| ENTRY SPECIFICATION |
{"name": "MIOS+B-IPF_V2",
"text": "1. This questionnaire asks about experiences you may have had after a very
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
stressful experience. Please indicate whether you had at least one experience
{"id": "q9290", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "8. I feel like I don't deserve a good life.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
as described below that is currently distressing (select all that apply).<br
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9291", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "9. I keep myself from having success.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
/><br />Select one or more:",
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9292", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "10. I no longer believe there is a higher power.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
"intro": "<br />",
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9293", "type": "ChoiceQuestion", "required": true, "inline": false,
"columns": 1,
"text": "11. I lost trust in others.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
"choices":[
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9294", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "12. I am angry all the time.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5822", "text": "1. I did something (or failed to do something) that went against my moral code or
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9295", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "13. I am not the good person I thought I was.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
values.", "quickKey": 1},
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9296", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "14. I have lost pride in myself.",
{"id": "c5823", "text": "2. I saw something (or people) do something or fail to do something that went
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
"restartDays": 2,
against my moral code or values.", "quickKey": 2},
]},
{"id": "q9297", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "15. I cannot be honest with other people.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5824", "text": "3. I was directly affected by someone doing something or failing to do something
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9298", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "16. For the following questions of the B-IPF assessment, reflect on how much this
experience made it hard for you to function in each of the areas listed. You
must answer OK to proceed.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
that went against my moral code or values.", "quickKey": 3},
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5840", "text": "1. OK", "quickKey": 1}
]},
{"id": "i2560", "type": "IntroText",
"text": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
questions. If the question does not apply, select not applicable.<br /><br
/>Overall in the past 30 days:"
},
{"id": "c5825", "text": "4. None of these apply. (If so, for the remaining items, please think about
{"id": "q9299", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "17. I had trouble in my romantic relationship with my spouse or partner.",
"intro": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
questions. If the question does not apply, select not applicable.<br /><br
/>Overall in the past 30 days:",
"columns": 1,
"choices":[
{"id": "c5832", "text": " 0 - Not at all", "quickKey": 0},
{"id": "c5833", "text": " 1", "quickKey": 1},
{"id": "c5834", "text": " 2", "quickKey": 2},
another type of very stressful event that is currently distressing and answer
{"id": "c5835", "text": " 3 - Somewhat", "quickKey": 3},
{"id": "c5836", "text": " 4", "quickKey": 4},
{"id": "c5837", "text": " 5", "quickKey": 5},
{"id": "c5838", "text": " 6 - Very much", "quickKey": 6},
{"id": "c5839", "text": " 7 - Not applicable in the past 30 days", "quickKey": 7}
]},
{"id": "q9300", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "18. I had trouble in my relationship with my children.",
"intro": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
questions. If the question does not apply, select not applicable.<br /><br
questions while keeping in mind the worst and most currently distressing event.)", "quickKey": 4}
/>Overall in the past 30 days:",
"columns": 1,
"choices":[
{"id": "c5832", "text": " 0 - Not at all", "quickKey": 0},
{"id": "c5833", "text": " 1", "quickKey": 1},
{"id": "c5834", "text": " 2", "quickKey": 2},
{"id": "c5835", "text": " 3 - Somewhat", "quickKey": 3},
{"id": "c5836", "text": " 4", "quickKey": 4},
{"id": "c5837", "text": " 5", "quickKey": 5},
{"id": "c5838", "text": " 6 - Very much", "quickKey": 6},
]},
{"id": "c5839", "text": " 7 - Not applicable in the past 30 days", "quickKey": 7}
]},
{"id": "q9301", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "19. I had trouble with my family relationships.",
"intro": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
questions. If the question does not apply, select not applicable.<br /><br
/>Overall in the past 30 days:",
"columns": 1,
"choices":[
{"id": "c5832", "text": " 0 - Not at all", "quickKey": 0},
{"id": "i2559", "type": "IntroText",
{"id": "c5833", "text": " 1", "quickKey": 1},
{"id": "c5834", "text": " 2", "quickKey": 2},
{"id": "c5835", "text": " 3 - Somewhat", "quickKey": 3},
{"id": "c5836", "text": " 4", "quickKey": 4},
{"id": "c5837", "text": " 5", "quickKey": 5},
{"id": "c5838", "text": " 6 - Very much", "quickKey": 6},
{"id": "c5839", "text": " 7 - Not applicable in the past 30 days", "quickKey": 7}
]},
{"id": "q9302", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "20. I had trouble with my friendships and socializing.",
"text": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
"intro": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
questions. If the question does not apply, select not applicable.<br /><br
/>Overall in the past 30 days:",
"columns": 1,
"choices":[
{"id": "c5832", "text": " 0 - Not at all", "quickKey": 0},
{"id": "c5833", "text": " 1", "quickKey": 1},
{"id": "c5834", "text": " 2", "quickKey": 2},
{"id": "c5835", "text": " 3 - Somewhat", "quickKey": 3},
{"id": "c5836", "text": " 4", "quickKey": 4},
with the following statements in terms of the impact of this experience (or
{"id": "c5837", "text": " 5", "quickKey": 5},
{"id": "c5838", "text": " 6 - Very much", "quickKey": 6},
{"id": "c5839", "text": " 7 - Not applicable in the past 30 days", "quickKey": 7}
]},
{"id": "q9303", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "21. I had trouble at work.",
"intro": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
questions. If the question does not apply, select not applicable.<br /><br
/>Overall in the past 30 days:",
"columns": 1,
"printTitle": "Moral Injury Outcome Scale and Brief Inventory of Psychological Functioning
experiences) in the last month."
"choices":[
{"id": "c5832", "text": " 0 - Not at all", "quickKey": 0},
{"id": "c5833", "text": " 1", "quickKey": 1},
{"id": "c5834", "text": " 2", "quickKey": 2},
{"id": "c5835", "text": " 3 - Somewhat", "quickKey": 3},
{"id": "c5836", "text": " 4", "quickKey": 4},
{"id": "c5837", "text": " 5", "quickKey": 5},
{"id": "c5838", "text": " 6 - Very much", "quickKey": 6},
{"id": "c5839", "text": " 7 - Not applicable in the past 30 days", "quickKey": 7}
]},
},
{"id": "q9304", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "22. I had trouble with my training and education.",
"intro": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
questions. If the question does not apply, select not applicable.<br /><br
/>Overall in the past 30 days:",
"columns": 1,
"choices":[
{"id": "c5832", "text": " 0 - Not at all", "quickKey": 0},
{"id": "c5833", "text": " 1", "quickKey": 1},
{"id": "c5834", "text": " 2", "quickKey": 2},
{"id": "q9284", "type": "ChoiceQuestion", "required": true, "inline": false,
{"id": "c5835", "text": " 3 - Somewhat", "quickKey": 3},
{"id": "c5836", "text": " 4", "quickKey": 4},
{"id": "c5837", "text": " 5", "quickKey": 5},
{"id": "c5838", "text": " 6 - Very much", "quickKey": 6},
{"id": "c5839", "text": " 7 - Not applicable in the past 30 days", "quickKey": 7}
]},
{"id": "q9305", "type": "ChoiceQuestion", "required": false, "inline": false,
"text": "23. I had trouble with day to day activities, such as doing household<br
/>chores, running errands and managing my medical care.",
"intro": "Select a rating from 0 (not at all) to 6 (very much) for each of the following
"text": "2. I blame myself.",
questions. If the question does not apply, select not applicable.<br /><br
/>Overall in the past 30 days:",
"columns": 1,
"choices":[
{"id": "c5832", "text": " 0 - Not at all", "quickKey": 0},
{"id": "c5833", "text": " 1", "quickKey": 1},
{"id": "c5834", "text": " 2", "quickKey": 2},
{"id": "c5835", "text": " 3 - Somewhat", "quickKey": 3},
{"id": "c5836", "text": " 4", "quickKey": 4},
{"id": "c5837", "text": " 5", "quickKey": 5},
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
{"id": "c5838", "text": " 6 - Very much", "quickKey": 6},
{"id": "c5839", "text": " 7 - Not applicable in the past 30 days", "quickKey": 7}
]}]
}
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
(MIOS+B-IPF_V2)",
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9285", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "3. I have lost faith in humanity.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"content":[
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9286", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "4. People would hate me if they really knew me.",
{"id": "i2558", "type": "IntroText",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
"text": "<br />"
]},
{"id": "q9287", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "5. I have trouble seeing goodness in others.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9288", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "6. People don't deserve second chances.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
with the following statements in terms of the impact of this experience (or
experiences) in the last month.",
"columns": 1,
{"id": "q9283", "type": "CheckQuestion", "required": true, "inline": false,
"choices":[
{"id": "c5826", "text": "1. Strongly Disagree", "quickKey": 1},
{"id": "c5827", "text": "2. Disagree", "quickKey": 2},
{"id": "c5828", "text": "3. Neither Agree or Disagree", "quickKey": 3},
{"id": "c5829", "text": "4. Agree", "quickKey": 4},
{"id": "c5830", "text": "5. Strongly Agree", "quickKey": 5}
]},
{"id": "q9289", "type": "ChoiceQuestion", "required": true, "inline": false,
"text": "7. I am disgusted by what happened.",
"intro": "Keeping this (or these) experience(s) in mind, please indicate how much you agree
|
