Attachment B36-3 DISC ODD

Attachment B36-3 DISC ODD.pdf

Longitudinal follow-up of Youth with Attention-Deficit/Hyperactivity Disorder identified in Community Settings: Examining Health Status, Correlates, and Effects associated with treatment for ADHD

Attachment B36-3 DISC ODD

OMB: 0920-0747

Document [pdf]
Download: pdf | pdf
0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

START NEW CARD
DUP COL 1 - 10
MOD.

E

2

[11 - 12]

CARD NO. 0

1
b

[13 - 14]
[15]

ODD
Now I am going to ask you some questions about __________ getting angry or doing
things that could get [him/her] into trouble.
1.

In the last year – that is, since [[NAME EVENT]/[NAME CURRENT MONTH]
of last year] – has __________ lost [his/her] temper?

0

2

7

9

[16]

IF YES, A. Was there a time in the last year when [he/she] lost [his/her] temper
at least once a week?

0

2

7

9

[17]

IF YES, B. Did [he/she] lose [his/her] temper at least once a week
for six months or longer?

0

2

7

9

[18]

C. About how often did [he/she] lose [his/her] temper?
Was it: nearly every day, a few days a week, or about
once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
D. Now, what about the last four weeks?
Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]], has [he/she] lost [his/
her] temper?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 21

[3]
[2]
[1]
0
7
9
0

[19]

2

7

9

[20]

[5/20/98]

0=NO

2.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] argued with or talked back to [you (or [his/her] [CARETAKERS])/[his/her]
[CARETAKERS]] (or [his/her][teachers/boss])?

0

2

7

9

[21]

IF YES, A. Was there a time in the last year when [he/she] argued with or talked
back to [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/her][teachers/boss]) at least once a week?

0

2

7

9

[22]

IF YES, B. Did [he/she] argue with or talk back to [you (or [his/her]
[CARETAKERS])/[his/her] [CARETAKERS]] (or
[his/her][teachers/boss]) at least once a week for six
months or longer?

0

2

7

9

[23]

C. About how often did [he/she] argue with or talk back to
[you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/her][teachers/boss])? Was it: nearly
every day, a few days a week, or about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] argued
with or talked back to [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/
her][teachers/boss])?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 22

[3]
[2]
[1]
0
7
9
0

[24]

2

7

9

[25]

[5/20/98]

0=NO

3.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] done things on purpose that [you (or [his/her] [CARETAKERS])/[his/her]
[CARETAKERS]] (or [his/her][teachers/boss]) told [him/her] not to do?

0

2

7

9

[26]

IF YES, A. Was there a time in the last year when [he/she] did things [he/she] was
told not to do at least once a week?

0

2

7

9

[27]

IF YES, B. Did [he/she] do things like this at least once a week for
six months or longer?

0

2

7

9

[28]

C. About how often did [he/she] do things on purpose that
[you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/her][teachers/boss]) told [him/her]
not to do? Was it: nearly every day, a few days a week,
or about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] done
things on purpose that [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/
her][teachers/boss]) told [him/her] not to do?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 23

3*
2*
1*
0
7
9
0

[29]

2

7

9

[30]

[5/20/98]

0=NO

4.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] refused to do what [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/her][teachers/boss]) told [him/her] to do?

0

2

7

9

[31]

IF YES, A. Was there a time in the last year when [he/she] refused to do things
at least once a week?

0

2

7

9

[32]

IF YES, B. Did [he/she] refuse to do what [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/
her][teachers/boss]) told [him/her] to do at least once a
week for six months or longer?

0

2

7

9

[33]

C. About how often did [he/she] refuse to do what [you (or
[his/her] [CARETAKERS])/[his/her] [CARETAKERS]] (or [his/her][teachers/boss]) told [him/her] to
do? Was it: nearly every day, a few days a week, or
about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
D. Now, what about the last four weeks?
Since [NAME EVENT//the beginning of/the middle of/
the end of LAST MONTH], has [he/she] refused to do
what [you (or [his/her] [CARETAKERS])/[his/her]
[CARETAKERS]] (or [his/her][teachers/boss]) told
[him/her] to do?

