ID

21424

Description

ODM form of Dr. Cohen's Scales. The form contains questions about a number of events that commonly happen in people's lives.Forms derived from http://www.psy.cmu.edu/~scohen/scales.html. Information related to scoring http://www.psy.cmu.edu/~scohen/LEL_scoring_revised.pdf

Link

http://www.psy.cmu.edu/~scohen/scales.html

Keywords

  1. 4/21/17 4/21/17 -
  2. 10/1/20 10/1/20 - Sarah Riepenhausen
Copyright Holder

Dr. Sheldon Cohen

Uploaded on

April 21, 2017

DOI

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License

Creative Commons BY-NC 3.0

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LEL Cohen’s Scale

LEL LIFE EVENTS CHECKLIST

LIFE EVENTS
Description

LIFE EVENTS

Alias
UMLS CUI-1
C0814587
1. Have you moved during the last 12 months?
Description

relocation of home

Data type

text

Alias
UMLS CUI [1]
C2699029
1a. If yes: Would you say that you moved to a neighborhood that is better, worse, or about the same as where you were living?
Description

neighborhood condition

Data type

text

Alias
UMLS CUI [1,1]
C0027569
UMLS CUI [1,2]
C0348080
1b. Overall, would you say that your moving was a good or bad experience?
Description

relocation of home; experience

Data type

text

Alias
UMLS CUI [1]
C2699029
UMLS CUI [2]
C0023672
2. Have you broken off an engagement to be married or ended an intimate relationship during the last 12 months?
Description

Break up of romance

Data type

text

Alias
UMLS CUI [1]
C0686969
2a. If yes: How would you rate your feelings about breaking up?
Description

Feelings Breakup of romance

Data type

text

Alias
UMLS CUI [1,1]
C1527305
UMLS CUI [1,2]
C0686969
3. Did you get married during the last 12 months?
Description

marriage

Data type

text

Alias
UMLS CUI [1]
C0024841
3a. If yes: Did you want to get married?
Description

Agree marriage

Data type

boolean

Alias
UMLS CUI [1,1]
C3641827
UMLS CUI [1,2]
C0024841
3b. Overall, would you rate getting married as a good or bad experience?
Description

marriage life event

Data type

text

Alias
UMLS CUI [1]
C0024841
4. Did someone you were close to die during the last 12 months?
Description

death close person

Data type

text

Alias
UMLS CUI [1]
C1716700
4. If yes, who:
Description

death close person

Data type

text

Alias
UMLS CUI [1]
C1716700
5. Were you separated or divorced during the last 12 months?
Description

Separated/Divorced

Data type

text

Alias
UMLS CUI [1]
C0682073
5a. If yes: Did you want to get separated or divorced?
Description

Agree Separated/Divorced

Data type

boolean

Alias
UMLS CUI [1,1]
C3641827
UMLS CUI [1,2]
C0682073
5b. Overall, would you rate your separation or divorce as a good or bad experience?
Description

Life Experiences Separated/Divorced

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0682073
6. Did you break up with a close friend during the last 12 months?
Description

separation from close friend

Data type

text

Alias
UMLS CUI [1,1]
C0443299
UMLS CUI [1,2]
C0814601
6a. If yes: Did you want to break up with this friend?
Description

Agree separation from close friend

Data type

boolean

Alias
UMLS CUI [1,1]
C3641827
UMLS CUI [1,2]
C0814601
6b. Overall, would you rate your breaking up as a good or bad experience?
Description

life experience separation from close friend

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0814601
7. Have you had any important relationship, for example, with your spouse, a close friend, your boss, or a family member become significantly worse during the last 12 months (this should not include the relationship referred to in item 6 above)?
Description

Problem situation Relationships Family Work

Data type

text

Alias
UMLS CUI [1,1]
C0438401
UMLS CUI [1,2]
C0439849
UMLS CUI [1,3]
C0015576
UMLS CUI [1,4]
C0043227
7a. If yes: With whom? (more than one response is possible)
Description

