11.3 Survey

OMB #: 0925-0593

OMB Expiration Date: 8/31/2014

Edinburgh Post Natal Depression Scale SAQ, Phase 2g

OMB Specification

Edinburgh Post Natal Depression Scale SAQ

Event Category:	Time-Based
Event:	3M
Administration:	N/A
Instrument Target:	Biological Mother
Instrument Respondent:	Biological Mother
Domain:	Neuro-Psychosocial
Document Category:	Scored Assessment
Method:	Self-Administered
Mode (for this instrument*):	In-Person, PAPI
OMB Approved Modes:	In-Person, PAPI
Estimated Administration Time:	2 minutes
Multiple Child/Sibling Consideration:	Per Event
Special Considerations:	N/A
Version:	1.0
MDES Release:	4.0

*This instrument is OMB-approved for multi-mode administration but this version of the instrument is designed for administration in this/these mode(s) only.

Source: Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

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Edinburgh Post Natal Depression Scale SAQ

TABLE OF CONTENTS

GENERAL PROGRAMMER INSTRUCTIONS: 1

NEURO-PSYCHOSOCIAL EDINBURGH POST NATAL DEPRESSION SCALE 3

FOR OFFICE USE ONLY: 7

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Edinburgh Post Natal Depression Scale SAQ

GENERAL PROGRAMMER INSTRUCTIONS:

WHEN PROGRAMMING INSTRUMENTS, VALIDATE FIELD LENGTHS AND TYPES AGAINST THE MDES TO ENSURE DATA COLLECTION RESPONSES DO NOT EXCEED THOSE OF THE MDES. SOME GENERAL ITEM LIMITS USED ARE AS FOLLOWS:

DATA ELEMENT FIELDS	MAXIMUM CHARACTERS PERMITTED	DATA TYPE	PROGRAMMER INSTRUCTIONS
ADDRESS AND EMAIL FIELDS	100	CHARACTER
UNIT AND PHONE FIELDS	10	CHARACTER
_OTH AND COMMENT FIELDS	255	CHARACTER	Limit text to 255 characters
FIRST NAME AND LAST NAME	30	CHARACTER	Limit text to 30 characters
ALL ID FIELDS	36	CHARACTER
ZIP CODE	5	NUMERIC
ZIP CODE LAST FOUR	4	NUMERIC
CITY	50	CHARACTER
DOB AND ALL OTHER DATE FIELDS (E.G., DT, DATE, ETC.)	10	NUMERIC CHARACTER	DISPLAY AS MM/DD/YYYY STORE AS YYYY-MM-DD HARD EDITS: MM MUST EQUAL 01 TO 12 DD MUST EQUAL 01 TO 31 YYYY MUST BE BETWEEN 1900 AND CURRENT YEAR.
TIME VARIABLES	TWO-DIGIT HOUR AND TWO-DIGIT MINUTE, AM/PM DESIGNATION	NUMERIC	HARD EDITS: HOURS MUST BE BETWEEN 00 AND 12; MINUTES MUST BE BETWEEN 00 AND 59

Instrument Guidelines for Participant and Respondent IDs:

PRENATALLY, THE P_ID IN THE MDES HEADER IS THAT OF THE PARTICIPANT (E.G. THE NON-PREGNANT WOMAN, PREGNANT WOMAN, OR THE FATHER).

POSTNATALLY, A RESPONDENT ID WILL BE USED IN ADDITION TO THE PARTICIPANT ID BECAUSE SOMEBODY OTHER THAN THE PARTICIPANT MAY BE COMPLETING THE INTERVIEW. FOR EXAMPLE, THE PARTICIPANT MAY BE THE CHILD AND THE RESPONDENT MAY BE THE MOTHER, FATHER, OR ANOTHER CAREGIVER. THEREFORE, MDES VERSION 2.2 AND ALL FUTURE VERSIONS CONTAIN A R_P_ID (RESPONDENT PARTICIPANT ID) HEADER FIELD FOR EACH POST-BIRTH INSTRUMENT. THIS WILL ALLOW ROCs TO INDICATE WHETHER THE RESPONDENT IS SOMEBODY OTHER THAN THE PARTICIPANT ABOUT WHOM THE QUESTIONS ARE BEING ASKED.