NOTE 1:

WAS A * RESPONSE CODED IN Q 3 OR Q 4?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 24

3*
2*
1*
0
7
9

[34]

0

2

0

[2]

7

9

[35]

[36]

[5/20/98]

0=NO

5.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

In the last year – that is, since [NAME CURRENT MONTH] of last year – has
__________ done things just to annoy people or to make them mad?

8, 88=NOT APPLICABLE

0

2

7

0

2

7

0

2

C. Was there a time in the last year when [he/she] did things just to annoy
people or make them mad at least once a week?

0

IF YES, D. Did [he/she] do things like this at least once a week for
six months or longer?

0

9, 99=DON’T KNOW

9

[37]

9

[38]

7

9

[39]

2

7

9

[40]

2

7

9

[41]

IF NO, GO TO Q 6

a:

IF SUBJECT DOESN’T HAVE SIBLING(S),
CODE “8” FOR A, THEN GO TO C

IF YES, A. Was this only with [his/her] brother or sister?
IF YES, B. Has [he/she] done things to annoy other people besides
[his/her] brother or sister or to make other people mad?

8

IF NO, GO TO Q 6

E. About how often did [he/she] do things to annoy people
or make them mad? Was it: nearly every day, a few days
a week, or about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
F. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] done
things to annoy people or make them mad?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 25

[3]
[2]
[1]
0
7
9
0

[42]

2

7

9

[43]

[5/20/98]

0=NO

6.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

0

2

7

0

2

7

0

2

C. Was there a time in the last year when [he/she] blamed people for
things [he/she] did at least once a week ?

0

IF YES, D. Did [he/she] blame someone else for [his/her] mistakes
or for things [he/she] did that [he/she] shouldn’t have
done at least once a week for six months or longer?

0

In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] blamed someone else for [his/her] mistakes or for things [he/she] did that [he/
she] shouldn’t have done?

9, 99=DON’T KNOW

9

[44]

9

[45]

7

9

[46]

2

7

9

[47]

2

7

9

[48]

IF NO, GO TO Q 7

b:

IF SUBJECT DOESN’T HAVE SIBLING(S),
CODE “8” FOR A, THEN GO TO C

IF YES, A. Was this only with [his/her] brother or sister?
IF YES, B. Has [he/she] blamed other people besides [his/her]
brother or sister for [his/her] mistakes?

8

IF NO, GO TO Q 7

E. About how often did [he/she] blame someone else for
[his/her] mistakes or for things [he/she] did that [he/
she] shouldn’t have? Was it: nearly every day, a few
days a week, or about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
F. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]), has [he/she] blamed
someone else for [his/her] mistakes or for things [he/
she] did that [he/she] shouldn’t have?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 26

[3]
[2]
[1]
0
7
9
0

[49]

2

7

9

[50]

[5/20/98]

0=NO

7.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] been grouchy or easily annoyed?

0

2

7

9

[51]

IF YES, A. Was there a time in the last year when [he/she] was grouchy or easily
annoyed at least once a week?

0

2

7

9

[52]

IF YES, B. Was [he/she] grouchy or easily annoyed at least once a
week for six months or longer?

0

2

7

9

[53]

C. About how often was [he/she] grouchy or easily annoyed? Was it: nearly every day, a few days a week, or
about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] been
grouchy or easily annoyed?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 27

[3]
[2]
[1]
0
7
9
0

[54]

2

7

9

[55]

[5/20/98]

0=NO

8.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] seemed mad at people or things?

8, 88=NOT APPLICABLE

0

2

7

0

2

7

0

2

C. Was there a time in the last year when [he/she] seemed mad at people
or things at least once a week?

0

IF YES, D. Did [he/she] seem mad at people or things at least once
a week for six months or longer?

0

9, 99=DON’T KNOW

9

[56]

9

[57]

7

9

[58]

2

7

9

[59]

2

7

9

[60]

IF NO, GO TO Q 9

c:

IF SUBJECT DOESN’T HAVE SIBLING(S),
CODE “8” FOR A, THEN GO TO C

IF YES, A. Was this only with [his/her] brother or sister?
IF YES, B. Has [he/she] seemed mad at other people besides [his/
her] brother or sister?

