“Preventing HIV Risk Behaviors among Hispanic Adolescents”
Attachment 3c: Adolescent Assessment Battery
(English Language)
Form Approved
OMB No. 0920-XXXX
Expiration Date XX/XX/20XX
“Preventing HIV Risk Behaviors among Hispanic Adolescents”
Adolescent Assessment Battery
Public reporting burden of this collection of information is estimated to average 60 minutes per response,, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a persons is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; Attn: OMB-PRA (0920-XXXX)
b. Adolescent Assessment Battery
i. Demographics
ii. Bicultural Involvement Questionnaire – Revised
iii. Parenting Practices
iv. Parent Relationship with Peer Group
v. Social Support Appraisal Scale
vi. Bond with School
vii. Family Relations Scale
viii. Parent-Adolescent Communication
ix. Identity Style Inventory
x. Multicultural Ethnic Identity Measure
xi. Youth Self Report Measure
xii. Attitudes Towards Drugs
xiii. Perceptions About Drugs
xiv. Drug Use
xv. Parent-Adolescent Communication about Sex
xvi. Attitudes about Sex
xvii. Sexual Behavior
xviii. Peer Sexual Behavior
Preliminary Data AD=Adolescent
PRE1. Enter the Respondent's ID number __ __ __ __ ID
PRE2. Enter the timepoint [PLEASE ENTER A TIMEPOINT BETWEEN 1 AND 5] __ Time Point
PRE3. Please enter your Site ID. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
PRE4. Please enter your interviewer ID. __ __ Interviewer
PRE5. Enter the Respondent's Age __ __ __ __ 9998 Refuse to Answer
A_Demog
You will be asked some demographic questions. Please remember that your answers to these questions will be kept secret. No one (including your parents) will know your answers to these questions.
HEP1. In what country were you born? (Choose one) 00 United States
01 Cuba
02 Nicaragua
03 Honduras
04 Puerto Rico
05 Colombia
06 Mexico
07 Venezuela
08 Dominican Republic
09 Costa Rica
10 El Salvador
11 Panama
12 Peru
13 Guatemala
14 Argentina
15 Ecuador
16 Bolivia
17 Uruguay
18 Paraguay
19 Chile
20 Other Country
98 Refuse to Answer
HEP2. How long have you lived in the United States? (Choose one) 0 Less than 3 Years
1 3 to 10 Years
2 More than 10 Years
8 Refuse to Answer
HEP3. When is your date of birth?
________
A_Bicult
Next you will be asked some questions regarding aspects of Hispanic culture and American culture. The following questions measure how comfortable you feel. You will be shown a scale from 1 to 5, and you will have to choose 1, 2, 3, 4 or 5. The higher the number that you choose, the more comfortable you feel. The lower the number that you choose, the less comfortable you feel. For example, if you don't feel at all comfortable, Not at all Comfortable, choose number 1. If you feel Very Comfortable, choose number 5. Remember that you can also choose 2, 3 or 4.
BIC1. How comfortable do you feel speaking SPANISH at home? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
BIC2. How comfortable do you feel speaking SPANISH in school? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
BIC4. How comfortable do you feel speaking SPANISH with friends? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
BIC5. How comfortable do you feel speaking SPANISH in general? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
BIC6. How comfortable do you feel speaking ENGLISH at home? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
BIC7. How comfortable do you feel speaking ENGLISH in school? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
BIC9. How comfortable do you feel speaking ENGLISH with friends? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
BIC10. How comfortable do you feel speaking ENGLISH in general? 1 Not at all Comfortable
2 .
3 .
4 .
5 Very Comfortable
8 Refuse to Answer
The following questions measure how much you enjoy different things. The higher the number that you choose, the more you enjoy what the question describes. The lower the number that you choose, the less you enjoy it. For example, if you don't enjoy it at all, Not at All, choose number 1. If you enjoy it Very Much, choose number 5. Remember that you can also choose 2, 3 or 4.
BIC11. How much do you enjoy HISPANIC music? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC12. How much do you enjoy HISPANIC dances? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC13. How much do you enjoy HISPANIC-oriented places? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC14. How much do you enjoy HISPANIC-type recreation? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC15. How much do you enjoy HISPANIC TV programs? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC16. How much do you enjoy HISPANIC radio stations? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC17. How much do you enjoy HISPANIC books and magazines? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC18. How much do you enjoy AMERICAN music? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC19. How much do you enjoy AMERICAN dances? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC20. How much do you enjoy AMERICAN-oriented places? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC21. How much do you enjoy AMERICAN-type recreation? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC22. How much do you enjoy AMERICAN TV programs? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC23. How much do you enjoy AMERICAN radio stations? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
BIC24. How much do you enjoy AMERICAN books and magazines? 1 Not at All
2 .
3 .
4 .
5 Very Much
8 Refuse to Answer
A-Par Pre-Question
PPQ1. Who is the person or people who is/are mostly in charge of taking care of you? (Choose one)
1 Mother and Father (biological or functional)
2 Mom only
3 Dad only
4 Grandparent
5 Aunt or Uncle
6 Older brother or sister
7 Other relative
8 Other adult who is not related to me
98 Refuse to Answer
A-Par
The following questions have to do with the kinds of things that you and your mother and father may have talked about or done together in the past six months. If there is someone else who cares for you instead of your mother and father, think of this person or persons when answering the following questions.
PAR1. When was the last time that you talked with your mom about what you were going to do for the coming day? (Choose one)
1 More than 1 month ago
2 Within last month
3 Within last week
4 Yesterday/today
5 Don't Know
8 Refuse to Answer
PAR2. When was the last time that you talked with your dad about what you were going to do for the coming day? (Choose one)
1 More than 1 month ago
2 Within last month
3 Within last week
4 Yesterday/today
5 Don't Know
8 Refuse to Answer
PAR3. How often did your mom talk to you about what you were going to do for the coming day? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR4. How often did your dad talk to you about what you were going to do for the coming day? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR5. When was the last time that you talked with your mom about what you had actually done during the day? (Choose one)
1 More than 1 month ago
2 Within last month
3 Within last week
4 Yesterday/today
5 Don't Know
8 Refuse to Answer
PAR6. When was the last time that you talked with your dad about what you had actually done during the day? (Choose one)
1 More than 1 month ago
2 Within last month
3 Within last week
4 Yesterday/today
5 Don't Know
8 Refuse to Answer
PAR7. How often did your mom talk with you about what you had actually done during the day? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR8. How often did your dad talk with you about what you had actually done during the day? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR9. How often did your mom talk with you about how things are going in school? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR10. How often did your dad talk with you about how things are going in school? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR11. In a typical week, what is the latest you can stay out on SCHOOL NIGHTS without supervision (Mon.-Thur.)? (Choose one)
1 I am not allowed out
2 Before 8:00pm
3 8:00 to 8:59pm
4 9:00 to 9:59pm
5 10:00 to 10:59pm
6 11:00pm or later
7 As late as I want
8 Refuse to Answer
PAR12. In a typical week, what is the latest you can stay out on FRIDAY and SATURDAY NIGHTS without supervision? (Choose one)
01 I am not allowed out
02 Before 9:00pm
03 9:00 to 9:59pm
04 10:00 to 10:59pm
05 11:00 to 11:59pm
06 12:00 to 12:59am
07 1:00 to 1:59am
08 After 2:00am
09 As late as I want
98 Refuse to Answer
PAR13. If you did not come home by the time that you were supposed to be in, would your parent(s) know? (Choose one)
0 No 1 Maybe 2 Certainly 8 Refuse to Answer
PAR14. If your parent(s) are not at home, do you leave a note for them or call them about where are you going? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR15. Do your parent(s) know who you are with when you are away from home? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR16. When you are out, do your parent(s) know what time you will be home? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR17. When your parents are not at home, do you know how to get in touch with them? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR18. Where do you usually go right after school? More than one response may be selected. (Check all that apply)
__ Home, supervised (adult or responsible minor present)
__ Home, unsupervised
__ Somewhere else, supervised (adult or responsible minor present)
__ Somewhere else, unsupervised
__ Somewhere else, don't know if supervised
__ Other
__ Don't know
__ Refuse to Answer
PAR19. Where do you usually go in the evening? More than one response may be selected. (Check all that apply)
__ Home, supervised (adult or responsible minor present)
__ Home, unsupervised
__ Somewhere else, supervised (adult or responsible minor present)
__ Somewhere else, unsupervised
__ Somewhere else, don't know if supervised
__ Other
__ Don't know
__ Refuse to Answer
PAR20. Where do you usually go on the weekends? More than one response may be selected. (Check all that apply)
__ Home, supervised (adult or responsible minor present)
__ Home, unsupervised
__ Somewhere else, supervised (adult or responsible minor present)
__ Somewhere else, unsupervised
__ Somewhere else, don't know if supervised
__ Other
__ Don't know
__ Refuse to Answer
PAR21. How many of your friends does your mom know? (Choose one) 0 none of my friends
1 some of my friends
2 most of my friends
3 all of my friends
4 Don't Know
8 Refuse to Answer
PAR22. How many of your friends does your dad know? (Choose one) 0 none of my friends
1 some of my friends
2 most of my friends
3 all of my friends
4 Don't Know
8 Refuse to Answer
