| Variable # | Item | Response Option |
| PD005PD006 | Are you able to get into and out of a car? Please base your response on the most difficult part of this activity. |
Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD017 | Are you able to get up off the floor from lying on your back? You can use a chair or other object to get up. |
Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD125 | Are you able to stand on your feet for one hour? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD158 | Are you able to walk up a steep slope? For example on a hill. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD159 | Are you able to to walk on uneven surfaces? For example on grass, dirt road or sidewalk. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD167 | Are you able to walk quickly indoors? For example to answer the telephone or the front door. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD209 | Are you able to run a short distance, such as to catch a bus? A short distance is roughly half a block or about 15-20 yards. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD438PD439 | Are you able to get in and out of a squatting position? Please base your response on the most difficult part of the activity. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD447 | Are you able to to stand up from a low, soft couch? Without holding on to anything. |
Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD450 | Are you able to bend over to pick up coins that are scattered on the floor? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD452 | Are you able to work at floor level? For example changing the face plate on an electric outlet. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD454 | Are you able to kneel on the floor for a long time? For example when cleaning the bathtub or playing with kids or pet. 3-5 minutes |
Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD462 | Are you able to climb 2 or 3 steps up a step ladder? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD465 | Are you able to walk around one floor of your home without tripping or losing your balance? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD499 | Are you able to go down one flight of stairs using a handrail? A flight of stairs is 12-15 steps. |
Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR001 | Are you able to stand in the shower to wash your hair? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR002 | Are you able to get in and out of the bathtub? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR005 | Are you able to reach into a cabinet from a step ladder or stool? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR006 | Are you able to to bend down to use a dust pan? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR012 | Are you able to kneel down to tie a shoe? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR013 | Are you able to bend to look under a car? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR016 | Are you able to crawl under a table to pick up something you dropped? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR067 | Are you able to walk the aisles of a grocery store using a shopping cart? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR068 | Are you able to walk from store to store while shopping ? For example in a shopping mall. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR069 | Are you able walk up a flight of stairs without a handrail? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR070 | Are you able to walk to the bathoom? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| DA038 | Are you able to do heavy housework? For example scrubbing floors, washing windows, moving furniture to clean. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD045 | Are you able to stand up from an armless, straight chair? Hint: Without holding on to anything. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD076 | Are you able to move from lying on your back to sitting on the edge of your bed? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD082 | Are you able to get in and out of bed? Hint: Base response on the most difficult part of the activity. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD106_1 | Are you able to sit on a stool without back support? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD125B_1 | Are you able to stand on your feet for one hour? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD151 | Are you able to walk a mile without resting? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD151B | Are you able to walk a mile without resting using your walking aid? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD178 | Are you able to move around on your hands and knees in a crawling position? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD184 | Are you able to go up three flights of stairs using a handrail? Hint: A flight of stairs is 12-15 steps. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD201 | Are you able to go up one flight of stairs using a handrail? Hint: A flight of stairs is 12-15 steps. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD436 | Are you able to get moving after you've been lying down on a couch? For example: Get to the sitting position, then walk or use your wheelchair. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD437 | Are you able to get down on the floor? For example: Moving from standing or your wheelchair to kneel or sit on the floor | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD440_PD441 | Are you able to get into and out of a kneeling position? Hint: Please base your response on the most difficult part of the activity. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD448 | Are you able to bend down to pick up clothing from the floor? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD453 | How long are you able to squat? | 20 minutes 10 minutes 2 minutes unable to do |
| PD455 | How long are you able to kneel? | 20 minutes 10 minutes 2 minutes unable to do |
| PD456 | Are you able to remain on your feet for at least 20 minutes? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD458 | How long are you able to walk without stopping? If you cannot walk without stopping for 15 minutes please select unable. |
More than an hour An hour 30 minutes 15 minutes unable to do I don't know |
| PD458B | How long are you able to walk without stopping using your walking aid? | More than an hour An hour 30 minutes 15 minutes unable to do I don't know |
| PD459 | How fast are you able to walk? | Faster than those around me At a normal pace compared to those around me At a slower pace than those around me Unable to do I don't know |
