1 WAS THERE EVER A TIME IN YOUR LIFE WHEN YOU HAD A STRONG FEAR OF

GROUP 1: ANIMALS

Bugs or spiders Snakes Any other animals

GROUP 2: NATURAL ENVIRONMENT

Still water, like a pool or a lake Storms Thunder or lightning

GROUP 3: MEDICAL SETTINGS

Going to the dentist Going to the doctor Getting a shot or injection Seeing blood Seeing injury Being in a hospital or doctors office

GROUP 4: CLOSED SPACES

Caves Tunnels Closets Elevators

GROUP 5: HIGH PLACES

Roofs Balconies Bridges High staircases

GROUP 6: FLYING

Flying Airplanes

PAPI V7 Respondent Booklet

WAS THERE EVER A TIME IN YOUR LIFE WHEN YOU HAD A STRONG FEAR OF SOCIAL OR PERFORMANCE SITUATIONS LIKE

Giving a speech Meeting new people Going to parties Speaking up at a meeting Being in a dating situation Using a public bathroom

WAS THERE EVER A TIME IN YOUR LIFE WHEN YOU HAD A STRONG FEAR OF

Being in crowds Going to public places Traveling alone Traveling away from home

PAPI V7 Respondent Booklet

3 WHAT WAS GOING ON THAT CAUSED THE EPISODE TO OCCUR?

STRESS, SUCH AS Overwork Tension Death of loved one Marital separation/divorce Job loss Stress Other stressful experience (please describe)

PHYSICAL ILLNESS, SUCH AS Exhaustion Menstrual cycle Pregnancy/postpartum Heart disease Thyroid disease Cancer Overweight Other physical illness or injury (please describe)

OTHER Other (please describe)

PAPI V7 Respondent Booklet

4 WHICH PROBLEMS DID YOU HAVE MOST OF THE DAY NEARLY EVERY DAY? (CHECK OFF YES RESPONSES IN BOXES )

Sad, empty, or depressed So sad that nothing could cheer you up Discouraged about your life Hopeless about the future Lost interest in almost all things Lost the ability to take pleasure Much smaller appetite than usual Much larger appetite than usual Gain weight without trying to Lost weight without trying to A lot more trouble that usual falling asleep Slept a lot more than usual Slept much less than usual Tired or low in energy A lot more energy than usual Talked or moved more slowly than is normal for you Anyone else noticed that you were talking or moved slowly So restless or jittery that you placed up and down

PAPI V7 Respondent Booklet

5 (CHECK OFF YES RESPONSES IN BOXES )

Anyone else noticed that you were restless Thoughts came much more slowly than usual Thoughts seemed to jump from one thing to another A lot more trouble concentrating that is normal for you Unable to make up your mind about things Lost self-confidence Not as good as other people Totally worthless Guilty Irritable, grouchy, or in a bad mood Nervous or anxious Sudden attacks of intense fear or panic Thought a lot about death Thought it would be better if you were dead Thought about committing suicide Made a suicide plan Made a suicide attempt Could not cope with everyday responsibilities Wanted to be alone rather than spend time with friends or relatives Less talkative than usual Often in tears

PAPI V7 Respondent Booklet

6 WHICH STATEMENT IN EACH SERIES COMES CLOSEST TO YOUR EXPERIENCE? Circle the number of the statement that comes closest to your experience.

Problems falling asleep 1. You never took longer than 30 minutes to fall asleep. 2. You took at least 30 minutes to fall asleep, less than half the time. 3. You took at least 30 minutes to fall asleep, more than half the time. 4. You took more than 60 minutes to fall asleep, more than half the time.

Waking up at night 1. You did not wake up at night. 2. You had a restless, light sleep with few brief awakenings each night. 3. You woke up at least once a night, but you got back to sleep easily. 4. You woke up more than once a night and stayed awake for 20 minutes or more, more than half the time.

Waking up too early 1. Most of the time, you woke up no more than 30 minutes before you needed to get up. 2. More than half the time, you woke up more than 30 minutes before you needed to get up. 3. You almost always woke up at least one hour or so before you needed to, but you went back to sleep eventually. 4. You woke up at least one hour before you needed to and couldnt get back to sleep.

The amount of sleep you got each night 1. You slept no longer than 7-8 hours/night, without napping during the day. 2. You slept no longer than 10 hours in a 24-hour period including naps. 3. You slept no longer than 12 hours in a 24-hour period including naps. 4. You slept longer than 12 hours in a 24-hour period including naps.