Problem situation Relationships Family Work

Data type

text

Alias
UMLS CUI [1,1]
C0438401
UMLS CUI [1,2]
C0439849
UMLS CUI [1,3]
C0015576
UMLS CUI [1,4]
C0043227
8. Did you have a child or adopt a child during the last 12 months?
Description

adoption of child

Data type

text

Alias
UMLS CUI [1]
C0237459
8a. If yes: Is this a first child?
Description

adoption of child

Data type

boolean

Alias
UMLS CUI [1]
C0237459
8b. Did you plan to have this child?
Description

plan Adoption of child

Data type

boolean

Alias
UMLS CUI [1,1]
C1301732
UMLS CUI [1,2]
C0237459
8c. Would you rate having a child and adjusting to having a child as a good or bad experience?
Description

life experiences Adoption of child

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0237459
9. Have you, a very close friend, or close family member had an accident that required emergency medical treatment during the last 12 months?
Description

Close friend was seriously sick - injured Family member; Emergency treatment

Data type

text

Alias
UMLS CUI [1,1]
C3259057
UMLS CUI [1,2]
C0086282
UMLS CUI [2]
C0013969
9a. If yes: Who? (more than one response is possible)
Description

Close friend was seriously sick - injured Family member; Emergency treatment

Data type

text

Alias
UMLS CUI [1,1]
C3259057
UMLS CUI [1,2]
C0086282
UMLS CUI [2]
C0013969
10. Have you, a very close friend, or close family member been hospitalized for a serious (life- threatening) illness during the last 12 months?
Description

Hospitalisation Close friend was seriously sick - injured Family member

Data type

text

Alias
UMLS CUI [1,1]
C0019993
UMLS CUI [1,2]
C3259057
UMLS CUI [1,3]
C0086282
10a. If yes: Who? (more than one response is possible)
Description

Hospitalisation Close friend was seriously sick - injured Family member

Data type

text

Alias
UMLS CUI [1,1]
C0019993
UMLS CUI [1,2]
C3259057
UMLS CUI [1,3]
C0086282
11a. (Women) Have you been pregnant during the last 12 months?
Description

pregnancy status

Data type

text

Alias
UMLS CUI [1]
C0552579
If yes: a. Was the pregnancy planned or unplanned?
Description

pregnancy planned

Data type

text

Alias
UMLS CUI [1]
C0032992
b. How would you rate being pregnant?
Description

life experience pregnancy

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0032961
11b. (Men) Has your wife, partner or girlfriend been pregnant during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
Description

pregnancy status partner

Data type

text

Alias
UMLS CUI [1,1]
C0552579
UMLS CUI [1,2]
C0682323
If yes: a. Was the pregnancy planned or unplanned?
Description

Pregnancy, Planned partner

Data type

text

Alias
UMLS CUI [1,1]
C0032992
UMLS CUI [1,2]
C0682323
b. How would you rate being pregnant?
Description

life experiences Pregnancy

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0032961
12a. (Women) Have you had an abortion during the last 12 months?
Description

Abortion

Data type

text

Alias
UMLS CUI [1]
C0156543
12b. (Men) Has your wife, partner or girlfriend had an abortion during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
Description

Abortion partner

Data type

text

Alias
UMLS CUI [1,1]
C0156543
UMLS CUI [1,2]
C0682323
13a. (Women) Have you had a miscarriage or stillbirth during the last 12 months?
Description

miscarriage or stillbirth

Data type

text

Alias
UMLS CUI [1,1]
C0438080
UMLS CUI [1,2]
C0595939
13b. (Men) Has your wife, partner or girlfriend had a miscarriage or stillbirth during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
Description

miscarriage or stillbirth partner

Data type

text

Alias
UMLS CUI [1,1]
C0438080
UMLS CUI [1,2]
C0595939
UMLS CUI [1,3]
C0682323
14. Have you or your spouse/partner lost or changed jobs or been involuntarily unemployed during the last 12 months?
Description

employment status partner

Data type

text

Alias
UMLS CUI [1,1]
C0242271
UMLS CUI [1,2]
C0682323
If yes: a. Who?
Description

employment status partner

Data type

text

Alias
UMLS CUI [1,1]
C0242271
UMLS CUI [1,2]
C0682323
b. Why did you (or spouse) leave? (answer only for you if both lost or changed jobs)
Description

reason Leaving job

Data type

text

Alias
UMLS CUI [1,1]
C0566251
UMLS CUI [1,2]
C0557455
c. Could you (or spouse) have stayed in your old job if you wanted?
Description

agree Leaving job

Data type

boolean

Alias
UMLS CUI [1,1]
C3641827
UMLS CUI [1,2]
C0557455
d. How would you rate your feelings about leaving your job? (or your spouse leaving his/her job)?
Description

life experiences Leaving job

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0557455
15. During the last 12 months, have you or your spouse/partner suffered a significant business or investment loss or has a business you owned failed?
Description