8

IF NO, GO TO Q 9

E. About how often did [he/she] seem mad at people or
things? Was it: nearly every day, a few days a week, or
about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
F. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] seemed
mad at people or things?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 28

3*
2*
1*
0
7
9
0

[61]

2

7

9

[62]

[5/20/98]

0=NO

9.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

In the last year – that is, since [NAME CURRENT MONTH] of last year – has
__________ gotten angry because [he/she] said [he/she] thought things were
unfair?

8, 88=NOT APPLICABLE

0

2

7

0

2

7

0

2

C. Was there a time in the last year when [he/she] got angry like this at
least once a week?

0

IF YES, D. Did [he/she] get angry at least once a week for six
months or longer?

0

9, 99=DON’T KNOW

9

[63]

9

[64]

7

9

[65]

2

7

9

[66]

2

7

9

[67]

IF NO, GO TO NOTE 2

d:

IF SUBJECT DOESN’T HAVE SIBLING(S),
CODE “8” FOR A, THEN GO TO C

IF YES, A. Was this only with [his/her] brother or sister?
IF YES, B. Has [he/she] gotten angry at other people besides [his/
her] brother or sister because [he/she] thought things
were unfair?

8

IF NO, GO TO NOTE 2

E. About how often was [he/she] angry because [he/she]
thought things were unfair? Was it: nearly every day, a
few days a week, or about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
F. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] been
angry because [he/she] thought things were unfair?

NOTE 2:

WAS A * RESPONSE CODED IN Q 8 OR Q 9?

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 29

3*
2*
1*
0
7
9

[68]

0

2

0

[2]

7

9

[69]

[70]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

10. In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] done mean things to people on purpose?

8, 88=NOT APPLICABLE

0

2

7

0

2

7

0

2

C. Has [he/she] done mean things to people on purpose more than once
in the last year?

0

IF YES, D. Has [he/she] done mean things to people on purpose
more than five times in the last year?

9, 99=DON’T KNOW

9

[71]

9

[72]

7

9

[73]

2

7

9

[74]

0

2*

7

9

[75]

IF YES, E. Has [he/she] done mean things to people
more than ten times in the last year?

0

2

7

9

[76]

F. Has [he/she] done mean things to people for at least six
months?

0

2

7

9

[77]

G. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] done
mean things to people on purpose?

0

2

7

9

[78]

IF NO, GO TO Q 11

e:

IF SUBJECT DOESN’T HAVE SIBLING(S),
CODE “8” FOR A, THEN GO TO C

IF YES, A. Was this only with [his/her] brother or sister?
IF YES, B. Has [he/she] done mean things to other people besides
[his/her] brother or sister?

8

IF NO, GO TO Q 11

START NEW CARD
DUP COL 1 - 12
CARD NO. 0

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 30

2
b

[13 - 14]
[15]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

11. In the last year (that is, since [NAME CURRENT MONTH] of last year), has [he/
she] gotten even with other people by doing things like hurting them, messing up
their things, or telling lies about them?

8, 88=NOT APPLICABLE

0

2

7

0

2

7

0

2

C. Did [he/she] get even with people like this more than once in the last
year?

0

IF YES, D. Has [he/she] done this more than five times in the last
year?

9, 99=DON’T KNOW

9

[16]

9

[17]

7

9

[18]

2

7

9

[19]

0

2*

7

9

[20]

IF YES, E. Has [he/she] done this more than ten
times in the last year?

0

2

7

9

[21]

F. Has [he/she] gotten even with people like this for at
least six months?

0

2

7

9

[22]

G. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] gotten
even with other people by doing things like hurting
them, messing up their things, or telling lies about
them?

0

2

7

9

[23]

0

[2]

12. In the last year (that is, since [NAME CURRENT MONTH] of last year), did [he/
she] swear or use dirty language?

0

2

7

9

[25]

IF YES, A. Was there a time in the last year when [he/she] swore or used dirty
language at least once a week?

0

2

7

9

[26]

IF YES, B. Did [he/she] swear or use dirty language that often for
six months or longer?

0

2

7

9

[27]

IF NO, GO TO NOTE 3

f:

IF SUBJECT DOESN’T HAVE SIBLING(S),
CODE “8” FOR A, THEN GO TO C

IF YES, A. Was this only with [his/her] brother or sister?
IF YES, B. Has [he/she] done things like this to other people
besides [his/her] brother or sister?