PAPI V7 Respondent Booklet

7 Sadness 1. You did not feel sad. 2. You felt sad less than half the time. 3. You felt sad more than half the time. 4. You felt sad nearly all the time.

Concentrating and making decisions 1. There was no change in your usual capacity to concentrate or make decisions. 2. You occasionally felt indecisive or found that your attention wandered. 3. Most of the time, you struggled to focus your attention or to make decisions. 4. You couldnt concentrate well enough to read or you couldnt make even minor decisions.

Feeling down on yourself 1. You saw yourself as equally worthwhile and deserving as other people. 2. You were more self-blaming than usual. 3. You largely believed that you caused problems for others. 4. You thought almost constantly about major and minor defects in yourself.

Interest in your daily activities 1. There was no change from usual in how interested you were in other people or activities. 2. You noticed that you were less interested in people or activities. 3. You found you had interest in only one or two of your formerly pursued activities. 4. You had virtually no interest in formerly pursued activities.

Energy 1. There was no change in your usual level of activity. 2. You got tired more easily than usual. 3. You had to make a big effort to start or finish your usual daily activities (for example, shopping, homework, cooking, or going to work). 4. You really couldnt carry out most of your usual daily activities because you just didnt have the energy.

PAPI V7 Respondent Booklet

8 Change in your Appetite 1. There was no change in your usual appetite. 2. You ate somewhat less often or lesser amounts of food than usual. 3. You ate much less than usual and only with personal effort. 4. You rarely ate within a 24-hr period, and only with extreme personal effort or when others persuaded you to eat. 5. You felt a need to eat more frequently than usual. 6. You regularly ate more often and/or greater amounts of food than usual 7. You felt driven to overeat both at mealtime and between meals. Changes in your Weight 1. You did not have a change in your weight. 2. You felt as if you had a slight weight loss. 3. You lost 2 pounds or more. 4. You lost 5 pounds or more. 5. You felt as if you had a slight weight gain. 6. You gained 2 pounds or more. 7. You gained 5 pounds or more.

Thoughts of Death or Suicide 1. You did not think of suicide or death. 2. You felt that life was empty or wondered if it was worth living. 3. You thought of suicide or death several times a week for several minutes. 4. You thought of suicide or death several times a day in some detail, or you made specific plans for suicide or actually tried to take your own life.

Feeling Slowed Down 1. You thought, spoke, and moved at your usual rate of speed. 2. You found that your thinking was slowed down or your voice sounded dull or flat 3. It took you several seconds to respond to most questions, and youre sure your thinking was slowed. 4. You were often unable to respond to questions without extreme effort.

Feeling Restless 1. You did not feel restless. 2. You were often fidgety, wringing your hands, or needing to shift how you were sitting. 3. You had impulses to move about and were quite restless. 4. At times, you were unable to stay seated and needed to pace around.

PAPI V7 Respondent Booklet

Interference Scale

None 0 1

Mild 2 3 4

Moderate 5 6 7

Severe 8 9

Very Severe 10

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10

WHICH STATEMENT IN EACH SERIES COMES CLOSEST TO YOUR EXPERIENCE DURING THE WORST FOUR DAYS? Circle the number of the statement that comes closest to your experience.

Mood 1. 2. 3. 4. Your mood was no more high than usual in terms of things like being happy, self-confident, or optimistic. Your mood was a little more high than usual. Your mood was quite a bit more high than usual, but never over the edge or inappropriate. Your mood was over the edge in terms of things like being unrealistically self-confident or optimistic or very happy even when bad things were happening. You were uncontrollably high in terms of things like laughing out loud without cause or singing loudly in public places.

5.

Physical Arousal 1. 2. 3. You had no increase in physical arousal in terms of things like energy or restlessness or difficulty sitting still. You had some increase in arousal, but not enough for most people to notice. You had a big enough increase in arousal for most people to notice, with things like increases in hand gestures, loudness, or being a lot more animated than usual. You were so highly aroused that you felt agitated or restless or hyper, but not enough to be out of control. You were uncontrollably agitated or restless or hyper.

4. 5.

Sexual Interest 1. 2. 3. 4. 5. You had no increase in sexual interest. You had a mild increase in sexual interest. You had a strong increase in sexual thoughts without talking about it or doing anything. You talked a lot more about sex than usual without doing anything about it. You inappropriately propositioned people or touched people sexually or engaged in other sexual behaviors you wouldnt normally do.

