
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q278D
How much did they interfere with your social life?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q280
In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your reactions to the [traumatic experience/traumatic experiences]? (You may use any number between 0 and 365 to answer.)
Min = 0; Max = 365
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q282
Since 2002, did you talk to a medical doctor or other professional about your reactions related to traumatic events? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q288
At any time in the past 12 months, did you receive professional treatment for these reactions?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder (PTS) - Question identifier:PTS_Q289
Since 2002, were you hospitalized overnight for your reactions related to traumatic events?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder - Sub block (PTS1)
Post Traumatic Stress Disorder - Sub block (PTS1) - Question identifier:PTS1_Q01A
During your lifetime, has experience ^X happened to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Post Traumatic Stress Disorder - Sub block (PTS1) - Question identifier:PTS1_Q01B
Since 2002, has experience ^X happened to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Military Sexual Trauma (MST)
Military Sexual Trauma (MST) - Question identifier:MST_R01
(Please refer to page 10 of the booklet.)
Earlier, you mentioned that you experienced event 1.
Military Sexual Trauma (MST) - Question identifier:MST_Q01A
Did this ever take place while deployed on a CAF operation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Military Sexual Trauma (MST) - Question identifier:MST_Q01B
Did this ever take place in your CAF workplace (other than on deployment)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Military Sexual Trauma (MST) - Question identifier:MST_Q01C
Were any of the persons who committed this or these acts a CAF member or civilian DND employee at the time of this or these events?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Military Sexual Trauma (MST) - Question identifier:MST_R02
(Please refer to page 10 of the booklet.)
Earlier, you mentioned that you experienced event 2.
Military Sexual Trauma (MST) - Question identifier:MST_Q02A
Did this ever take place while deployed on a CAF operation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Military Sexual Trauma (MST) - Question identifier:MST_Q02B
Did this ever take place in your CAF workplace (other than on deployment)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Military Sexual Trauma (MST) - Question identifier:MST_Q02C
Were any of the persons who committed this or these acts a CAF member or civilian DND employee at the time of this or these events?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK)
Smoking (SMK) - Question identifier:SMK_R1
The next questions are about smoking.
Smoking (SMK) - Question identifier:SMK_Q201A
In your lifetime, have you smoked a total of 100 or more cigarettes (about 4 packs)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q201B
Have you ever smoked a whole cigarette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q201C
At what age did you smoke your first whole cigarette?
Min = 5; Max = 130
Smoking (SMK) - Question identifier:SMK_Q202
At the present time, do you smoke cigarettes daily, occasionally or not at all?
- 1: Daily
- 2: Occasionally
- 3: Not at all
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q203
At what age did you begin to smoke cigarettes daily?
Min = 5; Max = 130
Smoking (SMK) - Question identifier:SMK_Q204
How many cigarettes do you smoke each day now?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q205B
On the days that you do smoke, how many cigarettes do you usually smoke?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q205C
In the past month, on how many days have you smoked 1 or more cigarettes?
Min = 0; Max = 31
Smoking (SMK) - Question identifier:SMK_Q205D
Have you ever smoked cigarettes daily?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q206A
When did you stop smoking? Was it... ?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q206B
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q206C
How many years ago was it?
Min = 3; Max = 125
Smoking (SMK) - Question identifier:SMK_Q207
At what age did you begin to smoke (cigarettes) daily?
Min = 5; Max = 130
Smoking (SMK) - Question identifier:SMK_Q208
How many cigarettes did you usually smoke each day?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q209A
When did you stop smoking daily? Was it... ?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q209B
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q209C
How many years ago was it?
Min = 3; Max = 125
Smoking (SMK) - Question identifier:SMK_Q210A
Was that when you completely quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q210B
When did you stop smoking completely? Was it... ?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q210C
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q210D
How many years ago was it?
Min = 3; Max = 125
Alcohol Use, Abuse and Dependence (AUD)
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R01
Now, some questions about your alcohol consumption.
When we use the word "drink" it means:
- one bottle or can of beer or a glass of draft
- one glass of wine or a wine cooler (one whole bottle of wine counts as 5 drinks)
- one drink or cocktail with 1 and a 1/2 ounces of liquor
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q01
During the past 12 months, that is, from ^DT_YEARAGO to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q02
(Please refer to page 11 of the booklet.)
During the past 12 months, how often did you drink alcoholic beverages?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 6 times a week
- 7: Every day
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q03
(Please refer to page 12 of the booklet.)
How often in the past 12 months have you had 5 or more drinks on one occasion?
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: 2 to 3 times a month
- 5: Once a week
- 6: More than once a week
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q04A
Have you ever had a drink?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q04B
Since 2002, have you had a drink?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q05
Since 2002, have you had 12 or more drinks in a year?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q06
On the days you drank in the past 12 months, about how many drinks did you usually have per day?
Min = 1; Max = 95
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q08
Since 2002, was there a year when you drank more than you did in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q10
(Please refer to page 11 of the booklet.)
Think about the period of time since 2002 when you drank most. During that time, how often did you usually have at least one drink?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 6 times a week
- 7: Every day
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q11
On the days you drank during that time, about how many drinks did you usually have per day?
Min = 1; Max = 95
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R13
The next questions are about problems you may have had because of drinking since 2002.
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13A
First, was there a time since 2002 when your drinking or being hung over frequently interfered with your work or responsibilities at school, on a job, or at home?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13A_1
Was there a time when your drinking caused arguments or other serious or repeated problems with your family, friends, neighbours, or co-workers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13B
Did you continue to drink even though it caused problems with these people?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13C
Since 2002, were there times when you were often under the influence of alcohol in situations where you could get hurt, for example when riding a bicycle, driving, or operating a machine?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13D
Were you arrested or stopped by the police because of drunk driving or drunken behavior since 2002?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13E
Since 2002, how many times were you arrested or stopped by the police due to drinking?
Min = 1; Max = 95
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q16
You just reported that:
[- your drinking interfered with your responsibilities]
[- your drinking caused problems with family, friends or others]
[- you continued to drink even though it caused problems]
[- you drank in situations where you could get hurt]
[- your drinking resulted in problems with the police]
How recently did you have [this problem/either of these problems/any of these problems] because of drinking?
