1 No > GO TO H8
2 Yes
-9 Missing
H2 What was this event or experience? Please describe it in detail.
LEH2A13 Event 1 ___________________________
LEH2B13 Event 2 ___________________________
LEH2C13 Event 2 ___________________________
H3 How did it change the course or direction of your life?
LEH3A13 Event 1 ___________________________
LEH3B13 Event 2 ___________________________
LEH3C13 Event 2 ___________________________
LEH413 H4 Would you describe this as a “chance” occurrence, that is, something you didn’t really control?
1 No
2 Yes
-9 Missing
1 No > GO TO H8
2 Yes
-9 Missing
LEH613 H6 What was this event or experience? Please describe it in detail.
______________________________________________________________________________________
______________________________________________________________________________________
LEH713 H7 How did this event or experience influence the direction of your life?
______________________________________________________________________________________
______________________________________________________________________________________
0 Not circled
1 Circled
-9 Missing
|
Event did not happen |
2000 |
2001 |
2002 |
Serious personal injury or illness |
LEH81A13 |
LEH81B13 |
LEH81C13 |
LEH81D13 |
Break-up of a serious romantic relationship |
LEH82A13 |
LEH82B13 |
LEH82C13 |
LEH82D13 |
Serious trouble with boss, supervisor or co-worker |
LEH83A13 |
LEH83B13 |
LEH83C13 |
LEH83D13 |
Being fired from work |
LEH84A13 |
LEH84B13 |
LEH84C13 |
LEH84D13 |
Took on a mortgage or major loan |
LEH85A13 |
LEH85B13 |
LEH85C13 |
LEH85D13 |
I was arrested |
LEH86A13 |
LEH86B13 |
LEH86C13 |
LEH86D13 |
I spent time in jail |
LEH87A13 |
LEH87B13 |
LEH87C13 |
LEH87D13 |
I was assaulted, beaten up, robbed, or raped |
LEH88A13 |
LEH88B13 |
LEH88C13 |
LEH88D13 |
I attempted suicide |
LEH89A13 |
LEH89B13 |
LEH89C13 |
LEH89D13 |
Death of my spouse or romantic partner |
LH810A13 |
LH810B13 |
LH810C13 |
LH810D13 |
Death of another close family member |
LH811A13 |
LH811B13 |
LH811C13 |
LH811D13 |
Death of a close friend |
LH812A13 |
LH812B13 |
LH812C13 |
LH812D13 |
Death of a pet |
LH813A13 |
LH813B13 |
LH813C13 |
LH813D13 |
Parental separation or divorce |
LH814A13 |
LH814B13 |
LH814C13 |
LH814D13 |
A parent remarried |
LH815A13 |
LH815B13 |
LH815C13 |
LH815D13 |
|
|
How many times in the past year have you |
||||
0 |
1 |
2 |
3 - 4 |
5 + |
||
PARK13 |
Parked your car illegally |
|
|
|
|
|
TCKET13 |
Failed to pay a parking ticket |
|
|
|
|
|
SPEED13 |
Driven 20 miles or more over the speed limit |
|
|
|
|
|
ACC13 |
Had an accident while driving (whether you were responsible or not) |
|
|
|
|
|
DRIVE13 |
Driven a car or motor vehicle after you’ve had too much to drink |
|
|
|
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|
SLIFT13 |
Taken something from a store without paying for it |
|
|
|
|
|
HIT13 |
Hit or threatened to hit someone |
|
|
|
|
|
ALCOH13 |
Sold or gave alcohol to kids under 21 |
|
|
|
|
|
FIGHT13 |
Been in a physical fight/fist fight |
|
|
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|
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