PAR23. How often do you have a friendly chat with your mom? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR24. How often do you have a friendly chat with your dad? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR25. How often does your mom find time to listen to you when you want to talk to her? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR26. How often does your dad find time to listen to you when you want to talk to him? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR27. How often do you and your mom do things together at home? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR28. How often do you and your dad do things together at home? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR29. On weekdays, how often do you do something together with your mom like making something, playing a game, talking or going out together? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR30. And on weekend days? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR31. On weekdays, how often do you do something together with your dad like making something, playing a game, talking or going out together? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR32. And on weekend days? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR33. Do you like spending time with your mom? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR34. Do you like spending time with your dad? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR35. How often do you help your mom? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR36. How often do you help your dad? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR37. How often would you rather be with your friends than with your family? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR38. How often do you help to plan a family activity? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR39. How often do you like to do things together with the family? (Choose one) 1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR40. How often do you go out with members of the family to movies, sports events, or other outings? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR41. How often do you go with members of the family to Church, Synagogue, or Sunday School? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR42. When you have done something that your parents like or approve of, how often does your mother not say anything about it, or ignore it? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR43. When you have done something that your parents like or approve of, how often does your father not say anything about it, or ignore it? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR44. When you have done something that your parents like or approve of, how often does your mother give you a wink or a smile? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR45. When you have done something that your parents like or approve of, how often does your father give you a wink or a smile? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR46. When you have done something that your parents like or approve of, how often does your mother say something nice about it; praise or approval? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR47. When you have done something that your parents like or approve of, how often does your father say something nice about it; praise or approval? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR48. When you have done something that your parents like or approve of, how often does your mother give you a hug, pat on the back, or kiss for it? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR49. When you have done something that your parents like or approve of, how often does your father give you a hug, pat on the back, or kiss for it? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR50. When you have done something that your parents like or approve of, how often does your mother give you some reward for it, like a present, extra allowance or something special to eat? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR51. When you have done something that your parents like or approve of, how often does your father give you some reward for it, like a present, extra allowance or something special to eat? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR52. When you have done something that your parents like or approve of, how often does your mother give you some special privilege such as staying up late, watching TV, or doing some special activity? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR53. When you have done something that your parents like or approve of, how often does your father give you some special privilege such as staying up late, watching TV, or doing some special activity? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR54. When you have done something that your parents like or approve of, how often does your mother do something special together with you, such as going to the movies, to a game, playing a game or going somewhere special? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR55. When you have done something that your parents like or approve of, how often does your father do something special together with you, such as going to the movies, to a game, playing a game or going somewhere special? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR56. When you have done something that your parents like or approve of, how often does your mother mention it to someone else? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR57. When you have done something that your parents like or approve of, how often does your father mention it to someone else? (Choose one)
1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR58. When you have done something that your parents like or approve of, how often does your mother ask you why you are not always good like this? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR59. When you have done something that your parents like or approve of, how often does your father ask you why you are not always good like this? (Choose one) 1 Almost never
2 Sometimes
3 Often
8 Refuse to Answer
9 Not Applicable
PAR60. Is there something else that your parents do when you do something they like?
1 Yes 0 No 8 Refuse to Answer
Now I'd like you to answer some questions about how you have felt about your mother/father in the past six months. Remember that if there is someone else who cares for you instead of your mother and father, think of this person or persons when answering the following questions.
PAR61. In the past 6 months, how often have you thought your mother was really good? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR62. In the past 6 months, how often have you thought your father was really good? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR63. In the past 6 months, how often have you thought your mother really bugged you a lot? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR64. In the past 6 months, how often have you thought your father really bugged you a lot? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR65. In the past 6 months, how often have you felt proud of your mother? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR66. In the past 6 months, how often have you felt proud of your father? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR67. In the past 6 months, how often have you wished that you had a different mother? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR68. In the past 6 months, how often have you wished that you had a different father? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR69. In the past 6 months, how often have you thought that your mother gave you problems? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR70. In the past 6 months, how often have you thought that your father gave you problems? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR71. In the past 6 months, how often have you felt that your mother was easy to get along with? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR72. In the past 6 months, how often have you felt that your father was easy to get along with? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR73. In the past 6 months, how often have you felt that your mother loved you? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR74. In the past 6 months, how often have you felt that your father loved you? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR75. In the past 6 months, how often have you felt that your mother was too strict or hard on you? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR76. In the past 6 months, how often have you felt that your father was too strict or hard on you? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR77. In the past 6 months, how often have you wished that your mother would just leave you alone? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR78. In the past 6 months, how often have you wished that your father would just leave you alone? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR79. In the past 6 months, how often have you liked being your mother's kid? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR80. In the past 6 months, how often have you liked being your father's kid? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR81. In the past 6 months, how often have you felt that your mother was happy? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR82. In the past 6 months, how often have you felt that your father was happy? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR83. In the past 6 months, how often have you felt that when your mother said something, she really meant it? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR84. In the past 6 months, how often have you felt that when your father said something, he really meant it? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR85. In the past 6 months, how often have you felt that when your mother punished you, you got the punishment that you deserved? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR86. In the past 6 months, how often have you felt that when your father punished you, you got the punishment that you deserved? (Choose one)
1 Almost never
2 Sometimes
3 Often
4 Not applicable
5 Don't Know
8 Refuse to Answer
PAR87. How many things would you like to change about your mother? (Choose one)
0 Nothing 1 A few things 2 A lot of things 8 Refuse to Answer
PAR88. How many things would you like to change about your father? (Choose one)
0 Nothing 1 A few things 2 A lot of things 8 Refuse to Answer
PAR89. Over the past 6 months, how well did you get along with your mother? (Choose one)
01 Not so well
02 Okay
03 Well
09 Not applicable
08 Refuse to Answer
PAR90. Over the past 6 months, how well did you get along with your father? (Choose one)
01 Not so well
02 Okay
03 Well
09 Not applicable
08 Refuse to Answer
PAR91. If your mother asks you to do something and you don't do it right away, does she give up trying to get you to do it? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR92. If your father asks you to do something and you don't do it right away, does he give up trying to get you to do it? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR93. If your mother warns you that you will get punished if you don't stop doing something, does she do what she says and punish you? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR94. If your father warns you that you will get punished if you don't stop doing something, does he do what he says and punish you? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR95. If, as a punishment you were grounded for a period of time, would your mother let you go out before the time is up? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR96. If, as a punishment you were grounded for a period of time, would your father let you go out before the time is up? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR97. If your mother had planned some punishment for you, could you talk her out of it? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR98. If your father had planned some punishment for you, could you talk him out of it? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR99. Does your mother let you get away with things for which you could have been punished? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR100. Does your father let you get away with things for which you could have been punished? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR101. Does your mother sometimes punish you for something and at other times not punish you for the same thing? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR102. Does your father sometimes punish you for something and at other times not punish you for the same thing? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR103. In general, do you feel that your mother is fair about disciplining you? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR104. In general, do you feel that your father is fair about disciplining you? (Choose one)
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR105. Do your parents disagree about how to discipline you? (Choose one) 1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR106. Who really has the
final say about things that affect you, e.g. discipline, staying out
late, getting special privileges, etc.?
Mark Not
Applicable if you have only 1 parent or caretaker. (Choose one)
1 My father (male caretaker) only
2 Mostly my father (male caretaker)
3 My father and mother equally
4 Mostly my mother (female caretaker)
5 My mother (female caretaker) only
6 All three of us
7 I decide what I should do
98 Refuse to Answer
99 Not Applicable
PAR106a. Who really has the
final say about things that affect you, e.g. discipline, staying out
late, getting special privileges, etc.?