- 1: In the past 30 days
- 2: 1 month to less than 6 months ago
- 3: 6 months to 12 months ago
- 4: More than 12 months ago
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q17
How old were you the last time (you had [this problem/either of these problems/any of these problems] because of drinking)?
Min = 0; Max = 130
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R19
The next questions are about some other problems you may have had because of drinking since 2002.
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19A
Since 2002, was there a time when you often had such a strong desire to drink that you couldn't stop yourself from taking a drink or found it difficult to think of anything else?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19A_1
Did you need to drink a larger amount of alcohol to get an effect, or did you ever find that you could no longer get a "buzz" or a high on the amount you used to drink?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19B
Since 2002, did you have times when you stopped, cut down, or went without drinking and then experienced withdrawal symptoms like fatigue, headaches, diarrhea, the shakes, or emotional problems?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19C
Did you have times when you took a drink to keep from having problems like these?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19D
Since 2002, did you have times when you started drinking even though you promised yourself you wouldn't, or when you drank a lot more than you intended?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19E
Were there times when you drank more frequently or for more days in a row than you intended?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19F
Since 2002, did you have times when you started drinking and became drunk when you didn't want to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19G
Were there times when you tried to stop or cut down on your drinking and found that you were not able to do so?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19H
Did you have periods of several days or more when you spent so much time drinking or recovering from the effects of alcohol that you had little time for anything else?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19I
Since 2002, did you have a time when you gave up or greatly reduced important activities because of your drinking, like sports, work, or seeing friends and family?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19J
Did you continue to drink when you knew you had a serious physical or emotional problem that might have been caused by or made worse by drinking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R22
[You reported that: (List of problems)].
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q23
Since 2002, did you have three or more of these problems in the same 12-month period?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q25
How recently did you have [this problem/either of these problems/any of these problems]?
- 1: In the past 30 days
- 2: 1 month to less than 6 months ago
- 3: 6 months to 12 months ago
- 4: More than 12 months ago
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q26
How old were you the last time you had any of these problems?
Min = 0; Max = 130
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q29
Since 2002, about how many different times did you make a serious attempt to quit drinking?
Min = 0; Max = 995
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R35
(Please refer to page 2 of the booklet.)
Think about the period of time that lasted one month or longer in the past 12 months when you were drinking the most. Please tell me what number best describes how much your drinking interfered with each of the following activities. For each activity, answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference."
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35A
In the past 12 months, how much did your drinking interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35B_1
How much did your drinking interfere with your ability to attend school?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35B_2
How much did your drinking interfere with your ability to work at a job?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 11: Not applicable
- 98: RF
- 99: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35C
Again, thinking about that period lasting one month or longer during the past 12 months when you were drinking the most, how much did your drinking interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference".)
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35D
How much did your drinking interfere with your social life?
- 00: No interference
- 01: I
- 02: I
- 03: I
- 04: I
- 05: I
- 06: I
- 07: I
- 08: I
- 09: V
- 10: Very severe interference
- 98: RF
- 99: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q36A
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 drinking?
Min = 0; Max = 365
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q39
Since 2002, did you talk to a medical doctor or other professional about your use of alcohol? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q41
During the past 12 months, did you receive professional treatment for your use of alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q42
Since 2002, were you hospitalized overnight for your use of alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB)
Substance Use (SUB) - Question identifier:SUB_R01A
(Please refer to page 13 of the booklet.)
The next questions are about medicines that are often used nonmedically. By "used nonmedically" we mean:
- either used without the recommendation of a health professional,
- or used in greater amounts than your health professional told you to use them,
- or used for any reason other than what a health professional said you should use them for.
Again, I would like to remind you that everything you say will remain strictly confidential.
Substance Use (SUB) - Question identifier:SUB_Q01A
(Please refer to page 14 of the booklet.)
The first group is sedatives or tranquilizers, sometimes called "downers" or "nerve pills." These are medicines people sometimes use to help them stay calm and relaxed or to sleep. Examples include valium, rohypnol, and diazepam. Have you ever used a sedative or tranquilizer nonmedically?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q01B
Have you ever used a sedative or tranquilizer that a doctor prescribed for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q01C
Was your use ever so regular that you felt that you could not stop using the sedative or tranquilizer prescribed for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q01D
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q01E
(Please refer to page 15 of the booklet.)
How often (did you use a sedative or tranquilizer in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q01F
How old were you when you first used a sedative or tranquilizer?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q02A
(Please refer to page 16 of the booklet.)
The second group of medicines is stimulants, sometimes called speed, ice, glass, crystal, crank, pep pills, or uppers. These are medicines that people sometimes use to stay awake, to improve their low mood, or to lose weight. Examples include dexamyl, methamphetamine, adderall, and ritalin. Have you ever used a stimulant nonmedically?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q02B
Have you ever used a stimulant that a doctor prescribed for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q02C
Was your use ever so regular that you felt that you could not stop using the stimulant prescribed for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q02D
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q02E
(Please refer to page 15 of the booklet.)
How often (did you use a stimulant in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q02F
How old were you when you first used a stimulant?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q03A
(Please refer to page 17 of the booklet.)
The third group of medicines is analgesics. These are medicines that people usually take as pain killers. Examples include codeine, morphine, and percodan. Have you ever used a pain killer nonmedically?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q03B
Have you ever used a pain killer that a doctor prescribed for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q03C
Was your use ever so regular that you felt that you could not stop using the pain killer prescribed for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q03D
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q03E
(Please refer to page 15 of the booklet.)
How often (did you use a pain killer in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q03F
How old were you when you first used a pain killer?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_R04A
The next questions are about your experience with several other types of drugs.
Substance Use (SUB) - Question identifier:SUB_Q04A
Have you ever used or tried marijuana or hashish?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q04A_1
How old were you the first time you used marijuana or hashish?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q04B
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q04C
(Please refer to page 15 of the booklet.)
How often (did you use marijuana or hashish in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q04D
Did you ever have a period where you used marijuana or hashish more than you did in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q04E
(Please refer to page 15 of the booklet.)
