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Below is a list of stressful life events that you may have experienced. Please indicate any of the following events that are currently applicable to you.
I am currently experiencing...
I am currently experiencing...
0 Yes
1 No
Yes | No | |
---|---|---|
(1) Financial problems (e.g., difficulty paying bills, being in debt). |
Yes | No |
(2) Work problems (e.g., unemployment, redundancy, retirement, problems/conflicts with colleagues, change of job role). |
Yes | No |
(3) Educational problems (e.g., difficulty with course work, deadline pressure). |
Yes | No |
(4) Housing problems (e.g., stressful home move, difficulty finding a secure residence, lack of secure residence). |
Yes | No |
(5) Relationship problems (e.g., break-up, sparation or divorce, conflict with family or friends, intimacy problems). |
Yes | No |
(6) My own health problems (e.g., illness onset or deterioration, medication issues, injury or disability). |
Yes | No |
(7) A loved one’s health problems (e.g., illness onset or deterioration, medication issues, injury or disability). |
Yes | No |
(8) Caregiving problems (e.g., emotional stress, time demands). |
Yes | No |
(9) Some other problem not mentioned above. |
Yes | No |
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This section should be completed only if you have answered ‘Yes’ to at least one of the events above. The following statements reflect problem that people sometimes experience in relation to a stressful life event(s). Thinking about the stressful life event(s) you identified above, please indicate how much you have been bothered by each of the following problems in the past month:
0 Not at all
1 A little bit
2 Moderately
3 Quite a bit
4 Extremely
0 | 1 | 2 | 3 | 4 | |
---|---|---|---|---|---|
(10) I worry a lot more since the stressful event(s). |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
(11) I can’t stop thinking about the stressful event(s). |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
(12) I often feel afraid about what might happen in the future since the stressful event(s). |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
(13) I find it difficult to adapt to life since the stressful event(s). |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
(14) I find it difficult to relax and feel calm since the stressful event(s). |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
(15) I find it difficult to achieve a state of inner peace since the stressful event(s). |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
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Question 16
Did these problems start within one month of the stressful event(s)?
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In the past month have the above problems:
0 Not at all
1 A little bit
2 Moderately
3 Quite a bit
4 Extremely
0 | 1 | 2 | 3 | 4 | |
---|---|---|---|---|---|
(17) Affected your relationships or social life? |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
(18) Affected your ability to work or your educational life? |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
(19) Affected any other important part of your life? |
0 Not at all | 1 A little bit | 2 Moderately | 3 Quite a bit | 4 Extremely |
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