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11

Sleep 1. 2. 3. 4. 5. You experienced no decrease in sleep. You slept less than normal by up to one hour. You slept less than normal by more than one hour. You slept less than usual and didnt feel the need for more sleep. You didnt feel the need for any sleep at all.

Irritability 1. 2. 3. You experienced no increase in irritability, in terms of things like feeling grumpy or acting annoyed or angry. You experienced some increase in irritability, but not enough for most people to notice. You experienced a big enough increase in irritability for most people to notice, with things like sometimes being short or snappy with people or having occasional outbursts of anger. You were very irritable most of the time. You were so hostile or uncooperative that it was impossible for people to be around you.

4. 5.

Talking 1. 2. 3. 4. 5. You experienced no increase in talkativeness. You wanted to be more talkative, but didnt actually talk a lot more than usual. At times you talked a lot more than usual or a lot more than the situation required. You often talked a lot more than the situation required or talked so much that it was hard for other people to interrupt you. You talked nonstop or so much that no one could interrupt you even when they tried.

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12

Racing Thoughts/Disorganized Thinking 1. 2. Your thoughts did not come more quickly or seem more confused or escape you more than usual. Your thoughts came somewhat more quickly than usual, or seemed a bit more confused than usual, or you lost your train of thought somewhat more than usual. Your thoughts raced through your mind, or you easily lost your train of thought, or your mind kept jumping from one topic to another. Your thoughts jumped around so much that people had a hard time following you or you couldnt keep yourself on track in a conversation. Your thoughts were going so fast or you were so confused that it was impossible for anyone to follow you or for you to make yourself understood.

3. 4. 5.

Impractical/Unrealistic Thinking 1. 2. 3. 4. You didnt think or talk about anything different than usual You thought a lot about new interests or new plans that were not very practical or realistic. You thought a lot about really strange unrealistic things like hyper-religious ideas or totally unrealistic plans. You had a lot of grandiose ideas about being able to do things you cant really do, or paranoid ideas about plots or conspiracies that dont really exist, or ideas about you being at the center of things that really dont have much to do with you. Your mind was so confused that you were having delusions or hearing voices or seeing things.

5.

Disruptive/Aggressive Behavior 1. 2. 3. 4. 5. You were no more disruptive or aggressive in your behavior than usual. You were often loud or sarcastic with people, but never threatened or got physical. You sometimes threatened people or made hostile demands, but never got physical. You frequently threatened or shouted at people, but without getting physical. You physically assaulted someone or destroyed property.

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13

Appearance 1. 2. 3. You dressed the same as always. You had a big reduction in neatness of dressing or grooming, but not so much that most people would get worried about you. You had a big change in dressing and grooming, either due to looking like a mess in terms of clothes and grooming or due to being very overdressed. You had an extreme change in dressing or grooming, like being only partly clothed or wearing wild make-up or looking like a total mess. You were completely un-groomed or disorganized in clothing or wore bizarre clothes.

4. 5.

Thought You Had a Problem 1. 2. 3. 4. 5. You recognized that you were sick and needed help. You realized that you might have a problem. You recognized that your behavior had changed a great deal, but didnt think it was a problem. You realized that there had been some change in your behavior, but didnt really appreciate how great it had been. You had times when you were totally unaware that your behavior was different from normal.

DID YOU HAVE 2 OR MORE OF THE FOLLOWING PROBLEMS?

14

Heart pounding or racing Sweating Trembling Feeling sick to your stomach Having a dry mouth Having chills or hot flushes Feeling numbness or tingling sensations Having trouble breathing Feeling like you were choking Having pain or discomfort in your chest Feeling dizzy or faint Afraid you might die Fear of losing control, going crazy, or passing out Feeling distant from situation as if you were not there Feeling that things around you were unreal

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15

DID YOU EVER STRONGLY FEAR

Meeting new people Talking to people in authority Speaking up in a meeting or class Going to parties or other social gatherings Acting, performing, or giving a talk in front of an audience Taking an important exam or interviewing for a job Working while someone watches Entering a room when others are already present Talking with people you dont know very well Expressing disagreement to people you dont know very well Writing or eating or drinking while someone watches Urinating in a public bathroom or using a bathroom away from home Being in a dating situation Any other social or performance situation where you could be the center of attention or where something embarrassing might happen

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16

DID YOU EVER STONGLY FEAR

Being home alone Being in crowds Traveling away from home Traveling alone or being alone away from home Using public transportation Driving a car Standing in a line in a public place Being in a department store, shopping mall, or supermarket Being in a movie theater, auditorium, lecture hall, or church Being in a restaurant or any other public places Being in a wide, open field or street

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17

DID YOU HAVE ANY OF THE FOLLOWING REACTIONS?