Thinking of the year when you used marijuana or hashish most, how often did you use it?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q04F
In your lifetime, how many times have you used marijuana or hashish?
Min = 2; Max = 995
Substance Use (SUB) - Question identifier:SUB_Q04G
Have you used marijuana or hashish more than 50 times in your lifetime?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q05A
Have you ever used or tried cocaine in any form, including powder, crack, free base, coca leaves, or paste?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q05A_1
How old were you the first time you used cocaine?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q05B
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q05C
(Please refer to page 15 of the booklet.)
How often (did you use cocaine in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q06A
Have you ever used or tried club drugs such as ecstasy, ketamine or MDMA?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q06A_1
How old were you the first time you used club drugs?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q06B
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q06C
(Please refer to page 15 of the booklet.)
How often (did you use club drugs in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q07A
Have you ever used or tried hallucinogens including LSD, mescaline, PCP, angel dust, mushrooms or peyote?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q07A_1
How old were you the first time you used hallucinogens?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q07B
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q07C
(Please refer to page 15 of the booklet.)
How often (did you use hallucinogens in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q08A
Have you ever used or tried heroin or opium?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q08A_1
How old were you the first time you used heroin or opium?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q08B
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q08C
(Please refer to page 15 of the booklet.)
How often (did you use heroin or opium in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q09A
Have you ever used any inhalants or solvents such as nitrous oxide, glue, paint or gasoline?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q09A_1
How old were you the first time you used inhalants or solvents?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q09B
Have you used it in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q09C
(Please refer to page 15 of the booklet.)
How often (did you use inhalants or solvents in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q10A
Have you ever used any other illegal drug?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q10A_1
How old were you the first time you used ^DT_OTHER?
Min = 0; Max = 130
Substance Use (SUB) - Question identifier:SUB_Q10B
Have you used ^DT_OTHER in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Substance Use (SUB) - Question identifier:SUB_Q10C
(Please refer to page 15 of the booklet)
How often (did you use ^DT_OTHER in the past 12 months)?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Every day
- 8: RF
- 9: DK
Mental Health Services 1 (SR1)
Mental Health Services 1 (SR1) - Question identifier:SR1_R001
Now I would like to ask you some questions about your contacts with health professionals.
Mental Health Services 1 (SR1) - Question identifier:SR1_Q001
Have you ever been hospitalized overnight or longer in any type of health care facility to receive help for problems with your emotions, mental health or use of alcohol or drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_R03
Earlier, you mentioned being hospitalized for problems with your emotions, mental health or use of alcohol or drugs.
Mental Health Services 1 (SR1) - Question identifier:SR1_Q003
Since 2002, how many times were you hospitalized for such problems?
Min = 0; Max = 251
Mental Health Services 1 (SR1) - Question identifier:SR1_Q005A
How recently was that?
- 1: During the past month
- 2: Between 2 and 6 months ago
- 3: Between 7 and 12 months ago
- 4: More than a year ago
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q005B
How old were you at the time of this admission?
Min = 0; Max = 130
Mental Health Services 1 (SR1) - Question identifier:SR1_Q005C
How long did you stay in the hospital for these problems (since 2002)?
Min = 1; Max = 6000
Mental Health Services 1 (SR1) - Question identifier:SR1_N005
Was that days, weeks, months or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Mental Health Services 1 (SR1) - Question identifier:SR1_Q006
How old were you at the time of your first admission for any of these problems (since 2002)?
Min = 0; Max = 130
Mental Health Services 1 (SR1) - Question identifier:SR1_Q007
In total, how much time did you spend in the hospital (since 2002)?
Min = 1; Max = 6000
Mental Health Services 1 (SR1) - Question identifier:SR1_N007A
Was that days, weeks, months, or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Mental Health Services 1 (SR1) - Question identifier:SR1_Q008
During the past 12 months, were you hospitalized overnight or longer for problems with your emotions, mental health or use of alcohol or drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q009
How long did you stay in the hospital for these problems (during the past 12 months)?
Min = 1; Max = 365
Mental Health Services 1 (SR1) - Question identifier:SR1_N009A
Was that days, weeks, or months?
- 1: Days
- 2: Weeks
- 3: Months
Mental Health Services 1 (SR1) - Question identifier:SR1_Q010
(Please refer to page 18 of the booklet.)
Since 2002, have you seen, or talked on the telephone, to any of the following professionals about your emotions, mental health or use of alcohol or drugs?
- 01: Psychiatrist
- 02: A family doctor, general practitioner or medical officer
- 03: Other medical doctor (such as a cardiologist, gynaecologist, urologist)
- 04: A psychologist
- 05: A nurse, nurse practitioner, physician's assistant (PA) or medic
- 06: A social worker, counsellor or psychotherapist
- 07: A religious or spiritual advisor such as a priest, chaplain or rabbi
- 08: Other professional
- 09: None
- 98: RF
- 99: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q011
With any of these professionals, did you ever have a session of psychological counselling or therapy that lasted 15 minutes or longer (since 2002)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q012
(Please refer to page 18 of the booklet.)
In the last 12 months, have you seen, or talked on the telephone to any of the following professionals (about your emotions, mental health or use of alcohol or drugs)?
- 01: Psychiatrist
- 02: A family doctor, general practitioner or medical officer
- 03: Other medical doctor (such as a cardiologist, gynaecologist, urologist)
- 04: A psychologist
- 05: A nurse, nurse practitioner, physician's assistant (PA) or medic
- 06: A social worker, counsellor or psychotherapist
- 07: A religious or spiritual advisor such as a priest, chaplain or rabbi
- 08: Other professional
- 09: None
- 98: RF
- 99: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q021
When was the last time you saw, or talked on the telephone with any of these professionals?
- 1: During the past month
- 2: Between 2 and 6 months ago
- 3: Between 7 and 12 months ago
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q090
You mentioned that you saw, or talked on the telephone, to other professionals about your problems with your emotions, mental health or use of alcohol or drugs.
Since 2002, what kind(s) of other professional(s) did you talk to about such problems?
