2006 NSDUH CAI Specs for Programming - Substance Abuse and ...

0 1 2 3 4 5 6 7 8 9 10
DK/REF, 95
AD66c
[IF AD38 = 1]How much did your [FEELNOUN] interfere with your ability to form and maintain close relationships
with other people during that period of time?
You can use any number between 0 and 10 to answer. If this activity doesn’t apply to you, type in 95.
No
Very Severe
Interference Mild Moderate Severe Interference
│
│
0 1 2 3 4 5 6 7 8 9 10
DK/REF, 95
AD66d [IF AD38 = 1] How much did [NUMPROBS] interfere with your social life during that period of time?
You can use any number between 0 and 10 to answer. If this activity doesn’t apply to you, type in 95.
No
Very Severe
Interference Mild Moderate Severe Interference
│
│
0 1 2 3 4 5 6 7 8 9 10
DK/REF, 95
AD68 [IF ANY RESPONSES TO AD66a – AD66d = 1-10 OR DK/REF] About how many days out of 365 in the past 12
months were you totally unable to work or carry out your normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
AD86
[IF AD38 NE BLANK] Here is a list of professionals some people talk to about the problems we have been asking
about:
General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
Another healer, like an herbalist, chiropractor, acupuncturist, or massage therapist
At any time in the past 12 months, did you see or talk to a medical doctor or other professional about your
[FEELNOUN]?
1 Yes
2 No
DK/REF
AD86a
[IF AD86 = 1] During the past 12 months, which professionals did you see or talk to about [NUMPROBS] with your
mood?
Select all that apply from the categories shown below. To select more than one answer from the list, press the space bar
between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1 General practitioner or family doctor
2 Other medical doctor like a cardiologist, gynecologist, urologist
3 Psychologist
December 2, 2005 342