Having trouble breathing Feeling like you were choking Having pain or discomfort in your chest Feeling sick to your stomach Feeling dizzy or faint Fear of losing control, going crazy, or passing out Afraid that you might die Having chills or hot flashes Feeling numbness or tingling sensations Feeling distant from situation as if you were not there Feeling that things around you were unreal

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18

EXAMPLES OF COMMONLY MENTIONED REASONS FOR BEING ANXIOUS

DIFFUSE WORRIES, SUCH AS . . .

Everything Nothing in particular

PERSONAL PROBLEMS, SUCH AS . . .

Finances Success at school or work Social life Relationships at school or work Relationships with family Physical appearance

HEALTH PROBLEMS, SUCH AS . . .

Physical health Mental health Substance use

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19 SPECIFIC ANXIETIES, SUCH AS . . .

Social phobias (e.g. meeting people after moving to a new town) Agoraphobia (e.g. leaving home alone after a divorce) Specific phobias (e.g. elevators after moving to a city) Obsessions (e.g. germs after Mad Cow Disease scare) Compulsions (e.g. repetitive hand washing)

SOCIETAL PROBLEMS, SUCH AS . . .

Crime/violence The economy The environment (e.g. global warming, pollution) Moral decline of society (e.g. commercialism, decline of the family) War/revolution

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20

DID ANY OF THESE 3 EXPERIENCES EVER HAPPEN TO YOU?

A. You seriously thought about committing suicide

B. You made a plan for committing suicide

C. You attempted suicide

WHICH OF THESE 3 STATEMENTS BEST DESCRIBES YOUR SITUATION?

1.

I made a serious attempt to kill myself and it was only luck that I did not succeed.

2.

I tried to kill myself, but knew that the method was not fool-proof.

3.

My attempt was a cry for help, I did not intend to die.

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21

WHAT METHOD DID YOU USE? A. Gun B. Razor, knife or other sharp instrument C. Overdose of prescription medications D. Overdose of over-the-counter medications E. Overdose of other drug (e.g. heroin, crack, alcohol) F. Poisoning (e.g. carbon monoxide, rat poison) G. Hanging, strangulation, suffocation H. Drowning I. Jumping from high places J. Motor vehicle crash K. Other (please describe)

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22

ALCOHOL EQUIVALENTS

HARD LIQUOR 1 mixed drink 1 shot glass pint 1 pint 1 fifth 1 quart or liter = 1 drink = 1 drink = 6 drinks = 12 drinks = 20 drinks = 24 drinks

WINE 1 glass 1 bottle 1wine cooler 1 gallon = 1 drink = 6 drinks = 1 drink = 30 drinks

BEER OR ALE 1 12 oz bottle 1 12 oz can 1 40 oz bottle 1 six pack 1 pitcher 1 case = 1 drink = 1 drink = 3 drinks = 6 drinks = 5 drinks = 24 drinks

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23

SEDATIVES AND TRANQUILIZERS (SLEEPING PILLS, DOWNERS, NERVE PILLS), SUCH AS . . .

Amobarbital Amytal Ativan Barbiturate Buticap Butisol Centrax Chloral Hydrate

Dalmane Deprol Diazepam Doriden Durax Equanil Halcion Librium

Limbitrol Mebaral Meprobamate Methaqualone Menrium Miltown Nembutal Noludar

Paxipam Pentobarbital Phenobarbital Placidyl Restoril Secobarbital Seconal Serax

Sk-Lygen Sopor Tranxene Tuinal Valium Xanax

STIMULANTS (AMPHETAMINES, UPPERS, SPEED, ICE, CRANK), SUCH AS . . .

Benzedrine (bennies) Biphetamine Cylert Desoxyn Dexamyl Dexedrine (dexies) Dextroamphetamine Didrex

Eskatrol Fastin Ionamin Mazanor Methamphetamine Methedrine Obredrin-L.A Paxipam

Paxipam Pentobarbital Phenobarbital Plegine Placidyl Pondomin Preludin Restoril

Ritalin Sanorex Secobarbital Seconal Serax Sk-Lygen Sopor Tenuate

Tepanil Tranxene Tuinal Valium Voranil Xanax

PAPI V7 Respondent Booklet

24

ANALGESICS (PAINKILLERS), SUCH AS . . .