- 01: Acupuncturist
- 02: Biofeedback teacher
- 03: Chiropractor
- 04: Energy healing specialist
- 05: Exercise or movement therapist
- 06: Herbalist
- 07: Homeopath or naturopath
- 08: Hypnotist
- 09: Guided imagery specialist
- 10: Massage therapist
- 11: Relaxation, yoga or meditation expert
- 12: Dietician
- 13: Other - Specify
- 98: RF
- 99: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q091
During the past 12 months, what kind of other professional did you see, or talk to the most often (about your emotions, mental health or use of alcohol and drugs)?
- 01: Acupuncturist
- 02: Biofeedback teacher
- 03: Chiropractor
- 04: Energy healing specialist
- 05: Exercise or movement therapist
- 06: Herbalist
- 07: Homeopath or naturopath
- 08: Hypnotist
- 09: Guided imagery specialist
- 10: Massage therapist
- 11: Relaxation, yoga or meditation expert
- 12: Dietician
- 13: Other - Specify
- 98: RF
- 99: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q100A
Since 2002, have you consulted, used or gone to any of the following self-help groups about problems with your emotions, mental health or use of alcohol or drugs?
- 1: Internet support group or chat room
- 2: Self help groups for mental or emotional health (e.g. bereavement, stress etc.)
- 3: Alcohol or drug use (e.g. Alcoholics Anonymous, Narcotics Anonymous etc.)
- 4: Telephone helpline
- 5: None
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q100B
Which self-help group did you use or go to the most often (since 2002)?
- 1: Internet support group or chat room
- 2: Self help groups for mental or emotional health (e.g. bereavement, stress etc.)
- 3: Alcohol or drug use (e.g. Alcoholics Anonymous, Narcotics Anonymous etc.)
- 4: Telephone helpline
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q100C
When was the last time you used or went to this self-help group (since 2002)?
- 1: During the past month
- 2: Between 2 and 6 months ago
- 3: Between 7 and 12 months ago
- 4: More than a year ago
- 8: RF
- 9: DK
Mental Health Services 1 (SR1) - Question identifier:SR1_Q100D
How many times did you use or go to this self-help group?
Min = 1; Max = 251
Mental Health Services 1 (SR1) - Question identifier:SR1_Q103
(Please refer to page 19 of the booklet.)
During the past 12 months, have you used or been in contact with any of the following Canadian Armed Forces or Veterans Affairs Canada resources for your own needs?
- 01: MFRC (Military Family Resource Centre)
- 02: Telephone consultation with CFMAP (Canadian Forces Member's Assistance Program)
- 03: CFMAP (Canadian Forces Member's Assistance Program) excluding telephone consultation
- 04: Health Information Line
- 05: CAF Harassment Line
- 06: National Defense and Canadian Forces Ombudsman
- 07: Veterans Ombudsman
- 08: VAC Assistance Service
- 09: Operational Stress Injury Clinic
- 10: Peer support of OSISS (Operational Stress Injury Social Support)
- 11: VAC on-line support (such as PTSD Coach, OSI Connect, My VAC Account)
- 12: Other - Specify
- 13: None
- 98: RF
- 99: DK
Mental Health Services 1 - Sub-Block (SR1S)
Mental Health Services 1 - Sub-Block (SR1S) - Question identifier:SR1S_Q023
Think of the ^DT_PROFESSIONAL you talked to the most often during the past 12 months. How many times did you see, or talk on the telephone, to this professional (about your emotions, mental health or use of alcohol or drugs)?
Min = 1; Max = 365
Mental Health Services 1 - Sub-Block (SR1S) - Question identifier:SR1S_Q024
Please refer to page 20 in the booklet.
Where did [this contact/these contacts] take place?
- 01: In a health care facility, when hospitalized as an overnight patient
- 02: MIR (medical inspection room) or other CAF medical facility
- 03: At work, excluding MIR (medical inspection room) or other CAF medical facility
- 04: Civilian doctor's office/Appointment clinic
- 05: Psychiatric outpatient clinic
- 06: Drug or alcohol outpatient clinic
- 07: Hospital emergency room
- 08: Other hospital outpatient clinic (e. g., day surgery, cancer)
- 09: Walk-in clinic/Community health center/CLSC
- 10: At home
- 11: Telephone consultation [including telephone consultation with CFMAP (Canadian Forces Member's Assistance Program)]
- 12: Other - Specify
- 98: RF
- 99: DK
Mental Health Services 1 - Sub-Block (SR1S) - Question identifier:SR1S_Q027
Have you stopped seeing the ^DT_PROFESSIONAL?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mental Health Services 1 - Sub-Block (SR1S) - Question identifier:SR1S_Q028
Please refer to page 21 of the booklet.
Why did you stop?
- 01: You felt better
- 02: You completed the recommended treatment
- 03: You thought it was not helping
- 04: You thought the problem would get better without more professional help
- 05: You couldn't afford to pay
- 06: You were too embarrassed to see the professional
- 07: You wanted to solve the problem without professional help
- 08: You had problems with things like transportation, childcare or your schedule
- 09: The service or program was no longer available
- 10: You were not comfortable with the professional's approach
- 11: Other - Specify
- 98: RF
- 99: DK
Medication Use (MED)
Medication Use (MED) - Question identifier:MED_R01
Now I'd like to ask a few questions about your use of medication, both prescription and over-the-counter.
Medication Use (MED) - Question identifier:MED_Q01A
Since 2002, did you take any medications to help with problems with your emotions, mental health or use of alcohol or drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication Use (MED) - Question identifier:MED_Q01B
In the past 12 months, that is, from [REFDATE - 365 (Date 1 year ago)] to yesterday, did you take any medication to help you with problems with your emotions, mental health or use of alcohol or drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication Use (MED) - Question identifier:MED_Q02
Now, think about the last 2 days, that is, yesterday and the day before yesterday. During those 2 days, how many different medications did you take for problems with your emotions, mental health, or use of alcohol or drugs?
Min = 0; Max = 95
Perceived Need for Care (PNC)
Perceived Need for Care (PNC) - Question identifier:PNC_R01
The following questions deal with different kinds of help you received, or thought you needed, for problems with your emotions, mental health or use of alcohol or drugs.
Perceived Need for Care (PNC) - Question identifier:PNC_Q01
During the past 12 months, did you receive the following kinds of help for problems with your emotions, mental health or use of alcohol or drugs?