Business worries

Data type

text

Alias
UMLS CUI [1]
C0425099
If yes: a. Who?
Description

Business worries

Data type

text

Alias
UMLS CUI [1]
C0425099
16. During the last 12 months, have you or your spouse/partner had any serious problems or disappointment at school or in an educational course (university, training program, etc.)? (answer only for you if both had disappointments)
Description

academic performance disappointment

Data type

text

Alias
UMLS CUI [1,1]
C0036373
UMLS CUI [1,2]
C0870427
If yes: a. Who?
Description

academic performance disappointment

Data type

text

Alias
UMLS CUI [1,1]
C0036373
UMLS CUI [1,2]
C0870427
b. What was the disappointment?
Description

academic performance disappointment

Data type

text

Alias
UMLS CUI [1,1]
C0036373
UMLS CUI [1,2]
C0870427
17. Have you or your spouse/partner had significant success at work or in an educational course (university, training program) during the last 12 months?
Description

success work education

Data type

text

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C0043227
UMLS CUI [1,3]
C0013622
If yes: a. Who?
Description

success work education

Data type

text

Alias
UMLS CUI [1,1]
C0597535
UMLS CUI [1,2]
C0043227
UMLS CUI [1,3]
C0013622
18. Has there been a significant change in your personal finances during the last 12 months?
Description

personal finances

Data type

text

Alias
UMLS CUI [1]
C0557159
If yes: a. Has the change been for the better or worse?
Description

life experiences Financial circumstances

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0557159
19. Has your house been broken into and/or burgled during the last 12 months?
Description

Victim of burglary

Data type

text

Alias
UMLS CUI [1]
C0521878
20. Have you or your spouse/partner or other member of your immediate family been assaulted or mugged during the last 12 months?
Description

recently physically assaulted

Data type

text

Alias
UMLS CUI [1]
C2169639
If yes: a. Who? (more than one response is possible)
Description

recently physically assaulted

Data type

text

Alias
UMLS CUI [1]
C2169639
21. Has the behavior of any member of your family been a significant problem for you during the last 12 months?
Description

behavior disorder family member

Data type

text

Alias
UMLS CUI [1,1]
C0004930
UMLS CUI [1,2]
C0086282
If yes: a. Who? (more than one response is possible)
Description

behavior disorder family member

Data type

text

Alias
UMLS CUI [1,1]
C0004930
UMLS CUI [1,2]
C0086282
22. Have you or your spouse/partner had to appear in court during the last 12 months as a defendant, a witness in a criminal case, or as party to a suit?
Description

Attend court

Data type

text

Alias
UMLS CUI [1]
C0422117
If yes: a. Who?
Description

Attend court

Data type

text

Alias
UMLS CUI [1]
C0422117
b. How would you rate the court experience?
Description

life experiences attend court

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C0422117
23. Have you had a pet (animal) to whom you were attached die, or get lost, or did you have to give it away during the last 12 months?
Description

Death of pet

Data type

text

Alias
UMLS CUI [1]
C0524346
24. Other than the events we have already asked about, have any other important things happened to you or to a very close friend or close family member in the last 12 months that made that period significantly different from a typical year?
Description

Important event

Data type

text

Alias
UMLS CUI [1]
C1287456
If yes: You can list up to three (3) events. Please do not feel obliged to include an additional event or events unless they were significant! Event 1: To whom?
Description

important event

Data type

text

Alias
UMLS CUI [1]
C1287456
What happened?
Description

important event

Data type

text

Alias
UMLS CUI [1]
C1287456
Did you want the event to happen?
Description

desire important event

Data type

boolean

Alias
UMLS CUI [1,1]
C0871633
UMLS CUI [1,2]
C1287456
How would you rate your feelings about this event?
Description

life experiences important event

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C1287456
Event 2: To whom?
Description

important event

Data type

text

Alias
UMLS CUI [1]
C1287456
What happened?
Description

important event

Data type

text

Alias
UMLS CUI [1]
C1287456
Did you want the event to happen?
Description

desire important event

Data type

boolean

Alias
UMLS CUI [1,1]
C0871633
UMLS CUI [1,2]
C1287456
How would you rate your feelings about this event?
Description