| PD460_1 | Are you able to walk for at least 30 minutes? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD461B | Are you able to cross the road at a 4-lane traffic light with curbs using your walking aid? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD466B | Are you able to walk in a busy place (e.g., crowded store) without losing your balance using your walking aid? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD512 | Are you able to run fast for 2 minutes? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD514 | Are you able to bend over from a sitting position to pick up an object you dropped on the floor? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD515 | Are you able to remain on your feet for 6 hours with short breaks? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD538_1 | Are you able to walk 150 feet (45 meters) on flat ground? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR011_1 | Are you able to unload a washing machine? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR014 | Are you able to sit in a car for more than 2 hours? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| Variable # | Item | Response Option |
| PD257 | Are you able to pull open a heavy door? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD354 | Are you able to pick up a kitchen chair and move it, in order to clean? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD467 | Are you able to push a full grocery cart? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD496 | Are you able to carry a full laundry basket for 30 feet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD497 | Are you able to carry a full paper grocery bag for 30 feet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD519 | Are you able to do yard work (e.g. plant shrubs or a garden) for 2 hours? For example: With occasional rest but continuous work. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR017 | Are you able to clean a floor using a mop? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR018 | Are you able to pull open a dresser drawer? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR021 | Are you able pull a small suitcase by the handle? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR023 | Are you able to lift a 2 liter soda bottle from the floor to a high shelf? A soda bottle=3.5lbs/1.5kg | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR024 | Are you able to clean out a closet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR028 | Are you able to lift a package weighing 10 lbs? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR029 | Are you able to carry a full kitchen trash bag outside? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR034 | Are you able to unload a full grocery cart into a car? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR036 | Are you able to move a sofa to clean under it? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR039 | Are you able to make a bed? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD259 | Are you able to push open a heavy door? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD263 | Are you able to push a vacuum? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD265 | Are you able to push a full wheelbarrow? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD394 | Are you able to carry a full laundry basket up a flight of stairs? Hint: A flight of stairs is 12-15 steps. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD470 | Are you able to pull a cord on a lawn mower, chain saw, generator or boat motor? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD476 | Are you able to reach overhead into a high cabinet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD479 | Are you able to work overhead for 20 minutes (e.g. organizing a high shelf in a closet)? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD495 | Are you able to carry a full plastic shopping bag for 30 feet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD505 | Are you able to lift a full 2 liter soda bottle from table height to a high shelf? A 2 liter soda bottle= 3.5 lbs/1.5 kg. |
Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD533 | Are you able to lift a full small (carry-on size) suitcase from table height to a high shelf? Hint: A full carry-on suitcase weighs 20 pounds/8 kg. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD534 | Are you able to lift a full large (check-in size) suitcase from the floor to table height? Hint: A full large suitcase weighs 40-50 pounds/18-23 kg. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD535 | Are you able to lift a full large (check-in size) suitcase from table height to a high shelf? Hint: A full large suitcase weighs 40-50 pounds/18-23 kg. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD537 | Are you able to carry a full large (check-in size) suitcase for 30 feet? Hint: A full large suitcase weighs 40-50 pounds/18-23 kg. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD542 | Are you able to trim a tree with long handle saw? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD548 | Are you able to carry a full small (carry-on size) suitcase for 30 feet? Hint: A full carry-on suitcase weighs 20 pounds/8 kg. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR025 | Are you able to lift a heavy box from the floor to table height? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR030 | Are you able to lift a 12 pack of soda cans from a grocery shelf to a grocery cart? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR035_1 | Are you able to unload the dishwasher? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| Variable # | Item | Response Option |
| PD281 | Are you able to open previously opened jars? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD298 | Are you able to turn faucets on and off? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD314 | Are you able to remove wrappings from small objects? For example: Like removing the packaging from a pack of batteries. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD315 | Are you able to pick out one key from group of keys? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD327 | Are you able to turn a key in a door lock? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD468 | Are you able to pick up coins from a table top? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD523 | Are you able to write for 20 minutes? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD525 | Are you able to put batteries in a flashlight, or remote control for your television? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD568 | Are you able to buckle a strap (e.g. on a bicycle helmet, child's car seat, or backpack)? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR046 | Are you able to hold an umbrella? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR047 | Are you able to use tweezers? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR050 | Are you able to remove a dollar bill from your wallet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR051 | Are you able to put coins into a slot? For example a vending machine. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR052 | Are you able to push the correct buttons on a remote control? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR055 | Are you able to close a zip lock bag? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR056 | Are you able to close a twist tie on a bag of bread? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR057 | Are you able to peel the sticker off something you bought? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR059 | Are you able to insert a plug into an electric outlet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR060 | Are you able to use a chip clip to close a bag? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR061 | Are you able to turn a dial? For example on a stove. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR062 | Are you able to use the trigger on a spray bottle? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PDR064 | Are you able to button your shirt? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD270_PD272 | Are you able to pick up and put down a pen or pencil? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD276 | Are you able to use a hammer to pound a nail? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD282 | Are you able to open a can with a hand can opener? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD288 | Are you able to use a lever handle to open a door? Hint: A lever handle is a handle that you push down to open a door. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD289 | Are you able to open childproof medicine bottles or jars? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD290 | Are you able to hold a full glass of water in one hand? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD292 | Are you able to cut a piece of paper with scissors? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD311 | Are you able to address an envelope with a pen? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD316 | Are you able to pick out a paper clip from group of clips? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD328 | Are you able to remove a gas cap from a car? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD330 | Are you able to change the bulb in a table lamp? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD343 | Are you able to reach behind you to get your seatbelt? Hint: A shoulder harness seatbelt. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD344 | Are you able to remove something from your back pocket? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD373 | Are you able to hold a book while reading? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD474 | Are you able to turn a door knob? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD475 | Are you able to tighten screws by hand with a screwdriver? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD539 | Are you able to staple 2 sheets of paper together? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD545 | Are you able to pull a pillow case off a pillow? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| PD547 | Are you able to tie a knot? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| pdr045_1 | Are you able to chop or slice vegetables for a large meal? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| pdr048_1 | Are you able to use a nut cracker? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| pdr058_1 | Are you able to open a bottle of soda? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| pdr065_1 | Are you able to put on a watch or bracelet? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| Variable # | Item | Response Option | ||||
| DA049 | Do you currently drive a car? | Yes (go to 053, 060, 061,066,067) No |
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| DA050 | Do you currently use a bus, train or subway to get around? | Yes (go to 068,070,071,072,073,074) No |
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| Driving | ||||||
| DA053 | Please specify your level of agreement: I can drive to a local store and back home on my own. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
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| DA060 | Are you able to park your car in a parking lot? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| DA061 | Are you able to stay within your lane while driving? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| DA066 | Are you able to drive in your own neighborhood? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| DA067 | Are you able to back out of a driveway? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| Public Transportation | ||||||
| DA068 | Please specify your level of agreement: I can usually get to the bus or train station on time. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
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| DA070 | Are you able to use a bus or train schedule to get to familiar places? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| DA071 | Are you able to use a bus or train schedule to get to unfamiliar places? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| DA072 | Are you able to get on the right bus or train? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| DA073 | Are you able to get on to a bus or train? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
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| DA074 | Are you able to get off the bus or train before the doors close? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| Variable # | Item | Response Option |
| CC008 | Are you able to wait your turn to speak? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC012 | Are you able to make small talk? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC013 | Are you able to figure out why a joke is funny? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC032 | Are you able to understand people in noisy places? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC035 | Are you able to speak clearly? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC050 | Are you able to get information you need when talking with people? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC045 | Are you able to get your point across when speaking with other people? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC040 | Are you able to organize what you want to say? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC046 | Are you able to give directions to another person? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC048 | Are you able to tell a doctor about a health problem? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC051 | Are you able to tell others your needs? For example when you're tired and need to rest. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC026 | Are you able to understand body language and facial expressions when talking to people? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC031 | Are you able to understand people on the phone? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC055 | Are you able to make an appointment over the phone? For example a haircut or dentist. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC056 | Are you able to write reminder notes to yourself? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC029 | Are you able to pay attention when someone is talking to you for a short time? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC092 | Are you able to use bank cards and automatic teller machines (ATMs)? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC049 | Are you able to remember the name of people you know when you see them? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC100 | Are you able to recall information that you have always known? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC114 | Are you able to keep track of the day of the week? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC113 | Are you able to find your way around in familiar places? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC119 | Are you able to get to places on time? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC081 | Are you able to follow instructions given over the phone? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC141 | Are you able to keep yourself safe at home? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| DA048 | Are you able to keep your medical appointments? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC001 | Please specify your level of agreement: I can keep up a conversation. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC025 | Please specify your level of agreement: I can follow what is being said when talking with someone I don't know. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC075 | Please specify your level of agreement: I am able to add and subtract numbers in my head. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC010 | Are you able to discuss your ideas with others? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC047 | Are you able to get your point across when you are upset? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC060 | Are you able to fill out applications? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC063 | Are you able to learn to do new things? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC065 | Are you able to do two things at once? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC066 | Are you able adjust to a new situation or change? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC069 | Are you able to check that your bills are correct? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC072 | Are you able figure out the correct price for something that is on sale? For example 25% off. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC088 | Are you able to pay attention for a long period of time? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC094 | Are you able to work hard on tasks you don't like? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC090 | Are you able to keep track of what you need to do each day? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC095 | Are you able to do your regular chores? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC098 | Are you able to make everyday decisions? For example what to wear, what to eat or what time to get up. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC099 | Are you able to think things through before making a decision? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC156 | Are you able to remember important numbers? For example a phone number. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC101 | Are you able to remember things for a short time? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC102 | Are you able remember something you read or heard earlier in the day? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC105 | Are you able remember a list of 4 or 5 errands without writing it down? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC112 | Are you able to find your way around in unfamiliar places? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC120 | Are you able to manage your time each day? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC117 | Are you able to keep important papers organized? For example bills, insurance documents and tax forms. | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC076 | Are you able to finish things that you start? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC084 | Are you able to think quickly? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC125 | Are you able to ask for help from others when difficult problems come up? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC133 | Are you able to understand written instructions? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| DA046 | Are you able to take your medications correctly? | Yes, without difficulty Yes, with a little difficulty Yes, with some difficulty Yes, with a lot of difficulty Unable to do I don't know |
| CC080 | Please specify your level of agreement: I am able to do many things at once. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC082 | Please specify your level of agreement: I am able to think clearly. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC068 | Please specify your level of agreement: I am able to do my work carefully. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC096 | Please specify your level of agreement: I am good at following through with plans I make. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| DA036 | Please specify your level of agreement: It takes me a long time to run errands. For example going to the bank or drugstore. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC033 | Please specify your level of agreement: People can understand me when I talk. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC058 | Please specify your level of agreement: I often make mistakes when writing down numbers. For example a phone number, checkbook entry. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC078 | Please specify your level of agreement: When I have something easy to do, I have trouble getting started. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC083 | Please specify your level of agreement:I have trouble putting my thoughts together. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC071 | Please specify your level of agreement: People often tell me I make mistakes in my work. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC108 | Please specify your level of agreement: I often forget whether or not I did important things, like take medications. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC129 | Please specify your level of agreement: I have to read something several times to understand it. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC019_1 | Please specify your level of agreement: I can relate to other people's feelings. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| CC036_1 | Please specify your level of agreement: I have to talk very slowly to make myself understood. | Strongly agree Agree Disagree Strongly disagree I don't know |