Mark Not
Applicable if you have 2 parents or caretakers.
(Choose
one) 07 I decide what I
should do
10 My parent
11 My parent and I
98 Refuse to Answer
99 Not Applicable
PAR107. When you have done something wrong, is there a difference in the kind of punishment you get depending on whether your mother is in a good or bad mood? (Choose one)
0 No difference 1 Some difference 2 Big difference 8 Refuse to Answer
PAR108. When you have done something wrong, is there a difference in the kind of punishment you get depending on whether your father is in a good or bad mood? (Choose one)
0 No difference 1 Some difference 2 Big difference 8 Refuse to Answer
PAR109. If you do something that you are not allowed to do or that your parents don't like, does your mother take away a privilege or pocket money? (Choose one) 0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR110. If you do something that you are not allowed to do or that your parents don't like, does your father take away a privilege or pocket money? (Choose one) 0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR111. If you do something that you are not allowed to do or that your parents don't like, does your mother send you out of the room? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR112. If you do something that you are not allowed to do or that your parents don't like, does your father send you out of the room? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR113. If you do something that you are not allowed to do or that your parents don't like, does your mother yell or scold? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR114. If you do something that you are not allowed to do or that your parents don't like, does your father yell or scold? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR115. If you do something that you are not allowed to do or that your parents don't like, does your mother calmly discuss what happened? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR116. If you do something that you are not allowed to do or that your parents don't like, does your father calmly discuss what happened? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR117. If you do something that you are not allowed to do or that your parents don't like, does your mother ignore it or not pay attention to it? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR118. If you do something that you are not allowed to do or that your parents don't like, does your father ignore it or not pay attention to it? (Choose one)
0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR119. If you do something that you are not allowed to do or that your parents don't like, does your mother slap or spank or hit you with something? (Choose one) 0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR120. If you do something that you are not allowed to do or that your parents don't like, does your father slap or spank or hit you with something? (Choose one) 0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR121. If you do something that you are not allowed to do or that your parents don't like, does your mother tell you to get out or lock you out of the house for a while? (Choose one) 0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR122. If you do something that you are not allowed to do or that your parents don't like, does your father tell you to get out or lock you out of the house for a while? (Choose one) 0 Nothing
1 Almost never
2 Sometimes
3 Almost always
8 Refuse to Answer
9 Not Applicable
PAR123. Is there something else that your parents do when you do something they do not like?
1 Yes 0 No 8 Refuse to Answer
Adolescent - Parent Relationship With Peer Group
PER1. Do your parents know any of your friends? 1 Yes
0 No
8 Refuse to Answer
PER2. How well do your parents know your best friends? (Choose one) 1 Not at all
2 A little bit
3 Somewhat well
4 Pretty well
5 Extremely well
8 Refuse to Answer
PER3. How often during a typical week do your parents supervise you and your best friends spending time together? (Choose one)
1 Not at all
2 A little bit
3 Somewhat often
4 Pretty often
5 Extremely often
8 Refuse to Answer
PER4. How often during a typical week do your parents spend time talking with you about your friends? (Choose one)
1 Not at all
2 A little bit
3 Somewhat often
4 Pretty often
5 Extremely often
8 Refuse to Answer
PER5. How well do your parents know the PARENTS of your best friends? (Choose one)
1 Not at all
2 A little bit
3 Somewhat well
4 Pretty well
5 Extremely well
8 Refuse to Answer
PER6. How often during a typical week do your parents see or talk to the PARENTS of your best friends? (Choose one)
1 Not at all
2 A little bit
3 Somewhat often
4 Pretty often
5 Extremely often
8 Refuse to Answer
A-SSAS
Below are some questions about how kids your age are treated by their family, their friends and their teachers and how they might feel about being treated that way.
SSA1. Can you count on your family for help or advice when you have problems? (Choose one)
1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA2. Do you and your family do a lot of things for each other? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA3. Does your family make you feel bad? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA4. Do you share a lot with your family? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA5. Do you have a hard time talking to your family? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA6. Do you feel like your family is never there when you need them? (Choose one)
1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA7. Do you feel left out by your family? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA8. Does your family listen to you? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA9. Are you an important member of your family? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA10. Do you think your family cares about you? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA11. Do you feel like you don't belong in your family? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA12. Do you feel left out by your friends? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA13. Are you well-liked by your fiends? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA14. Do you get picked on and teased by your friends? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA15. Do your friends make fun of you? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA16. Do your friends like to hear your ideas? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA17. Do you and your friends do a lot of things for each other? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA18. Do you feel very close to your friends? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA19. Can you count on your friends for help or advice when you have problems? (Choose one)
1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA20. Do you think your friends care about you? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA21. Do your friends make you feel bad? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA22. Do you feel like you don't belong in your class (at school)? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA23. Do you feel left out by your class? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA24. Do you feel like nobody in your class cares about you? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA25. Are you well-liked by your classmates? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA26. In your class, do kids do a lot of things for each other? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA27. Do you think your teacher cares about you? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA28. Are your teachers good to ask for help or advice about your problems? (Choose one)
1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA29. Do you feel very close to your teachers? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA30. Do your teachers make you feel like you are not good enough? (Choose one)
1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
SSA31. Do you have a hard time talking to your teachers? (Choose one) 1 Never
2 Hardly Ever
3 Sometimes
4 Most of the Time
5 Always
8 Refuse to Answer
Bonds with School
For each of the following statements, please decide how true each statement is for you.
BWS1. Most mornings I look forward to going to school. (Choose one) 1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
BWS2. I feel safe at my school. (Choose one) 1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
BWS3. My school is a nice place to be. (Choose one) 1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
BWS4. I like to take part in class discussions and activities. (Choose one) 1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
BWS5. I feel sure about how to do my work at school. (Choose one) 1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
BWS6. Doing well at school is important to me. (Choose one) 1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
BWS7. Kids at my school have a good chance to grow up and be successful. (Choose one)
1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
BWS8. I like my classes this year. (Choose one) 1 Almost never or never true
2 Sometimes true
3 Often true
4 Almost always or always true
8 Refuse to Answer
A-FamRel
The following questions have to do with families. We want to know how much each one is true about your family. Click on the item that indicates how true each one is about your family in your opinion.
FAM1. Family members feel very close to each other. (Choose one) 1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM2. My family expects too much of me. (Choose one) 1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM3. We can easily think of things to do together as a family. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM4. I have trouble accepting someone else's answer to a family problem. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM5. My family and I have the same views about what is right and wrong. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM6. My family doesn't let me be myself. (Choose one) 1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM7. Family members ask each other for help. (Choose one) 1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM8. I often don't understand what other family members are saying. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM10. I listen to what other family members have to say, even when I disagree. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM11. Family members like to spend free time with each other. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM12. I am tired of being blamed for family problems. (Choose one) 1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM14. If someone in the family has upset me, I keep it to myself. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM15. I am available when others in the family want to talk to me. (Choose one)
1 Not at all true
2 Hardly ever true
3 True a lot
4 Almost always or always true
8 Refuse to Answer
FAM16. Family togetherness is very important. (Choose one) 1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM17. Kids should value a close relationship with their family and not have to be asked to spend time at home. (Choose one)
1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM18. No matter what, family members should stick together. (Choose one) 1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM19. Family members should be able to speak their minds with one another. (Choose one)
1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM20. Parents should teach their children what they need to know to make it in the world. (Choose one)
1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM21. Children should always talk to their parents with respect. (Choose one) 1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM22. Kids should obey their parents even when they don't agree with them. (Choose one)
1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM23. Parents should expect kids my age to do some work around the house. (Choose one)
1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM24. Kids my age should call home if they think they might be late. (Choose one) 1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
FAM25. Kids my age should clean up for themselves without having to be told. (Choose one)
1 Strongly Disagree
2 Disagree
3 Agree
4 Strongly Agree
8 Refuse to Answer
A-Pac, Barnes-Olson
We are now going to ask you some questions about how well you communicate with your mother and father. Please tell us to what extent you agree that each statement describes your current relationship with your parent/s. Please remember that no one [including your parents] will know your answers to these questions.