life experiences important event

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C1287456
Event 3: To whom?
Description

important event

Data type

text

Alias
UMLS CUI [1]
C1287456
What happened?
Description

important event

Data type

text

Alias
UMLS CUI [1]
C1287456
Did you want the event to happen?
Description

desire important event

Data type

boolean

Alias
UMLS CUI [1,1]
C0871633
UMLS CUI [1,2]
C1287456
How would you rate your feelings about this event?
Description

life experiences important event

Data type

text

Alias
UMLS CUI [1,1]
C0023672
UMLS CUI [1,2]
C1287456

Similar models

LEL LIFE EVENTS CHECKLIST

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
LIFE EVENTS
C0814587 (UMLS CUI-1)
Item
1. Have you moved during the last 12 months?
text
C2699029 (UMLS CUI [1])
Code List
1. Have you moved during the last 12 months?
CL Item
No (Skip to Q.2)  (1)
CL Item
Yes (2)
Item
1a. If yes: Would you say that you moved to a neighborhood that is better, worse, or about the same as where you were living?
text
C0027569 (UMLS CUI [1,1])
C0348080 (UMLS CUI [1,2])
Code List
1a. If yes: Would you say that you moved to a neighborhood that is better, worse, or about the same as where you were living?
CL Item
Same  (1)
CL Item
Better  (2)
CL Item
Worse (3)
Item
1b. Overall, would you say that your moving was a good or bad experience?
text
C2699029 (UMLS CUI [1])
C0023672 (UMLS CUI [2])
Code List
1b. Overall, would you say that your moving was a good or bad experience?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
2. Have you broken off an engagement to be married or ended an intimate relationship during the last 12 months?
text
C0686969 (UMLS CUI [1])
Code List
2. Have you broken off an engagement to be married or ended an intimate relationship during the last 12 months?
CL Item
No (Skip to Q.3)  (1)
CL Item
Yes (2)
Item
2a. If yes: How would you rate your feelings about breaking up?
text
C1527305 (UMLS CUI [1,1])
C0686969 (UMLS CUI [1,2])
Code List
2a. If yes: How would you rate your feelings about breaking up?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
3. Did you get married during the last 12 months?
text
C0024841 (UMLS CUI [1])
Code List
3. Did you get married during the last 12 months?
CL Item
No (Skip to Q.4)  (1)
CL Item
Yes (2)
Agree marriage
Item
3a. If yes: Did you want to get married?
boolean
C3641827 (UMLS CUI [1,1])
C0024841 (UMLS CUI [1,2])
Item
3b. Overall, would you rate getting married as a good or bad experience?
text
C0024841 (UMLS CUI [1])
Code List
3b. Overall, would you rate getting married as a good or bad experience?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
4. Did someone you were close to die during the last 12 months?
text
C1716700 (UMLS CUI [1])
Code List
4. Did someone you were close to die during the last 12 months?
CL Item
No (Skip to Q.5)  (1)
CL Item
Yes (2)
Item
4. If yes, who:
text
C1716700 (UMLS CUI [1])
Code List
4. If yes, who:
CL Item
Spouse or intimate friend  (1)
CL Item
Parent  (2)
CL Item
Spouse's parent  (3)
CL Item
Brother or sister child other relatives  (4)
CL Item
Friend  (5)
CL Item
Other (6)
Item
5. Were you separated or divorced during the last 12 months?
text
C0682073 (UMLS CUI [1])
Code List
5. Were you separated or divorced during the last 12 months?
CL Item
No (Skip to Q.6)  (1)
CL Item
Yes (2)
Agree Separated/Divorced
Item
5a. If yes: Did you want to get separated or divorced?
boolean
C3641827 (UMLS CUI [1,1])
C0682073 (UMLS CUI [1,2])
Item
5b. Overall, would you rate your separation or divorce as a good or bad experience?
text
C0023672 (UMLS CUI [1,1])
C0682073 (UMLS CUI [1,2])
Code List
5b. Overall, would you rate your separation or divorce as a good or bad experience?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
6. Did you break up with a close friend during the last 12 months?
text
C0443299 (UMLS CUI [1,1])
C0814601 (UMLS CUI [1,2])
Code List
6. Did you break up with a close friend during the last 12 months?
CL Item
No (Skip to Q.7)  (1)
CL Item
Yes (2)
Agree separation from close friend
Item
6a. If yes: Did you want to break up with this friend?