- 01: Information about mental health problems, its treatments or available services
- 02: Medication
- 03: Counselling or therapy
- 04: Help for financial or housing problems
- 05: Help for problems with personal relationships
- 06: Help for employment status or work situation
- 07: Other - Specify
- 08: None
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q02A
You mentioned that you received information about mental health problems, its treatments or available services. Do you think you got as much of this kind of help as you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q02A_1
Please refer to page 22 of the booklet.
Why didn't you get more help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q02B
You mentioned that you did not receive information about mental health problems, its treatments or available services. Do you think you needed this kind of help?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q02B_1
Please refer to page 22 of the booklet.
Why didn't you get this help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q03A
You mentioned that you received medication. Do you think you got as much medication as you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q03A_1
Please refer to page 22 of the booklet.
Why didn't you get more medication?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q03B
You mentioned that you did not receive medication. Do you think you needed medication?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q03B_1
Please refer to page 22 of the booklet.
Why didn't you get medication?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q04A
You mentioned that you received counselling or therapy. Do you think you got as much of this kind of help as you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q04A_1
Please refer to page 22 of the booklet.
Why didn't you get more help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q04B
You mentioned that you did not receive counselling or therapy. Do you think you needed this kind of help?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q04B_1
Please refer to page 22 of the booklet.
Why didn't you get help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q05A
You mentioned that you received help for financial or housing problems. Do you think you got as much of this kind of help as you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q05A_1
Please refer to page 22 of the booklet.
Why didn't you get more help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q05B
You mentioned that you did not receive help for financial or housing problems. Do you think you needed this kind of help?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q05B_1
Please refer to page 22 of the booklet.
Why didn't you get help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q06A
You mentioned that you received help for problems with personal relationships. Do you think you got as much of this kind of help as you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q06A_1
Please refer to page 22 of the booklet.
Why didn't you get more help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q06B
You mentioned that you did not receive help for problems with personal relationships. Do you think you needed this kind of help?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q06B_1
Please refer to page 22 of the booklet.
Why didn't you get this help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q07A
You mentioned that you received help for your employment status or work situation. Do you think you got as much of this kind of help as you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q07A_1
Please refer to page 22 of the booklet.
Why didn't you get more help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q07B
You mentioned that you did not receive help for your employment status or work situation. Do you think you needed this kind of help?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived Need for Care (PNC) - Question identifier:PNC_Q07B_1
Please refer to page 22 of the booklet.
Why didn't you get this help?
- 01: Didn't know how or where to get this kind of help
- 02: Language problems
- 03: Couldn't afford to pay
- 04: Job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Have not gotten around to it
- 06: Afraid of what others would think
- 07: Help not readily available
- 08: Didn't have confidence in military health, administrative or social services
- 09: Other - Specify
- 98: RF
- 99: DK
Childhood Experiences and Stressors (CES)
Childhood Experiences and Stressors (CES) - Question identifier:CES_R01
The next few questions are about things that may have happened to you before you were 18 in your school, in your neighbourhood, or in your family. Your responses are important whether or not you have had any of these experiences. Remember that all information provided is strictly confidential.
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q01
(Please refer to page 23 of the booklet.)
Before age 16, how many times did EXPERIENCE 1 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q02
(Please refer to page 24 of the booklet.)
Before age 16, how many times did EXPERIENCE 2 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q03
(Please refer to page 25 of the booklet.)
Before age 16, how many times did EXPERIENCE 3 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q04
(Please refer to page 26 of the booklet.)
Before age 16, how many times did EXPERIENCE 4 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q05
(Please refer to page 27 of the booklet.)
Before age 16, how many times did EXPERIENCE 5 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q06
(Please refer to page 28 of the booklet.)
Before age 16, how many times did EXPERIENCE 6 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q07
(Please refer to page 29 of the booklet.)
Before age 16, how many times did EXPERIENCE 7 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q08
(Please refer to page 30 of the booklet.)
Before age 16, how many times did EXPERIENCE 8 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q09
(Please refer to page 31 of the booklet.)
Before age 10, how many times did EXPERIENCE 9 happen to you?
- 1: A (Never)
- 2: B (1 or 2 times)
- 3: C (3 to 5 times)
- 4: D (6 to 10 times)
- 5: E (More than 10 times)
- 8: RF
- 9: DK
Childhood Experiences and Stressors (CES) - Question identifier:CES_Q10
Before age 18, did a parent or other adult living in your home ever have a mental health problem like depression, severe anxiety, or addiction?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM)
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_R01
Next are some questions about the support that is available to you.
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_R02
People sometimes look to others for companionship, assistance or other types of support.
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q01
(Please refer to page 32 of the booklet)
How often is each of the following kinds of support available to you if you need it:
... someone you can count on to listen to you when you need to talk?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q02
(How often is each of the following kinds of support available to you if you need it:)
... someone to give you advice about a crisis?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q03
(How often is each of the following kinds of support available to you if you need it:)
... someone who shows you love and affection?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q04
(How often is each of the following kinds of support available to you if you need it:)
... someone to give you information in order to help you understand a situation?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q05
(How often is each of the following kinds of support available to you if you need it:)
... someone to confide in or talk to about yourself or your problems?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q06
(How often is each of the following kinds of support available to you if you need it:)
... someone who hugs you?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q07
(How often is each of the following kinds of support available to you if you need it:)
... someone whose advice you really want?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q08
(How often is each of the following kinds of support available to you if you need it:)
... someone to share your most private worries and fears with?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q09
(How often is each of the following kinds of support available to you if you need it:)
... someone to turn to for suggestions about how to deal with a personal problem?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q10
(How often is each of the following kinds of support available to you if you need it:)
... someone who understands your problems?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social support - Affection/ Emotional-Informational (SSM) - Question identifier:SSM_Q11
(How often is each of the following kinds of support available to you if you need it:)
... someone to love you and make you feel wanted?
- 1: None of the time
- 2: A little of the time
- 3: Some of the time
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Social Support - Sub- block (SSM2)
Social Support - Sub- block (SSM2) - Question identifier:SSM2_R12
You have just mentioned that if you needed support, someone would be available for you. The next questions are about the support or help you actually received in the past 12 months.
