SEARCH CES-Depression

SEARCH for Diabetes in Youth Study

4b3_CES_D cohort

SEARCH CES-Depression

OMB: 0920-0904

Document [pdf]
Download: pdf | pdf
The following questions ask you about how you felt or behaved in the past week. Please read each
question and shade in the best answer in the appropriate circle. Remember, there are no right or
wrong answers.
The response categories are:
Rarely or none of the time (less than once per week)
Some or a little of the time (1 - 2 days per week)
Occasionally or a moderate amount of the time (3 - 4 days per week)
Most or all of the time (5 - 7 days per week)

1. I was bothered by things that usually don’t bother me……......

2. I did not feel like eating: my appetite was poor……..….............

{

{

{

Rarely

Some

Occasionally

{

{

{

Rarely

Some

Occasionally

3. I felt that I could not shake off the blues even with the help of
family and friends……..…..…..…..…..…..…..….......................

{

{

{

Rarely

Some

Occasionally

4. I felt that I was just as good as other people……..…..…..........

{

{

{

Rarely

Some

Occasionally

5. I had trouble keeping my mind on what I was doing……..….....

6. I felt depressed……..…..…..…..…..…..…..…..…..…..….........

7. I felt that everything I did was an effort……..…..…..…............

8. I felt hopeful about the future……..….…..…..…..…...…..........

9. I thought my life had been a failure……..…..…..…..….............

10. I felt fearful……..…..…..…..…..…..…..…..…..…..…..….........

SEARCH 3 Cohort Study – CES-D 11-01-10

{

{

{

Rarely

Some

Occasionally

{

{

{

Rarely

Some

Occasionally

{

{

{

Rarely

Some

Occasionally

{

{

{

Rarely

Some

Occasionally

{

{

{

Rarely

Some

Occasionally

{

{

{

Rarely

Some

Occasionally

{
Most

{
Most

{
Most

{
Most

{
Most

{
Most

{
Most

{
Most

{
Most

{
Most
Page 1 of 3

The response categories are:
Rarely or none of the time (less than once per week)
Some or a little of the time (1 - 2 days per week)
Occasionally or a moderate amount of the time (3 - 4 days per week)
Most or all of the time (5 - 7 days per week)
11. My sleep was restless……..…..…..………..…..…..….................

12. I was happy……..…..…..…..…..…..…..…..…..…..…..............

13. I talked less than usual……..…..…..…..…..…..…..…..….........

{

{

{

{

Rarely

Some

Occasionally

Most

{

{

{

{

Rarely

Some

Occasionally

Most

{

{

{

{

Rarely

Some

Occasionally

Most

14. I felt lonely……..…..…..…..…..…..…..…..…..….…...…..........

{

{

{

{

Rarely

Some

Occasionally

Most

15. People were unfriendly……..…..…..….…..…..…..…...….........

{

{

{

{

Rarely

Some

Occasionally

Most

{

{

{

{

Rarely

Some

Occasionally

Most

{

{

{

{

Rarely

Some

Occasionally

Most

{

{

{

{

Rarely

Some

Occasionally

Most

16. I enjoyed life……..…..…..…..…..…..…..…..…..…..….............

17. I had crying spells……..…..…..…..….…..…..…..…...…...........

18. I felt sad……..…..…..…..…..…..…..….…..…..…..…...............

19. I felt that people disliked me……..…..…..…..…..…..…............

20. I could not get going……..…..…..…..….…..…...…..…............

{

{

{

{

Rarely

Some

Occasionally

Most

{

{

{

{

Rarely

Some

Occasionally

Most

This is the end of the questionnaire. Thank you for answering these questions.

SEARCH 3 Cohort Study – CES-D – 11-01-10

Page 2 of 3

FOR STUDY USE ONLY
Date Completed
Month

Day

Year

Date Reviewed

Reviewer Code
Month

Day

Year

Date Entered
Month

Day

SEARCH 3 Cohort Study – CES-D – 11-01-10

Year

Data Entry
Code

Page 3 of 3


File Typeapplication/pdf
File TitleMicrosoft Word - CESD 9-13-10 Cohort from 5-01-02 11-01-10 FINAL FINAL
Authorstmoxley
File Modified2011-05-10
File Created2010-10-30

© 2024 OMB.report | Privacy Policy