PAC1. I can discuss my beliefs with my mother without feeling restrained or embarrassed. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC3. Sometimes I have trouble believing everything my mother tells me. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC5. My mother is always a good listener. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC7. I am sometimes afraid to ask my mother for what I want. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC9. My mother has a tendency to say things to me which would be better left unsaid. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC11. My mother can tell how I'm feeling without asking. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC13. I am very satisfied with how my mother and I talk together. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC15. If I were in trouble, I could tell my mother. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC17. I openly show affection to my mother. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC19. When we are having a problem, I often give my mother the silent treatment. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC21. I am careful about what I say to my mother. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC23. When talking to my mother, I have a tendency to say things that would be better left unsaid. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC25. When I ask questions, I get honest answers from my mother. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC27. My mother tries to understand my point of view. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC29. There are topics I avoid discussing with my mother. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC31. I find it easy to discuss problems with my mother. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC33. It is very easy for me to express all my true feelings to my mother. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC35. My mother nags/bothers me. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC37. My mother insults me when she is angry with me. (Choose one) 1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
PAC39. I don't think I can tell my mother how I really feel about some things. (Choose one)
1 Strongly Disagree
2 Moderately Disagree
3 Neither Agree nor Disagree
4 Moderately Agree
5 Strongly Agree
8 Refuse to Answer
9 Not Applicable
Identity Style Inventory
For each of the following statements, please decide how true each statement is for you.
ISI1. I change my opinion of myself a lot. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI2. I've got a clear idea of what I want to be. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI3. I feel mixed up. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI4. The important things in life are clear to me. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI5. I've got it together. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI6. I know what kind of person I am. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI7. I can't decide what I want to do with my life. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI8. I have a strong sense of what it means to be a boy or a girl. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI9. I like myself and am proud of what I stand for. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI10. I don't really know who I am. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI11. I work to keep up a certain image when I'm with people. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
ISI12. I don't really feel involved. (Choose one) 1 Not at all true
2 Not really true
3 Not sure
4 A little true
5 Very much true
8 Refuse to Answer
Multicultural Ethnic Identity Measure
In this country, people come from many different countries and cultures, and there are many different words to describe the different backgrounds or ethnic groups that people come from. Some examples of the names of ethnic groups are Hispanic or Latino, Black or African American, Asian American, Chinese, Filipino, American Indian, Mexican American, Caucasian or White, Italian American, and many others. These questions are about your ethnicity or your ethnic group and how you feel about it or react to it.
MEI1. In terms of ethnic group, I consider myself to be ________________.
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
MEI2. I have spent time trying to find out more about my ethnic group, such as its history, traditions, and customs. (Choose one)
1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI3. I am active in organizations or social groups that include mostly members of my own ethnic group. (Choose one)
1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI4. I have a clear sense of my ethnic background and what it means for me. (Choose one)
1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI5. I think a lot about how my life will be affected by my ethnic group membership. (Choose one)
1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI6. I am happy that I am a member of the group I belong to. (Choose one) 1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI7. I have a strong sense of belonging to my own ethnic group. (Choose one) 1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI8. I understand pretty well what my ethnic group membership means to me. (Choose one)
1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI9. In order to learn more about my ethnic background, I have often talked to other people about my ethnic group. (Choose one)
1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI10. I have a lot of pride in my ethnic group. (Choose one) 1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI11. I participate in cultural practices of my own group, such as special food, music, or customs. (Choose one)
1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI12. I feel a strong attachment towards my own ethnic group. (Choose one) 1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI13. I feel good about my cultural or ethnic background. (Choose one) 1 Strongly Disagree
2 Disagree
3 Neutral
4 Agree
5 Strongly agree
8 Refuse to Answer
MEI14. My ethnicity is: (Choose one)
1 Asian or Asian American, including Chinese, Japanese, and others
2 Black or African American
3 Hispanic or Latino, including Mexican American, Central American, and others
4 White, Caucasian, Anglo, European American; not Hispanic
5 American Indian/Native American
6 Mixed; Parents are from two different groups
7 Other
8 Refuse to Answer
MEI15. My father's ethnicity is: (Choose one)
1 Asian or Asian American, including Chinese, Japanese, and others
2 Black or African American
3 Hispanic or Latino, including Mexican American, Central American, and others
4 White, Caucasian, Anglo, European American; not Hispanic
5 American Indian/Native American
6 Mixed; Parents are from two different groups
7 Other
8 Refuse to Answer
MEI16. My mother's ethnicity is: (Choose one)
1 Asian or Asian American, including Chinese, Japanese, and others
2 Black or African American
3 Hispanic or Latino, including Mexican American, Central American, and others
4 White, Caucasian, Anglo, European American; not Hispanic
5 American Indian/Native American
6 Mixed; Parents are from two different groups
7 Other
8 Refuse to Answer
Youth Self Report Measure
Below is a list of items that describe kids. For each item that describes you now or within the past 6 months, please decide if the item is very true or often true of you or somewhat or sometimes true of you. If the item does not describe you, choose not true.
YSR1. I act too young for my age. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR2. I drink alcohol without my parents' approval. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR3. I argue a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR4. I fail to finish things that I start. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR5. There is very little that I enjoy. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR6. I like animals. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR7. I brag. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR8. I have trouble concentrating or paying attention. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR9. I can't get my mind off certain thoughts. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR10. I have trouble sitting still. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR11. I'm too dependent on adults. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR12. I feel lonely. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR13. I feel confused or in a fog. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR14. I cry a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR15. I am pretty honest. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR16. I am mean to others. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR17. I daydream a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR18. I deliberately try to hurt or kill myself. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR19. I try to get a lot of attention. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR20. I destroy my own things. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR21. I destroy things belonging to others. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR22. I disobey my parents. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR23. I disobey at school. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR24. I don't eat as well as I should. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR25. I don't get along with other kids. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR26. I don't feel guilty after doing something I shouldn't. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR27. I am jealous of others. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR28. I break rules at home, school, or elsewhere. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR29. I am afraid of certain animals, situations, or places, other than school. (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR30. I am afraid of going to school. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR31. I am afraid I might think or do something bad. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR32. I feel that I have to be perfect. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR33. I feel that no one loves me. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR34. I feel that others are out to get me. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR35. I feel worthless or inferior. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR36. I accidentally get hurt a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR37. I get in many fights. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR38. I get teased a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR39. I hang around with kids who get in trouble. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR40. I hear sounds or voices that other people think aren't there. (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR41. I act without stopping to think. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR42. I would rather be alone than with others. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR43. I lie or cheat. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR44. I bite my fingernails. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR45. I am nervous or tense. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR46. Parts of my body twitch or make nervous movements. (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR47. I have nightmares. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR48. I am not liked by other kids. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR49. I can do certain things better than most kids. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR50. I am too fearful or anxious. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR51. I feel dizzy or lightheaded. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR52. I feel too guilty. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR53. I eat too much. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR54. I feel overtired without good reason. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR55. I am overweight. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR56. I have a physical problem without known medical cause: Aches or pains (not stomach or headaches) (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR56a. I have a physical problem without known medical cause: Headaches (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR56b. I have a physical problem without known medical cause: Nausea, feel sick (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR56c. I have a physical problem without known medical cause: Problems with eyes (not if corrected by glasses) (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR56d. I have a physical problem without known medical cause: Rashes or other skin problems (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR56e. I have a physical problem without known medical cause: Stomachaches (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR56f. I have a physical problem without known medical cause: Vomiting, throwing up (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR57. I physically attack people. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR58. I pick my skin or other parts of my body. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR59. I can be pretty friendly. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR60. I like to try new things. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR61. My school work is poor. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR62. I am poorly coordinated or clumsy. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR63. I would rather be with older kids than kids my own age. (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR64. I would rather be with younger kids than kids my own age. (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR65. I refuse to talk. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR66. I repeat certain acts over and over. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR67. I run away from home. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR68. I scream a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR69. I am secretive or keep things to myself. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR70. I see things that other people think aren't there. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR71. I am self-conscious or easily embarrassed. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR72. I set fires. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR73. I can work well with my hands. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR74. I show off or clown. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR75. I am too shy or timid. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR76. I sleep less than most kids. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR77. I sleep more than most kids during day and/or night. (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR78. I am inattentive or easily distracted. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR79. I have a speech problem. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR80. I stand up for my rights. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR81. I steal at home. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR82. I steal from places other than home. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR83. I store up too many things I don't need. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR84. I do things other people think are strange. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR85. I have thoughts that other people would think are strange. (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR86. I am stubborn. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR87. My moods or feelings change suddenly. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR88. I enjoy being with people. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR89. I am suspicious. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR90. I swear or use dirty language. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR91. I think about killing myself. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR92. I like to make others laugh. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR93. I talk too much. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR94. I tease others a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR95. I have a hot temper. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR96. I think about sex too much. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR97. I threaten to hurt people. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR98. I like to help others. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR99. I smoke, chew, or sniff tobacco. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR100. I have trouble sleeping. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR101. I cut classes or skip school. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR102. I don't have much energy. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR103. I am unhappy, sad, or depressed. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR104. I am louder than other kids. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR105. I use drugs for nonmedical purposes (don't include alcohol or tobacco) (Choose one)
0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR106. I like to be fair to others. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR107. I enjoy a good joke. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR108. I like to take life easy. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR109. I try to help other people when I can. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR110. I wish I were of the opposite sex. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR111. I keep from getting involved with others. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
YSR112. I worry a lot. (Choose one) 0 Not true
1 Somewhat or Sometimes true
2 Very true or Often true
8 Refuse to Answer
PRELIMINARY DATA -- DRUGS AD=Adolescent
PRE1. Please enter the Respondent's ID __ __ __ __ ID
PRE2. Enter the timepoint [PLEASE ENTER TIMEPOINT BETWEEN 1 AND 5] __ Time Point
PRE3. Please enter your Site ID. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
PRE4. Please enter your interviewer ID. __ __ Interviewer
ATTITUDES TOWARD DRUGS
The next several questions are about your attitudes and your friends' attitudes toward cigarettes, alcohol, and other drugs. Check the answer that is closest to how you feel about what the sentence says. Please remember that your answers to these questions will be kept secret. No one (including your parents) will know your answers.
