SCV Original Control Screener

Survey of Crime Victimization ‐ Original Control Screener 
SQTHEFT
I'm going to read some examples that will give you an idea of the kinds of
crimes this study covers.
As I go through them, tell me if any of these happened to you in the last 6
months, that is, since (_________, 20__) (REFERENCE PERIOD START).
Was something belonging to YOU stolen, such as-Read each category.
--Things that you carry, like luggage, a wallet, purse, briefcase, book --Clothing, jewelry, or cellphone --Bicycle or sports equipment --Things in your home - like a TV, stereo, or tools -- Things outside your home such as a garden hose or lawn furniture
-- Things belonging to children in the household
--Things from a vehicle, such as a package, groceries, camera, or CDs OR
--Did anyone ATTEMPT to steal anything belonging to you?
Ask only if necessary:
Did any incidents of this type happen to you?
1.
2.

Yes
No

SQTHEFTTIMES
How many times?
SQTHEFTSPEC
What happened?
Describe all incidents for this screener below.
SQBREAKIN

1 

(OTHER THAN ANY INCIDENTS ALREADY MENTIONED,) has anyone-Read each category.
--Broken in or ATTEMPTED to break into your home by forcing a door or
window, pushing past someone, jimmying a lock, cutting a screen, or entering
through an open door or window?
--Has anyone illegally gotten in or tried to get into a garage, shed, or storage
room?
OR
--Illegally gotten in or tried to get into a hotel or motel room or vacation home
where you were staying?
Ask only if necessary:
Did any incidents of this type happen to you?
1.
2.

Yes
No

SQBREAKINTIMES
How many times?
SQBREAKINSPEC
What happened?
Describe all incidents for this screener below.
SQTOTALVEHICLES
What was the TOTAL number of cars, vans, trucks, motorcycles, or other
motor vehicles owned by you or any other member of this household during
the last 6 months? Include those you no longer own.
If greater than 4, enter 4.
SQMVTHEFT
During the last 6 months, (OTHER THAN ANY INCIDENT ALREADY
MENTIONED,) (was the vehicle/were any of the vehicles) Read each category.
-- Stolen or used without permission?
-- Did anyone steal any parts such as a tire, car stereo, hubcap, or battery?
-- Did anyone steal any gas from (it/them)?
OR
-- Did anyone ATTEMPT to steal any vehicle or parts attached to (it/them)?
Ask only if necessary:
Did any incidents of this type happen to you?

2 

1.
2.

Yes
No

SQMVTHEFTTIMES
How many times?
SQMVTHEFTSPEC
What happened?
Describe all incidents for this screener below.
SQATTACKWHERE
(OTHER THAN ANY INCIDENTS ALREADY MENTIONED,) since
________ ___, 20__, were you attacked or threatened OR did you have
something stolen from you –

Read each category.
--At home including the porch or yard --At or near a friend's, relative's, or neighbor's home --At work or school --In places such as a storage shed or laundry room, a shopping mall,
restaurant, bank, or airport --While riding in any vehicle --On the street or in a parking lot --At such places as a party, theater, gym, picnic area, bowling lanes, or while
fishing or hunting OR
--Did anyone ATTEMPT to attack or ATTEMPT to steal anything belonging to
you from any of these places?
Ask only if necessary:
Did any incidents of this type happen to you?
1.
2.

Yes
No

SQATTACKWHERETIM
ES
How many times?
SQATTACKWHERESP
EC
What happened?
Describe all incidents for this screener below.
SQATTACKHOW

3 

(OTHER THAN ANY INCIDENTS ALREADY MENTIONED,) has anyone
attacked or threatened you in any of these ways –
Exclude telephone threats.
Read each category.
--With any weapon, for instance, a gun or knife --With anything like a baseball bat, frying pan, scissors, or stick --By something thrown, such as a rock or bottle --Include any grabbing, punching, or choking --Any rape, attempted rape, or other type of sexual attack --Any face to face threats OR
--Any attack or threat or use of force by anyone at all? Please mention it
even if you are not certain it was a crime.
Ask only if necessary:
Did any incidents of this type happen to you?
1.
2.

Yes
No

SQATTACKHOWTIME
S
How many times?
SQATTACKHOWSPEC
What happened?
Describe all incidents for this screener below.
SQTHEFTATTACKKNO
WNOFF

4 

People often don't think of incidents committed by someone they
know. (OTHER THAN ANY INCIDENTS ALREADY MENTIONED,) did
you have something stolen from you or were you attacked or threatened by
–
Exclude telephone threats.
Read each category.
--Someone at work or school --A neighbor or friend --A relative or family member --Any other person you’ve met or known?
Ask only if necessary:
Did any incidents of this type happen to you? 

1.
2.

Yes
No

SQTHEFTATTACKKNO
WNOFFTIMES
How many times?
SQTHEFTATTACKKNO
WNOFFSPEC
What happened?
Describe all incidents for this screener below.
SQSEXUAL
Incidents involving forced or unwanted sexual acts are often difficult to talk
about. (OTHER THAN ANY INCIDENTS ALREADY MENTIONED,) have
you been forced or coerced to engage in unwanted sexual activity by --

Read each category.
--Someone you didn't know --A casual acquaintance OR
--Someone you know well?
Ask only if necessary:
Did any incidents of this type happen to you?
1.

Yes

5 

2.

No

SQSEXUALTIMES
How many times?
SQSEXUALSPEC
What happened?
Describe all incidents for this screener below.

SQCALLPOLICECRIM
E
During the last 6 months, (OTHER THAN ANY INCIDENTS ALREADY
MENTIONED,) did you call the police to report something that happened to
you which you thought was a crime?

1.
2.

Yes
No

SQCALLPOLICESPEC
What happened?
Describe all incidents for this screener below.
SQCALLPOLICEATTA
CKTHREAT
If not sure ask:
Were you (WAS THE RESPONDENT) attacked or threatened, or was
something stolen or an attempt made to steal something that belonged to
you (THE RESPONDENT) or another household member?.

1.
2.

Yes
No

SQCALLPOLICEATTA
CKTHREATTIMES
How many times?
SQNOCALLPOLICECR
IME
During the last 6 months, (OTHER THAN ANY INCIDENTS ALREADY
MENTIONED,) did anything which you thought was a crime happen to YOU,
but you did NOT report to the police?

6 

1.
2.

Yes
No

SQNOCALLPOLICESP
EC
What happened?
Describe all incidents for this screener below.

SQNOCALLPOLICEAT
TACKTHREAT
If not sure ask:
Were you (WAS THE RESPONDENT) attacked or threatened, or was
something stolen or an attempt made to steal something that belonged to
you (THE RESPONDENT) or another household member?

1.
2.

Yes
No

SQNOCALLPOLICEAT
TACKTHREATTIMES
How many times?

7