boolean
C3641827 (UMLS CUI [1,1])
C0814601 (UMLS CUI [1,2])
Item
6b. Overall, would you rate your breaking up as a good or bad experience?
text
C0023672 (UMLS CUI [1,1])
C0814601 (UMLS CUI [1,2])
Code List
6b. Overall, would you rate your breaking up as a good or bad experience?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
7. Have you had any important relationship, for example, with your spouse, a close friend, your boss, or a family member become significantly worse during the last 12 months (this should not include the relationship referred to in item 6 above)?
text
C0438401 (UMLS CUI [1,1])
C0439849 (UMLS CUI [1,2])
C0015576 (UMLS CUI [1,3])
C0043227 (UMLS CUI [1,4])
Code List
7. Have you had any important relationship, for example, with your spouse, a close friend, your boss, or a family member become significantly worse during the last 12 months (this should not include the relationship referred to in item 6 above)?
CL Item
No (Skip to Q.8) (1)
CL Item
Yes (2)
Item
7a. If yes: With whom? (more than one response is possible)
text
C0438401 (UMLS CUI [1,1])
C0439849 (UMLS CUI [1,2])
C0015576 (UMLS CUI [1,3])
C0043227 (UMLS CUI [1,4])
Code List
7a. If yes: With whom? (more than one response is possible)
CL Item
Boss  (1)
CL Item
Spouse  (2)
CL Item
Friend  (3)
CL Item
Child  (4)
CL Item
Parent  (5)
CL Item
Other family member (6)
Item
8. Did you have a child or adopt a child during the last 12 months?
text
C0237459 (UMLS CUI [1])
Code List
8. Did you have a child or adopt a child during the last 12 months?
CL Item
No (Skip to Q.9) (1)
CL Item
Yes (2)
adoption of child
Item
8a. If yes: Is this a first child?
boolean
C0237459 (UMLS CUI [1])
plan Adoption of child
Item
8b. Did you plan to have this child?
boolean
C1301732 (UMLS CUI [1,1])
C0237459 (UMLS CUI [1,2])
Item
8c. Would you rate having a child and adjusting to having a child as a good or bad experience?
text
C0023672 (UMLS CUI [1,1])
C0237459 (UMLS CUI [1,2])
Code List
8c. Would you rate having a child and adjusting to having a child as a good or bad experience?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
9. Have you, a very close friend, or close family member had an accident that required emergency medical treatment during the last 12 months?
text
C3259057 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
C0013969 (UMLS CUI [2])
Code List
9. Have you, a very close friend, or close family member had an accident that required emergency medical treatment during the last 12 months?
CL Item
No (Skip to Q.10)  (1)
CL Item
Yes (2)
Item
9a. If yes: Who? (more than one response is possible)
text
C3259057 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
C0013969 (UMLS CUI [2])
Code List
9a. If yes: Who? (more than one response is possible)
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Child  (3)
CL Item
Parent  (4)
CL Item
Spouse’s parent  (5)
CL Item
Brother or sister  (6)
CL Item
Friend  (7)
CL Item
Other (8)
Item
10. Have you, a very close friend, or close family member been hospitalized for a serious (life- threatening) illness during the last 12 months?
text
C0019993 (UMLS CUI [1,1])
C3259057 (UMLS CUI [1,2])
C0086282 (UMLS CUI [1,3])
Code List
10. Have you, a very close friend, or close family member been hospitalized for a serious (life- threatening) illness during the last 12 months?
CL Item
No (Skip to Q.11) (1)
CL Item
Yes (2)
Item
10a. If yes: Who? (more than one response is possible)
text
C0019993 (UMLS CUI [1,1])
C3259057 (UMLS CUI [1,2])
C0086282 (UMLS CUI [1,3])
Code List
10a. If yes: Who? (more than one response is possible)
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Child  (3)
CL Item
Parent  (4)
CL Item
Spouse’s parent  (5)
CL Item
Brother or sister  (6)
CL Item
Friend  (7)
CL Item
Other (8)
Item
11a. (Women) Have you been pregnant during the last 12 months?
text
C0552579 (UMLS CUI [1])
Code List
11a. (Women) Have you been pregnant during the last 12 months?
CL Item
No (Skip to Q.12)  (1)
CL Item
Yes (2)
Item
If yes: a. Was the pregnancy planned or unplanned?
text
C0032992 (UMLS CUI [1])
Code List