DGA1. If I use alcohol or drugs, I will have more health problems than other people. (Choose one)
1 Disagree a lot
2 Disagree
3 Agree
4 Agree a lot
8 Refuse to Answer
DGA2. If I don't use alcohol or drugs I will be happier. (Choose one) 1 Disagree a lot
2 Disagree
3 Agree
4 Agree a lot
8 Refuse to Answer
DGA3. Smoking cigarettes fits with the kind of life I want to lead. (Choose one) 1 Disagree a lot
2 Disagree
3 Agree
4 Agree a lot
8 Refuse to Answer
DGA4. Getting drunk every now and then fits with the kind of life I want to lead. (Choose one)
1 Disagree a lot
2 Disagree
3 Agree
4 Agree a lot
8 Refuse to Answer
DGA5. Drugs do/would help me function at parties. (Choose one) 1 Disagree a lot
2 Disagree
3 Agree
4 Agree a lot
8 Refuse to Answer
DGA6. My friends think people who use drugs are stupid. (Choose one) 1 Disagree a lot
2 Disagree
3 Agree
4 Agree a lot
8 Refuse to Answer
DGA7. My friends think it is cool to get drunk. (Choose one) 1 Disagree a lot
2 Disagree
3 Agree
4 Agree a lot
8 Refuse to Answer
The next questions ask for your opinion on the effects of using certain drugs and other substances.
DGA8. How much do you think people risk harming themselves (physically or in other ways), if they try cigarettes once or twice? (Choose one)
1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA9. How much do you think people harm themselves (physically or in other ways), if they smoke cigarettes occasionally? (Choose one)
1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA10. How much do you think people risk harming themselves (physically or in other ways), if they try alcoholic beverages (beer, wine, liquor) once or twice? (Choose one) 1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA11. How much do you think people risk harming themselves (physically or in other ways), if they drink alcoholic beverages (beer, wine, liquor) occasionally. (Choose one) 1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA12. How much do you think people risk harming themselves (physically or in other ways), if they try marijuana once or twice? (Choose one)
1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA13. How much do you think people risk harming themselves (physically or in other ways), if they smoke marijuana cigarettes occasionally? (Choose one)
1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA14. How much do you think people harm themselves (physically or in other ways), if they try other drugs (like crack, cocaine, heroin, and pills) once or twice? (Choose one) 1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA15. How much do you think people risk harming themselves (physically or in other ways), if they take other drugs (like crack, cocaine, heroin and pills) occasionally? (Choose one) 1 Can't say/Don't know drug
2 Great Risk
3 Moderate Risk
4 Slight Risk
5 No Risk
8 Refuse to Answer
DGA16. How many times in the last year have you tried to talk with your parents about drug prevention? (Choose one)
1 None
2 Once
3 2-4 times
4 More than 4 times
8 Refuse to Answer
DGA17. How many times in the last year have you tried to talk with close friends about drug prevention? (Choose one)
1 None
2 Once
3 2-4 times
4 More than 4 times
8 Refuse to Answer
DGA18. How many times in the last year have you tried to talk with your teachers about drug prevention? (Choose one)
1 None
2 Once
3 2-4 times
4 More than 4 times
8 Refuse to Answer
DGA19. How many times in the last year have you tried to talk with others about drug prevention? (Choose one)
1 None
2 Once
3 2-4 times
4 More than 4 times
8 Refuse to Answer
PERCEPTIONS ABOUT DRUGS
The following questions have to do with what different people think about smoking, alcohol, and other drugs. Please remember that your answers to these questions will be kept secret. No one (including your parents) will know your answers to these questions.
DGP1. How would your parents feel if they found out you drank alcohol sometimes? (Choose one)
1 They would not be upset at all
2 They would be a little upset
3 They would be pretty upset
4 They would be very upset
8 Refuse to Answer
DGP2. If your friends found out that you drank sometimes, how do you think they'd feel? (Choose one)
1 They would approve
2 They would disapprove but still be my friends
3 They would disapprove and stop being my friends
4 They wouldn't care
8 Refuse to Answer
DGP3. How much would your teachers disapprove if they found out that you were using alcohol? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP4. How much would others disapprove if they found out that you were using alcohol? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP5. How would your parents feel if they found out you smoked cigarettes or used chewing tobacco, snuff or dip sometimes? (Choose one)
1 They would not be upset at all
2 They would be a little upset
3 They would be pretty upset
4 They would be very upset
8 Refuse to Answer
DGP6. If your friends found out that you smoked cigarettes or used chewing tobacco, snuff or dip, how do you think they'd feel? (Choose one)
1 They would approve
2 They would disapprove but still be my friends
3 They would disapprove and stop being my friends
4 They wouldn't care
8 Refuse to Answer
DGP7. How much would your teachers disapprove if they found out that you were smoking cigarettes? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP8. How much would others disapprove if they found out that you were smoking cigarettes? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP9. How would your parents feel if they found out you used marijuana sometimes? (Choose one)
1 They would not be upset at all
2 They would be a little upset
3 They would be pretty upset
4 They would be very upset
8 Refuse to Answer
DGP10. If your friends found out that you used marijuana sometimes, how do you think they'd feel? (Choose one)
1 They would approve
2 They would disapprove but still be my friends
3 They would disapprove and stop being my friends
4 They wouldn't care
8 Refuse to Answer
DGP11. How much would your teachers disapprove if they found out that you were smoking marijuana? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP12. How much would others disapprove if they found out that you were smoking marijuana? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP13. How much would your parents disapprove if they found out that you were using other drugs? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP14. How much would your close friends disapprove if they found out that you were using other drugs? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP15. How much would your teachers disapprove if they found out that you were using other drugs? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
DGP16. How much would others disapprove if they found out that you were using other drugs? (Choose one)
1 Very much
2 Somewhat
3 A little
4 Not at all
8 Refuse to Answer
The next few questions cover your feelings about alcohol and drugs.
DGP33. Pretend your best friend offered you a cigarette and you did not want it. How hard would it be to say "no"? (Choose one)
1 Not hard at all
2 Not very hard
3 Pretty hard
4 Very hard
8 Refuse to Answer
DGP34. Pretend your best friend offered you a drink of beer or wine and you did not want it. How hard would it be to say "no"? (Choose one)
1 Not hard at all
2 Not very hard
3 Pretty hard
4 Very hard
8 Refuse to Answer
DGP35. Pretend your best friend offered you some marijuana and you did not want it. How hard would it be to say "no"? (Choose one)
1 Not hard at all
2 Not very hard
3 Pretty hard
4 Very hard
8 Refuse to Answer
DGP36. Pretend your best friend offered you some other drug and you did not want it. How hard would it be to say "no"? (Choose one)
1 Not hard at all
2 Not very hard
3 Pretty hard
4 Very hard
8 Refuse to Answer
DRUG USE
We are now going to ask you some questions about cigarettes, alcohol, and drugs. Remember that no one (including your parents) will know your answers to these questions.
