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

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DK/REF<br />

YD37<br />

[IF YD28 NE BLANK] Think of the very first period of time in your life lasting two weeks or longer when you<br />

[FEELFILL] <strong>and</strong> also had some of the other problems we just asked about.<br />

Can you remember your exact age?<br />

1 Yes<br />

2 No<br />

DK/REF<br />

YD37a<br />

[IF YD37 = 1] How old were you?<br />

AGE:__________ [RANGE: 1-110 17]<br />

DK/REF<br />

YD37b [IF YD37 = 2 OR DK] About how old were you when you first had a period of time like this?<br />

AGE:__________ [RANGE: 1-110 17]<br />

DK/REF<br />

YD52<br />

[IF YD28 NE BLANK] In your entire life, how many times did you feel [FEELNOUN] <strong>for</strong> two weeks or longer while<br />

also having some of the other problems we asked about?<br />

If you are not sure of your answer, just make your best guess.<br />

# OF EPISODES______________ [RANGE: 1-1000]<br />

DK/REF<br />

YD38<br />

[IF YD28 NE BLANK] In the past 12 months, did you have a period of time when you felt [FEELNOUN] <strong>for</strong> two<br />

weeks or longer while also having some of the other problems we asked about?<br />

1 Yes<br />

2 No<br />

DK/REF<br />

YD66a<br />

[IF YD38 = 1] Think about the time in the past 12 months when [NUMPROBS] with your mood [WASWERE] the<br />

worst.<br />

Using the 0 to 10 scale shown below, where 0 means no problems <strong>and</strong> 10 means very severe problems, select the<br />

number that describes how much your [FEELNOUN] caused problems with each of the following activities during that<br />

time. You can use any number between 0 <strong>and</strong> 10 to answer. If this activity doesn’t apply to you, type in 95.<br />

How much did your [FEELNOUN] cause problems with your chores at home?<br />

No<br />

Very Severe<br />

Problems Mild Moderate Severe Problems<br />

│<br />

│<br />

0 1 2 3 4 5 6 7 8 9 10<br />

NUMBER: ______________[RANGE: 0-10, 95]<br />

DK/REF<br />

YD66b [IF YD38 = 1] During that time in the past 12 months when your [FEELNOUN] was worst, how much did this cause<br />

problems with your ability to do well at school or work?<br />

You can use any number between 0 <strong>and</strong> 10 to answer. If this activity doesn’t apply to you, type in 95.<br />

No<br />

Very Severe<br />

Problems Mild Moderate Severe Problems<br />

│<br />

│<br />

0 1 2 3 4 5 6 7 8 9 10<br />

NUMBER: ______________[RANGE: 0-10, 95]<br />

DK/REF<br />

December 2, 2005 361

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