If yes: a. Was the pregnancy planned or unplanned?
CL Item
Planned  (1)
CL Item
Unplanned (2)
Item
b. How would you rate being pregnant?
text
C0023672 (UMLS CUI [1,1])
C0032961 (UMLS CUI [1,2])
Code List
b. How would you rate being pregnant?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
11b. (Men) Has your wife, partner or girlfriend been pregnant during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
text
C0552579 (UMLS CUI [1,1])
C0682323 (UMLS CUI [1,2])
Code List
11b. (Men) Has your wife, partner or girlfriend been pregnant during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
CL Item
No (Skip to Q.12) (1)
CL Item
Yes (2)
Item
If yes: a. Was the pregnancy planned or unplanned?
text
C0032992 (UMLS CUI [1,1])
C0682323 (UMLS CUI [1,2])
Code List
If yes: a. Was the pregnancy planned or unplanned?
CL Item
Planned  (1)
CL Item
Unplanned (2)
Item
b. How would you rate being pregnant?
text
C0023672 (UMLS CUI [1,1])
C0032961 (UMLS CUI [1,2])
Code List
b. How would you rate being pregnant?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
12a. (Women) Have you had an abortion during the last 12 months?
text
C0156543 (UMLS CUI [1])
Code List
12a. (Women) Have you had an abortion during the last 12 months?
CL Item
No (Skip to Q.13)  (1)
CL Item
Yes (2)
Item
12b. (Men) Has your wife, partner or girlfriend had an abortion during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
text
C0156543 (UMLS CUI [1,1])
C0682323 (UMLS CUI [1,2])
Code List
12b. (Men) Has your wife, partner or girlfriend had an abortion during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
CL Item
No (Skip to Q.13)  (1)
CL Item
Yes (2)
Item
13a. (Women) Have you had a miscarriage or stillbirth during the last 12 months?
text
C0438080 (UMLS CUI [1,1])
C0595939 (UMLS CUI [1,2])
Code List
13a. (Women) Have you had a miscarriage or stillbirth during the last 12 months?
CL Item
No (Skip to Q.14) (1)
CL Item
Yes (2)
Item
13b. (Men) Has your wife, partner or girlfriend had a miscarriage or stillbirth during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
text
C0438080 (UMLS CUI [1,1])
C0595939 (UMLS CUI [1,2])
C0682323 (UMLS CUI [1,3])
Code List
13b. (Men) Has your wife, partner or girlfriend had a miscarriage or stillbirth during the last 12 months? [Tick no if you do not have a wife, partner, or girlfriend.]
CL Item
No (Skip to Q.14) (1)
CL Item
Yes (2)
Item
14. Have you or your spouse/partner lost or changed jobs or been involuntarily unemployed during the last 12 months?
text
C0242271 (UMLS CUI [1,1])
C0682323 (UMLS CUI [1,2])
Code List
14. Have you or your spouse/partner lost or changed jobs or been involuntarily unemployed during the last 12 months?
CL Item
No (Skip to Q.15)  (1)
CL Item
Yes (2)
Item
If yes: a. Who?
text
C0242271 (UMLS CUI [1,1])
C0682323 (UMLS CUI [1,2])
Code List
If yes: a. Who?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Both (3)
Item
b. Why did you (or spouse) leave? (answer only for you if both lost or changed jobs)
text
C0566251 (UMLS CUI [1,1])
C0557455 (UMLS CUI [1,2])
Code List
b. Why did you (or spouse) leave? (answer only for you if both lost or changed jobs)
CL Item
On strike  (1)
CL Item
Temporarily laid off  (2)
CL Item
Fired  (3)
CL Item
Found better job  (4)
CL Item
Plant or business closing or reorganizing  (5)
CL Item
Retired  (6)
CL Item
Other (7)
agree Leaving job
Item
c. Could you (or spouse) have stayed in your old job if you wanted?
boolean
C3641827 (UMLS CUI [1,1])
C0557455 (UMLS CUI [1,2])
Item
d. How would you rate your feelings about leaving your job? (or your spouse leaving his/her job)?
text
C0023672 (UMLS CUI [1,1])
C0557455 (UMLS CUI [1,2])
Code List
d. How would you rate your feelings about leaving your job? (or your spouse leaving his/her job)?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
15. During the last 12 months, have you or your spouse/partner suffered a significant business or investment loss or has a business you owned failed?
text
C0425099 (UMLS CUI [1])
Code List
15. During the last 12 months, have you or your spouse/partner suffered a significant business or investment loss or has a business you owned failed?
