How would you describe yourself? (Circle one number for each)
-9 Missing
| W8C413 | L1 | Dependent | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Independent | |
| W8C414 | L2 | Unemotional | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Emotional | |
| W8C415 | L3 | Submissive | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Dominant | |
| W8C416 | L4 | Calm in a MAJOR crisis | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Excitable in a MAJOR crisis | |
| W8C417 | L5 | Passive | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Active | |
| W8C418 | L6 | Self-centered | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Devoted completely to others | |
| W8C419 | L7 | Competitive | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Not Competitive | |
| W8C420 | L8 | Others' approval matters a lot | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Indifferent to others' approval | |
| W8C421 | L9 | Feelings easily hurt | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Feelings not easily hurt | |
| W8C422 | L10 | Aware of others' feelings | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Not aware of others' feelings | |
| W8C423 | L11 | Can make decisions easily | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Have difficulty making decisions | |
| W8C424 | L12 | Give up easily | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Persistent | |
| W8C425 | L13 | Cry very easily | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Never cry | |
| W8C426 | L14 | Very self-confident | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Not at all confident | |
| W8C427 | L15 | Feel inferior | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Feel superior | |
| W8C428 | L16 | Strong need for security | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Little need for security | |
| W8C429 | L17 | Go to pieces under pressure | 1 | 2 | 3 | 4 | 5 | 6 | 7 | Stand up well under pressure |
How strongly do you agree or disagree with each of the following statements? (Circle one number for each)
1 Strongly disagree
2 Disagree
3 Agree
4 Strongly Agree
-9 Missing
W8C430 L18 I feel I have a number of good qualities.
W8C431 L19 I certainly feel useless at times.
W8C432 L20 I
feel I do not have much to be proud of.
W8C433 L21 There is really no way I can solve some of the problems I have.
W8C434 L22 I take a positive attitude toward myself.
W8C435 L23 On the whole, I am satisfied with myself.
W8C436 L24 Sometimes I feel that I'm being pushed around in life.
W8C437 L25 I have little control over the things that happen to me.
W8C438 L26 I wish I could have more respect for myself.
W8C439 L27 I can do just about anything I really set my mind to do.
W8C440 L28 At times I think I am no good at all.
W8C441 L29 What happens to me in the future mostly depends on me.
W8C442 L30 I often feel helpless in dealing with the problems of life.
W8C443 L31 There is little I can do to change many of the important things in my life.
W8C444 L32 My health is excellent.
During the past month, how much of the time: (Circle ONE number for each)
1 No time
2 A little time
3 Some time
4 Most of the time
5 All of the time
-9 Missing
W8C445 L33 Have you felt that the future looks hopeful and promising?
W8C446 L34 Have you been under any strain, stress, or pressure?
W8C447 L35 Have you generally enjoyed the things you do?
W8C448 L36 Have you felt calm and peaceful?
W8C449 L37 Have you felt downhearted and blue?
W8C450 L38 Have you been moody or brooded about things?
W8C451 L39 Have you felt cheerful, lighthearted?
W8C452 L40 Have you felt depressed?
W8C453 L41 Have you been in low or very low spirits?
W8C454 L42 Have you felt lonely?
W8C455 L43 Has your daily life been full of things that are interesting to you?
W8C456 L44 Have you felt relaxed and free of tension?
W8C457 L45 Have you felt loved and wanted?
W8C458 L46 Have you been nervous?
W8C459 L47 Have you felt tense or "high strung"?
W8C460 L48 Have you felt emotionally stable?
W8C461 L49 Have your relationships with loved ones been full and complete?
W8C462 L50 Has living been a wonderful adventure for you?
W8C463 L51 Did your hands shake when you tried to do something?
W8C464 L52 Did you feel that you had nothing to look forward to?
W8C465 L53 Did you feel that nothing turned out the way you wanted it to?
W8C466 L54 How happy, satisfied, or pleased have you been with your personal life?
1 Extremely happy, could not have been more satisfied or pleased
2 Very happy most of the time
3 Generally satisfied, pleased
4 Sometimes satisfied, sometimes unhappy
5 Generally dissatisfied, unhappy
6 Very dissatisfied, unhappy most of the time
-9 Missing
W8C467 L55 Have you felt in firm control of your thought, emotions, and feelings?
1 Yes, very definitely
2 Yes, for the most part
3 Yes, I guess so
4 No, not too well
5 No, and I am somewhat disturbed about it
6 No, and I am very disturbed about it
-9 Missing
W8C468 L56 Did you ever think about taking your own life?
1 Yes, very often
2 Yes, fairly often
3 Yes, a couple of times
4 Yes, at one time
5 No, never
-9 Missing
W8C469 L57 Have you been anxious or worried?
1 Yes, extremely so, to the point of being sick or almost sick
2 Yes, very much so
3 Yes, quite a bit
4 Yes, some, enough to bother me
5 Yes, a little bit
6 No, not at all
-9 Missing
W8C470 L58 How often have you awakened feeling fresh and rested?
1 Always, every day
2 Almost every day
3 Most days
4 Some days, but usually not
5 Hardly ever
6 Never wake up feeling rested
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