Anileridine Buprenex Codeine Darvon Demerol Dilaudid Dolene

Levo-Dromoran Methadone Morphine Percodan Phenaphen with codeine Propoxyphene SK-65

Stadol Talacen Talwin Talwin NX Tylenol with codeine Wygesic

COCAINE

Powder Crack

Free base Coca leaves

Paste

OTHER DRUGS, SUCH AS . . .

Heroin Opium

Glue LSD (acid, white lightning)

Peyote

PAPI V7 Respondent Booklet

25 DID YOU EVER TAKE ANY OF THESE MEDICATIONS?

Acetophenazine Centrax Chlorpromazine Clorprothixene Clozapine Clozaril Droperidol Fluphenazine Haldol Haloperidol Inapsine Loxapine Loxitane Mellaril Mesoridazine Moban Molindone Navane Olanzapine Orap Permitil

Perphenazine Pimozide Prazepam Prolixin Quetiapine Risperdal Risperidone Serentil Seroquel Stelazine Taractan Thioridazine Thiothixene Thorazine Tindal Trifluoperazine Triflupromazine Trilafon Vesprin Zyprexa

PAPI V7 Respondent Booklet

26 HOW MANY TIMES DID YOU EVER MAKE A BET OF ANY KIND?

Never 1-10 Times 11-50 Times 51-100 Times 101-500 Times 501-1000 Times More Than 1000

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27 HOW MANY TIMES IN YOUR LIFE DID YOU EVER BET ON EACH OF THE FOLLOWING?

Never 1-10 Times 11-100 Times 101-500 Times More than 500 Times

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28 DID YOU EVER HAVE ANY OF THESE STRESSFUL EXPERIENCES? (CHECK OFF YES RESPONSES IN BOXES ) GROUP 1: Traumatic Personal Experiences Combat experience Relief worker in war zone Civilian in war zone Civilian in region of terror Refugee Kidnapped Toxic chemical exposure Automobile accident Other life-threatening accident Natural disaster Man-made disaster Life-threatening illness GROUP 2: Personal Violence Beaten up as a child by caregiver Beaten up by a spouse or romantic partner Beaten up by someone else Mugged or threatened with a weapon Raped Sexually assaulted Stalked Witnessed physical fights at home GROUP 3: Events Affecting Others Unexpected death of a loved one Childs serious illness Traumatic event to loved one Witnessed death or dead body or saw someone seriously hurt Accidentally caused serious injury or death Purposely injured, tortured, or killed someone Saw atrocities
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29 DID YOU HAVE ANY OF THESE REACTIONS? (CHECK OFF YES RESPONSES IN BOXES )

GROUP 1:

GROUP 2:

Trying not to think about it Staying away from reminders of it Being unable to remember parts of it Losing interest in things you used to enjoy Feeling emotionally distant from other people Trouble feeling normal feelings Feeling you have no reason to plan for the future

Unwanted memories Unpleasant dreams

Flashbacks Getting very upset when reminded of it Physical reactions

Sleep problems Irritability Trouble concentrating Being more aware or watchful Being jumpy or easily startled

PAPI V7 Respondent Booklet

30 DID YOU TAKE ANY OF THE FOLLOWING MEDICINES?

GENERIC DRUG NAMES Acetophenazine Alprazolam Amitriptyline Amoxapine Amphetamine Mixtures Diazepam Doxepin Droperidol Estazolam Ethchlorvynol Mesoridazine Meth-Amphetamine Methyl-Phenidate Mirtazapine Molindone Sertraline Temazepam Thioridazine Thiothixene Tranyl-Cypromine