CL Item
No (Skip to Q.16) (1)
CL Item
Yes (2)
Item
If yes: a. Who?
text
C0425099 (UMLS CUI [1])
Code List
If yes: a. Who?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Both (3)
Item
16. During the last 12 months, have you or your spouse/partner had any serious problems or disappointment at school or in an educational course (university, training program, etc.)? (answer only for you if both had disappointments)
text
C0036373 (UMLS CUI [1,1])
C0870427 (UMLS CUI [1,2])
Code List
16. During the last 12 months, have you or your spouse/partner had any serious problems or disappointment at school or in an educational course (university, training program, etc.)? (answer only for you if both had disappointments)
CL Item
No (Skip to Q.17) (1)
CL Item
Yes (2)
Item
If yes: a. Who?
text
C0036373 (UMLS CUI [1,1])
C0870427 (UMLS CUI [1,2])
Code List
If yes: a. Who?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Both (3)
Item
b. What was the disappointment?
text
C0036373 (UMLS CUI [1,1])
C0870427 (UMLS CUI [1,2])
Code List
b. What was the disappointment?
CL Item
Demoted  (1)
CL Item
Failed to get raise or promotion  (2)
CL Item
Failed a course  (3)
CL Item
Trouble with boss or coworkers  (4)
CL Item
Put on academic probation  (5)
CL Item
Failed to get into an educational course (college, training program, etc.)  (6)
CL Item
Other (7)
Item
17. Have you or your spouse/partner had significant success at work or in an educational course (university, training program) during the last 12 months?
text
C0597535 (UMLS CUI [1,1])
C0043227 (UMLS CUI [1,2])
C0013622 (UMLS CUI [1,3])
Code List
17. Have you or your spouse/partner had significant success at work or in an educational course (university, training program) during the last 12 months?
CL Item
No (Skip to Q.18)  (1)
CL Item
Yes (2)
Item
If yes: a. Who?
text
C0597535 (UMLS CUI [1,1])
C0043227 (UMLS CUI [1,2])
C0013622 (UMLS CUI [1,3])
Code List
If yes: a. Who?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Both (3)
Item
18. Has there been a significant change in your personal finances during the last 12 months?
text
C0557159 (UMLS CUI [1])
Code List
18. Has there been a significant change in your personal finances during the last 12 months?
CL Item
No (Skip to Q.19)  (1)
CL Item
Yes (2)
Item
If yes: a. Has the change been for the better or worse?
text
C0023672 (UMLS CUI [1,1])
C0557159 (UMLS CUI [1,2])
Code List
If yes: a. Has the change been for the better or worse?
CL Item
Better  (1)
CL Item
Worse (2)
Item
19. Has your house been broken into and/or burgled during the last 12 months?
text
C0521878 (UMLS CUI [1])
Code List
19. Has your house been broken into and/or burgled during the last 12 months?
CL Item
No (Skip to Q.20)  (1)
CL Item
Yes (2)
Item
20. Have you or your spouse/partner or other member of your immediate family been assaulted or mugged during the last 12 months?
text
C2169639 (UMLS CUI [1])
Code List
20. Have you or your spouse/partner or other member of your immediate family been assaulted or mugged during the last 12 months?
CL Item
No (Skip to Q.21)  (1)
CL Item
Yes (2)
Item
If yes: a. Who? (more than one response is possible)
text
C2169639 (UMLS CUI [1])
Code List
If yes: a. Who? (more than one response is possible)
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Child  (3)
CL Item
Parent  (4)
CL Item
Brother or sister  (5)
CL Item
Other (6)
Item
21. Has the behavior of any member of your family been a significant problem for you during the last 12 months?
text
C0004930 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
Code List
21. Has the behavior of any member of your family been a significant problem for you during the last 12 months?
CL Item
No (Skip to Q.22)  (1)
CL Item
Yes (2)
Item
If yes: a. Who? (more than one response is possible)
text
C0004930 (UMLS CUI [1,1])
C0086282 (UMLS CUI [1,2])
Code List
If yes: a. Who? (more than one response is possible)
CL Item
Spouse/partner  (1)
CL Item
Child  (2)
CL Item
Parent  (3)
CL Item
Brother or sister  (4)
CL Item
Other (5)
Item
