| ENTRY SPECIFICATION |
{"name": "CIA",
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8745", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "7. ... interfered with meals with family or friends?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8746", "type": "ChoiceQuestion", "required": false, "inline": false,
shape or weight ..."
"text": "8. ... made you upset?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8747", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "9. ... made you feel ashamed of yourself?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
{"id": "q8739", "type": "ChoiceQuestion", "required": false, "inline": false,
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8748", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "1. ... made it difficult to concentrate?",
"text": "10. ... made it difficult to eat out with others?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8749", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "11. ... made you feel guilty? ",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits, <br />exercising or feelings about your eating, shape or weight have
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8750", "type": "ChoiceQuestion", "required": false, "inline": false,
affected <br />your life over the past four weeks (28 days). Thank you. <br />
"text": "12. ... interfered with you doing things you used to enjoy?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8751", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "13. ... made you absent-minded?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
"copyright": "Copyright Bohn and Fairburn, 2008",
habits <br /> ... exercising <br /> ... or your feelings about your eating,
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8752", "type": "ChoiceQuestion", "required": false, "inline": false,
shape or weight ...",
"text": "14. ... made you feel a failure?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
"columns": 1,
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8753", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "15. ... interfered with your relationships with others?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
"choices":[
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8754", "type": "ChoiceQuestion", "required": false, "inline": false,
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
"text": "16. ... made you worry?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]}]
}
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8740", "type": "ChoiceQuestion", "required": false, "inline": false,
"restartDays": 2,
"text": "2. ... made you feel critical of yourself?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
"printTitle": "Clinical Impairment Assessment Questionnaire 3.0",
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8741", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "3. ... stopped you going out with others?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
"content":[
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8742", "type": "ChoiceQuestion", "required": false, "inline": false,
{"id": "i2470", "type": "IntroText",
"text": "4. ... affected your work performance (if applicable)?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
"text": "INSTRUCTIONS <br />Please select the option that best describes how your eating
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8743", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "5. ... made you forgetful?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits, <br />exercising or feelings about your eating, shape or weight have
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
{"id": "c5322", "text": "1. A little", "quickKey": 1},
{"id": "c5323", "text": "2. Quite a bit", "quickKey": 2},
{"id": "c5324", "text": "3. A lot", "quickKey": 3}
]},
{"id": "q8744", "type": "ChoiceQuestion", "required": false, "inline": false,
affected <br />your life over the past four weeks (28 days). Thank you. <br />
"text": "6. ... affected your ability to make everyday decisions?",
"intro": "INSTRUCTIONS <br />Please select the option that best describes how your eating
habits, <br />exercising or feelings about your eating, shape or weight have
affected <br />your life over the past four weeks (28 days). Thank you. <br />
<br /> <br /><strong>Over the past 28 days</strong>, to what extent have your <br /> ... eating
habits <br /> ... exercising <br /> ... or your feelings about your eating,
shape or weight ...",
"columns": 1,
"choices":[
{"id": "c5321", "text": "0. Not at all", "quickKey": 0},
|