DGU1. Have you ever smoked cigarettes?
0 No Skip to DGU10
1 Yes
8 Refuse to Answer
DGU2. How old were you when you first started smoking cigarettes?
______years old
DGU3. Have you smoked cigarettes in the past 3 months?
1 Yes
0 No Skip to DGU10
8 Refuse to Answer
DGU4. Have you smoked cigarettes regularly (i.e., at least 1 cigarette every day) in the past 3 months?
1 Yes
0 No
8 Refuse to Answer
DGU5. During the past 3 months, on average, how many cigarettes did you smoke each day?
______cigarettes
DGU6. During the past 3 months, on how many days did you smoke cigarettes?
______days
DGU7. Have you smoked cigarettes in the past 30 days? 1 Yes
0 No Skip to DGU10
8 Refuse to Answer
DGU7a. Have you smoked cigarettes regularly (i.e., at least 1 cigarette every day) in the past 30 days?
1 Yes
0 No
8 Refuse to Answer
DGU8. During the past 30 days, on average, how many cigarettes did you smoke each day?
______cigarettes
DGU9. During the past 30 days, on how many days did you smoke cigarettes?
______days
DGU10. Have you ever had any beer, wine, wine coolers, or liquor to drink- more than just a few sips?
1 Yes
0 No Skip to DGU22
8 Refuse to Answer
DGU11. How old were you when you first started drinking, not counting small tastes or sips of alcohol?
_____ years old
DGU12. On how many occasions have you had alcohol to drink - more than just a few sips in your lifetime?
______occasions
DGU13. On how many occasions (if any) have you been drunk or very high from drinking alcoholic beverages in your life?
______occasions
DGU14. In the past 3 months, have you had any beer, wine, wine coolers, or liquor to drink- more than just a few sips?
1 Yes
0 No Skip to DGU22
8 Refuse to Answer
DGU15. On how many occasions have you had alcohol to drink - more than just a few sips in the past 3 months?
______occasions
DGU16. During the last 3 months, what was the LARGEST number of drinks that you drank in a single day?
___________drinks
DGU17. During the last 3 months, about how many days did you drink 5 or more drink in a single day if you are a male OR 4 or more drink in a single day if you are a female?
_____ Day(s)
DGU18. On how many occasions (if any) have you been drunk or very high from drinking alcoholic beverages in the past 3 months?
______occasions
DGU19. In the past 30 days, have you had any beer, wine, wine coolers, or liquor to drink- more than just a few sips?
1 Yes
0 No Skip to DGU22
8 Refuse to Answer
DGU20. On how many occasions have you had alcohol to drink - more than just a few sips in the past 30 days?
______occasions
DGU21. On how many occasions (if any) have you been drunk or very high from drinking alcoholic beverages in the past 30 days?
______occasions
DGU22. Have you ever used drugs? 1 Yes
0 No Skip to DGU38
8 Refuse to Answer
DGU23. How old were you when you tried drugs for the first time?
_____ years old
DGU24. On how many occasions (if any) have you used marijuana (weed, pot, grass) or hashish (hash, hash oil) during your lifetime?
__ __ __ Occasions
000 zero (if 0, program DGU29, DGU34 into 0) 998 Refuse to Answer
DGU25. On how many occasions (if any) have you used inhalants, such as glue or solvents in your lifetime?
__ __ __ Occasions
000 zero (if 0, program DGU30, DGU35 into 0)
998 Refuse to Answer
DGU26. On how many occasions (if any) have you taken cocaine in your lifetime?
__ __ __ Occasions
000 zero (if 0, program DGU31, DGU36 into 0)
998 Refuse to Answer
DGU27. On how many occasions (if any) have you taken any other type of illegal drug, such as LSD, PCP, ecstasy, mushrooms, speed, ice, heroin, in your lifetime?
__ __ __ Occasions
000 zero (if 0, program DGU32, DGU37 into 0)
998 Refuse to Answer
DGU28. Have you used drugs in the past 3 months? 1 Yes
0 No Skip to DGU38
8 Refuse to Answer
DGU29. On how many occasions (if any) have you used marijuana (weed, pot, grass) or hashish (hash, hash oil) during the past 3 months?
__ __ __ Occasions
000 zero (if 0, program DGU34 into 0)
998 Refuse to Answer
DGU30. On how many occasions (if any) have you used inhalants, such as glue or solvents in the past 3 months?
__ __ __ Occasions
000 zero (if 0, program DGU35 into 0)
998 Refuse to Answer
DGU31. On how many occasions (if any) have you taken cocaine in the past 3 months?
__ __ __ Occasions
000 zero (if 0, program DGU36 into 0)
998 Refuse to Answer
DGU32. On how many occasions (if any) have you taken any other type of illegal drug, such as LSD, PCP, ecstasy, mushrooms, speed, ice, heroin, in the past 3 months?
__ __ __ Occasions
000 zero (if 0, program DGU37 into 0)
998 Refuse to Answer
DGU33. Have you used drugs in the past 30 days? 1 Yes
0 No Skip to DGU38
8 Refuse to Answer
DGU34. On how many occasions (if any) have you used marijuana (weed, pot, grass) or hashish (hash, hash oil) during the past 30 days?
__ __ __ Occasions
998 Refuse to Answer
DGU35. On how many occasions (if any) have you used inhalants, such as glue or solvents in the past 30 days?
__ __ __ Occasions
998 Refuse to Answer
DGU36. On how many occasions (if any) have you taken cocaine in the past 30 days?
__ __ __ Occasions
000 zero
998 Refuse to Answer
DGU37. On how many occasions (if any) have you taken any other type of illegal drug, such as LSD, PCP, ecstasy, mushrooms, speed, ice, heroin, during the last 30 days?
__ __ __ Occasions
Refuse to Answer
DGU38. Have you ever, even once, taken a prescription drug without a prescription or taken more than what was prescribed?
1 Yes
0 No Skip to DGU45
8 Refuse to Answer
DGU39. How old were you the first time you took a prescription drug without a prescription or taken more than what was prescribed?
_____ years old
DGU40. On how many occasions have you taken a prescription drug without a prescription or taken more than what was prescribed, in your lifetime?
__ __ __ Occasions
Refuse to Answer
DGU41. Have you taken a prescription drug without a prescription or taken more than what was prescribed in the past 3 months?
1 Yes
0 No Skip to DGU45
8 Refuse to Answer
DGU42. On how many occasions (if any) have you taken a prescription drug without a prescription or taken more than what was prescribed, in the past 3 months?
__ __ __ Occasions
998 Refuse to Answer
DGU43. Have you taken a prescription drug without a prescription or taken more than what was prescribed in the past 30 days?
1 Yes
0 No Skip to DGU45
8 Refuse to Answer
DGU44. On how many occasions (if any) have you taken a prescription drug without a prescription or taken more than what was prescribed, in the past 30 days?
__ __ __ Occasions
998 Refuse to Answer
DGU45. How many of your friends have ever had any beer, wine, wine coolers, or liquor to drink - more than just a few sips? (Choose one)
0 None of them
1 All of them
2 Most of them
3 Some of them
4 Very few of them
7 Don't Know
8 Refuse to Answer
DGU46. How many of your friends have ever smoked cigarettes? (Choose one)
0 None of them
1 All of them
2 Most of them
3 Some of them
4 Very few of them
7 Don't Know
8 Refuse to Answer
DGU47. Have any of your friends ever used drugs? 1 Yes
0 No
7 Don't Know
8 Refuse to Answer
Preliminary Data AD=Adolescent
PRE1. Enter the Respondent's I.D. Number __ __ __ __ ID
PRE2. Enter the timepoint (PLEASE ENTER TIMEPOINTS BETWEEN 1 AND 5 ONLY PLEASE) __ Time Point
PRE3. Please enter your Site ID. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
PRE4. Please enter your interviewer ID. __ __ Interviewer
PRE5. Please indicate your gender. 1 Male
2 Female
PACS-F
I am going to read you some statements that describe how teenagers might feel about talking to their parent/parent figure about sex. Please tell me if you strongly disagree, disagree, agree, or strongly agree with each. Remember that your answers to these questions will be kept secret. No one (including your parents) will know your answers to these questions.