22. Have you or your spouse/partner had to appear in court during the last 12 months as a defendant, a witness in a criminal case, or as party to a suit?
text
C0422117 (UMLS CUI [1])
Code List
22. Have you or your spouse/partner had to appear in court during the last 12 months as a defendant, a witness in a criminal case, or as party to a suit?
CL Item
No (Skip to Q.23) (1)
CL Item
Yes (2)
Item
If yes: a. Who?
text
C0422117 (UMLS CUI [1])
Code List
If yes: a. Who?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Both (3)
Item
b. How would you rate the court experience?
text
C0023672 (UMLS CUI [1,1])
C0422117 (UMLS CUI [1,2])
Code List
b. How would you rate the court experience?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
23. Have you had a pet (animal) to whom you were attached die, or get lost, or did you have to give it away during the last 12 months?
text
C0524346 (UMLS CUI [1])
Code List
23. Have you had a pet (animal) to whom you were attached die, or get lost, or did you have to give it away during the last 12 months?
CL Item
No (Skip to Q.24)  (1)
CL Item
Yes (2)
Item
24. Other than the events we have already asked about, have any other important things happened to you or to a very close friend or close family member in the last 12 months that made that period significantly different from a typical year?
text
C1287456 (UMLS CUI [1])
Code List
24. Other than the events we have already asked about, have any other important things happened to you or to a very close friend or close family member in the last 12 months that made that period significantly different from a typical year?
CL Item
No (DONE w/ Questionnaire) (1)
CL Item
Yes (2)
Item
If yes: You can list up to three (3) events. Please do not feel obliged to include an additional event or events unless they were significant! Event 1: To whom?
text
C1287456 (UMLS CUI [1])
Code List
If yes: You can list up to three (3) events. Please do not feel obliged to include an additional event or events unless they were significant! Event 1: To whom?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Child  (3)
CL Item
Parent  (4)
CL Item
Spouse’s parent  (5)
CL Item
Brother or sister  (6)
CL Item
Friend  (7)
CL Item
Other (8)
important event
Item
What happened?
text
C1287456 (UMLS CUI [1])
desire important event
Item
Did you want the event to happen?
boolean
C0871633 (UMLS CUI [1,1])
C1287456 (UMLS CUI [1,2])
Item
How would you rate your feelings about this event?
text
C0023672 (UMLS CUI [1,1])
C1287456 (UMLS CUI [1,2])
Code List
How would you rate your feelings about this event?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
Event 2: To whom?
text
C1287456 (UMLS CUI [1])
Code List
Event 2: To whom?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Child  (3)
CL Item
Parent  (4)
CL Item
Spouse’s parent  (5)
CL Item
Brother or sister  (6)
CL Item
Friend  (7)
CL Item
Other (8)
important event
Item
What happened?
text
C1287456 (UMLS CUI [1])
desire important event
Item
Did you want the event to happen?
boolean
C0871633 (UMLS CUI [1,1])
C1287456 (UMLS CUI [1,2])
Item
How would you rate your feelings about this event?
text
C0023672 (UMLS CUI [1,1])
C1287456 (UMLS CUI [1,2])
Code List
How would you rate your feelings about this event?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)
Item
Event 3: To whom?
text
C1287456 (UMLS CUI [1])
Code List
Event 3: To whom?
CL Item
You  (1)
CL Item
Spouse/partner  (2)
CL Item
Child  (3)
CL Item
Parent  (4)
CL Item
Spouse’s parent  (5)
CL Item
Brother or sister  (6)
CL Item
Friend  (7)
CL Item
Other (8)
important event
Item
What happened?
text
C1287456 (UMLS CUI [1])
desire important event
Item
Did you want the event to happen?
boolean
C0871633 (UMLS CUI [1,1])
C1287456 (UMLS CUI [1,2])
Item
How would you rate your feelings about this event?
text
C0023672 (UMLS CUI [1,1])
C1287456 (UMLS CUI [1,2])
Code List
How would you rate your feelings about this event?
CL Item
Very good  (1)
CL Item
Moderately good  (2)
CL Item
Slightly good  (3)
CL Item
Slightly bad  (4)
CL Item
Moderately bad  (5)
CL Item
Very bad (6)

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