Amphetamine Sulfate Bupropion Buspirone Carbamazepine Chloral Hydrate

Fluoxextine Fluphenazine Flurazepam Fluvoxamine Gabapentin

Nefazodone Nortriptyline Olanzapine Oxazepam Paroxetine

Trazodone Triazolam Trifluoperazine Triflupromazine Trimipramine

Chlordiazepoxide Chlorpromazine Citalopram Clomipramine Clonazepam

Halazepam Haloperidol Imipramine Isocarboxazid Lamotrigine

Pemoline Perphenazine Phenelzine Pimozide Prazepam

Valproic Acid Venlafaxine Zaleplon Zolpidem

Clorazepate Clorprothixen Clozapine Desipramine Dextroamphetamine

Lithium Lorazepam Loxapine Maprotiline Meprobamate

Propofol Protriptyline Quazepam Quetiapine Risperidone

Sulfate

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31

TRADE DRUG NAMES Adapin Adderall Ambien Anafranil Aquachloral Asendin Ativan Aventyl Hydrochloride Buspar Carbatrol Celexa Centrax Clozaril Cylert Dalmane Effexor Elavil Epitol Equanil Eskalith Etrafon Gen - Xene Halcion Haldol Inapsine Janimine Klonopin Lamictal Libritabs Librium Mellaril Miltown Mitran Moban Nardil Navane Neuramate Neurontin Norpramin Orap Pamelor Parnate Paxil Paxipam Permitil Serentil Seroquel Serzone Sinequan Sonata Stelazine Surmontil Taractan Tegretol Thorazine Tindal Tofranil Tranxene Triavil Trilafon

Depacon Depakene Depakote Desoxyn Desyrel Dexedrine Dextrostat Diprivan Doral

Limbitrol Lithane Lithobid Lithonate Lithotabs Loxitane Ludiomil Luvox Marplan

Placidyl Prolixin Prosom Prozac Remeron Restoril Risperdal Ritalin Serax

Valium Vesprin Vivactil Wellbutrin Xanax Zoloft Zyban Zyprexa

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32

WHICH OF THESE ARE REASONS WHY YOU STOPPED TAKING THE MEDICINE?

The medicine was not helping

You thought the problem would get better without more medicine

You couldnt afford to pay for the medicine

You were too embarrassed to continue taking the medicine

You wanted to solve the problem without medications

The medicine caused side-effects that made you stop

You were afraid that you would get dependent on the medication

Someone in your personal life pressured you to stop

Any other reason for stopping

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33

WHAT NUMBER BEST DESCRIBES YOUR PAIN?

No Pain 0 1

Mild 2 3 4

Moderate 5 6 7

Severe 8 9

Pain as Bad as You Can Imagine 10

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34

HOW MUCH DIFFICULTY DID YOU HAVE IN EACH OF THE FOLLOWING AREAS?

None Mild difficulty Moderate difficulty Severe difficulty

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35

HEALTH RATING SCALE

Worst Possible Health 0 10 20 30 40 50 60 70 80 90

Perfect Health 100

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36

HOW OFTEN DID YOU HAVE THE FOLLOWING FEELINGS IN THE PAST 30 DAYS?

All the time Most of the time Some of the time A little of the time None of the time

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37

HOW OFTEN DID YOU HAVE THESE EXPERIENCES IN THE PAST 30 DAYS?

Often Sometimes Rarely Never

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38

WHICH CATEGORY BEST DESCRIBES THE INDUSTRY IN WHICH YOU WORK?

1. 2. 3. 4. 5. 6. 7. 8. 9.

Agriculture, hunting and forestry Fishing Mining and quarrying Manufacturing Electricity, gas and water supply Construction Wholesale and retail trade; repair of motor vehicles Hotels and restaurants Transport, storage and communications

10. Financial intermediation 11. Real estate, renting and business activities 12. Public administration and defense 13. Education 14. Health and social work 15. Other community, social and personal service activities 16. Private households with employed persons 17. Extra-territorial organizations and bodies

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39

WHAT NUMBER BEST DESCRIBES HOW MUCH SOMEONE IN YOUR HEALTH COULD EXPECT TO EARN IF THEY TRIED TO GET A JOB?

No Money 0 10 20 30 40 50 60 70 80 90

Money Expected With No Health Problems 100

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40

HOW OFTEN DID YOU HAVE THESE EXPERIENCES IN THE PAST 30 DAYS?

All of the time Most of the time About half of the time Some of the time A little of the time None of the time

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41

WHAT NUMBER BEST DESCRIBES YOUR OVERALL JOB PERFORMANCE?

Worst Job Performance 0 1

Bellow Average 2 3 4

Average 5 6 7

Above Average 8 9

Top Job Performance 10

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42

WHICH LETTER REPRESENTS YOUR INCOME OR EARNINGS IN THE PAST 12 MONTHS FROM EACH OF THE FOLLOWING SOURCES?