A REMINDER:

ALL RESPONDENTS MUST BE CONSENTED AND HAVE RECORDS IN THE PERSON, PARTICIPANT, PARTICIPANT_CONSENT AND LINK_PERSON_PARTICIPANT TABLES, WHICH CAN BE PRELOADED INTO EACH INSTRUMENT. ADDITIONALLY, IN POST-BIRTH QUESTIONNAIRES WHERE THERE IS THE ABILITY TO LOOP THROUGH A SET OF QUESTIONS FOR MULTIPLE CHILDREN, IT IS IMPORTANT TO CAPTURE AND STORE THE CORRECT CHILD P_ID ALONG WITH THE LOOP INFORMATION. IN THE MDES VARIABLE LABEL/DEFINITION COLUMN, THIS IS INDICATED AS FOLLOWS: EXTERNAL IDENTIFIER: PARTICIPANT ID FOR CHILD DETAIL.

NEURO-PSYCHOSOCIAL EDINBURGH POST NATAL DEPRESSION SCALE

NEP01000. As you are pregnant or have recently had a baby, we would like to know how you are feeling. Please check the answer that comes closest to how you have felt IN THE PAST 7 DAYS, not just how you feel today.

In the past 7days:

PARTICIPANT INSTRUCTIONS

• Please choose only one answer per question.

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP02000/(DEP_LAUGH_FUNNY). I have been able to laugh and see the funny side of things

Label	Code	Go To
As much as I always could	1
Not quite so much now	2
Definitely not so much now	3
Not at all	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP03000/(DEP_FORWARD_ENJOY). I have looked forward with enjoyment to things

Label	Code	Go To
As much as I ever did	1
Rather less than I used to	2
Definitely less than I used to	3
Hardly at all	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP04000/(DEEP_BLAME_WRONG). I have blamed myself unnecessarily when things went wrong

Label	Code	Go To
Yes, most of the time	1
Yes, some of the time	2
Not very often	3
No, never	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP05000/(DEP_ANXIOUS). I have been anxious or worried for no good reason

Label	Code	Go To
No, not at all	1
Hardly ever	2
Yes, sometimes	3
Yes, very often	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP06000/(DEP_PANICKY). I have felt scared or panicky for no very good reason

Label	Code	Go To
Yes, quite a lot	1
Yes, sometimes	2
No, not much	3
No, not at all	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP07000/(DEP_NO_COPE). Things have been getting on top of me

Label	Code	Go To
Yes, most of the time I haven't been able to cope at all	1
Yes, sometimes I haven't been coping as well as usual	2
No, most of the time I have coped quite well	3
No, I have been coping as well as ever	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP08000/(DEP_DIFF_SLEEP). I have been so unhappy that I have had difficulty sleeping

Label	Code	Go To
Yes, most of the time	1
Yes, sometimes	2
Not very often	3
No, not at all	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP09000/(DEP_MISERABLE). I have felt sad or miserable

Label	Code	Go To
Yes, most of the time	1
Yes, quite often	2
Not very often	3
Not at all	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP10000/(DEP_CRYING). I have been so unhappy that I have been crying

Label	Code	Go To
Yes, most of the time	1
Yes, quite often	2
Only occasionally	3
No, never	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP11000/(DEP_HARM_SELF). The thought of harming myself has occurred to me

Label	Code	Go To
Yes, quite often	1
Sometimes	2
Hardly ever	3
Never	4

SOURCE

Cox, J.L., Holden, J.M., and Sagovsky, R. 1987. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.  British Journal of Psychiatry 150:782-786

NEP11100. Thank you for participating in the National Children's Study and for taking the time to complete this survey.

FOR OFFICE USE ONLY:

FOU01000/(P_ID). Insert participant ID:__________________________________

FOU02000/(R_P_ID). Insert respondent ID:___________________________________

Public reporting burden for this collection of information is estimated to average 2 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0593*). Do not return the completed form to this address.