SXF1. (Ask of Women Only) My
(parent/parent figure) has talked to me about sex.
(A
parent figure is the person who is responsible for taking care of
me). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF2. (Ask of Women Only) I can discuss sex with my (parent/parent figure) without feeling embarrassed. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF3. (Ask of Women Only) If I were pregnant, I would tell my (parent/parent figure) (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF4. (Ask of Women Only) When I ask questions about sex, I get honest answers from my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF5. (Ask of Women Only) I am afraid to ask my (parent/parent figure) about sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF6. (Ask of Women Only) Sex is a topic I avoid discussing with my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF7. (Ask of Women Only) I find it easy to discuss sex with my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF8. (Ask of Women Only) If I had a sexually transmitted disease, I would tell my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF9. (Ask of Women Only) My (parent/parent figure) worries a lot about me getting pregnant. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF10. (Ask of Women Only) My (parent/parent figure) does not trust that I can make good decisions about sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF11. (Ask of Women Only) My (parent/parent figure) is always accusing me of having sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF12. (Ask of Women Only) My (parent/parent figure) has talked to me about HIV/AIDS. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF13. (Ask of Women Only) My (parent/parent figure) has talked to me about safe sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXF14. (Ask of Women Only) My (parent/parent figure) has talked to me about birth control. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
PACS-M
I am going to read you some statements that describe how teenagers might feel about talking to their parent/parent figure about sex. Please tell me if you strongly disagree, disagree, agree, or strongly agree with each. Remember that your answers to these questions will be kept secret. No one (including your parents) will know your answers to these questions.
SXM1. (Ask of Men Only) My (parent/parent figure) has talked to me about sex. (A parent figure is the person who is responsible for taking care of me). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM2. (Ask of Men Only) I can discuss sex with my (parent/parent figure) without feeling embarrassed. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM3. (Ask of Men Only) If I got a girl pregnant, I would tell my (parent/parent figure) (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM4. (Ask of Men Only) When I ask questions about sex, I get honest answers from my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM5. (Ask of Men Only) I am afraid to ask my (parent/parent figure) about sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM6. (Ask of Men Only) Sex is a topic I avoid discussing with my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM7. (Ask of Men Only) I find it easy to discuss sex with my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM8. (Ask of Men Only) If I had a sexually transmitted disease, I would tell my (parent/parent figure). (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM9. (Ask of Men Only) My (parent/parent figure) worries a lot about me getting a girl pregnant. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM10. (Ask of Men Only) My (parent/parent figure) does not trust that I can make good decisions about sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM11. (Ask of Men Only) My (parent/parent figure) is always accusing me of having sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM12. (Ask of Men Only) My (parent/parent figure) has talked to me about HIV/AIDS. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM13. (Ask of Men Only) My (parent/parent figure) has talked to me about safe sex. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
SXM14. (Ask of Men Only) My (parent/parent figure) has talked to me about birth control. (Choose one)
1 Strongly Agree
2 Agree
3 Disagree
4 Strongly Disagree
8 Refuse to Answer
ATTITUDES ABOUT SEX
The following questions ask how you feel about different behaviors. Please indicate how good or bad an idea it is to do the following, whether others would approve (think it is okay) or disapprove (think it is not okay) of the behavior, and whether you plan to do these behaviors in the next 3 months. Click on the answer that best describes your feelings. Please remember that no one (including your parents) will know your answers to these questions. Try to answer the questions even if you have not had sex or never used condoms.
SXA1. How do you feel about having sex in the next three months? (Choose one) 1 Very Bad Idea
2 Bad Idea
3 In the Middle
4 Good Idea
5 Very Good Idea
8 Refuse to Answer
SXA2. Would most people who are important to you approve or disapprove of you having sex in the next three months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA3. Would your sexual partner approve or disapprove of having sex with you in the next three months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA4. Would your mother approve or disapprove of you having sex in the next 3 months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA5. Would your father approve or disapprove of you having sex in the next 3 months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA6. Would your friends approve or disapprove of you having sex in the next 3 months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA7. How likely is it that you will decide to have sex in the next 3 months? (Choose one)
1 Very Unlikely
2 Unlikely
3 In the Middle
4 Likely
5 Very Likely
8 Refuse to Answer
SXA8. How do you feel about using a condom if you have sex in the next 3 months? (Choose one)
1 Very Bad Idea
2 Bad Idea
3 In the Middle
4 Good Idea
5 Very Good Idea
8 Refuse to Answer
SXA9. Would most people who are important to you approve or disapprove of you using a condom if you have sex in the next 3 months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA10. Would your sexual partner approve or disapprove of you using a condom if the two of you had sex in the next three months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA11. Would your mother approve or disapprove of you using a condom if you have sex in the next 3 months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA12. Would your father approve or disapprove of you using a condom if you have sex in the next 3 months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA13. Would your friends approve or disapprove of you using a condom if you have sex in the next 3 months? (Choose one)
1 Disapprove Strongly
2 Disapprove
3 In the Middle
4 Approve
5 Approve Strongly
8 Refuse to Answer
SXA14. How likely is it that you will decide to use a condom if you have sex in the next 3 months? (Choose one)
1 Very Unlikely
2 Unlikely
3 In the Middle
4 Likely
5 Very Likely
8 Refuse to Answer
How much do you agree with each of the following statements about sex?
SXA15. Not having sex will help me further my education. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA16. Not having sex will help me focus on getting a good job. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA17. Not having sex will help me feel proud of myself. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA18. If I do not have sex, people will call me names. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA19. If I do not have sex, boys and/or girls will not want to go out with me. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA20. If I do not have sex during my teenage years, I will be proud of myself. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA21. If I do not have sex, my parents will be proud of me. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
How much do you agree or disagree with each of the following statements about condoms? Try to answer the questions even if you have not had sex or have never used condoms.
SXA22. If I used a condom, sex would not feel as good. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA23. Condoms are embarrassing to use. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA24. Condoms help prevent STDs. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA25. Condoms help prevent pregnancy. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA26. Sex feels unnatural when a condom is used. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA27. Condoms help prevent AIDS. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA28. Condoms make you not want to have sex because you have to stop to put one on. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA29. When a condom is used, sex still feels good. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA30. When a condom is used, sex is more fun. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA31. A lot of times condoms break when you are using them. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
Try to answer the following questions even if you do not have a partner at this moment.
SXA32. Saying we have to use a condom would make my partner think I am having sex with other people. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA33. Saying we have to use a condom is like saying to my partner "I don't trust you". (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA34. My sexual partner is likely to break up with me if I said we had to use a condom. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Strongly Agree
8 Refuse to Answer
SXA35. My sexual partner would be happier if we used a condom. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Strongly Agree
8 Refuse to Answer
SXA36. If I had a condom with me, my partner would not like it. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA37. If I have sex during my teen years, I am likely to get pregnant/get someone pregnant. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA38. If I have sex without a condom, I am likely to [get pregnant/get someone pregnant] during my teen years. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA39. If I have sex, I am likely to get AIDS. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA40. If I have sex without a condom, I am likely to get AIDS. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA41. If I have sex during my teen years, then I am less likely to graduate from high school. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA42. If I have sex during my teen years, then I am less likely to have the career that I am hoping for. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA43. If I have sex before I am married, then God is likely to be angry at me. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA44. If I have sex during my teen years, then my parents will find out. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA45. If I have sex, and my parents find out, then they will be angry at me. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA46. If I do not have sex with my girlfriend/boyfriend, then she/he will break up with me. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA47. If I have sex, then I will be more popular with girls. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA48. If I have sex, then I will be more popular with boys. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA49. Condoms cost too much. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA50. It is easy for me to have a condom with me all the time. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA51. It is hard for me to get condoms. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA52. It is too much trouble to carry around condoms. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA53. I can get condoms. (Choose one) 1 Disagree strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA54. I can't talk to my partner about using condoms. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA55. I can get my partner to use a condom, even if she/he doesn't want to. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA56. I can say to my partner that we should use a condom. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA57. Before we are ready to have sex, I can talk to my partner about using a condom. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA58. I can put a condom on my partner/myself without turning him/her off. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA59. If I am sexually aroused, I can stop before sex to use a condom. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA60. I can say no to sex if my partner and I do not have a condom. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA61. I can stop sex to get a condom, if I do not have one. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA62. I can use a condom, even if the room is dark. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA63. I am sure that I can use a condom if I have sex. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Strongly Agree
8 Refuse to Answer
SXA64. I will try to get my sexual partner to use condoms if we have sex in the next 3 months. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA65. I plan to use condoms if I have sex in the next 3 months. (Choose one) 1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Agree Strongly
8 Refuse to Answer
SXA66. How old should a girl be before she has sex? __ __ years old
98 Refuse to Answer
SXA67. How old should a boy be before he has sex? __ __ years old
98 Refuse to Answer
SXA67a. I can use a condom/get my partner to use a condom without turning him/her off. (Choose one)
1 Disagree Strongly
2 Disagree
3 In the Middle
4 Agree
5 Strongly Agree
8 Refuse to Answer
Sometimes we want to do something, but it's hard to do it. For the following statements, click on the response that best expresses how easy or hard it would be for you to do each of the things listed. Please remember that no one (including your parents) will know your answers to these questions.