| Variable # | Item | Response Option |
| BH035 | Please specify your level of agreement: I usually accomplish what I set out to do. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH038 | Please specify your level of agreement: I ask for help when I need to. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH039 | Please specify your level of agreement: I don’t mind when people give me advice. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH048 | Please specify your level of agreement: I am able to adjust to other people's ways. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH049 | Please specify your level of agreement: I make an effort to get to know other people. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH052 | Please specify your level of agreement: I always try to get along with others. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH057 | Please specify your level of agreement: I work well in a group. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II020 | Please specify your level of agreement: I get along well with people outside my family | Strongly agree Agree Disagree Strongly disagree I don't know |
| II158 | Please specify your level of agreement: I feel that there are people I can turn to. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II248 | Please specify your level of agreement: I respect other people's point of view. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II334 | Please specify your level of agreement: I am good at making new friends. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II405 | Please specify your level of agreement: I'm comfortable trying different ways to do things. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II432 | Please specify your level of agreement: When I'm asked to do a really difficult task, I keep at it until I get it done. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II462 | Please specify your level of agreement: If I make a mistake, I know I can deal with it. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II467 | Please specify your level of agreement: I think people trust me. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II526 | Please specify your level of agreement: I look at both sides of an issue. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II551 | Please specify your level of agreement: I am willing to accept help from others. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II561 | Please specify your level of agreement: I am comfortable making eye contact with others. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II585 | Please specify your level of agreement: I can get back on track when I am distracted. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II990 | Please specify your level of agreement: People tell me I'm flexible and agreeable. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II991 | Please specify your level of agreement: Most people like what I have to say. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II993 | Please specify your level of agreement: I'm usually able to help solve other people's problems. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II995 | Please specify your level of agreement: I'm comfortable just seeing what the day brings. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II996 | Please specify your level of agreement: I look for the good in difficult situations. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II999 | Please specify your level of agreement: I believe that things end up alright most of the time. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC150 | Please specify your level of agreement: When there is a problem I am able to work things out with other people. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| BH025_C | Please specify your level of agreement: I can handle stressful situations. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II324_C | Please specify your level of agreement: It's easy to do what people in authority ask me to do. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II982_C | Please specify your level of agreement: I like large family gatherings. | Strongly agree Agree Disagree Strongly disagree I don't know |
| Variable # | Item | Response Option |
| CC004 | Please specify your level of agreement: People tell me I stand too close when I am talking to them. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH030 | Please specify your level of agreement: People say I show no emotion. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH005 | Please specify your level of agreement: I often get upset with the people around me. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH020 | Please specify your level of agreement: People often tell me my behavior is inappropriate. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH004 | Please specify your level of agreement: I often get angry when I'm told what to do. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH026 | Please specify your level of agreement: When I am stressed, I find myself losing control. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH003 | Please specify your level of agreement: Sometimes I do things to hurt myself. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH011 | Please specify your level of agreement: I have difficulty calming down. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH024 | Please specify your level of agreement: The same thoughts keep running through my head. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II206 | Please specify your level of agreement: I get very loud when I do not get what I want. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II208 | Please specify your level of agreement: I sometimes get physical when I'm angry. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II212 | Please specify your level of agreement: Sometimes I shout or yell for no reason. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II257 | Please specify your level of agreement: People know that I get angry easily. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II493 | Please specify your level of agreement: I can't stop myself from doing the same thing over and over. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II151 | Please specify your level of agreement: I feel people are against me. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH053 | Please specify your level of agreement: I have a hard time accepting criticism. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH058 | Please specify your level of agreement: I often say things that upset others. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH059 | Please specify your level of agreement: I difficulty letting people know how I feel. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II615 | In the past 7 days, I had trouble controlling my temper. | Never Rarely Sometimes Often Always |