8

IF NO, GO TO NOTE 3

NOTE 3:

WAS A * RESPONSE CODED IN Q 10 OR Q 11?

[24]

C. About how often did [he/she] swear or use dirty language? Was it: nearly every day, a few days a week, or
about once a week?
Nearly every day .......................................................
A few days a week ....................................................
About once a week ....................................................
Less than once a week ...............................................
Refuse to answer .......................................................
Don’t know ................................................................
Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 31

3
2
1
0
7
9

[28]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle
of/the end of [LAST MONTH]]), has [he/she] sworn or
used dirty language?

g:

8, 88=NOT APPLICABLE

0

2

7

9, 99=DON’T KNOW

9

[29]

IF 2 OR MORE [ ] RESPONSES WERE CODED IN Q 1 - 11
AND NOTES 1 - 3, CONTINUE
ALL OTHERS, GO TO CD, P. 37

13. You said that in the last year ________ [NAME [ ] SYMPTOMS IN Q 1 - 11 AND
NOTES 1 - 3].
How old was [he/she] the first time [he/she] began to do these things?
CODE AGE (66 = WHOLE LIFE, ALWAYS) ----------------------------------->

|____ ____| YRS.

[30-31]

IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE (44 = PRE-K, 55 = KINDERGARTEN,
13 = COLLEGE FRESHMAN, 14 = SOPHOMORE, 15 = JUNIOR,
16 = SENIOR, 17 = POST B.A.) ----------------------------------------------------->

|____ ____| GRADE

[32-33]

h:

IF [AGE/GRADE] GIVEN WAS CHILD’S CURRENT
[AGE/GRADE], GO TO Q 14
IF [AGE/GRADE] GIVEN WAS CHILD’S CURRENT
[AGE/GRADE] MINUS ONE, GO TO A
ALL OTHERS, GO TO B
A. Was that more than a year ago – that is, before [[NAME EVENT]/
[NAME CURRENT MONTH] of last year]?

0

2

7

9

[34]

0

2

7

9

[35]

0

2

7

9

[36]

IF NO, GO TO Q 14
B. Since that first time, was there ever a time when [he/she] didn’t do
these things?
IF NO, GO TO Q 14
C. Did that time when [he/she] didn’t do these things last for two months
or more?
IF NO, GO TO Q 14
D. You said that [he/she] [NAME [ ] SYMPTOMS IN Q 1 - 11 AND
NOTES 1 - 3]in the last year.
How old was [he/she] when doing these things began this time?
CODE AGE (88 = NEVER STARTED AGAIN) ---------------->

|____ ____| YRS.

[37-38]

IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE (44 = PRE-K, 55 = KINDERGARTEN,
13 = COLLEGE FRESHMAN, 14 = SOPHOMORE,
15 = JUNIOR, 16 = SENIOR, 17 = POST B.A.,
88 = NEVER STARTED AGAIN) ---------------------------------->

|____ ____| GRADE

[39-40]

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 32

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

i:

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

IF [AGE/GRADE] GIVEN WAS CHILD’S
CURRENT [AGE/GRADE] MINUS ONE, GO TO E
ALL OTHERS, GO TO Q 14

E. Did [he/she] start to do these things again more than a year ago – that
is, before [[NAME EVENT]/[NAME CURRENT MONTH] of last
year]?

0

2

7

9

[41]

2

7

9

[42]

14. You said that in the last year __________ [NAME [ ] SYMPTOMS IN Q 1 - 11
AND NOTES 1 - 3].
Now I’d like you to think back to the time in the last year when [his/her] doing these
things caused the most problems.
At that time, did [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]]
get annoyed or upset with [him/her] because [he/she] was angry or uncooperative?

0

1

IF YES, A. How often did [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] get annoyed or upset with [him/her] because [he/she] was
like that? Would you say: a lot of the time, some of the time, or hardly
ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
15. At that time, did being angry or uncooperative keep __________ from doing things
or going places with [you or [his/her] family/[his/her] family]?

3
2
1
7
9
0

[43]

1

2

7

9

[44]

IF YES, A. How often did being like that keep [him/her] from doing things or
going places with [you or [his/her] family/[his/her] family]? Would
you say: a lot of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
16. At that time, did being angry or uncooperative keep [him/her] from doing things or
going places with other [children/people [his/her] age]?