SXA68. How easy or hard would it be for you to get your girlfriend or boyfriend to use condoms during sex, even if she or he didn't want to? (Choose one)
1 Very hard
2 Hard
3 In the Middle
4 Easy
5 Very easy
8 Refuse to Answer
SXA69. How easy or how hard would it be for you to get your girlfriend or boyfriend to not have sex with you, even if she or he wanted to? (Choose one)
1 Very hard
2 Hard
3 In the Middle
4 Easy
5 Very easy
8 Refuse to Answer
SXA70. How easy or how hard would it be to use condoms when you have sex? (Choose one)
1 Very hard
2 Hard
3 In the Middle
4 Easy
5 Very easy
8 Refuse to Answer
Sexual Risk Behaviors
The next set of questions is about your sexual behavior. By sex, we mean vaginal, anal, or oral sex. Please remember that your answers are strictly confidential.
SB1. Have you ever had vaginal, anal, or oral sex?
Yes........................................................................ 1
No......................................................................... 0 (Skip to the instruction before PSB)
REFUSED............................................................ 7
SB2. When you first had vaginal, anal, or oral sex, how old were you?
Please enter an age.
|___|___|
ENTER AGE IN YEARS
REFUSED............................................................ 77
DON'T KNOW..................................................... 99
SB2 must be equal to or less than current age.
Error message: “Your response is greater than your recorded age. Please press the “Back” button, press “Clear,” and try again.”
SB3. In your lifetime, with how many men have you had vaginal, anal, or oral sex?
Please enter a number or enter zero for none.
|___|___|___|___| (if 0, skip to SB4)
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
SB3a. With how many of these men have you had only oral sex?
Please enter a number or enter zero for none.
|___|___|___|___|
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
HARD EDIT: SB3a must be equal to or less than SB3.
Error message: “Your response is greater than your lifetime number of male partners. Please press the “Back” button, press “Clear”, and try again.”
SB4. In your lifetime, with how many women have you had vaginal, anal, or oral sex?
Please enter a number or enter zero for none.
|___|___|___|___| (if 0, skip to SB5)
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
SB4a. With how many of these women have you had only oral sex?
Please enter a number or enter zero for none.
|___|___|___|___|
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
HARD EDIT: SB4a must be equal to or less than SB4.
Error message: “Your response is greater than your lifetime number of female partners. Please press the “Back” button, press “Clear”, and try again.”
SB5. Have you ever had vaginal or anal sex without using a condom?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB6. Have you ever had oral sex without using a condom?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB7. Have you ever been under the influence of alcohol before having sex?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB8. Have you ever been under the influence of illegal drugs while having sex?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB9. Have you ever been under the influence of non-medical use medications (e.g., medications that were not prescribed or medications that were prescribed, but taken in amounts larger to what was prescribed) while having sex?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB10. The last time you had sexual intercourse, did you or your partner use a condom?
Yes........................................................................ 1
No......................................................................... 0
REFUSED............................................................ 7
SB11. The last time you had sexual intercourse, were you high on alcohol or drugs?
Yes........................................................................ 1
No......................................................................... 0
REFUSED............................................................ 7
SB12. The last time you had sexual intercourse, did you have a couple of drinks and/or any drugs before having sexual intercourse?
Yes........................................................................ 1
No......................................................................... 0
REFUSED............................................................ 7
SB13. In the past 3 months, have you had vaginal, anal, or oral sex?
Yes........................................................................ 1
No......................................................................... 0 (Skip to SB21)
REFUSED............................................................ 7
SB14. In the past 3 months, with how many men have you had vaginal, anal, or oral sex?
Please enter a number or enter zero for none.
|___|___|___|___| (if 0, skip to SB15)
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
HARD EDIT: SB14 must be equal to or less than SB3.
Error message: “Your response is greater than your lifetime number of male partners. Please press the “Back” button, press “Clear,” and try again.”
SB14a. With how many of these men have you had only oral sex?
Please enter a number or enter zero for none.
|___|___|___|___|
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
HARD EDIT: SB14a must be equal to or less than SB14.
Error message: “Your response is greater than your number of male partners in the past 3 months. Please press the “Back” button, press “Clear,” and try again.”
SB15. In the past 3 months, with how many women have you had vaginal, anal, or oral sex?
Please enter a number or enter zero for none.
|___|___|___|___| (if 0, skip to SB16)
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
HARD EDIT: SB15 must be equal to or less than SB4.
Error message: “Your response is greater than your lifetime number of female partners. Please press the “Back” button, press “Clear,” and try again.”
SB15a. With how many of these women have you had only oral sex?
Please enter a number or enter zero for none.
|___|___|___|___|
ENTER NUMBER
REFUSED...................................................... 77777
DON'T KNOW............................................... 99999
HARD EDIT: SB15a must be equal to or less than SB15.
Error message: “Your response is greater than your number of female partners in the past 12 months. Please press the “Back” button, press “Clear,” and try again.”
SB16. In the past 3 months, about how often have you had vaginal or anal sex without using a condom?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB17. In the past 3 months, about how often have you had oral sex only without using a condom?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB18. During the past 3 months, have you been under the influence of alcohol before having sex?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB19. During the past 3 months, have you been under the influence of illegal drugs while having sex?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB20. During the past 3 months, have you been under the influence of non-medical use medications (e.g., medications that were not prescribed or medications that were prescribed, but taken in amounts larger to what was prescribed) while having sex?
Never.................................................................... 1
Less than half of the time...................................... 2
About half of the time........................................... 3
Not always, but more than half of the time........... 4
Always.................................................................. 5
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB21. Has a doctor or other health care professional ever told you that you had a sexually transmitted disease (STD)?
Yes........................................................................ 1
No......................................................................... 2
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
SB22. In the past 3 months, has a doctor or other health care professional told you that you had had a sexually transmitted disease (STD)?
Yes........................................................................ 1
No......................................................................... 2
REFUSED............................................................ 7
DON'T KNOW..................................................... 9
Peer Sexual Behavior
Think of your FRIENDS in general when answering these questions.
PSB1. How many of your friends have ever had (oral, vaginal, or anal) sexual intercourse? (Choose one)
0 none of them Skip to end of questionnaire
1 some of them
2 most of them
3 all of them
8 Refuse to Answer
PSB3. The last time your friends had sexual intercourse, how many of them used a condom? (Choose one)
0 all of them used a condom
1 most of them used a condom
2 some of them used a condom
3 none of them used a condom
8 Refuse to Answer
PSB6. In the past 3 months, how many of your friends have had sexual intercourse? (Choose one)
0 all of them Skip to end of questionnaire
1 most of them
2 some of them
3 none of them
8 Refuse to Answer
PSB7. When your friends had sex in the past 3 months, how many of them used condoms (rubbers)? (Choose one)
0 all of them used a condom
1 most of them used a condom
2 some of them used a condom
3 none of them used a condom
8 Refuse to Answer
| File Type | application/msword |
| Author | ibi0 |
| Last Modified By | ziy6 |
| File Modified | 2010-07-13 |
| File Created | 2010-07-13 |