A. Less than $0 (Loss) B. $0 (None) C. $1 - $999 D. $1,000 - $1,999 E. $2,000 - $2,999 F. $3,000 - $3,999 G. $4,000 - $4,999 H. $5,000 - $5,999 I. J. $6,000 $6,999 $7,000 - $7,999

S. T. U. V. W. X. Y. Z.

$16,000 - $16,999 $17,000 - $17,999 18,000 - $18,999 $19,000 - $19,999 $20,000 - $24,999 $25,000 - $29,999 $30,000 - $34,999 $35,000 - $39,999

AA. $40,000 - $44,999 BB. $45,000 - $49,999 CC. $50,000 - $74,999 DD. $75,000 - $99,999 EE. $100,000 - $149,000 FF. $150,000 - $199,999 GG. $200,000 - $299,999 HH. $300,000 - $499,999 II. $500,000 - $999,999

K. $8,000 - $8,999 L. $9,000 - $9,999

M. $10,000 - $10,999 N. $11,000 - $11,999 O. $12,000 - $12,999 P. $13,000 - $13,999 Q. $14,000 - $14,999 R. $15,000 - $15,999

JJ. $1,000,000 or more

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43

DID YOU EVER DO ANY OF THE THINGS ON THIS LIST?

Pushed, grabbed or shoved Threw something Slapped, hit, or punched

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44

HOW OFTEN DO YOU DISAGREE ABOUT EACH OF THE FOLLOWING MATTERS?

All of the time Most of the time Sometimes Rarely Never

HOW OFTEN ARE YOU IN CONTACT?

Nearly every day 3-4 days a week 1-2 days a week 1-2 days a month Less than once a month Never

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45

WHERE DO YOU STAND COMPARED TO OTHER PEOPLE IN THE UNITED STATES?

10 9 8 7 6 5 4 3 2 1

10 = The people who are the best off those who have the most money, the most education and the most respected jobs.

1 = The people who are the worst off those who have the least money, least education, and the least respected jobs or no job.

WHERE DO YOU STAND RELATIVE TO OTHER PEOPLE IN YOUR COMMUNITY?

10 9 8 7 6 5 4 3 2 1

10 = The people who have the highest standing in your community.

1 = The people who have the lowest standing in your community.

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46 How often have you had the following?

Very Often

Often

Sometimes

Rarely

Never

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47

As a child or teenager, did you do any of the following things?

Did you often tell lies to trick people into giving you things or doing what you wanted them to do? Did you often get out of doing things you were supposed to do by fooling people or lying to them? Did you often stay out much later at night than your parents wanted?

Did you often skip school without permission? Did you ever shoplift or steal something worth at least $10?

Did you ever steal money or other things from your parents or the other people you lived with? Did you ever break into someones locked car, or a locked home or building?

Did you ever set a fire to try to cause serious damage? Other than by setting fires, did you ever deliberately damage someones property by doing something like breaking windows, slashing tires, vandalizing, or writing graffiti on buildings? Did you ever run away from home and stay away for at least four days? Did you run away from home overnight more than once?

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48

As a child or teenager, did you do any of the following things?

Did you have a period when you often bullied, threatened, or frightened people, including smaller or younger children? Did you often get involved in physical fights?

Did you ever use a weapon on another person, like a baseball bat, glass bottle, knife, gun, or brick? Were you ever physically cruel to an animal and hurt it on purpose? (This does not include hunting or getting rid of pests like rodents or insects.) Were you ever physically cruel to a person and hurt them on purpose?

Did you ever force someone to give you something like money, jewelry, or clothing by threatening them or causing them injury? Did you ever steal someones purse, wallet, luggage, package or bag by grabbing it from them? Did you ever make anyone do something sexual by either forcing, intimidating, or threatening them?

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49

DID YOU EVER IN YOUR LIFETIME GO TO SEE ANY OF THESE PROFESSIONALS FOR PROBLEMS WITH YOUR EMOTIONS OR NERVES OR YOUR USE OF ALCOHOL OR DRUGS?

A. B. C.

A psychiatrist General practitioner or family doctor Any other medical doctor, like a cardiologist, gynecologist or urologist

D. E. F. G.

Psychologist Social worker Counselor Any other mental health professional, such as a psychotherapist or a mental health nurse

H. I. J.

A nurse, occupational therapist, or other health professional A religious or spiritual advisor like a minister, priest, or rabbi Any other healer, like an herbalist, chiropractor, or spiritualist

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50

IN WHICH OF THESE LOCATIONS DID YOU SEE THE PROFESSIONAL?