| CC079_C | Please specify your level of agreement: When I have something hard to do, I have trouble getting started. | Strongly agree Agree Disagree Strongly disagree I don't know |
| CC134_C | Please specify your level of agreement: Others have told me that I do things that put me at risk. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH029_C | Please specify your level of agreement: I seem to worry about my health a lot. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH008_C | Please specify your level of agreement: I have difficulty following the rules. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH018_C | Please specify your level of agreement: I find that I have a hard time sitting still when I need to. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH007_C | Please specify your level of agreement: I am always watching or on guard for threats. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| BH013_C | Please specify your level of agreement: Sometimes I feel on top of the world for no reason. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH044_C | Please specify your level of agreement: I often have difficulty dealing with people. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH056_C | Please specify your level of agreement: People have told me that sometimes I act strange. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH072_C | Please specify your level of agreement: I respect other people's property. | Strongly agree Agree Disagree Strongly disagree I don't know |
| BH070_C_R1 | Please specify your level of agreement: I can hear things that others can't. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II284_C | In the past 7 days, I was resentful when I didn't get my way. | Never Rarely Sometimes Often Always |
| II610_C | In the past 7 days, I threatened violence toward people or property . | Never Rarely Sometimes Often Always |
| II626_C | In the past 7 days, I looked forward with enjoyment to upcoming events. | Never Rarely Sometimes Often Always |
| II596_C_AG11 | In the past 7 days, I had sudden feelings of panic. | Never Rarely Sometimes Often Always |
| Variable # | Item | Response Option |
| II139 | Please specify your level of agreement: I feel good about myself. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II594 | In the past 7 days, I felt indecisive. Hint: Indecisive meaning having trouble making decisions | Never Rarely Sometimes Often Always |
| II596 | In the past 7 days, I had sudden feelings of panic. | Never Rarely Sometimes Often Always |
| II597 | In the past 7 days, many situations made me worry. | Never Rarely Sometimes Often Always |
| II094 | In the past 7 days, I felt hopeless about the future. | Never Rarely Sometimes Often Always |
| II603 | In the past 7 days, I felt that nothing was interesting. | Never Rarely Sometimes Often Always |
| II605 | In the past 7 days, I felt that nothing could cheer me up. | Never Rarely Sometimes Often Always |
| II607 | In the past 7 days, I felt emotionally exhausted. | Never Rarely Sometimes Often Always |
| II608 | In the past 7 days, I had trouble enjoying the things I used to enjoy. | Never Rarely Sometimes Often Always |
| II609 | In the past 7 days, it was hard to keep up enthusiasm to get things done. | Never Rarely Sometimes Often Always |
| II419 | In the past 7 days, I got fidgety. Hint: Fidgety meaning unable to sit still. | Never Rarely Sometimes Often Always |
| II616 | In the past 7 days, I was preoccupied with my worries. | Never Rarely Sometimes Often Always |
| II617 | In the past 7 days, I had trouble paying attention. | Never Rarely Sometimes Often Always |
| II592 | In the past 7 days, I felt nervous when my normal routine was disturbed. | Never Rarely Sometimes Often Always |
| II619 | In the past 7 days, just being around people irritated me. | Never Rarely Sometimes Often Always |
| II306 | In the past 7 days, I was bothered if I had to depend on others for help. | Never Rarely Sometimes Often Always |
| II634 | In the past 7 days, I have trouble keeping in touch with others. | Never Rarely Sometimes Often Always |
| II984_1 | Please specify your level of agreement: I don't know why I cry so often. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II600_1 | In the past 7 days, I suddenly became emotional for no reason. | Never Rarely Sometimes Often Always |
| II538 | Please specify your level of agreement: I feel sick when I have to speak in front of people. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II395 | Please specify your level of agreement: I stay alone at home to avoid people. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II537 | Please specify your level of agreement: I worry people are criticizing me even when they are not. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II474 | Please specify your level of agreement: I am so tired when I wake up, it's hard to get going. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II983 | Please specify your level of agreement: I dwell on my problems. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II164 | Please specify your level of agreement: I have a lot of energy. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II591 | In the past 7 days, I felt something awful would happen. | Never Rarely Sometimes Often Always |
| II583 | In the past 7 days, I was afraid of what the future holds for me. | Never Rarely Sometimes Often Always |
| II602 | In the past 7 days, I felt that I had nothing to look forward to | Never Rarely Sometimes Often Always |
| II618 | In the past 7 days, it was hard to adjust to unexpected changes. | Never Rarely Sometimes Often Always |
| II635 | In the past 7 days, I avoided public places or activities. | Never Rarely Sometimes Often Always |
| II986 | Please specify your level of agreement: I am so tired that I rest or sleep most of the day. | Strongly agree Agree Disagree Strongly disagree Unable to do I don't know |
| II498 | Please specify your level of agreement: I am unable to think with all the noise in my head. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II505 | Please specify your level of agreement: When I'm stressed, I can't figure out what to do. | Strongly agree Agree Disagree Strongly disagree I don't know |
| II606 | In the past 7 days, I was critical of myself for my mistakes. | Never Rarely Sometimes Often Always |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |