BAM-R-CSG-SUD (169)    MH TEST/SURVEY SPEC (601.712)

Name Value
INSTRUMENT BAM-R-CSG-SUD
LAST UPDATE 2023-12-27 13:55:30
ENTRY CHECKSUM 3939848796
ENTRY SPECIFICATION
{"name": "BAM-R-CSG-SUD", 
    "columns": 3, 
   {"id": "q9119", "type": "IntegerQuestion", "required": false, 
    "text": "7B. Sedatives and/or Tranquilizers (benzos, Valium, Xanax, Ativan, Ambien, barbs,
 Phenobarbital, downers, etc.)?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9120", "type": "IntegerQuestion", "required": false, 
    "text": "7C. Cocaine and/or Crack?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9121", "type": "IntegerQuestion", "required": false, 
    "choices":[
    "text": "7D. Other Stimulants (amphetamine, methamphetamine, Dexedrine, Ritalin, Adderall,
 speed, crystal meth, ice, etc.)?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9122", "type": "IntegerQuestion", "required": false, 
    "text": "7E. Opiates (Heroin, Morphine, Dilaudid, Demerol, Oxycontin, oxy, codeine
 (Tylenol 2,3,4), Percocet, Vicodin, Fentanyl, etc.)?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9123", "type": "IntegerQuestion", "required": false, 
     {"id": "c2418", "text": "1. Clinician Interview", "quickKey": 1}, 
    "text": "7F. Inhalants (glues, adhesives, nail polish remover, paint thinner, etc.)?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9124", "type": "IntegerQuestion", "required": false, 
    "text": "7G. Other drugs (steroids, non-prescription sleep and diet pills, Benadryl,
 Ephedra, other over-the-counter or unknown medications)?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9107", "type": "ChoiceQuestion", "required": false, "inline": true, 
    "text": "8. In the past 30 days, how much were you bothered by cravings or urges to drink
     {"id": "c2419", "text": "2. Self Report", "quickKey": 2}, 
 alcohol or use drugs?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "columns": 2, 
    "choices":[
     {"id": "c212", "text": "0. Not at all", "quickKey": 0}, 
     {"id": "c717", "text": "1. Slightly", "quickKey": 1}, 
     {"id": "c685", "text": "2. Moderately", "quickKey": 2}, 
     {"id": "c2312", "text": "3. Considerably", "quickKey": 3}, 
     {"id": "c687", "text": "4. Extremely", "quickKey": 4}
   ]}, 
     {"id": "c2420", "text": "3. Phone", "quickKey": 3}
   {"id": "q9108", "type": "ChoiceQuestion", "required": false, "inline": true, 
    "text": "9. How confident are you that you will NOT use alcohol and drugs in the next 30
 days?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "columns": 2, 
    "choices":[
     {"id": "c212", "text": "0. Not at all", "quickKey": 0}, 
     {"id": "c717", "text": "1. Slightly", "quickKey": 1}, 
     {"id": "c685", "text": "2. Moderately", "quickKey": 2}, 
     {"id": "c2312", "text": "3. Considerably", "quickKey": 3}, 
   ]}, 
     {"id": "c687", "text": "4. Extremely", "quickKey": 4}
   ]}, 
   {"id": "q9125", "type": "IntegerQuestion", "required": false, 
    "text": "10. In the past 30 days, how many days did you attend self-help meetings like AA
 or NA to support your recovery?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9126", "type": "IntegerQuestion", "required": false, 
    "text": "11. In the past 30 days, how many days were you in any situations or with any
 people that might put you at an increased risk for using alcohol or drugs (i.e.,
   {"id": "i1096", "type": "IntroText", 
 around risky \u0022people, places or things\u0022)?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9109", "type": "ChoiceQuestion", "required": false, "inline": true, 
    "text": "12. Does your religion or spirituality help support your recovery?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "columns": 2, 
    "choices":[
     {"id": "c212", "text": "0. Not at all", "quickKey": 0}, 
     {"id": "c717", "text": "1. Slightly", "quickKey": 1}, 
    "text": "Instructions<br />This is a standard set of questions about several areas of your
     {"id": "c685", "text": "2. Moderately", "quickKey": 2}, 
     {"id": "c2312", "text": "3. Considerably", "quickKey": 3}, 
     {"id": "c687", "text": "4. Extremely", "quickKey": 4}
   ]}, 
   {"id": "q9127", "type": "IntegerQuestion", "required": false, 
    "text": "13. In the past 30 days, how many days did you spend much of the time at work,
 school, or doing volunteer work?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9110", "type": "ChoiceQuestion", "required": false, "inline": true, 
 life such as your health, alcohol and drug use, etc. The questions generally ask
    "text": "14. Do you have enough income (from legal sources) to pay for necessities such as
 housing, transportation, food and clothing for yourself and your dependents?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "columns": 2, 
    "choices":[
     {"id": "c237", "text": "0. No", "quickKey": 0}, 
     {"id": "c241", "text": "1. Yes", "quickKey": 1}
   ]}, 
   {"id": "q9111", "type": "ChoiceQuestion", "required": false, "inline": true, 
    "text": "15. In the past 30 days, how much have you been bothered by arguments or problems
 about the past 30 days. Please consider each question and answer as accurately
 getting along with any family members or friends?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "columns": 2, 
    "choices":[
     {"id": "c212", "text": "0. Not at all", "quickKey": 0}, 
     {"id": "c717", "text": "1. Slightly", "quickKey": 1}, 
     {"id": "c685", "text": "2. Moderately", "quickKey": 2}, 
     {"id": "c2312", "text": "3. Considerably", "quickKey": 3}, 
     {"id": "c687", "text": "4. Extremely", "quickKey": 4}
   ]}, 
 "restartDays": 7, 
 as possible.<br />  "
   {"id": "q9128", "type": "IntegerQuestion", "required": false, 
    "text": "16. In the past 30 days, how many days did you contact or spend time with any
 family members or friends who are supportive of your recovery?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9112", "type": "ChoiceQuestion", "required": false, "inline": true, 
    "text": "17. How satisfied are you with your progress toward achieving your recovery
 goals?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "columns": 2, 
    }, 
    "choices":[
     {"id": "c212", "text": "0. Not at all", "quickKey": 0}, 
     {"id": "c717", "text": "1. Slightly", "quickKey": 1}, 
     {"id": "c685", "text": "2. Moderately", "quickKey": 2}, 
     {"id": "c2312", "text": "3. Considerably", "quickKey": 3}, 
     {"id": "c687", "text": "4. Extremely", "quickKey": 4}
   ]}], 
 "rules":[
   {"question": "q9115", "operator": "EQ", "value": 0, 
    "skips":["q9116","q9129","q9130"]}, 
   {"id": "q9106", "type": "ChoiceQuestion", "required": false, "inline": true, 
   {"question": "q9117", "operator": "EQ", "value": 0, 
    "skips":["q9118","q9119","q9120","q9121","q9122","q9123","q9124"]}]
}
    "text": "1. In the past 30 days, how would you say your physical health has been?", 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 life such as your health, alcohol and drug use, etc. The questions generally ask
 about the past 30 days. Please consider each question and answer as accurately
 as possible.<br />  ", 
    "columns": 2, 
    "choices":[
 "printTitle": "Brief Addiction Monitor - Revised for CSG-SUD (BAM-R-CSG-SUD)", 
     {"id": "c1059", "text": "0. Excellent", "quickKey": 0}, 
     {"id": "c1060", "text": "1. Very good", "quickKey": 1}, 
     {"id": "c1061", "text": "2. Good", "quickKey": 2}, 
     {"id": "c1062", "text": "3. Fair", "quickKey": 3}, 
     {"id": "c1063", "text": "4. Poor", "quickKey": 4}
   ]}, 
   {"id": "q9113", "type": "IntegerQuestion", "required": false, 
    "text": "2. In the past 30 days, how many nights did you have trouble falling asleep or
 staying asleep?", 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 "content":[
 life such as your health, alcohol and drug use, etc. The questions generally ask
 about the past 30 days. Please consider each question and answer as accurately
 as possible.<br />  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9114", "type": "IntegerQuestion", "required": false, 
    "text": "3. In the past 30 days, how many days have you felt depressed, anxious, angry or
 very upset throughout most of the day?", 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 life such as your health, alcohol and drug use, etc. The questions generally ask
 about the past 30 days. Please consider each question and answer as accurately
   {"id": "q9104", "type": "DateQuestion", "required": false, "inline": true, 
 as possible.<br />  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9115", "type": "IntegerQuestion", "required": false, 
    "text": "4. In the past 30 days, how many days did you drink ANY alcohol?", 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 life such as your health, alcohol and drug use, etc. The questions generally ask
 about the past 30 days. Please consider each question and answer as accurately
 as possible.<br />  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9116", "type": "IntegerQuestion", "required": false, 
    "text": "A. Date of administration:", 
    "text": "5A. In the past 30 days, how many days did you have at least 5 drinks (if you are
 a man) or at least 4 drinks (if you are a woman)?  [One drink is considered one
 shot of hard liquor (1.5 oz.) or 12-ounce can/bottle of beer or 5-ounce glass of
 wine.]", 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 life such as your health, alcohol and drug use, etc. The questions generally ask
 about the past 30 days. Please consider each question and answer as accurately
 as possible.<br />  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "q9129", "type": "IntegerQuestion", "required": false, 
    "controlWidth": 120, "daysBack": 30, "daysAhead": 0},
    "text": "5B. In the past 30 days, on the days that you consumed alcohol, what was the
 average number of drinks you consumed on those days?", 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 life such as your health, alcohol and drug use, etc. The questions generally ask
 about the past 30 days. Please consider each question and answer as accurately
 as possible.<br />  ", 
    "controlWidth": 60, "min": 0, "max": 999}, 
   {"id": "q9130", "type": "IntegerQuestion", "required": false, 
    "text": "5C. In the past 30 days, on the days that you consumed alcohol, what was the
 highest number of drinks you consumed in one day?", 
   {"id": "q9105", "type": "ChoiceQuestion", "required": false, "inline": true, 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 life such as your health, alcohol and drug use, etc. The questions generally ask
 about the past 30 days. Please consider each question and answer as accurately
 as possible.<br />  ", 
    "controlWidth": 60, "min": 0, "max": 999}, 
   {"id": "q9117", "type": "IntegerQuestion", "required": false, 
    "text": "6. In the past 30 days, how many days did you use any illegal or street drugs or
 abuse any prescription medications?", 
    "intro": "Instructions<br />This is a standard set of questions about several areas of your
 life such as your health, alcohol and drug use, etc. The questions generally ask
    "text": "B. Method of administration:", 
 about the past 30 days. Please consider each question and answer as accurately
 as possible.<br />  ", 
    "controlWidth": 60, "min": 0, "max": 30}, 
   {"id": "i1097", "type": "IntroText", 
    "text": "7. In the past 30 days, how many days did you use any of the following drugs:  "
    }, 
   {"id": "q9118", "type": "IntegerQuestion", "required": false, 
    "text": "7A. Marijuana (cannabis, pot, weed)?", 
    "intro": "7. In the past 30 days, how many days did you use any of the following drugs:  ", 
    "controlWidth": 60, "min": 0, "max": 30},