Social Support - Sub- block (SSM2) - Question identifier:SSM2_Q12A
(In the past 12 months, did you receive the following support:)
...someone [to show you affection/to hug you/to love you and make you feel wanted]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Support - Sub- block (SSM2) - Question identifier:SSM2_Q12B
When you needed it, how often did you receive this kind of support (in the past 12 months)?
- 1: Almost always
- 2: Frequently
- 3: Half the time
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Social Support - Sub- block (SSM2) - Question identifier:SSM2_Q13A
(In the past 12 months, did you receive the following support:)
...someone [to listen to you/to give you advice/to give you information/to confide in/to advise you/to share your worries and fears with/to turn to for suggestions/to understand your problems]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social Support - Sub- block (SSM2) - Question identifier:SSM2_Q13B
When you needed it, how often did you receive this kind of support (in the past 12 months)?
- 1: Almost always
- 2: Frequently
- 3: Half the time
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES)
Moral Injury Events Scale (MIES) - Question identifier:MIES_R01
(Please refer to page 33 of the booklet.)
I am going to read you a series of statements regarding your experiences at any time since joining the military. Please tell me how strongly you agree or disagree with each of the following statements.
Again, I would like to remind you that everything you say will remain strictly confidential.
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q01
I saw things that were morally wrong.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q02
I am troubled by having witnessed others' immoral acts.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q03
I acted in ways that violated my own moral code or values.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q04
I am troubled by having acted in ways that violated my own morals or values.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q05
I violated my own morals by failing to do something that I felt I should have done.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q06
I am troubled because I violated my morals by failing to do something that I felt I should have done.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q07
I feel betrayed by leaders who I once trusted.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q08
I feel betrayed by fellow service members who I once trusted.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Moral Injury Events Scale (MIES) - Question identifier:MIES_Q09
I feel betrayed by others outside the CAF military who I once trusted.
- 1: Strongly disagree
- 2: Moderately disagree
- 3: Slightly disagree
- 4: Slightly agree
- 5: Moderately agree
- 6: Strongly agree
- 8: RF
- 9: DK
Deployment Experience (DEX)
Deployment Experience (DEX) - Question identifier:DEX_R01
Please refer to reference card 2.
The next questions ask about stressful events that might have happened to you while you were on a CAF deployment. This card is provided to help you keep track of these events and you may take it with you at the end of the interview.
Deployment Experience - Sub block (DEX1)
Deployment Experience - Sub block (DEX1) - Question identifier:DEX1_Q01A
During any CAF deployment, has experience ^X happened to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Deployment Experience - Sub block (DEX1) - Question identifier:DEX1_Q01B
Since 2002, has experience ^X happened to you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Stress (STR)
Stress (STR) - Question identifier:STR_R1
Now a few questions about the stress in your life.
Stress (STR) - Question identifier:STR_Q1
In general, how would you rate your ability to handle unexpected and difficult problems, for example, a family or personal crisis?
Would you say your ability is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q2
In general, how would you rate your ability to handle the day-to-day demands in your life, for example, handling work, family and volunteer responsibilities?
Would you say your ability is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q3
Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?
- 01: Time pressures / not enough time
- 02: Own physical health problem or condition
- 03: Own emotional or mental health problem or condition
- 04: Financial situation (e.g., not enough money, debt)
- 05: Own work situation (e.g., hours of work, working conditions)
- 06: School
- 07: Employment status (e.g., unemployment)
- 08: Caring for - own children
- 09: Caring for - others
- 10: Other personal or family responsibilities
- 11: Personal relationships
- 12: Discrimination
- 13: Personal and family's safety
- 14: Health of family members
- 15: Other - Specify
- 16: Nothing
- 98: RF
- 99: DK
Stress (STR) - Question identifier:STR_Q6_1
(Please refer to page 34 of the booklet.)
People have different ways of dealing with stress. Thinking about the ways you deal with stress, please tell me how often you do each of the following.
How often do you try to solve the problem?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_2
To deal with stress, how often do you talk to others?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_3
When dealing with stress, how often do you avoid being with people?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_4
How often do you sleep more than usual to deal with stress?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_5A
When dealing with stress, how often do you try to feel better by eating more, or less, than usual?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_5B
(When dealing with stress), how often do you try to feel better by smoking more cigarettes than usual?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Not applicable
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_5C
(When dealing with stress), how often do you try to feel better by drinking alcohol?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_5D
(When dealing with stress), how often do you try to feel better by using drugs or medication?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_6
How often do you jog or do other exercise to deal with stress?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_7
How often do you pray or seek spiritual help to deal with stress?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_8
To deal with stress, how often do you try to relax by doing something enjoyable?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_9
To deal with stress, how often do you try to look on the bright side of things?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_10
When dealing with stress, how often do you blame yourself?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Stress (STR) - Question identifier:STR_Q6_11
To deal with stress, how often do you wish the situation would go away or somehow be finished?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Employment Status (EMS)
Employment Status (EMS) - Question identifier:EMS_Q10
Which category best describes your current employment status? Are you...?
- 01: Working full-time (30 hours or more per week)
- 02: Working part-time (less than 30 hours per week)
- 03: Self-employed
- 04: Unemployed and looking for work
- 05: A student attending school full-time
- 06: Retired
- 07: Not in the workforce (full-time homemaker or unemployed and not looking for work)
- 08: Other
- 98: RF
- 99: DK
Work Stress (WST)
Work Stress (WST) - Question identifier:WST_R401
(Please refer to page 35 of the booklet.)
The next few questions are about your main job or business in the past 12 months. I'm going to read you a series of statements that might describe your job situation. Please tell me if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree.
Work Stress (WST) - Question identifier:WST_Q401
Your job required that you learn new things.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q402
Your job required a high level of skill.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q403
Your job allowed you freedom to decide how you did your job.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q404
Your job required that you do things over and over.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q405
Your job was very hectic.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q406
You were free from conflicting demands that others made.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q407
Your job security was good.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q408
Your job required a lot of physical effort.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q409
You had a lot to say about what happened in your job.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q410
You were exposed to hostility or conflict from the people you worked with.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q411
Your supervisor was helpful in getting the job done.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q412
The people you worked with were helpful in getting the job done.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 6: Not applicable
- 8: RF
- 9: DK
Work Stress (WST) - Question identifier:WST_Q413
How satisfied were you with your job?