A. B. C. D. E. F. G. H.

Hospital emergency department Psychiatric outpatient clinic Drug or alcohol outpatient clinic Private office Social service agency or department Program in jail or prison Drop-in center or program for people with emotional problems with alcohol or drugs Church or other religious building

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51

WHICH OF THESE THREE STATEMENTS BEST DESCRIBES WHY YOU DIDNT WANT TO SEE A PROFESSIONAL?

1.

I didnt think I had a problem

2.

I had a problem, but thought I could handle it on my own

3.

I thought that I needed help but didnt believe professional treatment would be helpful

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52

WHICH OF THESE WERE THE MAIN THINGS YOU WERE HOPING TO GET FROM TREATMENT?

A. B. C. D. E. F. G.

To help with your emotions (e.g., Sadness, anger) To control problem behaviors (e.g., Drinking problems, gambling) To deal with general body complaints (e.g., Tiredness, headaches) To help make a life decision (e.g., To get married or change jobs) To cope with ongoing stress (e.g., Job stress, marital problems) To cope with recent stressful events (e.g., Divorce, death of a loved one) To come to terms with your past (e.g., Feelings about your childhood)

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53

DID YOU USE ANY OF THESE THERAPIES IN THE PAST 12 MONTHS

Acupuncture Biofeedback Chiropractic Energy healing Exercise or movement therapy Herbal therapy (e.g., St. Johns wort, chamomile) High dose mega-vitamins Homeopathy Hypnosis Imagery techniques Massage therapy Prayer or other spiritual practices Relaxation or meditation techniques Special diets Spiritual healing by others Any other non-traditional remedy or therapy (Please describe)

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54

WHAT TYPES OF HERBAL MEDICINES DID YOU USE?

Chamomile Kava Lavender St. Johns wort Valerian Chasteberry Black cohosh Other (Please describe)

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55

WHAT KIND OF SELF-HELP GROUP DID YOU GO TO IN THE PAST 12 MONTHS?

A.

Groups for people with substance problems (such as Alcoholics Anonymous or Rational Recovery)

B.

Groups for people with emotional problems (such as Grow, The Manic Depressive Association, or Emotions Anonymous

C. D.

Groups for people with eating problems Groups for dealing with the death of a loved one (such as The Compassionate Friends or Widow to Widow)

E.

Groups for people making other life transitions (such as Parents Without Partners or Empty Nesters)

F.

Groups for survivors (such as Adult Children of Alcoholics or Survivors of Childhood Sexual Abuse)

G.

Groups for people with physical disabilities or illnesses (such as Living with Cancer or Living with Aids)

H. I.

Parent support groups (such as Toughlove or Parents Anonymous) Groups for the families of people with a physical illness (such as the Candlelighters or Families of Children with Cancer)

J.

Groups for the families of people with emotional or substance problems (such as the National Alliance for the Mentally Ill or Al Anon)

K.

Any other self-help group, mutual help group, or support group

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56

WHICH OF THE FOLLOWING STATEMENTS BEST DESCRIBES THE RELATIONSHIP BETWEEN YOUR PARTICIPATION IN THE SELF-HELP GROUP AND YOUR SEEING A PROFESSIONAL?

1. 2.

A professional ran the group A professional asked me to attend the group as part of my treatment, but the group was not run by a professional You attended the self-help group at the same time you saw a professional, but the two were not related You attended the self-help group at a different time than when you saw a professional

3.

4.

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57 WHICH CONDITIONS RESULTED FROM THAT INJURY?

1. Broken or dislocated bones 2. Sprain, strain, or pulled muscle 3. Cuts, scrapes, or puncture wounds 4. Head injury, concussion 5. Bruise, contusion, or internal bleeding 6. Burn, scald 7. Poisoning from chemicals, medicines, or drugs 8. Respiratory problem such as breathing, cough, pneumonia

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58 WHERE DID THE INJURY OCCUR?

1. 2. 3. 4. 5. 6. 7. 8. 9.

Your home or yard Someone elses home or yard School (including playground) Workplace Traveling to or from work or as part of work Street or highway (not traveling for work) Public space (e.g., Sidewalk) or building Farm or agricultural area Place of recreation or sports (except at school)

PAPI V7 Respondent Booklet