3
2
1
7
9
0

[45]

1

2

7

9

[46]

IF YES, A. How often did being like that keep [him/her] from doing things or
going places with other [children/people [his/her] age]? Would you
say: a lot of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 33

3
2
1
7
9

[47]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

j:

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

IF CHILD DID NOT ATTEND SCHOOL OR WORK IN LAST
YEAR, CODE “8” IN Q 17 AND Q 18, THEN GO TO Q 19

17. When the problems were worst, did being angry or uncooperative [make it difficult
for [him/her] to do [his/her] schoolwork or cause problems with [his/her] grades/
make it difficult for [him/her] to do [his/her] work]?

0

1

2

7

8

9

[48]

IF YES, A. How bad were the problems [he/she] had with [his/her] [schoolwork/
work] because [he/she] was like that? Would you say: very bad, bad,
or not too bad?
Very bad ..........................................................................................
Bad ..................................................................................................
Not too bad ......................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
18. At that time, did being angry or uncooperative cause ________’s [teachers/boss]
to be annoyed or upset with [him/her]?

3
2
1
7
9
0

[49]

1

2

7

8

9

[50]

IF YES, A. How often [were/was] [his/her] [teachers/boss] annoyed or upset
with [him/her] because [he/she] was like that? Would you say: a lot
of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
19. When the problems were worst, did it seem like being angry or uncooperative made
[him/her] feel bad or made [him/her] feel upset?

3
2
1
7
9
0

[51]

1

2

7

9

[52]

IF YES, A. How bad did being like that with other people seem to make [him/her]
feel? Would you say: very bad, bad, or not too bad?
Very bad ..........................................................................................
Bad ..................................................................................................
Not too bad ......................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
20. In the last year – that is, since [NAME CURRENT MONTH] of last year – has [he/
she] been to see someone at a hospital or a clinic or at their office because of these
behaviors?

3
2
1
7
9

[53]

0

2

7

9

[54]

0

2

7

9

[55]

IF YES, GO TO OPTIONAL DETAILS, NEXT PAGE
IF NO, A. Does [he/she] have an appointment set up to see someone because of
these behaviors?
IF YES, GO TO OPTIONAL DETAILS, NEXT PAGE

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 34

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

OPTIONAL DETAILS:
21.

Who [did ________ see//is ________ going to see]? (WRITE IN:)
Name:

|____ ____|

[56-57]

|____ ____|

[58-59]

Profession:
Address:

A. IF SOMEONE WAS SEEN, ASK:
What did the person [he/she] saw say was the matter?

k:

IF CHILD IS AGE 7 OR OLDER, CONTINUE
ALL OTHERS, GO TO CD, P. 37

Whole Life Screen
22. You said that in the last year [he/she] [NAME SYMPTOMS IN Q 1 - 11 AND
NOTES 1 - 3].
Now I want you to think back to before the last year … since the time [he/she] turned
five years old up until the last twelve months.
(INTERVIEWER: point out age five on whole life chart.)
Since [he/she] turned five years old, was there ever a time when [he/she] was more
angry and uncooperative than [he/she] has been in the last year?

0

2

7

9

[60]

IF YES, A. How old was [he/she] when it was worst?
(INTERVIEWER: IF MORE THAN ONE YEAR IS REPORTED,
ASK: “During which single year of age was [he/she] the worst?” IF
MORE THAN ONE YEAR STILL REPORTED, ENTER YOUNGEST
AGE.)
CODE AGE -------------------------------------------------------------->

|____ ____|

[61-62]

IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE (44 = PRE-K, 55 = KINDERGARTEN,
13 = COLLEGE FRESHMAN, 14 = SOPHOMORE,
15 = JUNIOR, 16 = SENIOR, 17 = POST B.A.) ------------------>

|____ ____|

[63-64]

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 35

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

INTENTIONALLY LEFT BLANK

Module E: Disruptive Behavior Disorders
Oppositional Defiant Disorder
DISC IV-P, past year

Page 36

[5/20/98]


File Typeapplication/pdf
File TitleP-ODD past year
SubjectP-ODD past year
AuthorEmerson
File Modified2003-10-17
File Created2003-10-17

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