- 1: Very satisfied
- 2: Somewhat satisfied
- 3: Not too satisfied
- 4: Not at all satisfied
- 8: RF
- 9: DK
Physical Activity - Short Form (PHS)
Physical Activity - Short Form (PHS) - Question identifier:PHS_R01
The next questions are about physical activity done for leisure, work, housework, or for transportation.
Physical Activity - Short Form (PHS) - Question identifier:PHS_Q01
In the past 7 days, how many times did you participate in moderate or vigorous physical activity?
Min = 0; Max = 35
Physical Activity - Short Form (PHS) - Question identifier:PHS_Q02
About how much time did you spend on each occasion?
- 1: 0 to 15 minutes
- 2: 16 to 30 minutes
- 3: 31 to 60 minutes
- 4: 61 minutes to 2 hours
- 5: More than 2 hours
- 8: RF
- 9: DK
Height and weight - Self-reported (HWT)
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q1
It is important to know when analyzing health whether or not the person is pregnant. Are you pregnant?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q2
The next questions are about height and weight. How tall are you without shoes on?
- 0: Less than 1' / 12" (less than 29.2 cm.)
- 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
- 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
- 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
- 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
- 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
- 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
- 7: 7'0" and over (212.1 cm. and over)
- 8: RF
- 9: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2A
Select the exact height.
- 00: 1'0" / 12" (29.2 to 31.7 cm.)
- 01: 1'1" / 13" (31.8 to 34.2 cm.)
- 02: 1'2" / 14" (34.3 to 36.7 cm.)
- 03: 1'3" / 15" (36.8 to 39.3 cm.)
- 04: 1'4" / 16" (39.4 to 41.8 cm.)
- 05: 1'5" / 17" (41.9 to 44.4 cm.)
- 06: 1'6" / 18" (44.5 to 46.9 cm.)
- 07: 1'7" / 19" (47.0 to 49.4 cm.)
- 08: 1'8" / 20" (49.5 to 52.0 cm.)
- 09: 1'9" / 21" (52.1 to 54.5 cm.)
- 10: 1'10" / 22" (54.6 to 57.1 cm.)
- 11: 1'11" / 23" (57.2 to 59.6 cm.)
- 98: RF
- 99: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2B
Select the exact height.
- 00: 2'0" / 24" (59.7 to 62.1 cm.)
- 01: 2'1" / 25" (62.2 to 64.7 cm.)
- 02: 2'2" / 26" (64.8 to 67.2 cm.)
- 03: 2'3" / 27" (67.3 to 69.8 cm.)
- 04: 2'4" / 28" (69.9 to 72.3 cm.)
- 05: 2'5" / 29" (72.4 to 74.8 cm.)
- 06: 2'6" / 30" (74.9 to 77.4 cm.)
- 07: 2'7" / 31" (77.5 to 79.9 cm.)
- 08: 2'8" / 32" (80.0 to 82.5 cm.)
- 09: 2'9" / 33" (82.6 to 85.0 cm.)
- 10: 2'10" / 34" (85.1 to 87.5 cm.)
- 11: 2'11" / 35" (87.6 to 90.1 cm.)
- 98: RF
- 99: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2C
Select the exact height.
- 00: 3'0" / 36" (90.2 to 92.6 cm.)
- 01: 3'1" / 37" (92.7 to 95.2 cm.)
- 02: 3'2" / 38" (95.3 to 97.7 cm.)
- 03: 3'3" / 39" (97.8 to 100.2 cm.)
- 04: 3'4" / 40" (100.3 to 102.8 cm.)
- 05: 3'5" / 41" (102.9 to 105.3 cm.)
- 06: 3'6" / 42" (105.4 to 107.9 cm.)
- 07: 3'7" / 43" (108.0 to 110.4 cm.)
- 08: 3'8" / 44" (110.5 to 112.9 cm.)
- 09: 3'9" / 45" (113.0 to 115.5 cm.)
- 10: 3'10" / 46" (115.6 to 118.0 cm.)
- 11: 3'11" / 47" (118.1 to 120.6 cm.)
- 98: RF
- 99: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2D
Select the exact height.
- 00: 4'0" / 48" (120.7 to 123.1 cm.)
- 01: 4'1" / 49" (123.2 to 125.6 cm.)
- 02: 4'2" / 50" (125.7 to 128.2 cm.)
- 03: 4'3" / 51" (128.3 to 130.7 cm.)
- 04: 4'4" / 52" (130.8 to 133.3 cm.)
- 05: 4'5" / 53" (133.4 to 135.8 cm.)
- 06: 4'6" / 54" (135.9 to 138.3 cm.)
- 07: 4'7" / 55" (138.4 to 140.9 cm.)
- 08: 4'8" / 56" (141.0 to 143.4 cm.)
- 09: 4'9" / 57" (143.5 to 146.0 cm.)
- 10: 4'10" / 58" (146.1 to 148.5 cm.)
- 11: 4'11" / 59" (148.6 to 151.0 cm.)
- 98: RF
- 99: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2E
Select the exact height.
- 00: 5'0" (151.1 to 153.6 cm.)
- 01: 5'1" (153.7 to 156.1 cm.)
- 02: 5'2" (156.2 to 158.7 cm.)
- 03: 5'3" (158.8 to 161.2 cm.)
- 04: 5'4" (161.3 to 163.7 cm.)
- 05: 5'5" (163.8 to 166.3 cm.)
- 06: 5'6" (166.4 to 168.8 cm.)
- 07: 5'7" (168.9 to 171.4 cm.)
- 08: 5'8" (171.5 to 173.9 cm.)
- 09: 5'9" (174.0 to 176.4 cm.)
- 10: 5'10" (176.5 to 179.0 cm.)
- 11: 5'11" (179.1 to 181.5 cm.)
- 98: RF
- 99: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2F
Select the exact height.
- 00: 6'0" (181.6 to 184.1 cm.)
- 01: 6'1" (184.2 to 186.6 cm.)
- 02: 6'2" (186.7 to 189.1 cm.)
- 03: 6'3" (189.2 to 191.7 cm.)
- 04: 6'4" (191.8 to 194.2 cm.)
- 05: 6'5" (194.3 to 196.8 cm.)
- 06: 6'6" (196.9 to 199.3 cm.)
- 07: 6'7" (199.4 to 201.8 cm.)
- 08: 6'8" (201.9 to 204.4 cm.)
- 09: 6'9" (204.5 to 206.9 cm.)
- 10: 6'10" (207.0 to 209.5 cm.)
- 11: 6'11" (209.6 to 212.0 cm.)
- 98: RF
- 99: DK
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q3A
In 2002, how much did you weigh?
Min = 1; Max = 575
Height and weight - Self-reported (HWT) - Question identifier:HWT_N4A
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q3B
How much do you weigh?
Min = 1; Max = 575
Height and weight - Self-reported (HWT) - Question identifier:HWT_N4B
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q4
Do you consider yourself...?
- 1: Overweight
- 2: Underweight
- 3: Just about right
- 8: RF
- 9: DK
Income (INC)
Income (INC) - Question identifier:INC_R01
Although many health expenses are covered by health insurance, there is still a relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.
Income (INC) - Question identifier:INC_Q01
(Please turn to page 36 of the booklet.)
Thinking about the total income for all household members, from which of the following sources did your household receive any income in the past 12 months?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q02
What was the main source of income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q03
What is your best estimate of the total household income received by all household members, from all sources, before taxes and deductions, in the past 12 months?
Min = -9000000; Max = 90000000
Income (INC) - Question identifier:INC_Q05A
Can you estimate in which of the following groups your household income falls? Was the total household income in the past 12 months...?
- 1: Less than $50,000, including income loss
- 2: $50,000 and more
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q05B
Please stop me when I have read the category which applies to your household. Was it...?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $30,000
- 6: $30,000 to less than $40,000
- 7: $40,000 to less than $50,000
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q05C
Please stop me when I have read the category which applies to your household. Was it...?
- 1: $50,000 to less than $60,000
- 2: $60,000 to less than $70,000
- 3: $70,000 to less than $80,000
- 4: $80,000 to less than $90,000
- 5: $90,000 to less than $100,000
- 6: $100,000 to less than $150,000
- 7: $150,000 and over
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q06
Thinking about your total personal income, from which of the following sources did you receive any income in the past 12 months?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q07
What was the main source of your personal income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Worker's compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q08A
What is your best estimate of your total personal income, before taxes and deductions, from all sources in the past 12 months?
Min = -9000000; Max = 90000000
Income (INC) - Question identifier:INC_Q08B
Can you estimate in which of the following groups your personal income falls? Was your total personal income in the past 12 months...?
- 1: Less than $30,000, including income loss
- 2: $30,000 and more
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q08C
Please stop me when I have read the category which applies to you. Was it...?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $25,000
- 6: $25,000 to less than $30,000
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q08D
Please stop me when I have read the category which applies to you. Was it...?
- 01: $30,000 to less than $40,000
- 02: $40,000 to less than $50,000
- 03: $50,000 to less than $60,000
- 04: $60,000 to less than $70,000
- 05: $70,000 to less than $80,000
- 06: $80,000 to less than $90,000
- 07: $90,000 to less than $100,000
- 08: $100,000 and over
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q12
With your current household income, do you have any difficulty meeting basic expenses such as food, shelter and clothing?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Income 2 (INC1)
Income 2 (INC1) - Question identifier:INC1_Q03
How satisfied are you with your financial situation?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Language of Preference (LP)
Language of Preference (LP) - Question identifier:LP_Q01
Would you prefer that I speak in English or in French?
- 1: English
- 2: French
- 3: Other
Language of Preference (LP) - Question identifier:LP_N02
Select respondent's preferred non-official language.
If necessary, ask: (What language would you prefer?)
- 03: Chinese
- 04: Italian
- 05: Punjabi
- 06: Spanish
- 07: Portuguese
- 08: Polish
- 09: German
- 10: Vietnamese
- 11: Arabic
- 12: Tagalog
- 13: Greek
- 14: Tamil
- 15: Cree
- 16: Afghan
- 17: Cantonese
- 18: Hindi
- 19: Mandarin
- 20: Persian (Farsi)
- 21: Russian
- 22: Ukrainian
- 23: Urdu
- 24: Inuktitut
- 25: Hungarian
- 26: Korean
- 27: Serbo-Croatian
- 28: Gujarati
- 29: Dari
- 90: Other - Specify
HC: De-facto marital status without confirmation - MSNC
HC: De-facto marital status without confirmation - MSNC - Question identifier:MSNC_Q01
What is [your/FNAME's] marital status? [Are/Is you/he/she]... ?
- 1: Married
- 2: Living common-law
- 3: Widowed
- 4: Separated
- 5: Divorced
- 6: Single, never married
- 9: Don't know
- 8: Refusal
HC: Education Sublock Highest certificate, diploma or degree short version - EHG1
HC: Education Sublock Highest certificate, diploma or degree short version - EHG1 - Question identifier:EHG1_Q01
What is the highest certificate, diploma or degree that you have completed?
- 1: Less than high school diploma or its equivalent
- 2: High school diploma or a high school equivalency certificate
- 3: Trade certificate or diploma
- 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
- 5: University certificate or diploma below the bachelor's level
- 6: Bachelor's degree (e.g. B.A., B.Sc., LL.B.)
- 7: University certificate, diploma or degree above the bachelor's level
- 9: Don't know
- 8: Refusal
Record Linkage Statement (RLS)
Record Linkage Statement (RLS) - Question identifier:RLS_Q01
Statistics Canada will combine your responses with information from the 2002 survey, DND and VAC administrative data files. Statistics Canada may also add information from other surveys or administrative sources.
- 1: Continue
- 2: Respondent does not want his/her responses combined with other sources
Possible future contact (PFC)
Possible future contact (PFC) - Question identifier:PFC_R01
As part of this study, we may need to get in touch in the future.
- Date modified: