{"aaData": [["1", "
None
\n", "
0
\n"], ["10", "
severe
\n", "
4
\n"], ["100", "", "
A
\n"], ["1000", "
Agree
\n", "
4
\n"], ["1001", "
Strongly agree
\n", "
5
\n"], ["1002", "
Moderate (1 to 3 hours per 24 hours)
\n", "
2
\n"], ["1003", "
False; not at all true
\n", "
1
\n"], ["1004", "
Slightly true
\n", "
2
\n"], ["1005", "
Mainly true
\n", "
3
\n"], ["1006", "
Very true
\n", "
4
\n"], ["1007", "
A little bit
\n", "
2
\n"], ["1008", "
Several days
\n", "
2
\n"], ["1009", "
More than half the days
\n", "
3
\n"], ["101", "", "
B
\n"], ["1010", "
Nearly every day
\n", "
4
\n"], ["1011", "
Children get into trouble because their parents punish them too much.
\n", "
1
\n"], ["1012", "
The trouble with most children nowadays is that their parents are too easy with them.
\n", "
2
\n"], ["1013", "
Many of the unhappy things in people's lives are partly due to bad luck.
\n", "
1
\n"], ["1014", "
One of the major reasons why we have wars is because people don't take enough interest in politics.
\n", "
1
\n"], ["1015", "
There will always be wars, no matter how hard people try to prevent them.
\n", "
2
\n"], ["1016", "
In the long run people get the respect they deserve in this world.
\n", "
1
\n"], ["1017", "
Unfortunately, an individual's worth often passes unrecognized no matter how hard he tries.
\n", "
2
\n"], ["1018", "
Most students don't realize the extent to which their grades are influenced by accidental happenings.
\n", "
2
\n"], ["1019", "
Capable people who fail to become leaders have not taken advantage of their opportunities.
\n", "
2
\n"], ["102", "", "
C
\n"], ["1020", "
People who can't get others to like them don't understand how to get along with others.
\n", "
2
\n"], ["1021", "
Trusting to fate has never turned out as well for me as making a decision to take a definitive course of action.
\n", "
2
\n"], ["1022", "
In the case of the well prepared student there is rarely if ever such a thing as an unfair test.
\n", "
1
\n"], ["1023", "
Many times exam questions tend to be so unrelated to course work that studying is really useless.
\n", "
2
\n"], ["1024", "
Becoming a success is a matter of hard work, luck has little or nothing to do with it.
\n", "
1
\n"], ["1025", "
Getting a good job depends mainly on being in the right place at the right time.
\n", "
2
\n"], ["1026", "
In my case getting what I want has little or nothing to do with luck.
\n", "
1
\n"], ["1027", "
Many times we might just as well decide what to do by flipping a coin.
\n", "
2
\n"], ["1028", "
Getting people to do the right thing depends upon ability, luck has little or nothing to do with it.
\n", "
2
\n"], ["1029", "
As far as world affairs are concerned, most of us are the victims of forces we can neither understand or control.
\n", "
1
\n"], ["103", "
Invention
\n", "
A
\n"], ["1030", "
By taking an active part in political and social affairs the people can control world events.
\n", "
2
\n"], ["1031", "
It is usually best to cover up one's own mistakes.
\n", "
2
\n"], ["1032", "
In the long run the bad things that happen to us are balanced by the good ones.
\n", "
1
\n"], ["1033", "
A good leader expects people to decide for themselves what they should do.
\n", "
1
\n"], ["1034", "
It is impossible for me to believe that chance or luck plays an important role in my life.
\n", "
2
\n"], ["1035", "
There's not much use in trying too hard to please people, if they like you, they like you.
\n", "
2
\n"], ["1036", "
Most of the time I can't understand why politicians behave the way they do.
\n", "
1
\n"], ["1037", "
In the long run the people are responsible for bad government on a national as well as on a local level.
\n", "
2
\n"], ["1038", "
Major holidays only
\n", "
2
\n"], ["1039", "
More than 4 times a year
\n", "
3
\n"], ["104", "
Myth
\n", "
B
\n"], ["1040", "
Weekly
\n", "
4
\n"], ["1041", "
More than once a week
\n", "
5
\n"], ["1042", "
Against religion
\n", "
1
\n"], ["1043", "
Not at all religious
\n", "
2
\n"], ["1044", "
Only slightly religious
\n", "
3
\n"], ["1045", "
Fairly religious
\n", "
4
\n"], ["1046", "
Deeply religious
\n", "
5
\n"], ["1047", "
Quite a bit
\n", "
3
\n"], ["1048", "
A great deal
\n", "
4
\n"], ["1049", "
Occasionally (at least once a week)
\n", "
2
\n"], ["105", "
Construction
\n", "
C
\n"], ["1050", "
Regularly (once a day)
\n", "
3
\n"], ["1051", "
Frequently (twice a day or more)
\n", "
4
\n"], ["1052", "
Once a day
\n", "
4
\n"], ["1053", "
Twice a day or more
\n", "
5
\n"], ["1054", "
Not at all
\n", "
0
\n"], ["1055", "
A little bit
\n", "
1
\n"], ["1056", "
Moderately
\n", "
2
\n"], ["1057", "
Quite a bit
\n", "
3
\n"], ["1058", "
Extremely
\n", "
4
\n"], ["1059", "
Excellent
\n", "
1
\n"], ["106", "
Difficult
\n", "
D
\n"], ["1060", "
Very good
\n", "
2
\n"], ["1061", "
Good
\n", "
3
\n"], ["1062", "
Fair
\n", "
4
\n"], ["1063", "
Poor
\n", "
5
\n"], ["106376", "
Yes
\n", ""], ["106377", "
No
\n", ""], ["106378", "
Refused
\n", ""], ["106379", "
Patient unable to complete
\n", ""], ["106380", "
Not Reported
\n", "
0
\n"], ["106381", "
Very mild - Occasionally is somewhat concerned about body, symptoms, or physical illness.
\n", "
1
\n"], ["106382", "
Mild - Occasionally is moderately concerned about body, or often is somewhat concerned.
\n", "
2
\n"], ["106383", "
Moderate- Occasionally is very concerned, or often is moderately concerned.
\n", "
3
\n"], ["106384", "
Moderately severe - Often is very concerned.
\n", "
4
\n"], ["106385", "
Severe - Is very concerned.
\n", "
5
\n"], ["106386", "
Very severe - Is very concerned nearly all of the time.
\n", "
6
\n"], ["106387", "
Less than 5 min
\n", "
3
\n"], ["106388", "
6-30 min
\n", "
2
\n"], ["106389", "
31-60 min
\n", "
1
\n"], ["106390", "
After 1 hr.
\n", "
0
\n"], ["106391", "
10 or less
\n", "
0
\n"], ["106392", "
11-20
\n", "
1
\n"], ["106393", "
21-30
\n", "
2
\n"], ["106394", "
31 or more
\n", "
3
\n"], ["106395", "
None of the time
\n", ""], ["106396", "
Rarely
\n", ""], ["106397", "
Some of the time
\n", ""], ["106398", "
Often
\n", ""], ["106399", "
All of the time
\n", ""], ["1064", "
Much better now than one year ago
\n", "
1
\n"], ["1065", "
Somewhat better now than one year ago
\n", "
2
\n"], ["1066", "
About the same as one year ago
\n", "
3
\n"], ["1067", "
Somewhat worse now than one year ago
\n", "
4
\n"], ["1068", "
Much worse now than one year ago
\n", "
5
\n"], ["1069", "
Yes, limited a lot.
\n", "
1
\n"], ["107", "
Truth
\n", "
E
\n"], ["1070", "
Yes, limited a little.
\n", "
2
\n"], ["1071", "
No, not limited at all.
\n", "
3
\n"], ["1072", "
Yes.
\n", "
1
\n"], ["1073", "
No.
\n", "
2
\n"], ["1074", "
Not at all.
\n", "
1
\n"], ["1075", "
Slightly.
\n", "
2
\n"], ["1076", "
Moderately.
\n", "
3
\n"], ["1077", "
Quite a bit.
\n", "
4
\n"], ["1078", "
Extremely.
\n", "
5
\n"], ["1079", "
None.
\n", "
1
\n"], ["108", "
Neutron
\n", "
A
\n"], ["1080", "
Very mild.
\n", "
2
\n"], ["1081", "
Mild.
\n", "
3
\n"], ["1082", "
Moderate.
\n", "
4
\n"], ["1083", "
Severe.
\n", "
5
\n"], ["1084", "
Very severe.
\n", "
6
\n"], ["1085", "
A little bit.
\n", "
2
\n"], ["1086", "
All of the time.
\n", "
1
\n"], ["1087", "
Most of the time.
\n", "
2
\n"], ["1088", "
A good bit of the time.
\n", "
3
\n"], ["1089", "
Some of the time.
\n", "
4
\n"], ["109", "
Proton
\n", "
B
\n"], ["1090", "
A little of the time.
\n", "
5
\n"], ["1091", "
None of the time.
\n", "
6
\n"], ["1092", "
Some of the time.
\n", "
3
\n"], ["1093", "
A little of the time.
\n", "
4
\n"], ["1094", "
None of the time.
\n", "
5
\n"], ["1095", "
Definitely true.
\n", "
1
\n"], ["1096", "
Mostly true.
\n", "
2
\n"], ["1097", "
Don't know.
\n", "
3
\n"], ["1098", "
Mostly false.
\n", "
4
\n"], ["1099", "
Definitely false.
\n", "
5
\n"], ["11", "
no awareness
\n", "
0
\n"], ["110", "
Electron
\n", "
C
\n"], ["1100", "
Somewhat
\n", "
2
\n"], ["1101", "
Moderately so
\n", "
3
\n"], ["1102", "
Very much so
\n", "
4
\n"], ["1103", "
Almost never
\n", "
1
\n"], ["1104", "
Often
\n", "
3
\n"], ["1105", "
Almost always
\n", "
4
\n"], ["1106", "
Agree strongly
\n", "
1
\n"], ["1107", "
Agree mildly
\n", "
2
\n"], ["1108", "
Disagree mildly
\n", "
3
\n"], ["1109", "
Disagree strongly
\n", "
4
\n"], ["111", "
Valence
\n", "
D
\n"], ["1110", "
None or a little of the time
\n", "
1
\n"], ["1111", "
Some of the time
\n", "
2
\n"], ["1112", "
Good part of the time
\n", "
3
\n"], ["1113", "
Most or all of the time
\n", "
4
\n"], ["1114", "
Rarely or none of the time (less than 1 day)
\n", "
0
\n"], ["1115", "
Some or a little of the time (1-2 days)
\n", "
1
\n"], ["1116", "
Occasionally or a moderate amount of time (3-4 days)
\n", "
2
\n"], ["1117", "
Most or all of the time (5-7 days)
\n", "
3
\n"], ["1118", "
Children get into trouble because their parents punish them too much
\n", "
1
\n"], ["1119", "
The trouble with most children nowadays is that their parents are too easy with them
\n", "
2
\n"], ["112", "
Charge
\n", "
E
\n"], ["1120", "
Many of the unhappy things in people's lives are partly due to bad luck
\n", "
1
\n"], ["1121", "
One of the major reasons why we have wars is because people don't take enough interest in politics
\n", "
1
\n"], ["1122", "
There will always be wars, no matter how hard people try to prevent them
\n", "
2
\n"], ["1123", "
In the long run people get the respect they deserve in this world
\n", "
1
\n"], ["1124", "
Unfortunately, an individual's worth often passes unrecognized no matter how hard he tries
\n", "
2
\n"], ["1125", "
Most students don't realize the extent to which their grades are influenced by accidental happenings
\n", "
2
\n"], ["1126", "
Capable people who fail to become leaders have not taken advantage of their opportunities
\n", "
2
\n"], ["1127", "
People who can't get others to like them don't understand how to get along with others
\n", "
2
\n"], ["1128", "
Trusting to fate has never turned out as well for me as making a decision to take a definite course of action
\n", "
2
\n"], ["1129", "
In the case of the well prepared student there is rarely if ever such a thing as an unfair test
\n", "
1
\n"], ["113", "", "
A
\n"], ["1130", "
Many times exam questions tend to be so unrelated to course work that studying is really useless
\n", "
2
\n"], ["1131", "
Becoming a success is a matter of hard work, luck has little or nothing to do with it
\n", "
1
\n"], ["1132", "
Getting a good job depends mainly on being in the right place at the right time
\n", "
2
\n"], ["1133", "
This world is run by the few people in power, and there is not much the little guy can do about it
\n", "
2
\n"], ["1134", "
It is not always wise to plan too far ahead because many things turn out to be a matter of good or bad fortune anyhow
\n", "
2
\n"], ["1135", "
In my case getting what I want has little or nothing to do with luck
\n", "
1
\n"], ["1136", "
Many times we might just as well decide what to do by flipping a coin
\n", "
2
\n"], ["1137", "
Who gets to be the boss often depends on who was lucky enough to be in the right place first
\n", "
1
\n"], ["1138", "
Getting people to do the right thing depends upon ability, luck has little or nothing to do with it
\n", "
2
\n"], ["1139", "
As far as world affairs are concerned, most of us are the victims of forces we can neither understand, nor control
\n", "
1
\n"], ["114", "", "
B
\n"], ["1140", "
By taking an active part in political and social affairs the people can control world events
\n", "
2
\n"], ["1141", "
Most people don't realize the extent to which their lives are controlled by accidental happenings
\n", "
1
\n"], ["1142", "
In the long run the bad things that happen to us are balanced by the good ones
\n", "
1
\n"], ["1143", "
Most misfortunes are the result of lack of ability, ignorance, laziness or all three
\n", "
2
\n"], ["1144", "
It is difficult for people to have much control over the things politicians do in office
\n", "
2
\n"], ["1145", "
Sometimes I can't understand how teachers arrive at the grades they give
\n", "
1
\n"], ["1146", "
High school graduate/GED
\n", ""], ["1147", "
A good leader expects people to decide for themselves what they should do
\n", "
1
\n"], ["1148", "
Many times I feel that I have little influence over the things that happen to me
\n", "
1
\n"], ["1149", "
It is impossible for me to believe that chance or luck plays an important role in my life
\n", "
2
\n"], ["115", "", "
C
\n"], ["1150", "
There's not much use in trying too hard to please people, if they like you, they like you
\n", "
2
\n"], ["1151", "
Sometimes I feel that I don't have enough control over the direction my life is taking
\n", "
2
\n"], ["1152", "
Most of the time I can't understand why politicians behave the way they do
\n", "
1
\n"], ["1153", "
In the long run, the people are responsible for bad government on a national as well as on a local level
\n", "
2
\n"], ["1154", "
There is a direct connection between how hard I study and the grades I get
\n", "
2
\n"], ["1155", "
Skipped
\n", "
X
\n"], ["1156", "
Not asked (due to responses on other questions)
\n", "
X
\n"], ["1158", "
4-year college graduate
\n", ""], ["1159", "
Wife, husband or partner
\n", ""], ["116", "", "
D
\n"], ["1160", "
Other family (parents, children, other relatives)
\n", ""], ["1161", "
Friends/roommates
\n", ""], ["1162", "
Community/church
\n", ""], ["1163", "
No one
\n", ""], ["1164", "
Apartment or house
\n", ""], ["1165", "
Halfway house/group home/board and care home/residential center/supervised housing
\n", ""], ["1166", "
School or dormitory
\n", ""], ["1167", "
Hospital or detox center
\n", ""], ["1168", "
Nursing home/assisted living
\n", ""], ["1169", "
Shelter/street
\n", ""], ["117", "", "
E
\n"], ["1170", "
Jail/prison
\n", ""], ["1171", "
Yes, 1 - 10 hours per week
\n", ""], ["1172", "
Yes, 11 - 30 hours per week
\n", ""], ["1173", "
Yes, more than 30 hours per week
\n", ""], ["1174", "
Yes, I receive disability for medical reasons
\n", ""], ["1175", "
Yes, I receive disability for psychiatric reasons
\n", ""], ["1176", "
I receive disability for substance abuse
\n", ""], ["1177", "
totally worn out
\n", ""], ["1178", "
Extremely high mood
\n", ""], ["1179", "
Extreme suffering
\n", ""], ["118", "
1/5
\n", "
A
\n"], ["1180", "
Extremely well
\n", ""], ["1181", "
Extremely tense or anxious
\n", ""], ["1182", "
None/bedrest/nurse assist
\n", "
1
\n"], ["1183", "
Crutches/cane(s)/walker
\n", "
2
\n"], ["1184", "
Furniture
\n", "
3
\n"], ["1185", "
Very Severe (8 hours or more per 24 hours)
\n", "
4
\n"], ["1186", "
Weakness
\n", "
2
\n"], ["1187", "
Impaired
\n", "
3
\n"], ["1188", "
Oriented to own ability/knows own limitations
\n", "
1
\n"], ["1189", "
Overestimates/forgets limitations
\n", "
2
\n"], ["119", "
3/5
\n", "
B
\n"], ["1190", "
Extremely unhappy
\n", "
0
\n"], ["1191", "
Fairly unhappy
\n", "
1
\n"], ["1192", "
A little unhappy
\n", "
2
\n"], ["1193", "
Happy
\n", "
3
\n"], ["1194", "
Very happy
\n", "
4
\n"], ["1195", "
Extremely happy
\n", "
5
\n"], ["1196", "
Perfect
\n", "
6
\n"], ["1197", "
More often than not
\n", "
3
\n"], ["1198", "
A little true
\n", "
1
\n"], ["1199", "
Mostly true
\n", "
3
\n"], ["12", "
aware, no distress
\n", "
1
\n"], ["120", "
3/7
\n", "
C
\n"], ["1200", "
Almost completely true
\n", "
4
\n"], ["1201", "
Completely true
\n", "
5
\n"], ["1202", "
Almost completely
\n", "
4
\n"], ["1203", "
Completely limited.
\n", "
1
\n"], ["1204", "
Very limited.
\n", "
2
\n"], ["1205", "
Slightly limited.
\n", "
3
\n"], ["1206", "
No impairment.
\n", "
4
\n"], ["1207", "
Boring
\n", "
0
\n"], ["1208", "
Insteresting
\n", "
1
\n"], ["1209", "
Insteresting
\n", "
1
\n"], ["121", "
6/7
\n", "
D
\n"], ["1210", "
Bad
\n", "
0
\n"], ["1211", "
Empty
\n", "
0
\n"], ["1212", "
Full
\n", "
1
\n"], ["1213", "
Fragile
\n", "
0
\n"], ["1214", "
Sturdy
\n", "
1
\n"], ["1215", "
Discouraging
\n", "
0
\n"], ["1216", "
Hopeful
\n", "
1
\n"], ["1217", "
Slightly limited
\n", ""], ["1218", "
Miserable
\n", "
0
\n"], ["1219", "
Enjoyable
\n", "
1
\n"], ["122", "
9/10
\n", "
E
\n"], ["1220", "
Disagee
\n", "
2
\n"], ["1221", "
Baseline
\n", "
1
\n"], ["1222", "
8 - week
\n", "
2
\n"], ["1223", "
16 - week
\n", "
3
\n"], ["1224", "
24 - week
\n", "
4
\n"], ["1225", "
No personal goals
\n", "
1
\n"], ["1226", "
A personal goal, but have not done anything to achieve the goal
\n", "
2
\n"], ["1227", "
Very moist.
\n", "
2
\n"], ["1228", "
Occasionally moist.
\n", "
3
\n"], ["1229", "
Rarely moist.
\n", "
4
\n"], ["123", "
Rock
\n", "
A
\n"], ["1230", "
Bedfast.
\n", "
1
\n"], ["1231", "
Chair fast.
\n", "
2
\n"], ["1232", "
Walks occasionally.
\n", "
3
\n"], ["1233", "
Walks frequently.
\n", "
4
\n"], ["1234", "
Constantly moist.
\n", "
1
\n"], ["1235", "
Completely immobile.
\n", "
1
\n"], ["1236", "
No limitation.
\n", "
4
\n"], ["1237", "
Very poor.
\n", "
1
\n"], ["1238", "
Probably inadequate.
\n", "
2
\n"], ["1239", "
Adequate.
\n", "
3
\n"], ["124", "
Army
\n", "
B
\n"], ["1240", "
Excellent.
\n", "
4
\n"], ["1241", "
Problem.
\n", "
1
\n"], ["1242", "
Potential problem.
\n", "
2
\n"], ["1243", "
No apparent problem.
\n", "
3
\n"], ["1244", "
Able to rise in single movement
\n", ""], ["1245", "
Pushes up, successful in one attempt
\n", ""], ["1246", "
Multiple attempts but successful
\n", ""], ["1247", "
Unable to rise without assistance
\n", ""], ["1248", "
A personal goal and made it a little way toward achieving it
\n", "
3
\n"], ["1249", "
A personal goal and have gotten pretty far in achieving the goal
\n", "
4
\n"], ["125", "
Cannon
\n", "
C
\n"], ["1250", "
Normal/bed rest/immobile
\n", "
1
\n"], ["1251", "
A personal goal and have achieved it
\n", "
5
\n"], ["1252", "
Not very much
\n", "
1
\n"], ["1253", "
Only when there is a serious problem
\n", "
2
\n"], ["1254", "
Extreme change
\n", ""], ["1255", "
Extremely supportive
\n", ""], ["1256", "
Extremely severe
\n", ""], ["1257", "
Extremely worried
\n", ""], ["1258", "
Extremely in control
\n", ""], ["1259", "
Extremely irritable
\n", ""], ["126", "
Bow
\n", "
D
\n"], ["1260", "
Much of the time
\n", "
4
\n"], ["1261", "
A lot of the time and they really help with my mental health
\n", "
5
\n"], ["1262", "
0 times a week
\n", "
1
\n"], ["1263", "
1 to 2 times a week
\n", "
2
\n"], ["1264", "
3 to 4 times a week
\n", "
3
\n"], ["1265", "
5 to 7 times a week
\n", "
4
\n"], ["1266", "
8 or more times a week
\n", "
5
\n"], ["1267", "
2 hours or less a week
\n", "
1
\n"], ["1268", "
3 to 5 hours a week
\n", "
2
\n"], ["1269", "
6 to 15 hours a week
\n", "
3
\n"], ["127", "
Slingshot
\n", "
E
\n"], ["1270", "
16 to 30 hours a week
\n", "
4
\n"], ["1271", "
More than 30 hours a week
\n", "
5
\n"], ["1272", "
Symptoms really bother me a lot
\n", "
1
\n"], ["1273", "
White, not Hispanic
\n", "
1
\n"], ["1274", "
Black, not Hispanic
\n", "
2
\n"], ["1275", "
Hispanic, White
\n", "
3
\n"], ["1276", "
Hispanic, Black
\n", "
4
\n"], ["1277", "
American Indian/Alaskan
\n", "
5
\n"], ["1278", "
Pacific Islander
\n", "
7
\n"], ["1279", "
Unknown/Other
\n", "
8
\n"], ["128", "
2/3
\n", "
A
\n"], ["1280", "
Veteran declined to answer
\n", "
2
\n"], ["1281", "
Clinician failed to ascertain
\n", "
3
\n"], ["1282", "
Community residence
\n", "
1
\n"], ["1283", "
Symptoms bother me quite a bit
\n", "
2
\n"], ["1284", "
Residential admission (e.g., PRRP)
\n", "
3
\n"], ["1285", "
Lodging status, whether in the community or the hospital
\n", "
4
\n"], ["1286", "
Pre-WW II
\n", "
1
\n"], ["1287", "
World War II
\n", "
2
\n"], ["1288", "
Pre-Korean War
\n", "
3
\n"], ["1289", "
Korean War
\n", "
4
\n"], ["129", "
1 1/2
\n", "
B
\n"], ["1290", "
Between Korean and Vietnam War
\n", "
5
\n"], ["1291", "
Vietnam War
\n", "
6
\n"], ["1292", "
Post-Vietnam War
\n", "
7
\n"], ["1293", "
Persian Gulf War
\n", "
8
\n"], ["1294", "
Observed others
\n", "
1
\n"], ["1295", "
Participated
\n", "
2
\n"], ["1296", "
At a VA
\n", "
1
\n"], ["1297", "
At a non-VA
\n", "
2
\n"], ["1298", "
At a VA and non-VA
\n", "
3
\n"], ["1299", "
Symptoms bother me somewhat
\n", "
3
\n"], ["13", "
aware, mild distress
\n", "
2
\n"], ["130", "", "
C
\n"], ["1300", "
Symptoms bother me very little
\n", "
4
\n"], ["1301", "
Retired
\n", "
1
\n"], ["1302", "
Certified 100% disabled
\n", "
2
\n"], ["1303", "
Symptoms don't bother me at all
\n", "
5
\n"], ["1304", "
Not looking for work
\n", "
4
\n"], ["1305", "
Looking for work, unable to find a job
\n", "
3
\n"], ["1306", "
Less than 2 weeks
\n", "
1
\n"], ["1307", "
More than 2 weeks
\n", "
2
\n"], ["1308", "
VAMC clinician or program
\n", "
1
\n"], ["1309", "
Vet Center
\n", "
2
\n"], ["131", "
3/4
\n", "
D
\n"], ["1310", "
Non-VA clinician or agency
\n", "
3
\n"], ["1311", "
Community outreach by your program
\n", "
4
\n"], ["1312", "
Self-referred or referred by a friend
\n", "
5
\n"], ["1313", "
Yes, outpatient only
\n", "
1
\n"], ["1314", "
Yes, inpatient/residential only
\n", "
2
\n"], ["1315", "
Yes, both outpatient and inpatient
\n", "
3
\n"], ["1316", "
Inpatient admission
\n", "
2
\n"], ["1317", "
PCT
\n", "
1
\n"], ["1318", "
SUPT
\n", "
2
\n"], ["1319", "
WSDTT
\n", "
3
\n"], ["132", "
1/3
\n", "
E
\n"], ["1320", "
Symptoms really get in my way a lot
\n", "
1
\n"], ["1321", "
Symptoms get in my way quite a bit
\n", "
2
\n"], ["1322", "
Symptoms get in my way somewhat
\n", "
3
\n"], ["1323", "
Symptoms get in my way very little
\n", "
4
\n"], ["1324", "
Symptoms don't get in my way at all
\n", "
5
\n"], ["1325", "
Don't know how to prevent relapses
\n", "
1
\n"], ["1326", "
Know a little, but haven't made a relapse prevention plan
\n", "
2
\n"], ["1327", "
Know one or two things to do, but don't have a written plan
\n", "
3
\n"], ["1328", "
Know several things to do, but don't have a written plan
\n", "
4
\n"], ["1329", "
Have a written plan and have shared it with others
\n", "
5
\n"], ["133", "
Memory
\n", "
A
\n"], ["1330", "
Within the last month
\n", "
1
\n"], ["1331", "
In the past 2 to 3 months
\n", "
2
\n"], ["1332", "
In the past 4 to 6 months
\n", "
3
\n"], ["1333", "
1 or 2
\n", "
0
\n"], ["1334", "
Not difficult at all
\n", "
1
\n"], ["1335", "
Somewhat difficult
\n", "
2
\n"], ["1336", "
Very difficult
\n", "
3
\n"], ["1337", "
Extremely difficult
\n", "
4
\n"], ["1338", "
Pulse rate 80 or below
\n", "
0
\n"], ["1339", "
Pulse rate 81 - 100
\n", "
1
\n"], ["134", "
Hope
\n", "
B
\n"], ["1340", "
Pulse rate 101 - 120
\n", "
2
\n"], ["1341", "
In the past 7 to 12 months
\n", "
4
\n"], ["1342", "
No report of chills or flushing
\n", "
0
\n"], ["1343", "
Subjective report of chills or flushing
\n", "
1
\n"], ["1344", "
Flushed or observable moistness on face
\n", "
2
\n"], ["1345", "
Beads of sweat on brow or face
\n", "
3
\n"], ["1346", "
Sweat streaming off face
\n", "
4
\n"], ["1347", "
Able to sit still
\n", "
0
\n"], ["1348", "
Haven't had a relapse in the past year
\n", "
5
\n"], ["1349", "
Frequent shifting or extraneous movements of legs/arms
\n", "
2
\n"], ["135", "
Sorrow
\n", "
C
\n"], ["1350", "
Unable to sit still for more than a few seconds
\n", "
3
\n"], ["1351", "
Pupils pinned or normal size for room light
\n", "
0
\n"], ["1352", "
Pupils possibly larger than normal for room light
\n", "
1
\n"], ["1353", "
Pupils moderately dilated
\n", "
2
\n"], ["1354", "
Pupils so dilated that only the rim of the iris is visible
\n", "
3
\n"], ["1355", "
Mild diffuse discomfort
\n", "
1
\n"], ["1356", "
No hospitalization in the past year
\n", "
5
\n"], ["1357", "
Not well at all
\n", "
1
\n"], ["1358", "
Nasal stuffiness or unusually moist eyes
\n", "
1
\n"], ["1359", "
Nose running or tearing
\n", "
2
\n"], ["136", "
Hate
\n", "
D
\n"], ["1360", "
Nose constantly running or tears streaming down cheeks
\n", "
3
\n"], ["1361", "
No GI symptoms
\n", "
0
\n"], ["1362", "
Stomach cramps
\n", "
1
\n"], ["1363", "
Nausea or loose stool
\n", "
2
\n"], ["1364", "
Vomiting or diarrhea
\n", "
3
\n"], ["1365", "
Multiple episodes of diarrhea or vomiting
\n", "
4
\n"], ["1366", "
No tremor
\n", "
0
\n"], ["1367", "
Tremor can be felt, but not observed
\n", "
1
\n"], ["1368", "
Slight tremor observable
\n", "
2
\n"], ["1369", "
Gross tremor or muscle twitching
\n", "
3
\n"], ["137", "
Forget
\n", "
E
\n"], ["1370", "
No yawning
\n", "
0
\n"], ["1371", "
Yawning once or twice during assessment
\n", "
1
\n"], ["1372", "
Yawning three or more times during assessment
\n", "
2
\n"], ["1373", "
Yawning several times per minute
\n", "
3
\n"], ["1374", "
Patient reports increasing irritability or anxiousness
\n", "
1
\n"], ["1375", "
Patient obviously irritable or anxious
\n", "
2
\n"], ["1376", "
Not very well
\n", "
2
\n"], ["1377", "
Skin is smooth
\n", "
0
\n"], ["1378", "
Piloerection of skin can be felt or hairs standing up on arms
\n", "
1
\n"], ["1379", "
Prominent Piloerection
\n", "
2
\n"], ["138", "
Riches bring tears
\n", "
A
\n"], ["1380", "
All right
\n", "
3
\n"], ["1381", "
Reports difficulty sifting still, but is able to do so
\n", "
1
\n"], ["1382", "
Patient reports severe diffuse aching of joints or muscles
\n", "
2
\n"], ["1383", "
Patient is rubbing joints or muscles and is unable to sit still because of discomfort
\n", "
3
\n"], ["1384", "
Patient so irritable or anxious that participation in the assessment is difficult
\n", "
3
\n"], ["1385", "
Pulse rate greater than 120
\n", "
3
\n"], ["1386", "
Well
\n", "
4
\n"], ["1387", "
Asthma
\n", "
1
\n"], ["1388", "
Bronchitis
\n", "
2
\n"], ["1389", "
COPD
\n", "
3
\n"], ["139", "
The lazy ox wishes for steed trappings, and the steed
\n", "
B
\n"], ["1390", "
Pneumonia
\n", "
4
\n"], ["1391", "
Shortness of Breath
\n", "
5
\n"], ["1392", "
Tuberculosis
\n", "
6
\n"], ["1393", "
Allergies
\n", "
1
\n"], ["1394", "
Lupus Erythematosis
\n", "
2
\n"], ["1395", "
Social
\n", "
1
\n"], ["1396", "
1 beer/wine a day
\n", "
2
\n"], ["1397", "
> 6 beers/wines a day
\n", "
3
\n"], ["1398", "
> 2 shots
\n", "
4
\n"], ["1399", "
I don't know about any self-help activities
\n", "
1
\n"], ["14", "
aware, moderate distress
\n", "
3
\n"], ["140", "
There are no birds in the last year's nest
\n", "
C
\n"], ["1400", "
I know about some self-help activities, but I'm not interested
\n", "
2
\n"], ["1401", "
I'm interested in self-help activities, but I have not participated in the past year
\n", "
3
\n"], ["1402", "
I participate in self-help activities occasionally
\n", "
4
\n"], ["1403", "
I participate in self-help activities regularly
\n", "
5
\n"], ["1404", "
1-30 mins/week
\n", "
1
\n"], ["1405", "
31-60 mins/week
\n", "
2
\n"], ["1406", "
61-90 mins/week
\n", "
3
\n"], ["1407", "
91-120 mins/week
\n", "
4
\n"], ["1408", "
120+ mins/week
\n", "
5
\n"], ["1409", "
N/A
\n", "
0
\n"], ["141", "
Hope springs eternal in the human breast
\n", "
D
\n"], ["1410", "
Cannot assess
\n", "
0
\n"], ["1411", "
Terrible
\n", "
1
\n"], ["1412", "
Greatly worsened
\n", "
1
\n"], ["1413", "
Somewhat worsened
\n", "
2
\n"], ["1414", "
Stayed the same
\n", "
3
\n"], ["1415", "
Somewhat improved
\n", "
4
\n"], ["1416", "
Greatly improved
\n", "
5
\n"], ["1417", "
0+ to 6 months post IDF/Entry
\n", "
1
\n"], ["1418", "
6+ to 12 months post IDF/Entry
\n", "
2
\n"], ["1419", "
12+ to 18 months post IDF/Entry
\n", "
3
\n"], ["142", "
To live is to learn
\n", "
E
\n"], ["1420", "
18+ to 24 months post IDF/Entry
\n", "
4
\n"], ["1421", "
24+ to 30 months post IDF/Entry
\n", "
5
\n"], ["1422", "
30+ to 36 months post IDF/Entry
\n", "
6
\n"], ["1423", "
36+ to 42 months post IDF/Entry
\n", "
7
\n"], ["1424", "
42+ to 48 months post IDF/Entry
\n", "
8
\n"], ["1425", "
Risperidone (Risperdal)
\n", "
1
\n"], ["1426", "
Olanzapine (Zyprexa)
\n", "
2
\n"], ["1427", "
Quetiapine (Seroquel)
\n", "
3
\n"], ["1428", "
Aripiprazole (Abilify)
\n", "
4
\n"], ["1429", "
Ziprasidone (Geodon)
\n", "
5
\n"], ["143", "
Sailboat
\n", "
A
\n"], ["1430", "
Clozapine (Clozaril or FazaClo)
\n", "
6
\n"], ["1431", "
Chlorpromazine (Thorazine)
\n", "
7
\n"], ["1432", "
Thioridazine (Mellaril)
\n", "
8
\n"], ["1433", "
Divalproex (Depakote), Valproate, or Valproic Acid (Depakene)
\n", "
9
\n"], ["1434", "
I never missed taking my medication
\n", "
0
\n"], ["1435", "
I missed only a couple of times, but basically took all the medicine
\n", "
1
\n"], ["1436", "
I missed the medicine several times, but took at least half of it
\n", "
2
\n"], ["1437", "
I took less than half of what was prescribed
\n", "
3
\n"], ["1438", "
I stopped taking the medicine all together
\n", "
4
\n"], ["1439", "
Loss
\n", "
1
\n"], ["144", "
Cow
\n", "
B
\n"], ["1440", "
Gain
\n", "
2
\n"], ["1441", "
It is a job for disabled persons only
\n", "
0
\n"], ["1442", "
It is a job for anyone (competitive)
\n", "
1
\n"], ["1443", "
Definitely would not be interested
\n", "
0
\n"], ["1444", "
Might be interested
\n", "
1
\n"], ["1445", "
Definitely would be interested
\n", "
2
\n"], ["1446", "
Gross income
\n", "
0
\n"], ["1447", "
Take-home pay
\n", "
1
\n"], ["1448", "
About half the time
\n", "
3
\n"], ["1449", "
Alcohol use really gets in my way a lot
\n", "
1
\n"], ["145", "
Vegetable
\n", "
C
\n"], ["1450", "
Alcohol use gets in my way quite a bit
\n", "
2
\n"], ["1451", "
Alcohol use gets in my way somewhat
\n", "
3
\n"], ["1452", "
Alcohol use gets in my way very little
\n", "
4
\n"], ["1453", "
Alcohol use is not a factor in my functioning
\n", "
5
\n"], ["1454", "
Drug use really gets in my way a lot
\n", "
1
\n"], ["1455", "
Drug use gets in my way quite a bit
\n", "
2
\n"], ["1456", "
Drug use gets in my way somewhat
\n", "
3
\n"], ["1457", "
Very severe
\n", "
4
\n"], ["1458", "
One
\n", "
1
\n"], ["1459", "
Two
\n", "
2
\n"], ["146", "
Mineral
\n", "
D
\n"], ["1460", "
Three
\n", "
3
\n"], ["1461", "
Four
\n", "
4
\n"], ["1462", "
Low
\n", "
l
\n"], ["1463", "
medium
\n", "
m
\n"], ["1464", "
High
\n", "
h
\n"], ["1465", "
Single, never married
\n", "
1
\n"], ["1466", "
Married or partnered
\n", "
2
\n"], ["1467", "
Separated or divorced
\n", "
3
\n"], ["1468", "
Less than high school
\n", "
1
\n"], ["1469", "
High school graduate or equivalent
\n", "
2
\n"], ["147", "
Bird
\n", "
E
\n"], ["1470", "
Some college, associate degree or technical degree
\n", "
3
\n"], ["1471", "
Post baccalaureate
\n", "
5
\n"], ["1472", "
Unemployed, looking for work
\n", "
1
\n"], ["1473", "
Unemployed, not looking for work
\n", "
2
\n"], ["1474", "
Working part-time
\n", "
3
\n"], ["1475", "
Working full-time
\n", "
4
\n"], ["1476", "
Student
\n", "
5
\n"], ["1477", "
Volunteer
\n", "
6
\n"], ["1478", "
Yes, one episode
\n", "
1
\n"], ["1479", "
Yes, two episodes
\n", "
2
\n"], ["148", "", "
A
\n"], ["1480", "
Yes, three episodes
\n", "
3
\n"], ["1481", "
Yes, four episodes
\n", "
4
\n"], ["1482", "
Yes, five or more episodes
\n", "
5
\n"], ["1483", "
Yes, one fall
\n", "
1
\n"], ["1484", "
Yes, two falls
\n", "
2
\n"], ["1485", "
Yes, three falls
\n", "
3
\n"], ["1486", "
Yes, four falls
\n", "
4
\n"], ["1487", "
Yes, five or more falls
\n", "
5
\n"], ["1488", "
Less than 10 feet
\n", "
1
\n"], ["1489", "
Between 10 and 30 feet
\n", "
2
\n"], ["149", "", "
B
\n"], ["1490", "
Between 31 and 50 feet
\n", "
3
\n"], ["1491", "
Greater than 50 feet
\n", "
4
\n"], ["1492", "
Improvised Explosive Device (IED)
\n", "
1
\n"], ["1493", "
Rocket Propelled Grenade (RPG)
\n", "
2
\n"], ["1494", "
Part-time
\n", "
1
\n"], ["1495", "
Grenade
\n", "
4
\n"], ["1496", "
Bomb
\n", "
5
\n"], ["1497", "
Full-time
\n", "
2
\n"], ["1498", "
Little interest or pleasure
\n", "
0
\n"], ["1499", "
Feeling down, depressed or hopeless
\n", "
1
\n"], ["15", "
aware, severe distress
\n", "
4
\n"], ["150", "", "
C
\n"], ["1500", "
Trouble falling or staying asleep; or sleeping too much
\n", "
2
\n"], ["1501", "
Feeling tired or having little energy
\n", "
3
\n"], ["1502", "
Poor appetite or overeating
\n", "
4
\n"], ["1503", "
Less than 30 minutes
\n", "
1
\n"], ["1504", "
Feeling bad about yourself
\n", "
5
\n"], ["1505", "
Trouble concentrating on things
\n", "
6
\n"], ["1506", "
Moving or speaking slowly or being fidgety or restless
\n", "
7
\n"], ["1507", "
**Thoughts that you would be better off dead or of hurting
\n", "
8
\n"], ["1508", "
Yes, for traumatic brain injury
\n", "
1
\n"], ["1509", "
Yes, for other medical reasons
\n", "
2
\n"], ["151", "", "
D
\n"], ["1510", "
Yes, in the past
\n", "
1
\n"], ["1511", "
Yes, currently
\n", "
2
\n"], ["1512", "
Uncertain
\n", "
2
\n"], ["1513", "
Not assessed
\n", "
3
\n"], ["1514", "
Head/headaches
\n", "
1
\n"], ["1515", "
Leg(s)
\n", "
2
\n"], ["1516", "
Arm(s)
\n", "
3
\n"], ["1517", "
Neck
\n", "
4
\n"], ["1518", "
Shoulder(s)
\n", "
5
\n"], ["1519", "
Low back
\n", "
6
\n"], ["152", "", "
E
\n"], ["1520", "
Upper back
\n", "
7
\n"], ["1521", "
Better
\n", "
1
\n"], ["1522", "
Worse
\n", "
2
\n"], ["1523", "
About the same
\n", "
3
\n"], ["1524", "
Suspected / probable
\n", "
2
\n"], ["1525", "
Depression
\n", "
1
\n"], ["1526", "
PTSD
\n", "
2
\n"], ["1527", "
Anxiety disorder (other than PTSD)
\n", "
3
\n"], ["1528", "
Alcohol abuse/dependence
\n", "
4
\n"], ["1529", "
Trouble falling or staying asleep
\n", "
9
\n"], ["153", "
God made the country, but man made the town
\n", "
A
\n"], ["1530", "
Psychotic disorder
\n", "
6
\n"], ["1531", "
Other AXIS I disorder
\n", "
7
\n"], ["1532", "
Somatoform disorder
\n", "
8
\n"], ["1533", "
Single hand
\n", "
1
\n"], ["1534", "
Double hand
\n", "
2
\n"], ["1535", "
Single upper extremity, above elbow
\n", "
3
\n"], ["1536", "
Single upper extremity, below elbow
\n", "
4
\n"], ["1537", "
Single lower extremity, above knee
\n", "
5
\n"], ["1538", "
Single lower extremity, below knee
\n", "
6
\n"], ["1539", "
Double lower extremity, above knee
\n", "
7
\n"], ["154", "
The rushing tide grinds the pebbles smooth
\n", "
B
\n"], ["1540", "
Double lower extremity, above/below knee
\n", "
8
\n"], ["1541", "
VA Consultation submitted
\n", "
1
\n"], ["1542", "
Patient will be seen outside VA
\n", "
2
\n"], ["1543", "
No services needed
\n", "
3
\n"], ["1544", "
Patient refused or not interested
\n", "
4
\n"], ["1545", "
Audiology
\n", "
0
\n"], ["1546", "
ENT
\n", "
1
\n"], ["1547", "
Neurology
\n", "
2
\n"], ["1548", "
Neuropsychology / Neuropsychological assessment
\n", "
3
\n"], ["1549", "
Occupational Therapy
\n", "
4
\n"], ["155", "
The structures of man live not forever
\n", "
C
\n"], ["1550", "
Ophthalmology / Optometry
\n", "
5
\n"], ["1551", "
Physical Therapy
\n", "
6
\n"], ["1552", "
PM and R
\n", "
7
\n"], ["1553", "
Prosthetics
\n", "
8
\n"], ["1554", "
Psychiatry
\n", "
9
\n"], ["1555", "
Psychology
\n", "
1
\n"], ["1556", "
Speech-Language Pathology
\n", "
1
\n"], ["1557", "
Substance Use / Addictive Disorder Evaluation and/or Treatment
\n", "
1
\n"], ["1558", "
Sleeping too much
\n", "
1
\n"], ["1559", "
Poor appetite
\n", "
1
\n"], ["156", "
'tis distance lends enchantment to the view
\n", "
D
\n"], ["1560", "
Overeating
\n", "
1
\n"], ["1561", "
Moving or speaking slowly
\n", "
1
\n"], ["1562", "
West Roxbury (V1)
\n", "
0
\n"], ["1563", "
Syracuse (V2)
\n", "
1
\n"], ["1564", "
Bronx (V3)
\n", "
2
\n"], ["1565", "
Philadelphia (V4)
\n", "
3
\n"], ["1566", "
Washington, DC (V5)
\n", "
4
\n"], ["1567", "
Augusta (V7)
\n", "
5
\n"], ["1568", "
Lexington (V9)
\n", "
6
\n"], ["1569", "
Cleveland (V10)
\n", "
7
\n"], ["157", "
Truth crushed to earth shall rise again
\n", "
E
\n"], ["1570", "
Indianapolis (V11)
\n", "
8
\n"], ["1571", "
Hines (V12)
\n", "
9
\n"], ["1572", "
Being fidgety or restless
\n", "
1
\n"], ["1573", "
Houston (V16)
\n", "
1
\n"], ["1574", "
Dallas (V17)
\n", "
1
\n"], ["1575", "
Tucson (v18)
\n", "
1
\n"], ["1576", "
Denver (V19)
\n", "
1
\n"], ["1577", "
Seattle (V20)
\n", "
1
\n"], ["1578", "
Trouble falling or staying asleep
\n", "
2
\n"], ["1579", "
Blood work
\n", "
1
\n"], ["158", "
V,x, and z
\n", "
A
\n"], ["1580", "
Urine drug screen
\n", "
2
\n"], ["1581", "
Incoordination or Dizziness
\n", "
1
\n"], ["1582", "
Headaches or Visual Disturbance
\n", "
2
\n"], ["1583", "
Non-Headache Pain
\n", "
3
\n"], ["1584", "
Nausea/Loss of Appetite
\n", "
4
\n"], ["1585", "
Poor attention, concentration, or memory
\n", "
5
\n"], ["1586", "
Anxiety or Irritability
\n", "
7
\n"], ["1587", "
Insomnia
\n", "
8
\n"], ["1588", "
Seizures
\n", "
9
\n"], ["1589", "
Moving or speaking slowly
\n", "
9
\n"], ["159", "
Y,w, and u
\n", "
B
\n"], ["1590", "
Thoughts that you would be better off dead or of hurting yourself
\n", "
1
\n"], ["1591", "
Patient will be discussed with mental health specialist.
\n", "
1
\n"], ["1592", "
Mental Health appointment is being made.
\n", "
2
\n"], ["1593", "
Suicidal ideation will continue to be monitored.
\n", "
3
\n"], ["1594", "
Care Manager discussed with patient not to harm self, assessed and reinforced social support, persons to contact, and what patient has done in the past to feel better or resist suicide.
\n", "
4
\n"], ["1595", "
Consult: Patient will be discussed with mental health specialist
\n", "
1
\n"], ["1596", "
Mental Health appointment is being made
\n", "
2
\n"], ["1597", "
Suicidal ideation will continue to be monitored
\n", "
3
\n"], ["1598", "
Care Manager discussed with patient not to harm self
\n", "
4
\n"], ["1599", "
Care Manager assessed and reinforced social support
\n", "
5
\n"], ["16", "
no
\n", "
0
\n"], ["160", "
Z,x, and v
\n", "
C
\n"], ["1600", "
Care Manager suggested persons to contact
\n", "
6
\n"], ["1601", "
Care Manager reviewed what patient has done in the past to feel better
\n", "
7
\n"], ["1602", "
Care Manager discussed previous ways pt resisted suicide
\n", "
8
\n"], ["1603", "
Verbalizes he wouldn't consider suicide or harming self
\n", "
1
\n"], ["1604", "
Has passive thoughts of death
\n", "
2
\n"], ["1605", "
Has thoughts about act of suicide but has no plan
\n", "
3
\n"], ["1606", "
Has suicide plan but says he won't act on it
\n", "
4
\n"], ["1607", "
Has suicide plan and may act on it
\n", "
5
\n"], ["1608", "
Using drugs/alcohol
\n", "
0
\n"], ["1609", "
Has hallucinations or delusions
\n", "
1
\n"], ["161", "
V,x, and y
\n", "
D
\n"], ["1610", "
Access to guns
\n", "
2
\n"], ["1611", "
No support person nearby
\n", "
3
\n"], ["1612", "
Family history of suicide
\n", "
4
\n"], ["1613", "
Previous attempt
\n", "
5
\n"], ["1614", "
Richmond (V6)
\n", "
3
\n"], ["1615", "
Experienced recent losses
\n", "
6
\n"], ["1616", "
Elderly
\n", "
7
\n"], ["1617", "
Elderly and not eating
\n", "
8
\n"], ["1618", "
In pain
\n", "
9
\n"], ["1619", "
Yes, threatened homicide policy initiated
\n", "
1
\n"], ["162", "
U,w, and z
\n", "
E
\n"], ["1620", "
Yes, threatened homicide policy not initiated
\n", "
2
\n"], ["1621", "
Unknown/Not sure
\n", "
2
\n"], ["1622", "
Tampa (V8)
\n", "
3
\n"], ["1623", "
Yes, psychotherapy only
\n", "
1
\n"], ["1624", "
Yes, antidepressants only
\n", "
2
\n"], ["1625", "
Yes, both psychotherapy and antidepressants
\n", "
3
\n"], ["1626", "
One time
\n", "
1
\n"], ["1627", "
Two times
\n", "
2
\n"], ["1628", "
Three times
\n", "
3
\n"], ["1629", "
Four or more trials
\n", "
4
\n"], ["163", "
$16
\n", "
A
\n"], ["1630", "
One group session
\n", "
1
\n"], ["1631", "
Multiple group sessions
\n", "
2
\n"], ["1632", "
1 or 2 individual sessions
\n", "
3
\n"], ["1633", "
Multiple individual sessions
\n", "
4
\n"], ["1634", "
Impaired function more than half the time
\n", "
1
\n"], ["1635", "
Impaired function less than half the time
\n", "
2
\n"], ["1636", "
No, but ordered
\n", "
1
\n"], ["1637", "
Significant
\n", "
3
\n"], ["1638", "
Activation (over-stim)
\n", "
0
\n"], ["1639", "
Agitation
\n", "
1
\n"], ["164", "
$12
\n", "
B
\n"], ["1640", "
Anxiety
\n", "
2
\n"], ["1641", "
Blurred vision
\n", "
3
\n"], ["1642", "
Confusion
\n", "
4
\n"], ["1643", "
Constipation
\n", "
5
\n"], ["1644", "
Diarrhea
\n", "
6
\n"], ["1645", "
Difficulty urinating
\n", "
7
\n"], ["1646", "
Dizziness/light-headedness
\n", "
8
\n"], ["1647", "
Dry mouth
\n", "
9
\n"], ["1648", "
Headaches
\n", "
1
\n"], ["1649", "
Irritability/anger
\n", "
1
\n"], ["165", "
$24
\n", "
C
\n"], ["1650", "
Loss of appetite
\n", "
1
\n"], ["1651", "
Memory problems
\n", "
1
\n"], ["1652", "
Muscle weakness
\n", "
1
\n"], ["1653", "
Palo Alto (V21)
\n", "
8
\n"], ["1654", "
Nausea/upset stomach
\n", "
1
\n"], ["1655", "
West Los Angeles (V22)
\n", "
8
\n"], ["1656", "
Nightmares
\n", "
1
\n"], ["1657", "
Sedation
\n", "
1
\n"], ["1658", "
Sexual dysfunction
\n", "
1
\n"], ["1659", "
Minneapolis (V23)
\n", "
8
\n"], ["166", "
$15
\n", "
D
\n"], ["1660", "
Sweating
\n", "
1
\n"], ["1661", "
Tachycardia
\n", "
2
\n"], ["1662", "
Tremor
\n", "
2
\n"], ["1663", "
Not problematic
\n", "
0
\n"], ["1664", "
Mortar
\n", "
3
\n"], ["1665", "
Drug abuse/dependence
\n", "
5
\n"], ["1666", "
Problematic
\n", "
1
\n"], ["1667", "
Shortness of breath at rest
\n", "
0
\n"], ["1668", "
Chest pains not previously evaluated by your physician
\n", "
1
\n"], ["1669", "
Active infection more than a cold
\n", "
2
\n"], ["167", "
$18
\n", "
E
\n"], ["1670", "
Hernia in the groin or belly area that causes you symptoms
\n", "
3
\n"], ["1671", "
Bleeding in the back of the eye - Retinal hemorrhage
\n", "
4
\n"], ["1672", "
Loss of balance because of dizziness or passing out
\n", "
5
\n"], ["1673", "
Any chronic problem that has recently been out-of-control, unstable or flared up
\n", "
6
\n"], ["1674", "
Arthritis or joint pain
\n", "
7
\n"], ["1675", "
Back pain or spinal disc disease
\n", "
8
\n"], ["1676", "
Osteoporosis or bone disease
\n", "
9
\n"], ["1677", "
Amputation
\n", "
1
\n"], ["1678", "
Spinal cord injury
\n", "
1
\n"], ["1679", "
Lung disease such as emphysema, COPD, or asthma
\n", "
1
\n"], ["168", "
Birds of a feather flock together
\n", "
A
\n"], ["1680", "
Heart disease such as heart failure, heart attack, heart surgery
\n", "
1
\n"], ["1681", "
Poor blood circulation in the legs
\n", "
1
\n"], ["1682", "
or carotid artery surgery in the neck
\n", "
1
\n"], ["1683", "
Diabetes - even if controlled by medication or diet
\n", "
1
\n"], ["1684", "
Adequate
\n", "
1
\n"], ["1685", "
Inconsistent eating pattern
\n", "
4
\n"], ["1686", "
Smoking
\n", "
1
\n"], ["1687", "
Someone in your immediate family with heart problems at an age younger than 50
\n", "
2
\n"], ["1688", "
None of the above
\n", "
2
\n"], ["1689", "
Underweight
\n", "
1
\n"], ["169", "
Correspondence is half a presence
\n", "
B
\n"], ["1690", "
Normal weight for my height and age
\n", "
2
\n"], ["1691", "
Overweight, but not obese
\n", "
3
\n"], ["1692", "
Obese
\n", "
4
\n"], ["1693", "
I have been overweight since childhood (before age 18)
\n", "
1
\n"], ["1694", "
I have gained weight gradually over the years
\n", "
2
\n"], ["1695", "
I have gained most of the excess weight in a short period of time
\n", "
3
\n"], ["1696", "
I have gained and lost weight many times over the years (\"yo-yo\")
\n", "
4
\n"], ["1697", "
As a group, my family is not overweight or obese
\n", "
1
\n"], ["1698", "
As a group, some members of my family are overweight or obese
\n", "
2
\n"], ["1699", "
As a group, most members of my family are overweight or obese
\n", "
3
\n"], ["17", "
yes
\n", "
1
\n"], ["170", "
Patience is the key of glory
\n", "
C
\n"], ["1700", "
I am not considering trying to control my weight at this time
\n", "
1
\n"], ["1701", "
I am considering trying to control my weight sometime within the next six months
\n", "
2
\n"], ["1702", "
I am ready to make some changes to control my weight
\n", "
3
\n"], ["1703", "
I am actively working on controlling my weight at this time
\n", "
4
\n"], ["1704", "
I have been continuously and successfully doing things to control my weight for more than the last six months
\n", "
5
\n"], ["1705", "
10 lbs or less
\n", "
1
\n"], ["1706", "
11 - 25 lbs
\n", "
2
\n"], ["1707", "
26 - 50 lbs
\n", "
3
\n"], ["1708", "
51 - 100 lbs
\n", "
4
\n"], ["1709", "
More than 100 lbs
\n", "
5
\n"], ["171", "
The calamities of one nation turn to the benefit of another
\n", "
D
\n"], ["1710", "
Very sure I can (100% sure I can)
\n", "
1
\n"], ["1711", "
Somewhat sure I can (50% sure I can)
\n", "
2
\n"], ["1712", "
Not sure I can (25% sure I can)
\n", "
3
\n"], ["1713", "
I can't do it (0% sure I can)
\n", "
4
\n"], ["1714", "
Very satisfied
\n", "
1
\n"], ["1715", "
Moderately satisfied
\n", "
2
\n"], ["1716", "
Neither satisfied or unsatisfied
\n", "
3
\n"], ["1717", "
Moderately dissatisfied
\n", "
4
\n"], ["1718", "
Very dissatisfied
\n", "
5
\n"], ["1719", "
Eating because of emotions or stress
\n", "
0
\n"], ["172", "
The tongue is the neck's enemy
\n", "
E
\n"], ["1720", "
Family or relationship problems
\n", "
1
\n"], ["1721", "
Boredom
\n", "
2
\n"], ["1722", "
Loneliness or loss of loved one
\n", "
3
\n"], ["1723", "
Eating too much
\n", "
4
\n"], ["1724", "
Poor food choices or habits
\n", "
5
\n"], ["1725", "
Not getting enough physical activity
\n", "
6
\n"], ["1726", "
Difficulty with self control
\n", "
7
\n"], ["1727", "
Hungry all the time
\n", "
8
\n"], ["1728", "
Feeling bad about myself
\n", "
9
\n"], ["1729", "
Love to eat
\n", "
1
\n"], ["173", "
Unhealthy
\n", "
A
\n"], ["1730", "
Quit smoking
\n", "
1
\n"], ["1731", "
Pregnancy / childbirth
\n", "
1
\n"], ["1732", "
Illness or injury
\n", "
1
\n"], ["1733", "
Medications led to weight gain
\n", "
1
\n"], ["1734", "
To some extent
\n", "
3
\n"], ["1735", "
Eating at restaurants or fast food places too often
\n", "
0
\n"], ["1736", "
Person who prepares my food is uncooperative or unsupportive
\n", "
1
\n"], ["1737", "
Too much high calorie food available at home or work
\n", "
2
\n"], ["1738", "
Too little time to prepare and eat healthy food
\n", "
3
\n"], ["1739", "
Too little money to buy healthy food
\n", "
4
\n"], ["174", "
Undemocratic
\n", "
B
\n"], ["1740", "
Feeling hungry much of the time
\n", "
5
\n"], ["1741", "
Strong long-term eating habits
\n", "
6
\n"], ["1742", "
Difficulties such as stress or depression
\n", "
7
\n"], ["1743", "
Being with others who overeat
\n", "
8
\n"], ["1744", "
Too little time
\n", "
0
\n"], ["1745", "
Too little money
\n", "
1
\n"], ["1746", "
Safety concerns
\n", "
2
\n"], ["1747", "
No place to walk or be active
\n", "
3
\n"], ["1748", "
No transportation
\n", "
4
\n"], ["1749", "
Lack of support or encouragement from others
\n", "
5
\n"], ["175", "
Unuseful
\n", "
C
\n"], ["1750", "
Difficulties such as stress, depression, etc.
\n", "
6
\n"], ["1751", "
Do not like to exercise
\n", "
7
\n"], ["1752", "
Daily habits or routines that do not include exercise
\n", "
8
\n"], ["1753", "
Pain
\n", "
9
\n"], ["1754", "
Back problems
\n", "
1
\n"], ["1755", "
Arthritis
\n", "
1
\n"], ["1756", "
Muscular problems
\n", "
1
\n"], ["1757", "
Heart or lung disease
\n", "
1
\n"], ["1758", "
Joint problems
\n", "
1
\n"], ["1759", "
Too tired
\n", "
1
\n"], ["176", "
Unholy
\n", "
D
\n"], ["1760", "
Job or work schedule
\n", "
1
\n"], ["1761", "
Too much stress
\n", "
0
\n"], ["1762", "
General unhappiness
\n", "
1
\n"], ["1763", "
Anxiety problems or disorders/nervousness
\n", "
3
\n"], ["1764", "
Bipolar disorder (Manic depressive disorder)
\n", "
5
\n"], ["1765", "
Schizophrenia
\n", "
6
\n"], ["1766", "
Post traumatic stress disorder (PTSD)
\n", "
7
\n"], ["1767", "
Obsessive / compulsive disorder
\n", "
8
\n"], ["1768", "
Eating disorder/binge eating/anorexia/bulimia
\n", "
9
\n"], ["1769", "
Tobacco Use/Smoking
\n", "
1
\n"], ["177", "
Unsuccessful
\n", "
E
\n"], ["1770", "
Substance Abuse or Dependence
\n", "
1
\n"], ["1771", "
None of these
\n", "
1
\n"], ["1772", "
Two times a day
\n", "
2
\n"], ["1773", "
Three times a day
\n", "
3
\n"], ["1774", "
Four times a day
\n", "
4
\n"], ["1775", "
Five or more times each day
\n", "
5
\n"], ["1776", "
Less than once a week
\n", "
0
\n"], ["1777", "
Two times per week
\n", "
2
\n"], ["1778", "
Three times per week
\n", "
3
\n"], ["1779", "
Four or more times per week
\n", "
4
\n"], ["178", "
20-40
\n", "
A
\n"], ["1780", "
I don't drink drinks sweetened with sugar or juice
\n", "
0
\n"], ["1781", "
One to two glasses, cans, or drink boxes per day
\n", "
1
\n"], ["1782", "
Three or more glasses, cans, or drink boxes per day
\n", "
2
\n"], ["1783", "
None or less than one a week on average
\n", "
0
\n"], ["1784", "
One to 14
\n", "
1
\n"], ["1785", "
More than 14
\n", "
2
\n"], ["1786", "
I eat slowly
\n", "
1
\n"], ["1787", "
I eat at a moderate pace
\n", "
2
\n"], ["1788", "
I eat fast
\n", "
3
\n"], ["1789", "
Less than one day a week
\n", "
0
\n"], ["179", "
15-20
\n", "
B
\n"], ["1790", "
One day a week
\n", "
1
\n"], ["1791", "
Two or three days a week
\n", "
2
\n"], ["1792", "
Four or five days a week
\n", "
3
\n"], ["1793", "
Most days or multiple times a day
\n", "
4
\n"], ["1794", "
No, not limited in climbing
\n", "
1
\n"], ["1795", "
Moderately limited d._________ Greatly limited
\n", "
3
\n"], ["1796", "
Unable to climb a flight of stairs most days
\n", "
4
\n"], ["1797", "
No, not limited in walking
\n", "
1
\n"], ["1798", "
Unable to walk several blocks most days
\n", "
4
\n"], ["1799", "
No, not limited in lifting
\n", "
1
\n"], ["18", "", "
A
\n"], ["180", "
12-24
\n", "
C
\n"], ["1800", "
Unable to lift or carry packages most days
\n", "
4
\n"], ["1801", "
Avoid
\n", "
0
\n"], ["1802", "
Elderly, not eating
\n", "
5
\n"], ["1803", "
Daily exercise
\n", "
2
\n"], ["1804", "
I strongly dislike exercise
\n", "
1
\n"], ["1805", "
I dislike exercise
\n", "
2
\n"], ["1806", "
Exercise is ok
\n", "
3
\n"], ["1807", "
I like to exercise
\n", "
4
\n"], ["1808", "
Mildly disagree
\n", "
3
\n"], ["1809", "
Neither agree or disagree
\n", "
4
\n"], ["181", "
18-24
\n", "
D
\n"], ["1810", "
Mildly agree
\n", "
5
\n"], ["1811", "
High blood pressure, even if controlled by medication
\n", "
1
\n"], ["1812", "
High blood cholesterol, even if controlled by medication or diet
\n", "
1
\n"], ["1813", "
Active 3 days
\n", "
1
\n"], ["1814", "
Homemaker
\n", "
1
\n"], ["1815", "
Elderly, not eating: referral initiated
\n", "
6
\n"], ["1816", "
Recent gain
\n", "
1
\n"], ["1817", "
Recent loss
\n", "
2
\n"], ["1818", "
Active smoker
\n", "
1
\n"], ["1819", "
St Louis (V15)
\n", "
1
\n"], ["182", "
11-22
\n", "
E
\n"], ["1820", "
No loss of consciousness
\n", "
0
\n"], ["1821", "
Less than one minute
\n", "
1
\n"], ["1822", "
One minute to 30 minutes
\n", "
2
\n"], ["1823", "
Greater than 30 minutes to 6 hours
\n", "
3
\n"], ["1824", "
Greater than 6 hours to 24 hours
\n", "
4
\n"], ["1825", "
Greater than 24 hours to 7 days
\n", "
5
\n"], ["1826", "
Greater than 7 days
\n", "
6
\n"], ["1827", "
No alteration of consciousness
\n", "
0
\n"], ["1828", "
Thirty minutes to 24 hours
\n", "
2
\n"], ["1829", "
Greater than 7 days to 1 month
\n", "
4
\n"], ["183", "
He who stands not firm fails himself
\n", "
A
\n"], ["1830", "
Greater than 1 month to 3 months
\n", "
5
\n"], ["1831", "
Greater than 3 months
\n", "
6
\n"], ["1832", "
No Posttraumatic Amnesia
\n", "
0
\n"], ["1833", "
Correct year
\n", "
0
\n"], ["1834", "
Incorrect year
\n", "
1
\n"], ["1835", "
Correct month
\n", "
0
\n"], ["1836", "
Incorrect month
\n", "
3
\n"], ["1837", "
Correct time
\n", "
0
\n"], ["1838", "
Incorrect time
\n", "
1
\n"], ["1839", "
No mistakes
\n", "
0
\n"], ["184", "
All forms that perish other forms supply
\n", "
B
\n"], ["1840", "
One mistake
\n", "
2
\n"], ["1841", "
Two or more mistakes
\n", "
4
\n"], ["1842", "
No errors
\n", "
0
\n"], ["1843", "
One error
\n", "
2
\n"], ["1844", "
Two errors
\n", "
4
\n"], ["1845", "
Three errors
\n", "
6
\n"], ["1846", "
Four errors
\n", "
8
\n"], ["1847", "
Five or more errors
\n", "
10
\n"], ["1848", "
Cancer
\n", "
2
\n"], ["1849", "
Hx of MI,CAD, CHF
\n", "
3
\n"], ["185", "
What can't be cured must be endured
\n", "
C
\n"], ["1850", "
Hx of lung dz, emphysema, asthma, bronchitis
\n", "
4
\n"], ["1851", "
Diabetes
\n", "
5
\n"], ["1852", "
Pain location
\n", "
7
\n"], ["1853", "
Pain level
\n", "
8
\n"], ["1854", "
HTN/cardio
\n", "
1
\n"], ["1855", "
Sedative/hypnotic agents
\n", "
2
\n"], ["1856", "
Anti-inflam agents
\n", "
3
\n"], ["1857", "
Analgesics
\n", "
4
\n"], ["1858", "
Hormones
\n", "
5
\n"], ["1859", "
Levodopa
\n", "
6
\n"], ["186", "
The quiet mind is richer than a crown
\n", "
D
\n"], ["1860", "
Cimetidine
\n", "
7
\n"], ["1861", "
Antineoplastics agents
\n", "
8
\n"], ["1862", "
Stimulants
\n", "
9
\n"], ["1863", "
OTC meds
\n", "
1
\n"], ["1864", "
Herbs/Supplements
\n", "
2
\n"], ["1865", "
Other [Illicit]
\n", "
3
\n"], ["1866", "
Daily
\n", "
1
\n"], ["1867", "
Two or three times a week
\n", "
2
\n"], ["1868", "
One or two
\n", "
1
\n"], ["1869", "
Three or four
\n", "
2
\n"], ["187", "
Let in the fox's nose, his body soon follows
\n", "
E
\n"], ["1870", "
Five or six
\n", "
3
\n"], ["1871", "
Seven to nine
\n", "
4
\n"], ["1872", "
Ten or more
\n", "
5
\n"], ["1873", "
Yes, wants treatment
\n", "
1
\n"], ["1874", "
Yes, does not want treatment
\n", "
2
\n"], ["1875", "
Yes, LESS than half the days in a month
\n", "
1
\n"], ["1876", "
Yes, MORE than half the days in the month
\n", "
2
\n"], ["1877", "
One factor
\n", "
1
\n"], ["1878", "
Two factors
\n", "
2
\n"], ["1879", "
Three factors
\n", "
3
\n"], ["188", "
Animal
\n", "
A
\n"], ["1880", "
Four factors
\n", "
4
\n"], ["1881", "
No change in symptoms in past 3 months
\n", "
5
\n"], ["1882", "
Patient in PTSD treatment program already
\n", "
1
\n"], ["1883", "
Patient has two or more factors and wants referral
\n", "
2
\n"], ["1884", "
Patient has two or more factors and does NOT want referral
\n", "
3
\n"], ["1885", "
Not sure
\n", "
1
\n"], ["1886", "
Diagnosis in PL
\n", "
3
\n"], ["1887", "
Lithium, valproic acid [Depakote] or lamotrigine [Lamictal]
\n", "
4
\n"], ["1888", "
Not sure/Unknown
\n", "
2
\n"], ["1889", "
Medical disability
\n", "
3
\n"], ["189", "
Bone
\n", "
B
\n"], ["1890", "
Unemployed, seeking work
\n", "
4
\n"], ["1891", "
Unemployed, NOT seeking employment
\n", "
5
\n"], ["1892", "
Significant other
\n", "
2
\n"], ["1893", "
Alone
\n", "
1
\n"], ["1894", "
Family
\n", "
2
\n"], ["1895", "
Dependent on others
\n", "
2
\n"], ["1896", "
No children
\n", "
0
\n"], ["1897", "
Dependent children
\n", "
1
\n"], ["1898", "
Adult children
\n", "
2
\n"], ["1899", "
Little or none
\n", "
1
\n"], ["19", "", "
B
\n"], ["190", "
Person
\n", "
C
\n"], ["1900", "
Friends
\n", "
2
\n"], ["1901", "
Church
\n", "
3
\n"], ["1902", "
Social group
\n", "
4
\n"], ["1903", "
Agency
\n", "
5
\n"], ["1904", "
Financial
\n", "
1
\n"], ["1905", "
Home
\n", "
2
\n"], ["1906", "
Work
\n", "
3
\n"], ["1907", "
Education
\n", "
5
\n"], ["1908", "
Legal
\n", "
6
\n"], ["1909", "
Own health
\n", "
7
\n"], ["191", "
Symbol
\n", "
D
\n"], ["1910", "
Family members' health
\n", "
8
\n"], ["1911", "
WWII
\n", "
1
\n"], ["1912", "
Korea
\n", "
2
\n"], ["1913", "
Vietnam
\n", "
3
\n"], ["1914", "
1st Gulf War
\n", "
4
\n"], ["1915", "
OEF/OIF
\n", "
5
\n"], ["1916", "
Peacetime
\n", "
6
\n"], ["1917", "
Meds
\n", "
1
\n"], ["1918", "
Psychotherapy
\n", "
2
\n"], ["1919", "
Self-help & monitoring
\n", "
3
\n"], ["192", "
Vapor
\n", "
E
\n"], ["1920", "
Transient low mood; does not have depression Sxs at this time (PHQ-9 score less than 5). Not currently appropriate for care management, but please re-consult if symptoms worsen.
\n", "
1
\n"], ["1921", "
Sxs of depression (PHQ-9 score between 5 and 9) but not MDD
\n", "
2
\n"], ["1922", "
Bereavement, lost a spouse, close relative in last two months. Major depression treatment not appropriate. Care manager will provide education and watchful waiting with recheck at 2 months.
\n", "
3
\n"], ["1923", "
Dysthymia with feelings of depression and impaired functioning over last two years and PHQ-9 between 4 and 9. Treat with antidepressant meds or psychotherapy and care management.
\n", "
4
\n"], ["1924", "
Probable major depression (PHQ-9 score above 9) or incipient relapse (PHQ-9 between 5 and 9 with history of depression). Patient prefers watchful waiting.
\n", "
5
\n"], ["1925", "
Probable major depression (PHQ-9 score above 9) or incipient relapse (PHQ-9 between 5 and 9 with history of depression). Treat with antidepressant meds or psychotherapy and care management.
\n", "
6
\n"], ["1926", "
Dysthymia plus major depression; feelings of depression and impaired functioning over last two years and PHQ-9 score above 9. Treat with antidepressant meds or psychotherapy and care management.
\n", "
7
\n"], ["1927", "
Refer to MH /substance abuse tx.
\n", "
0
\n"], ["1928", "
Refer to MH/substance abuse tx.
\n", "
1
\n"], ["1929", "
Meds & freq f/u
\n", "
2
\n"], ["193", "
Into each life some rain must fall
\n", "
A
\n"], ["1930", "
MH referral
\n", "
3
\n"], ["1931", "
Refer to MH/sub abuse tx
\n", "
4
\n"], ["1932", "
Refer to MH.
\n", "
5
\n"], ["1933", "
Refer to MH/PTSD tx.
\n", "
6
\n"], ["1934", "
Urgent referral to MH.
\n", "
7
\n"], ["1935", "
Eval may be warranted.
\n", "
8
\n"], ["1936", "
Tx adjust or refer to MH.
\n", "
9
\n"], ["1937", "
Depressive response to non-antidepressant med.
\n", "
1
\n"], ["1938", "
Refer to specialty program.
\n", "
1
\n"], ["1939", "
Eval/tx of pain may improve mood.
\n", "
1
\n"], ["194", "
Necessity is the mother of invention
\n", "
B
\n"], ["1940", "
Longer tx, freq. f/u.
\n", "
1
\n"], ["1941", "
Longer tx freq f/u.
\n", "
1
\n"], ["1942", "
Refer for assessment
\n", "
1
\n"], ["1943", "
Refer for nutritional eval
\n", "
1
\n"], ["1944", "
Refer for smoking cessation.
\n", "
1
\n"], ["1945", "
Refer for diabetic ed.
\n", "
1
\n"], ["1946", "
PC eval
\n", "
1
\n"], ["1947", "
Encourage interests, hobbies, pleasurable acts.
\n", "
2
\n"], ["1948", "
Pt has vegetative or severe symptoms
\n", "
1
\n"], ["1949", "
Pt has past hx of successful tx with antidepressants
\n", "
2
\n"], ["195", "
Fine feathers do not make the bird
\n", "
C
\n"], ["1950", "
Pt prefers antidepressants
\n", "
3
\n"], ["1951", "
Pt has significant pain
\n", "
4
\n"], ["1952", "
Pt refuses MHS referral
\n", "
5
\n"], ["1953", "
Patient has vegetative or severe symptoms
\n", "
1
\n"], ["1954", "
Patient has past hx of successful tx with antidepressants
\n", "
2
\n"], ["1955", "
Patient prefers antidepressants
\n", "
3
\n"], ["1956", "
Patient has significant pain
\n", "
4
\n"], ["1957", "
Patient refuses MHS referral
\n", "
5
\n"], ["1958", "
f/u.
\n", "
1
\n"], ["1959", "
Patient has social stress or isolation
\n", "
1
\n"], ["196", "
Nobility of soul is mankind's richest treasure
\n", "
D
\n"], ["1960", "
Patient has hx of successful treatment w/ psychotherapy
\n", "
2
\n"], ["1961", "
Patient prefers psychotherapy
\n", "
3
\n"], ["1962", "
Patient has contraindications for medications
\n", "
4
\n"], ["1963", "
Patient refuses anti-depressants
\n", "
5
\n"], ["1964", "
Patient has indications for referral but refuses
\n", "
1
\n"], ["1965", "
Patient will accept Mental Health referral
\n", "
2
\n"], ["1966", "
Watchful waiting
\n", "
0
\n"], ["1967", "
Consider antidepressant
\n", "
1
\n"], ["1968", "
Continue antidepressant
\n", "
2
\n"], ["1969", "
Consider referral to Mental Health
\n", "
3
\n"], ["197", "
Sit a beggar on horseback, he will ride the horse at a gallop
\n", "
E
\n"], ["1970", "
Consider adjusting dose or changing medication
\n", "
4
\n"], ["1971", "
Consider treatment after further evaluation/treatment
\n", "
5
\n"], ["1972", "
Consider lab testing on next primary care visit for:
\n", "
6
\n"], ["1973", "
TSH
\n", "
7
\n"], ["1974", "
T4
\n", "
8
\n"], ["1975", "
CA++
\n", "
9
\n"], ["1976", "
BUN
\n", "
1
\n"], ["1977", "
CREATININE
\n", "
1
\n"], ["1978", "
B12
\n", "
1
\n"], ["1979", "
SGOT
\n", "
1
\n"], ["198", "", "
A
\n"], ["1980", "
AST
\n", "
1
\n"], ["1981", "
SGPT
\n", "
1
\n"], ["1982", "
ALT
\n", "
1
\n"], ["1983", "
Patient needs follow-up with Primary care provider for med management
\n", "
1
\n"], ["1984", "
Other (see comments)
\n", "
1
\n"], ["1985", "
Care manager will follow patient unless otherwise directed by primary care.
\n", "
0
\n"], ["1986", "
Unless otherwise directed, care manager will refer patient to MH.
\n", "
1
\n"], ["1987", "
Patient is currently in mental health and monitor for adherence to appt.
\n", "
2
\n"], ["1988", "
Patient does not meet protocol for care management.
\n", "
3
\n"], ["1989", "
Patient will be discussed with supervising psychiatrist.
\n", "
4
\n"], ["199", "", "
B
\n"], ["1990", "
Unable to reach patient, letter has been sent
\n", "
5
\n"], ["1991", "
Patient refused assessment, consult can be re-initiated.
\n", "
6
\n"], ["1992", "
Too hearing impaired to communicate by phone.
\n", "
7
\n"], ["1993", "
Too cognitively impaired per protocol cognitive screening.
\n", "
8
\n"], ["1994", "
Suicidal ideation makes patient inappropriate at this time.
\n", "
9
\n"], ["1995", "
Patient received and reviewed
\n", "
1
\n"], ["1996", "
Patient received but did not review
\n", "
2
\n"], ["1997", "
Patient not sure or material not received
\n", "
3
\n"], ["1998", "
Contacting PCP, DCM, local resources at VA or in community.
\n", "
0
\n"], ["1999", "
Depression symptoms worse with ETOH & substance abuse
\n", "
1
\n"], ["2", "
Minimal, may be extreme normal
\n", "
1
\n"], ["20", "", "
C
\n"], ["200", "", "
D
\n"], ["2000", "
Treatment more difficult with ETOH & substance abuse
\n", "
2
\n"], ["2001", "
Diet
\n", "
3
\n"], ["2002", "
Exercise
\n", "
4
\n"], ["2003", "
Keep scheduled appts
\n", "
5
\n"], ["2004", "
Leisure activities/participate in enjoyable activities
\n", "
6
\n"], ["2005", "
Social support
\n", "
7
\n"], ["2006", "
Goals for stress reduction
\n", "
8
\n"], ["2007", "
Anti-depressant treatment
\n", "
9
\n"], ["2008", "
Taking meds as prescribed and not over-medicating
\n", "
1
\n"], ["2009", "
Refill RX on time
\n", "
1
\n"], ["201", "", "
E
\n"], ["2010", "
Anti-depressant instructions
\n", "
1
\n"], ["2011", "
Sleep hygiene
\n", "
1
\n"], ["2012", "
Relapse information
\n", "
1
\n"], ["2013", "
Contact Card
\n", "
0
\n"], ["2014", "
Medication Instructions
\n", "
1
\n"], ["2015", "
General Depression
\n", "
5
\n"], ["2016", "
Self-Help Material
\n", "
6
\n"], ["2017", "
PHQ-9 Score
\n", "
7
\n"], ["2018", "
Community Resources
\n", "
8
\n"], ["2019", "
he may be depressed
\n", "
0
\n"], ["202", "
Senate
\n", "
A
\n"], ["2020", "
Pt doesn't understand seriousness of need for treatment
\n", "
1
\n"], ["2021", "
doesn't think treatment will help
\n", "
2
\n"], ["2022", "
is uncomfortable talking about personal things
\n", "
3
\n"], ["2023", "
is embarrassed
\n", "
4
\n"], ["2024", "
has conflicting religious beliefs
\n", "
5
\n"], ["2025", "
thinks other problems are more important
\n", "
6
\n"], ["2026", "
thinks treatment will take too long or be too expensive
\n", "
7
\n"], ["2027", "
Unable to read
\n", "
8
\n"], ["2028", "
Unable to write
\n", "
9
\n"], ["2029", "
Homeless
\n", "
1
\n"], ["203", "
Kremlin
\n", "
B
\n"], ["2030", "
Visually impaired
\n", "
1
\n"], ["2031", "
Hearing impaired
\n", "
1
\n"], ["2032", "
Patient disagrees he may be depressed
\n", "
0
\n"], ["2033", "
Patient doesn't understand seriousness of need for treatment
\n", "
1
\n"], ["2034", "
Patient is uncomfortable talking about personal things
\n", "
3
\n"], ["2035", "
Patient is embarrassed
\n", "
4
\n"], ["2036", "
Patient has conflicting religious beliefs
\n", "
5
\n"], ["2037", "
Patient thinks other problems are more important
\n", "
6
\n"], ["2038", "
Patient thinks treatment will take too long or be too expensive
\n", "
7
\n"], ["2039", "
Reading
\n", "
1
\n"], ["204", "
House of lords
\n", "
C
\n"], ["2040", "
Discussion
\n", "
2
\n"], ["2041", "
Lecture/Class
\n", "
3
\n"], ["2042", "
Demonstration
\n", "
4
\n"], ["2043", "
Media (AV)
\n", "
5
\n"], ["2044", "
Computer Literate
\n", "
6
\n"], ["2045", "
Encourage interests, hobbies, pleasurable acts
\n", "
2
\n"], ["2046", "
Pain location (see comments)
\n", "
7
\n"], ["2047", "
Pain level (see comments)
\n", "
8
\n"], ["2048", "
Diagnosis in Problem List
\n", "
3
\n"], ["2049", "
Tx adjust or refer to MH
\n", "
9
\n"], ["205", "
Reichstag
\n", "
D
\n"], ["2050", "
Depressive response to non-antidepressant med
\n", "
1
\n"], ["2051", "
Refer to specialty program
\n", "
1
\n"], ["2052", "
Eval/tx of pain may improve mood
\n", "
1
\n"], ["2053", "
Refer for diabetic ed
\n", "
1
\n"], ["2054", "
Thoughts that you be better off dead or of hurting yourself in some way
\n", "
9
\n"], ["2055", "
Has suicide plan and may act on it [invoke MC suicide protocol]
\n", "
5
\n"], ["2056", "
The patient will be discussed with mental health specialist
\n", "
1
\n"], ["2057", "
Patient doesn't think treatment will help
\n", "
2
\n"], ["2058", "
Care Manager discussed previous ways patient resisted suicide
\n", "
8
\n"], ["2059", "
ETOH with depression. Refer to MH /substance abuse tx.
\n", "
1
\n"], ["206", "
President
\n", "
E
\n"], ["2060", "
ETOH, no depression. Refer to MH/substance abuse tx.
\n", "
2
\n"], ["2061", "
Frequent anxiety or panic with depression. Meds & freq f/u
\n", "
3
\n"], ["2062", "
Frequent anxiety or panic without depression. MH referral
\n", "
4
\n"], ["2063", "
Substance use other than ETOH. Refer to MH/sub abuse tx
\n", "
5
\n"], ["2064", "
Bipolar disorder. Refer to MH.
\n", "
6
\n"], ["2065", "
PTSD screen positive. Refer to MH/PTSD tx.
\n", "
7
\n"], ["2066", "
Psychosis. Urgent referral to MH.
\n", "
8
\n"], ["2067", "
Memory loss, poor cognition. Eval may be warranted.
\n", "
9
\n"], ["2068", "
Poor response, SE to antidepre tx. Tx adjust or refer to MH. 11. Depressive response to non-antidepressant med
\n", "
1
\n"], ["2069", "
Recent returning combat veteran (OEF/OIF). Refer to specialty program.
\n", "
1
\n"], ["207", "
Strong
\n", "
A
\n"], ["2070", "
Significant pain. Eval/tx of pain may improve mood.
\n", "
1
\n"], ["2071", "
Low social support, isolation. Longer tx, freq. f/u.
\n", "
1
\n"], ["2072", "
Multiple physical symp. Longer tx freq f/u.
\n", "
1
\n"], ["2073", "
Severe sleep disorder symptom. Refer for assessment
\n", "
1
\n"], ["2074", "
Severe loss of appetite and wt. Refer for nutritional eval
\n", "
1
\n"], ["2075", "
Patient is smoking. Refer for smoking cessation.
\n", "
1
\n"], ["2076", "
Poor diabetic control. Refer for diabetic ed.
\n", "
1
\n"], ["2077", "
Non-prescription meds of possible concern. PC eval
\n", "
1
\n"], ["2078", "
Needs activation. Encourage interests, hobbies, pleasurable acts.
\n", "
2
\n"], ["2079", "
Poor response, SE to antidepre Tx. Tx adjust or refer to MH.
\n", "
1
\n"], ["208", "
Fast
\n", "
B
\n"], ["2080", "
Sweating
\n", "
2
\n"], ["2081", "
Consider referral to Mental Health
\n", "
4
\n"], ["2082", "
Consider lab testing on next primary care visit (see below)
\n", "
7
\n"], ["2083", "
Patient needs follow-up with PC provider for med management
\n", "
8
\n"], ["2084", "
T4
\n", "
2
\n"], ["2085", "
CA++
\n", "
3
\n"], ["2086", "
BUN
\n", "
4
\n"], ["2087", "
CREATININE
\n", "
5
\n"], ["2088", "
SGOT
\n", "
7
\n"], ["2089", "
ALT
\n", "
1
\n"], ["209", "
Solid
\n", "
C
\n"], ["2090", "
Unless otherwise directed, care manager will refer patient to MH.
\n", "
2
\n"], ["2091", "
Patient does not meet protocol for care management.
\n", "
4
\n"], ["2092", "
Patient will be discussed with supervising psychiatrist.
\n", "
5
\n"], ["2093", "
Depression symptoms worse with ETOH & substance abuse
\n", "
2
\n"], ["2094", "
Treatment more difficult with ETOH & substance abuse
\n", "
3
\n"], ["2095", "
Anti-depressant treatment
\n", "
1
\n"], ["2096", "
Patient doesn't understand seriousness of need for treatment
\n", "
2
\n"], ["2097", "
Patient has conflicting religious beliefs
\n", "
6
\n"], ["2098", "
Unable to read
\n", "
9
\n"], ["2099", "
Better than before
\n", "
1
\n"], ["21", "", "
D
\n"], ["210", "
Hard
\n", "
D
\n"], ["2100", "
Worse than before
\n", "
2
\n"], ["2101", "
One week
\n", "
1
\n"], ["2102", "
Two to three weeks
\n", "
2
\n"], ["2103", "
Four to seven weeks
\n", "
3
\n"], ["2104", "
Eight to twelve weeks
\n", "
4
\n"], ["2105", "
Thirteen to seventeen weeks
\n", "
5
\n"], ["2106", "
Eighteen to twenty-one weeks
\n", "
6
\n"], ["2107", "
Twenty-two to twenty-six weeks
\n", "
7
\n"], ["2108", "
Twenty-seven weeks and greater
\n", "
8
\n"], ["2109", "
Yes, ordered
\n", "
2
\n"], ["211", "
Opaque
\n", "
E
\n"], ["2110", "
Higher dose
\n", "
1
\n"], ["2111", "
Lower dose
\n", "
2
\n"], ["2112", "
Added med
\n", "
3
\n"], ["2113", "
Different med
\n", "
4
\n"], ["2114", "
Med stopped due to side-effects
\n", "
5
\n"], ["2115", "
Med stopped: not needed
\n", "
6
\n"], ["2116", "
Med stopped: non-compliance
\n", "
7
\n"], ["2117", "
Antidepressant started for first time
\n", "
8
\n"], ["2118", "
No at all
\n", "
0
\n"], ["2119", "
Two to three times a week
\n", "
2
\n"], ["212", "
Not at all
\n", "
1
\n"], ["2120", "
Patient now agrees he may be depressed
\n", "
1
\n"], ["2121", "
Patient understands seriousness of need for treatment
\n", "
2
\n"], ["2122", "
Patient now thinks treatment will help
\n", "
3
\n"], ["2123", "
Patient becoming comfortable talking about personal things
\n", "
4
\n"], ["2124", "
Patient expresses less embarrassment
\n", "
5
\n"], ["2125", "
Patient has less conflict with religious beliefs
\n", "
6
\n"], ["2126", "
Patient understands this problem is on par with others
\n", "
7
\n"], ["2127", "
Patient not concerned with treatment duration or expense
\n", "
8
\n"], ["2128", "
Open access
\n", "
1
\n"], ["2129", "
Clinic only
\n", "
1
\n"], ["213", "
Sometimes
\n", "
2
\n"], ["2130", "
Group only
\n", "
2
\n"], ["2131", "
Clinic and group
\n", "
3
\n"], ["2132", "
No, no clinical benefit anticipated
\n", "
0
\n"], ["2133", "
No, Care Manager unaware of any available family member(s)
\n", "
1
\n"], ["2134", "
Obtain more history
\n", "
1
\n"], ["2135", "
Obtain, improve & monitor treatment adherence
\n", "
2
\n"], ["2136", "
Reduce family stress
\n", "
3
\n"], ["2137", "
No, care manager attempted contact, but family member did not call back.
\n", "
0
\n"], ["2138", "
Yes, care manager contacted by family member, but pt has not given permission to discuss, so only general depression education
\n", "
2
\n"], ["2139", "
Yes, care manager contacted family, but family refused to speak to care manager
\n", "
3
\n"], ["214", "
Moderately often
\n", "
3
\n"], ["2140", "
Spouse
\n", "
1
\n"], ["2141", "
Mother
\n", "
3
\n"], ["2142", "
Father
\n", "
4
\n"], ["2143", "
Adult child
\n", "
5
\n"], ["2144", "
Education about illness
\n", "
1
\n"], ["2145", "
Education about treatment adherence
\n", "
2
\n"], ["2146", "
Crisis Management
\n", "
3
\n"], ["2147", "
Assessment
\n", "
4
\n"], ["2148", "
Referral to other VA services for veteran
\n", "
5
\n"], ["2149", "
Referral to support group or other family services
\n", "
6
\n"], ["215", "
Often
\n", "
4
\n"], ["2150", "
No impact observed
\n", "
0
\n"], ["2151", "
Worsened treatment
\n", "
1
\n"], ["2152", "
Improved treatment
\n", "
2
\n"], ["2153", "
Patient is actively participating in depression care management and will be contacted by care manager over the next six months to monitor depressive symptoms, treatment compliance and self-help activities
\n", "
0
\n"], ["2154", "
Mental health follow-up has been initiated; patient will be followed in mental health from now on, but care manager will encourage and monitor appointment compliance and re-assess at 24 weeks
\n", "
1
\n"], ["2155", "
Watchful Waiting. Appt compliance will be monitored, and patient will be contacted at 4 weeks and 12 weeks to re-assess situation.
\n", "
2
\n"], ["2156", "
Patient is ready for discharge from panel as indicated by low PHQ-9 scores on two successive assessments over one to two months, no MDD trigger symptoms, and compliant with medication and appointments
\n", "
3
\n"], ["2157", "
Patient is ready for discharge from panel: 6 months of guideline-concordant follow-up care have been completed.
\n", "
4
\n"], ["2158", "
Patient requests no further care manager follow-up.
\n", "
5
\n"], ["2159", "
Refused further follow-up. States not depressed, declined treatment.
\n", "
6
\n"], ["216", "
All the time
\n", "
5
\n"], ["2160", "
Unable to reach after 5 tries. Letter sent.
\n", "
7
\n"], ["2161", "
PCP requested no further follow-up.
\n", "
8
\n"], ["2162", "
Deceased or Other
\n", "
9
\n"], ["2163", "
Primary care
\n", "
1
\n"], ["2164", "
Primary care & mental health
\n", "
2
\n"], ["2165", "
Mental health
\n", "
3
\n"], ["2166", "
Mental health subspecialty
\n", "
4
\n"], ["2167", "
Community
\n", "
5
\n"], ["2168", "
Consider lab testing on next visit
\n", "
1
\n"], ["2169", "
Patient is compliant with medication & no side effects. No change.
\n", "
3
\n"], ["217", "
Never
\n", "
0
\n"], ["2170", "
Based on side effects and compliance, consider changing medication
\n", "
4
\n"], ["2171", "
Based on anti-depressant effect, consider increasing medication
\n", "
5
\n"], ["2172", "
Patient would like to begin medication
\n", "
6
\n"], ["2173", "
No, patient told to continue
\n", "
0
\n"], ["2174", "
Recognizing signs of depression
\n", "
1
\n"], ["2175", "
Anticipating and preparing for upsetting events
\n", "
2
\n"], ["2176", "
Seeking support from family and friends
\n", "
3
\n"], ["2177", "
Calling the PCP or TelCare
\n", "
4
\n"], ["2178", "
Other (explain below)
\n", "
5
\n"], ["2179", "
PHQ9 <5, No Hx depression- DC after 9 months
\n", "
1
\n"], ["218", "
Monthly or less
\n", "
1
\n"], ["2180", "
PHQ9 <5, Hx depression, DC trial at 2 years
\n", "
2
\n"], ["2181", "
PHQ9 5-9, Continue or increase treatment
\n", "
3
\n"], ["2182", "
PHQ9 >10, increase treatment depending on course up to this point
\n", "
4
\n"], ["2183", "
Encourage patient to resume treatment
\n", "
5
\n"], ["2184", "
Pt would benefit from extended depression care management
\n", "
6
\n"], ["2185", "
Consider re-consult
\n", "
7
\n"], ["2186", "
Send relapse material to patient in 3 months
\n", "
1
\n"], ["2187", "
Re-instate follow-up contacts with new consult and patient consent
\n", "
2
\n"], ["2188", "
Telephone
\n", "
1
\n"], ["2189", "
In person
\n", "
2
\n"], ["219", "
Two to four times a month
\n", "
2
\n"], ["2190", "
LESS than fifteen minutes
\n", "
1
\n"], ["2191", "
Fifteen to thirty minutes
\n", "
2
\n"], ["2192", "
Thirty-one to sixty minutes
\n", "
3
\n"], ["2193", "
Antidepressant treatment
\n", "
1
\n"], ["2194", "
Antidepressant instructions
\n", "
1
\n"], ["2195", "
No, Care Manager unaware of any available family member(s)
\n", "
1
\n"], ["2196", "
Yes, care manager contacted by family member, but patient has not given permission to discuss, so only general depression
\n", "
2
\n"], ["2197", "
Patient is actively participating in depression care management and will be contacted by care manager over the next six months to
\n", "
0
\n"], ["2198", "
monitor depressive symptoms, treatment compliance and self-help activities
\n", "
1
\n"], ["2199", "
Mental health follow-up has been initiated; patient will be followed in mental health from now on, but care manager will encourage and
\n", "
2
\n"], ["22", "", "
E
\n"], ["220", "
Two to three times per week
\n", "
3
\n"], ["2200", "
monitor appointment compliance and re-assess at 24 weeks
\n", "
3
\n"], ["2201", "
Patient is ready for discharge from panel as indicated by low PHQ-9 scores on two successive assessments over one to two months,
\n", "
5
\n"], ["2202", "
no MDD trigger symptoms, and compliant with medication and appointments
\n", "
6
\n"], ["2203", "
Based on antidepressant effect, consider increasing medication
\n", "
5
\n"], ["2204", "
Patient would benefit from extended depression care management
\n", "
6
\n"], ["2205", "
One try
\n", "
1
\n"], ["2206", "
Two tries
\n", "
2
\n"], ["2207", "
Three tries
\n", "
3
\n"], ["2208", "
Four tries
\n", "
4
\n"], ["2209", "
Five tries
\n", "
5
\n"], ["221", "
Four or more times a week
\n", "
4
\n"], ["2210", "
Multiple individual sessions
\n", "
4
\n"], ["2211", "
Transient low mood; does not have depression Sxs at this time (PHQ-9 score less than 5). Not currently appropriate for care
\n", "
1
\n"], ["2212", "
management, but please re-consult if symptoms worsen.
\n", "
2
\n"], ["2213", "
Sxs of depression (PHQ-9 score between 5 and 9) but not MDD; no prior history, no dysthymia. Likely to respond to PC interventions
\n", "
3
\n"], ["2214", "
DCM will provide education and watchful waiting. Recheck at 3 mos.
\n", "
4
\n"], ["2215", "
Bereavement, lost a spouse, close relative in last two months. Major depression treatment not appropriate. Care manager will
\n", "
5
\n"], ["2216", "
provide education and watchful waiting with recheck at 2 months.
\n", "
6
\n"], ["2217", "
Dysthymia with feelings of depression and impaired functioning over last two years and PHQ-9 between 4 and 9. Treat with
\n", "
7
\n"], ["2218", "
Poor response, SE to antidepressant Tx. Tx adjust or refer to MH.
\n", "
1
\n"], ["2219", "
Patient refuses antidepressants
\n", "
5
\n"], ["222", "
0 drinks
\n", "
0
\n"], ["2220", "
No, attempted contact, but family member did not call back.
\n", "
0
\n"], ["2221", "
Yes, contacted by family, given only general depression
\n", "
2
\n"], ["2222", "
Yes, contacted family, but they refused to discuss patient
\n", "
3
\n"], ["2223", "
Primary care and mental health
\n", "
2
\n"], ["2224", "
Patient is actively participating in depression care management and will be contacted by care manager over the next six months to monitor depressive symptoms, treatment compliance and self-help activities.
\n", "
0
\n"], ["2225", "
Mental health follow-up has been initiated; patient will be followed in mental health from now on, but care manager will encourage and monitor appointment compliance and re-assess at 24 weeks.
\n", "
1
\n"], ["2226", "
Patient is ready for discharge from panel as indicated by low PHQ-9 scores on two successive assessments over one to two months, no MDD trigger symptoms, and compliance with medication and appointments.
\n", "
3
\n"], ["2227", "
Patient refused further follow-up. States he/she is not depressed, and declined treatment.
\n", "
6
\n"], ["2228", "
Deceased
\n", "
9
\n"], ["2229", "
PHQ9 score less than 5, No Hx depression- DC after 9 months
\n", "
1
\n"], ["223", "
3 or 4
\n", "
1
\n"], ["2230", "
PHQ9 score less than 5, Hx depression, DC trial at 2 years
\n", "
2
\n"], ["2231", "
PHQ9 between 5 and 9, Continue or increase treatment
\n", "
3
\n"], ["2232", "
PHQ9 score 10+, increase treatment based on course up to this point
\n", "
4
\n"], ["2233", "
Natural causes
\n", "
1
\n"], ["2234", "
Possible suicide
\n", "
2
\n"], ["2235", "
Accident
\n", "
3
\n"], ["2236", "
LESS than 1 mile
\n", "
1
\n"], ["2237", "
One to five miles
\n", "
2
\n"], ["2238", "
Six to ten miles
\n", "
3
\n"], ["2239", "
Eleven to twenty miles
\n", "
4
\n"], ["224", "
5 or 6
\n", "
2
\n"], ["2240", "
Twenty-one to thirty miles
\n", "
5
\n"], ["2241", "
Thirty-one to forty miles
\n", "
6
\n"], ["2242", "
Forty-one to fifty miles
\n", "
7
\n"], ["2243", "
MORE than fifty miles
\n", "
8
\n"], ["2244", "
Does not apply
\n", "
0
\n"], ["2245", "
LESS than 1 minute
\n", "
1
\n"], ["2246", "
One to fifteen minutes
\n", "
2
\n"], ["2247", "
Sixteen to thirty minutes
\n", "
3
\n"], ["2248", "
Thirty-one to forty-five minutes
\n", "
4
\n"], ["2249", "
Forty-six to sixty minutes
\n", "
5
\n"], ["225", "
7 to 9
\n", "
3
\n"], ["2250", "
MORE than an hour
\n", "
6
\n"], ["2251", "
1st, 0 to 6 months
\n", "
1
\n"], ["2252", "
2nd, 6+ to 12 months
\n", "
2
\n"], ["2253", "
3rd, 12+ to 18 months
\n", "
3
\n"], ["2254", "
4th, 18+ to 24 months
\n", "
4
\n"], ["2255", "
Probable suicide
\n", "
2
\n"], ["2256", "
Illness
\n", "
3
\n"], ["2257", "
1-5 miles
\n", "
2
\n"], ["2258", "
6-10 miles
\n", "
3
\n"], ["2259", "
11-20 miles
\n", "
4
\n"], ["226", "
10 or more
\n", "
4
\n"], ["2260", "
21-30 miles
\n", "
5
\n"], ["2261", "
31-40 miles
\n", "
6
\n"], ["2262", "
41-50 miles
\n", "
7
\n"], ["2263", "
50+ miles
\n", "
8
\n"], ["2264", "
Less than a minute
\n", "
1
\n"], ["2265", "
1-15 minutes
\n", "
2
\n"], ["2266", "
16-30 minutes
\n", "
3
\n"], ["2267", "
31-45 minutes
\n", "
4
\n"], ["2268", "
46-60 minutes
\n", "
5
\n"], ["2269", "
61+ minutes
\n", "
6
\n"], ["227", "
Less than monthly
\n", "
1
\n"], ["2270", "
Transient low mood; does not have depression Sxs at this time (PHQ-9 < 5). Not currently appropriate for care management, but please re-consult if symptoms worsen.
\n", "
1
\n"], ["2271", "
Sxs of depression (PHQ 5-9) but not MDD; no prior history, no dysthymia. Likely to respond to PC interventions such as stress reduction, social support, exercise. DCM will provide education and watchful waiting and recheck at 3 mos.
\n", "
2
\n"], ["2272", "
Probable major depression (PHQ-9 > 9) or incipient relapse (PHQ-9 is 5-9 with history of depression). Patient prefers watchful waiting.
\n", "
5
\n"], ["2273", "
Probable major depression (PHQ-9 > 9) or incipient relapse (PHQ-9 is 5-9 with history of depression). Treat with antidepressant meds or psychotherapy and care management.
\n", "
6
\n"], ["2274", "
Dysthymia plus major depression; feelings of depression and impaired functioning over last two years and PHQ-9 > 9. Treat with antidepressant meds or psychotherapy and care management.
\n", "
7
\n"], ["2275", "
African-American, not Hispanic
\n", "
2
\n"], ["2276", "
Hispanic, African-American
\n", "
4
\n"], ["2277", "
Korean Conflict
\n", "
2
\n"], ["2278", "
Peace keeping operation (e.g., Lebanon, Somalia, Bosnia, Kosovo)
\n", "
4
\n"], ["2279", "
Operation Desert Storm (1st Iraq War)
\n", "
5
\n"], ["228", "
Monthly
\n", "
2
\n"], ["2280", "
Operation Enduring Freedom (Afghanistan War)
\n", "
6
\n"], ["2281", "
Operation Iraqi Freedom (2nd Iraq War)
\n", "
7
\n"], ["2282", "
No, did not participate myself or witness others.
\n", "
0
\n"], ["2283", "
Yes, observed others but did not participate myself.
\n", "
1
\n"], ["2284", "
Yes, participated myself.
\n", "
2
\n"], ["2285", "
Decline to answer.
\n", "
3
\n"], ["2286", "
Somewhat well
\n", "
3
\n"], ["2287", "
Very well
\n", "
4
\n"], ["2288", "
I have had no desire to make an active suicide attempt
\n", "
1
\n"], ["2289", "
Has been weak.
\n", "
2
\n"], ["229", "
Weekly
\n", "
3
\n"], ["2290", "
Has been moderate to strong.
\n", "
3
\n"], ["2291", "
I never thought of suicide
\n", "
1
\n"], ["2292", "
Rarely or occasionally.
\n", "
2
\n"], ["2293", "
Off and on.
\n", "
3
\n"], ["2294", "
Persistently or continuously.
\n", "
4
\n"], ["2295", "
I did not think about suicide.
\n", "
1
\n"], ["2296", "
I was sure I had control over attempting.
\n", "
2
\n"], ["2297", "
I was unsure of my sense of control over attempting.
\n", "
3
\n"], ["2298", "
I had no sense of control over attempting.
\n", "
4
\n"], ["2299", "
Declined to answer
\n", "
2
\n"], ["23", "
A common beast of burden in Malaya
\n", "
A
\n"], ["230", "
Daily or almost daily
\n", "
4
\n"], ["2300", "
Fairly good
\n", "
2
\n"], ["2301", "
Fairly bad
\n", "
3
\n"], ["2302", "
Very bad
\n", "
4
\n"], ["2303", "
Once or a few times
\n", "
1
\n"], ["2304", "
Once or twice a week
\n", "
2
\n"], ["2305", "
Very poor
\n", "
6
\n"], ["2306", "
Some
\n", "
3
\n"], ["2307", "
Quite a lot
\n", "
4
\n"], ["2308", "
Could not do daily work
\n", "
5
\n"], ["2309", "
Very little
\n", "
2
\n"], ["231", "
0 drinks
\n", "
0
\n"], ["2310", "
Could not do social activities
\n", "
5
\n"], ["2311", "
Could not do daily activities
\n", "
5
\n"], ["2312", "
Considerably
\n", "
4
\n"], ["2313", "
More than 40
\n", "
1
\n"], ["2314", "
21-40
\n", "
2
\n"], ["2315", "
10 - 20
\n", "
3
\n"], ["2316", "
Less than 10
\n", "
4
\n"], ["2317", "
Every day
\n", "
1
\n"], ["2318", "
Several days a week
\n", "
2
\n"], ["2319", "
About once a week
\n", "
3
\n"], ["232", "
1 or 2
\n", "
1
\n"], ["2320", "
Yes, VA only
\n", "
1
\n"], ["2321", "
Yes, non VA only
\n", "
2
\n"], ["2322", "
Yes, VA and non VA
\n", "
3
\n"], ["2323", "
Most days
\n", "
2
\n"], ["2324", "
Once a week or more
\n", "
1
\n"], ["2325", "
Two or three times a month
\n", "
2
\n"], ["2326", "
Once a month
\n", "
3
\n"], ["2327", "
Two or three times a year
\n", "
4
\n"], ["2328", "
Once a day or more
\n", "
1
\n"], ["2329", "
Two or three times a week
\n", "
2
\n"], ["233", "
3 or 4
\n", "
2
\n"], ["2330", "
Employed full-time for pay
\n", "
1
\n"], ["2331", "
Employed part-time for pay
\n", "
2
\n"], ["2332", "
Full-time student
\n", "
3
\n"], ["2333", "
Unemployed (not retired officially or certified 100% disabled by the VA)
\n", "
4
\n"], ["2334", "
Retired officially
\n", "
5
\n"], ["2335", "
2 or 3 times a month
\n", "
4
\n"], ["2336", "
Destroyed property?
\n", "
1
\n"], ["2337", "
Threatened someone with physical violence (without a weapon)?
\n", "
2
\n"], ["2338", "
Had a physical fight with someone?
\n", "
3
\n"], ["2339", "
Threatened someone with a weapon?
\n", "
4
\n"], ["234", "
5 or 6
\n", "
3
\n"], ["2340", "
Used a weapon against someone?
\n", "
5
\n"], ["2341", "
Had thoughts of hurting someone?
\n", "
6
\n"], ["2342", "
Were verbally abusive?
\n", "
7
\n"], ["2343", "
Broke off contact with someone out of anger or fear of losing control?
\n", "
8
\n"], ["2344", "
Unhappy
\n", "
2
\n"], ["2345", "
Mostly dissatisfied
\n", "
3
\n"], ["2346", "
Mixed
\n", "
4
\n"], ["2347", "
Mostly satisfied
\n", "
5
\n"], ["2348", "
Pleased
\n", "
6
\n"], ["2349", "
Delighted
\n", "
7
\n"], ["235", "
7 to 9
\n", "
4
\n"], ["2350", "
Very easy
\n", "
1
\n"], ["2351", "
Somewhat easy
\n", "
2
\n"], ["2352", "
Extremely effective
\n", "
1
\n"], ["2353", "
Very effective
\n", "
2
\n"], ["2354", "
Somewhat effective
\n", "
3
\n"], ["2355", "
Not effective
\n", "
4
\n"], ["2356", "
Somewhat Satisfied
\n", "
2
\n"], ["2357", "
Somewhat Dissatisfied
\n", "
3
\n"], ["2358", "
Very
\n", "
2
\n"], ["2359", "
Almost not at all
\n", "
4
\n"], ["236", "
10 or more
\n", "
5
\n"], ["2360", "
A lot
\n", "
1
\n"], ["2361", "
Almost none
\n", "
4
\n"], ["2362", "
Completely
\n", "
1
\n"], ["2363", "
Mostly neutral
\n", "
3
\n"], ["2364", "
Somewhat unfriendly and uncaring
\n", "
4
\n"], ["2365", "
Very much better
\n", "
1
\n"], ["2366", "
Somewhat better
\n", "
2
\n"], ["2367", "
Somewhat worse
\n", "
4
\n"], ["2368", "
Very much worse
\n", "
5
\n"], ["2369", "
In outpatient treatment
\n", "
1
\n"], ["237", "
No
\n", "
N
\n"], ["2370", "
In inpatient or residential treatment
\n", "
2
\n"], ["2371", "
Not in treatment
\n", "
3
\n"], ["2372", "
Yes, married or partnered
\n", "
1
\n"], ["2373", "
Yes, divorced or separated
\n", "
2
\n"], ["2374", "
Yes, widowed
\n", "
3
\n"], ["2375", "
Patient to receive both VA and non-VA services
\n", "
5
\n"], ["2376", "
Return to clinic for follow up appointment
\n", "
6
\n"], ["2377", "
Patient to receive both VA and non-VA services
\n", "
5
\n"], ["2378", "
Full-time student or trainee
\n", "
1
\n"], ["2379", "
Part-time student or trainee
\n", "
2
\n"], ["238", "
Yes, but not in the last year
\n", "
1
\n"], ["2380", "
Not attending school or training program
\n", "
3
\n"], ["2381", "
No cognitive decline
\n", "
1
\n"], ["2382", "
Very mild cognitive decline---Forgetful
\n", "
2
\n"], ["2383", "
Mild cognitive decline---Early confusional
\n", "
3
\n"], ["2384", "
Moderate cognitive decline---Late confusional
\n", "
4
\n"], ["2385", "
Moderately severe cognitive decline---Early dementia
\n", "
5
\n"], ["2386", "
Severe cognitive decline---Middle dementia
\n", "
6
\n"], ["2387", "
Very severe cognitive decline---Late dementia
\n", "
7
\n"], ["2388", "
Asian
\n", "
2
\n"], ["2389", "
Native Hawaiian or Other Pacific Islander
\n", "
4
\n"], ["239", "
Yes, during the last year
\n", "
2
\n"], ["2390", "
Halfway house/group home/residential center/supervised housing
\n", "
2
\n"], ["2391", "
Never: not used in the last 3 months
\n", "
0
\n"], ["2392", "
Once or twice: 1 to 2 times in the last 3 months.
\n", "
1
\n"], ["2393", "
Monthly: 1 to 3 times in one month.
\n", "
2
\n"], ["2394", "
Weekly: 1 to 4 times per week.
\n", "
3
\n"], ["2395", "
Daily or almost daily: 5 to 7 days per week.
\n", "
4
\n"], ["2396", "
Yes, in the past 3 months
\n", "
1
\n"], ["2397", "
Yes, but not in the past 3 months
\n", "
2
\n"], ["2398", "
Once weekly or less
\n", "
1
\n"], ["2399", "
Fewer than 3 days in a row
\n", "
2
\n"], ["24", "
An extinct ancestor of the musk ox
\n", "
B
\n"], ["240", "
No
\n", "
1
\n"], ["2400", "
Three or more days in a row
\n", "
4
\n"], ["2401", "
One to three times
\n", "
1
\n"], ["2402", "
Four to twelve times
\n", "
2
\n"], ["2403", "
Thirteen to fifty times
\n", "
3
\n"], ["2404", "
More than fifty times.
\n", "
4
\n"], ["2405", "
Less than one month
\n", "
1
\n"], ["2406", "
One to three months
\n", "
2
\n"], ["2407", "
Four to six months
\n", "
3
\n"], ["2408", "
Seven months or more
\n", "
4
\n"], ["2409", "
One or two times
\n", "
1
\n"], ["241", "
Yes
\n", "
Y
\n"], ["2410", "
Three to twelve times
\n", "
2
\n"], ["2411", "
Thirteen to twenty-five times
\n", "
3
\n"], ["2412", "
More than twenty-six times
\n", "
4
\n"], ["2413", "
1% to 25%
\n", "
1
\n"], ["2414", "
26% to 50%
\n", "
2
\n"], ["2415", "
51% to 75%
\n", "
3
\n"], ["2416", "
76% or more
\n", "
4
\n"], ["2417", "
Fifty-one or more times
\n", "
4
\n"], ["2418", "
Clinician Interview
\n", "
1
\n"], ["2419", "
Self Report
\n", "
2
\n"], ["242", "
Rarely
\n", "
2
\n"], ["2420", "
Phone
\n", "
3
\n"], ["2421", "
One to three nights
\n", "
1
\n"], ["2422", "
Four to eight nights
\n", "
2
\n"], ["2423", "
Nine to fifteen nights
\n", "
3
\n"], ["2424", "
Sixteen to thirty nights
\n", "
4
\n"], ["2425", "
One to three days
\n", "
1
\n"], ["2426", "
Four to eight days
\n", "
2
\n"], ["2427", "
Nine to fifteen days
\n", "
3
\n"], ["2428", "
Sixteen to thirty days
\n", "
4
\n"], ["2429", "
No nausea and no vomiting
\n", "
0
\n"], ["243", "
Sometimes
\n", "
3
\n"], ["2430", "
Mild nausea with no vomiting
\n", "
1
\n"], ["2431", "
Moderate nausea with no vomiting
\n", "
2
\n"], ["2432", "
Moderate nausea with strong urge to vomit
\n", "
3
\n"], ["2433", "
Intermittent nausea with dry heaves
\n", "
4
\n"], ["2434", "
Strong intermittent nausea with dry heaves
\n", "
5
\n"], ["2435", "
Nearly constant nausea with dry heaves
\n", "
6
\n"], ["2436", "
Constant nausea, frequent dry heaves and vomiting
\n", "
7
\n"], ["2437", "
Very mild itching, pins and needles, burning or numbness
\n", "
1
\n"], ["2438", "
Mild itching, pins and needles, burning or numbness
\n", "
2
\n"], ["2439", "
Moderate itching, pins and needles, burning or numbness
\n", "
3
\n"], ["244", "
Often
\n", "
4
\n"], ["2440", "
Moderately severe hallucinations
\n", "
4
\n"], ["2441", "
Severe hallucinations
\n", "
5
\n"], ["2442", "
Extremely severe hallucinations
\n", "
6
\n"], ["2443", "
Continuous hallucinations
\n", "
7
\n"], ["2444", "
Not visible, but can be felt fingertip to fingertip
\n", "
1
\n"], ["2445", "
Slightly visible
\n", "
2
\n"], ["2446", "
Moderate, with patient's arms extended
\n", "
4
\n"], ["2447", "
Moderate, with arms not extended
\n", "
5
\n"], ["2448", "
Severe, with arms extended
\n", "
6
\n"], ["2449", "
Severe, even with arms not extended
\n", "
7
\n"], ["245", "
Yes, sometimes
\n", "
2
\n"], ["2450", "
Very mild harshness or ability to frighten
\n", "
1
\n"], ["2451", "
Mild harshness or ability to frighten
\n", "
2
\n"], ["2452", "
Moderate harshness or ability to frighten
\n", "
3
\n"], ["2453", "
No sweat visible
\n", "
0
\n"], ["2454", "
Barely perceptible sweating, palms moist
\n", "
1
\n"], ["2455", "
Mild sweating
\n", "
2
\n"], ["2456", "
Moderate sweating
\n", "
3
\n"], ["2457", "
Beads of sweat obvious on forehead
\n", "
4
\n"], ["2458", "
Sweating over most of face
\n", "
5
\n"], ["2459", "
Sweating over face and body
\n", "
6
\n"], ["246", "
Yes, usually
\n", "
3
\n"], ["2460", "
Drenching sweats
\n", "
7
\n"], ["2461", "
Very mild sensitivity
\n", "
1
\n"], ["2462", "
Mild sensitivity
\n", "
2
\n"], ["2463", "
Moderate sensitivity
\n", "
3
\n"], ["2464", "
No anxiety, at ease
\n", "
0
\n"], ["2465", "
Mildly anxious
\n", "
1
\n"], ["2466", "
Several symptoms of mild anxiety
\n", "
2
\n"], ["2467", "
Moderately anxious, not guarded
\n", "
3
\n"], ["2468", "
Moderately anxious, or guarded, so anxiety is inferred
\n", "
4
\n"], ["2469", "
Clearly anxious
\n", "
5
\n"], ["247", "
Had a job throughout the year
\n", "
1
\n"], ["2470", "
Severe anxiety
\n", "
6
\n"], ["2471", "
Equivalent to acute panic states as seen in severe delirium or acute schizophrenic reactions
\n", "
7
\n"], ["2472", "
Not present
\n", "
0
\n"], ["2473", "
Normal activity
\n", "
0
\n"], ["2474", "
Somewhat more than normal activity
\n", "
1
\n"], ["2475", "
More than normal
\n", "
2
\n"], ["2476", "
Fidgety and restless
\n", "
3
\n"], ["2477", "
Moderately fidgety and restless
\n", "
4
\n"], ["2478", "
Very fidgety and restless
\n", "
5
\n"], ["2479", "
Unable to set for long periods
\n", "
6
\n"], ["248", "
Without a job for less than 1 month
\n", "
2
\n"], ["2480", "
Paces back and forth during most of the interview, or constantly thrashes about
\n", "
7
\n"], ["2481", "
Oriented and can do serial additions
\n", "
0
\n"], ["2482", "
Cannot do serial additions or is uncertain about date
\n", "
1
\n"], ["2483", "
Disoriented for date by no more than 2 calendar days
\n", "
2
\n"], ["2484", "
Disoriented for date by more than 2 calendar days
\n", "
3
\n"], ["2485", "
Disoriented for place/or person
\n", "
4
\n"], ["2486", "
High school graduate, or better
\n", "
2
\n"], ["2487", "
Incorrect day
\n", "
0
\n"], ["2488", "
Correct day
\n", "
1
\n"], ["2489", "
Incorrect state
\n", "
0
\n"], ["249", "
Without a job for about 1 to 3 months
\n", "
3
\n"], ["2490", "
Correct state
\n", "
1
\n"], ["2491", "
Incorrect amount
\n", "
0
\n"], ["2492", "
Correct amount
\n", "
1
\n"], ["2493", "
Zero to four animals
\n", "
0
\n"], ["2494", "
Five to nine animals
\n", "
1
\n"], ["2495", "
Ten to fourteen animals
\n", "
2
\n"], ["2496", "
Fifteen or more animals
\n", "
3
\n"], ["2497", "
None recalled
\n", "
0
\n"], ["2498", "
One recalled
\n", "
1
\n"], ["2499", "
Two recalled
\n", "
2
\n"], ["25", "
A period when night and day are of equal duration
\n", "
C
\n"], ["250", "
Without a job more than 3 months
\n", "
4
\n"], ["2500", "
Three recalled
\n", "
3
\n"], ["2501", "
Four recalled
\n", "
4
\n"], ["2502", "
Five recalled
\n", "
5
\n"], ["2503", "
Incorrect
\n", "
0
\n"], ["2504", "
Correct
\n", "
1
\n"], ["2505", "
Incorrect markers
\n", "
0
\n"], ["2506", "
Correct markers
\n", "
1
\n"], ["2507", "
Incorrect figure
\n", "
0
\n"], ["2508", "
Correct figure
\n", "
1
\n"], ["2509", "
Incorrect size
\n", "
0
\n"], ["251", "
Yes, but only for a few hours
\n", "
2
\n"], ["2510", "
Correct size
\n", "
1
\n"], ["2511", "
Incorrect name
\n", "
0
\n"], ["2512", "
Correct name
\n", "
1
\n"], ["2513", "
Incorrect work
\n", "
0
\n"], ["2514", "
Correct work
\n", "
1
\n"], ["2515", "
Receives no assistance (for example, gets in and out of tub by self).
\n", "
1
\n"], ["2516", "
Receives assistance in bathing only one part of body (such as back or leg).
\n", "
2
\n"], ["2517", "
Receives assistance in bathing more than one part of the body (or not bathed).
\n", "
3
\n"], ["2518", "
Gets clothes and dresses self without assistance.
\n", "
1
\n"], ["2519", "
Gets clothes and dresses self without assistance except for tying shoes.
\n", "
2
\n"], ["252", "
Yes, for 1 or 2 days
\n", "
3
\n"], ["2520", "
Receives assistance in getting clothes, or dressing, or stays partly undressed.
\n", "
3
\n"], ["2521", "
No assistance needed (may use cane or walker and may manage bedpan, empting same later).
\n", "
1
\n"], ["2522", "
Receives assistance in going to toilet, or cleaning self, or arranging clothes, or in use of night bedpan.
\n", "
2
\n"], ["2523", "
Does not go to \"toilet room\" for elimination process.
\n", "
3
\n"], ["2524", "
Moves in and out bed, or chair, without assistance (may use support object like cane or walker).
\n", "
1
\n"], ["2525", "
Moves in and out of bed or chair with assistance.
\n", "
2
\n"], ["2526", "
Does not get out of bed.
\n", "
3
\n"], ["2527", "
Controls urination and bowel movement completely by self.
\n", "
1
\n"], ["2528", "
Has occasional \"accidents.\"
\n", "
2
\n"], ["2529", "
Supervision helps keep urine or bowel control: catheter is used or is incontinent.
\n", "
3
\n"], ["253", "
Yes, for many days
\n", "
4
\n"], ["2530", "
Feeds self without assistance.
\n", "
1
\n"], ["2531", "
Feed self except for help cutting meat or buttering bread.
\n", "
2
\n"], ["2532", "
Receives assistance in feeding, or, is fed partly or completely by tubes or intravenous fluids.
\n", "
3
\n"], ["2533", "
no pain at all
\n", "
0
\n"], ["2534", "
worse possible pain
\n", "
1
\n"], ["2535", "
significant limitation in basic activities
\n", "
0
\n"], ["2536", "
can perform vigorous activities without limitation
\n", "
1
\n"], ["2537", "
most energy ever
\n", "
1
\n"], ["2538", "
very poor strength and endurance
\n", "
0
\n"], ["2539", "
very high strength and endurance
\n", "
1
\n"], ["254", "
Yes, once
\n", "
2
\n"], ["2540", "
not depressed at all
\n", "
0
\n"], ["2541", "
extremely depressed
\n", "
1
\n"], ["2542", "
not anxious at all
\n", "
0
\n"], ["2543", "
extremely anxious
\n", "
1
\n"], ["2544", "
not safe at all
\n", "
0
\n"], ["2545", "
extremely safe
\n", "
1
\n"], ["2546", "
On station
\n", "
1
\n"], ["2547", "
Off station
\n", "
2
\n"], ["2548", "
Outpatient
\n", "
1
\n"], ["2549", "
Inpatient
\n", "
2
\n"], ["255", "
Yes, several times
\n", "
3
\n"], ["2550", "
On pass
\n", "
1
\n"], ["2551", "
Unauthorized absence
\n", "
2
\n"], ["2552", "
On unit
\n", "
3
\n"], ["2553", "
Off unit
\n", "
4
\n"], ["2554", "
Remained outpatient
\n", "
1
\n"], ["2555", "
Died
\n", "
2
\n"], ["2556", "
Hospitalized at:
\n", "
3
\n"], ["2557", "
Face-to-face
\n", "
1
\n"], ["2558", "
Written
\n", "
3
\n"], ["2559", "
Patient self-report
\n", "
1
\n"], ["256", "
Once or twice
\n", "
2
\n"], ["2560", "
Family member
\n", "
2
\n"], ["2561", "
Outside agent
\n", "
3
\n"], ["2562", "
VA staff
\n", "
4
\n"], ["2563", "
Unknown/not asked
\n", "
0
\n"], ["2564", "
Unknown
\n", "
0
\n"], ["2565", "
Substance abuse
\n", "
1
\n"], ["2566", "
MHICM
\n", "
2
\n"], ["2567", "
Life Skills Center
\n", "
4
\n"], ["2568", "
HCHB
\n", "
5
\n"], ["2569", "
Non-VA MentalHealth Care
\n", "
6
\n"], ["257", "
Three or 4 times
\n", "
3
\n"], ["2570", "
Ambulatory care
\n", "
7
\n"], ["2571", "
CBOC
\n", "
8
\n"], ["2572", "
Specialty Clinic
\n", "
9
\n"], ["2573", "
None necessary -- Patient died
\n", "
0
\n"], ["2574", "
Limit the means
\n", "
1
\n"], ["2575", "
Develop a crisis management plan
\n", "
2
\n"], ["2576", "
Immediate planning for the future
\n", "
3
\n"], ["2577", "
Decrease isolation
\n", "
4
\n"], ["2578", "
Decrease anxiety and agitation
\n", "
5
\n"], ["2579", "
Medication management
\n", "
6
\n"], ["258", "
Five or more times
\n", "
4
\n"], ["2580", "
Hospitalization
\n", "
7
\n"], ["2581", "
Refer for mental health treatment
\n", "
8
\n"], ["2582", "
Provide emergency phone contact numbers
\n", "
9
\n"], ["2583", "
Assure follow-up appointment is made
\n", "
1
\n"], ["2584", "
Inform/involve someone close to patient
\n", "
1
\n"], ["2585", "
Increase contact frequency
\n", "
1
\n"], ["2586", "
Help patient through the crisis
\n", "
1
\n"], ["2587", "
Spouse
\n", "
1
\n"], ["2588", "
Partner/Companion
\n", "
2
\n"], ["2589", "
House/Roommate
\n", "
3
\n"], ["259", "
None
\n", "
1
\n"], ["2590", "
Friend
\n", "
4
\n"], ["2591", "
Neighbor
\n", "
5
\n"], ["2592", "
Parent/Child/Other relative
\n", "
6
\n"], ["2593", "
Other (please describe)
\n", "
7
\n"], ["2594", "
No pain
\n", "
0
\n"], ["2595", "
Very intense pain
\n", "
1
\n"], ["2596", "
No interference
\n", "
0
\n"], ["2597", "
Extreme interference
\n", "
1
\n"], ["2598", "
No change
\n", "
0
\n"], ["2599", "
Not at all supportive
\n", "
0
\n"], ["26", "
A symbol used in theoretical mathematics
\n", "
D
\n"], ["260", "
Up to 3 drinks
\n", "
2
\n"], ["2600", "
Extremely supportive
\n", "
1
\n"], ["2601", "
Extremely low mood
\n", "
0
\n"], ["2602", "
Not at all severe
\n", "
0
\n"], ["2603", "
Not at all worried
\n", "
0
\n"], ["2604", "
Extremely worried
\n", "
1
\n"], ["2605", "
Not at all in control
\n", "
0
\n"], ["2606", "
Extremely in control
\n", "
1
\n"], ["2607", "
No suffering
\n", "
0
\n"], ["2608", "
Not at all attentive
\n", "
0
\n"], ["2609", "
Extremely attentive
\n", "
1
\n"], ["261", "
Up to 1/2 pint
\n", "
3
\n"], ["2610", "
Not at all irritable
\n", "
0
\n"], ["2611", "
Extremely irritable
\n", "
1
\n"], ["2612", "
Not at all tense or anxious
\n", "
0
\n"], ["2613", "
Quite frequently
\n", "
3
\n"], ["2614", "
Nearly always
\n", "
4
\n"], ["2615", "
Extreme change
\n", "
1
\n"], ["2616", "
Extremely high mood
\n", "
1
\n"], ["2617", "
Very often
\n", "
1
\n"], ["2618", "
Extreme interference
\n", "
1
\n"], ["2619", "
Extreme suffering
\n", "
1
\n"], ["262", "
Up to 1 pint
\n", "
4
\n"], ["2620", "
Extremely attentive
\n", "
1
\n"], ["2621", "
Extremely well
\n", "
1
\n"], ["2622", "
Extremely tense or anxious
\n", "
1
\n"], ["2623", "
USED ONLY TO REPOINT DATA
\n", ""], ["2624", "
Items were read to the patient.
\n", "
0
\n"], ["2625", "
Less than high school education
\n", "
0
\n"], ["2626", "
Incorrect
\n", "
0
\n"], ["2627", "
Incorrect or missing
\n", "
0
\n"], ["2628", "
Pulse rate 80 or below (Score 0)
\n", "
0
\n"], ["2629", "
Pulse rate 81 - 100 (Score 1)
\n", "
1
\n"], ["263", "
Up to 1 quart
\n", "
5
\n"], ["2630", "
No memory loss or slight inconsistent forgetfulness
\n", "
0
\n"], ["2631", "
Consistent slight forgetfulness; partial recollection of events; \"benign\" forgetfulness
\n", "
1
\n"], ["2632", "
Moderate memory loss; more marked for recent events; defect interferes with everyday activities
\n", "
2
\n"], ["2633", "
Severe memory loss; only highly learned material retained; new material rapidly lost
\n", "
3
\n"], ["2634", "
Severe memory loss; only fragments remain
\n", "
4
\n"], ["2635", "
Fully oriented
\n", "
0
\n"], ["2636", "
Fully oriented except for slight difficulty with time relationships
\n", "
1
\n"], ["2637", "
Moderate difficulty with time relationships; oriented for place at examination; may have geographic disorientation elsewhere
\n", "
2
\n"], ["2638", "
Severe difficulty with time relationships; usually disoriented to time, often to place
\n", "
3
\n"], ["2639", "
Oriented to person only
\n", "
4
\n"], ["264", "
More than 1 quart
\n", "
6
\n"], ["2640", "
Solves everyday problems & handles business & financial affairs well; judgment good in relation to past performance
\n", "
0
\n"], ["2641", "
Slight impairment in solving problems, similarities, and differences
\n", "
1
\n"], ["2642", "
Moderate difficulty in handling problems, similarities, and differences; social judgment usually maintained
\n", "
2
\n"], ["2643", "
Severely impaired in handling problems, similarities, and differences; social judgment usually impaired
\n", "
3
\n"], ["2644", "
Unable to make judgments or solve problems
\n", "
4
\n"], ["2645", "
Independent function at usual level in job, shopping, volunteer and social groups
\n", "
0
\n"], ["2646", "
Slight impairment in these activities
\n", "
1
\n"], ["2647", "
Unable to function independently at these activities although may still be engaged in some; appears normal to casual inspection
\n", "
2
\n"], ["2648", "
No pretense of independent function outside home: Appears well enough to be taken to functions outside a family home
\n", "
3
\n"], ["2649", "
No pretense of independent function outside home: Appears too ill to be taken to functions outside a family home
\n", "
4
\n"], ["265", "
A little
\n", "
2
\n"], ["2650", "
Life at home, hobbies, and intellectual interests well maintained
\n", "
0
\n"], ["2651", "
Life at home, hobbies, and intellectual interests slightly impaired
\n", "
1
\n"], ["2652", "
Mild but definite impairment of function at home; more difficult chores abandoned; more complicated hobbies and interests abandoned
\n", "
2
\n"], ["2653", "
Only simple chores preserved; very restricted interests, poorly maintained
\n", "
3
\n"], ["2654", "
No significant function in home
\n", "
4
\n"], ["2655", "
Fully capable of self-care
\n", "
0
\n"], ["2656", "
Needs prompting
\n", "
1
\n"], ["2657", "
Requires assistance in dressing, hygiene, keeping of personal effects
\n", "
2
\n"], ["2658", "
Requires much help with personal care; frequent incontinence
\n", "
3
\n"], ["2659", "
Solves everyday problems; handles business and financial affairs well; judgment good in relation to past performance
\n", "
0
\n"], ["266", "
Yes
\n", "
3
\n"], ["2660", "
Asian
\n", ""], ["2661", "
Native Hawaiian or Other Pacific Islander
\n", ""], ["2662", "
Pulse rate 101 - 120 (Score 2)
\n", "
2
\n"], ["2663", "
Pulse rate greater than 120 (Score 4)
\n", "
3
\n"], ["2664", "
No report of chills or flushing (Score 0)
\n", "
0
\n"], ["2665", "
Subjective report of chills or flushing (Score 1)
\n", "
1
\n"], ["2666", "
Flushed or observable moistness on face (Score 2)
\n", "
2
\n"], ["2667", "
Beads of sweat on brow or face (Score 3)
\n", "
3
\n"], ["2668", "
Sweat streaming off face (Score 4)
\n", "
4
\n"], ["2669", "
Able to sit still (Score 0)
\n", "
0
\n"], ["267", "
Very much
\n", "
4
\n"], ["2670", "
Reports difficulty sitting still, but is able to do so (Score 1)
\n", "
1
\n"], ["2671", "
Frequent shifting or extraneous movements of legs/arms (Score 3)
\n", "
2
\n"], ["2672", "
Unable to sit still for more than a few seconds (Score 5)
\n", "
3
\n"], ["2673", "
Pupils pinned or normal size for room light (Score 0)
\n", "
0
\n"], ["2674", "
Pupils possibly larger than normal for room light (Score 1)
\n", "
1
\n"], ["2675", "
Pupils moderately dilated (Score 2)
\n", "
2
\n"], ["2676", "
Pupils so dilated that only the rim of the iris is visible (Score 5)
\n", "
3
\n"], ["2677", "
Not present (Score 0)
\n", "
0
\n"], ["2678", "
Mild diffuse discomfort (Score 1)
\n", "
1
\n"], ["2679", "
Patient reports severe diffuse aching of joints or muscles (Score 2)
\n", "
2
\n"], ["268", "
Usually (or do not drink)
\n", "
1
\n"], ["2680", "
Patient is rubbing joints or muscles and is unable to sit still because of discomfort (Score 4)
\n", "
3
\n"], ["2681", "
Nasal stuffiness or unusually moist eyes (Score 1)
\n", "
1
\n"], ["2682", "
Nose running or tearing (Score 2)
\n", "
2
\n"], ["2683", "
Nose constantly running or tears streaming down cheeks (Score 4)
\n", "
3
\n"], ["2684", "
No GI symptoms (Score 0)
\n", "
0
\n"], ["2685", "
Stomach cramps (Score 1)
\n", "
1
\n"], ["2686", "
Nausea or loose stool (Score 2)
\n", "
2
\n"], ["2687", "
Vomiting or diarrhea (Score 3)
\n", "
3
\n"], ["2688", "
Multiple episodes of diarrhea or vomiting (Score 5)
\n", "
4
\n"], ["2689", "
No tremor (Score 0)
\n", "
0
\n"], ["269", "
Often
\n", "
2
\n"], ["2690", "
Tremor can be felt, but not observed (Score 1)
\n", "
1
\n"], ["2691", "
Slight tremor observable (Score 2)
\n", "
2
\n"], ["2692", "
Gross tremor or muscle twitching (Score 4)
\n", "
3
\n"], ["2693", "
No yawning (Score 0)
\n", "
0
\n"], ["2694", "
Yawning once or twice during assessment (Score 1)
\n", "
1
\n"], ["2695", "
Yawning three or more times during assessment (Score 2)
\n", "
2
\n"], ["2696", "
Yawning several times per minute (Score 4)
\n", "
3
\n"], ["2697", "
None (Score 0)
\n", "
0
\n"], ["2698", "
Patient reports increasing irritability or anxiousness (Score 1)
\n", "
1
\n"], ["2699", "
Patient obviously irritable or anxious (Score 2)
\n", "
2
\n"], ["27", "
A technical term used in compiling the daily meteorological forecasts
\n", "
E
\n"], ["270", "
Rarely or never
\n", "
4
\n"], ["2700", "
Patient so irritable or anxious that participation in the assessment is difficult (Score 4)
\n", "
3
\n"], ["2701", "
Skin is smooth (Score 0)
\n", "
0
\n"], ["2702", "
Piloerection of skin can be felt or hairs standing up on arms (Score 3)
\n", "
1
\n"], ["2703", "
Prominent piloerection (Score 5)
\n", "
2
\n"], ["2704", "
Undetermined
\n", "
1
\n"], ["2705", "
Undetermined SDV, With Injury, Interrupted by Self/Other
\n", "
1
\n"], ["2706", "
Undetermined SDV, With Injury
\n", "
2
\n"], ["2707", "
Undetermined SDV, Fatal
\n", "
3
\n"], ["2708", "
Suicide Attempt, With Injury
\n", "
4
\n"], ["2709", "
Suicide Attempt, With Injury, Interrupted by Self/Other
\n", "
5
\n"], ["271", "
For about the last 6 months or less
\n", "
2
\n"], ["2710", "
Suicide
\n", "
6
\n"], ["2711", "
Undetermined SDV, Without Injury, Interrupted by Self/Other
\n", "
1
\n"], ["2712", "
Undetermined SDV, Without Injury
\n", "
2
\n"], ["2713", "
Suicide Attempt, Without Injury, Interrupted by Self/Other
\n", "
3
\n"], ["2714", "
Suicide Attempt, Without Injury
\n", "
4
\n"], ["2715", "
Veteran not in treatment
\n", "
0
\n"], ["2716", "
Hospitalized (location of hospitalization: specify)
\n", "
2
\n"], ["2717", "
Veteran self-report
\n", "
1
\n"], ["2718", "
Other (Specify)
\n", "
5
\n"], ["2719", "
At least one supportive relationship
\n", "
1
\n"], ["272", "
For more than the last 6 months
\n", "
3
\n"], ["2720", "
Some supportive relationships
\n", "
2
\n"], ["2721", "
Good social and/or family support
\n", "
3
\n"], ["2722", "
No changes
\n", "
0
\n"], ["2723", "
Medication Changes (describe)
\n", "
1
\n"], ["2724", "
Therapy Changes (describe)
\n", "
2
\n"], ["2725", "
Admission to inpatient Unit
\n", "
3
\n"], ["2726", "
Non-VA Mental Health Care
\n", "
6
\n"], ["2727", "
Specialty Clinic(s), specify
\n", "
9
\n"], ["2728", "
None necessary due to fatality
\n", "
0
\n"], ["2729", "
Revise crisis management plan
\n", "
3
\n"], ["273", "
No, I drink a little most of the time.
\n", "
1
\n"], ["2730", "
Develop specific goals and plans for the future
\n", "
4
\n"], ["2731", "
Increase social engagement
\n", "
5
\n"], ["2732", "
Inform/involve someone close to Veteran of Safety Plan
\n", "
1
\n"], ["2733", "
No description
\n", "
2
\n"], ["2734", "
Nausea 1
\n", "
1
\n"], ["2735", "
Nausea 2
\n", "
2
\n"], ["2736", "
Nausea 3
\n", "
3
\n"], ["2737", "
Nausea 5
\n", "
5
\n"], ["2738", "
Nausea 6
\n", "
6
\n"], ["2739", "
Tremor 2
\n", "
2
\n"], ["274", "
Yes, I don't touch a drop between drinking periods.
\n", "
2
\n"], ["2740", "
Tremor 3
\n", "
3
\n"], ["2741", "
Tremor 5
\n", "
5
\n"], ["2742", "
Tremor 6
\n", "
6
\n"], ["2743", "
Sweating 2
\n", "
2
\n"], ["2744", "
Sweating 3
\n", "
3
\n"], ["2745", "
Sweating 5
\n", "
5
\n"], ["2746", "
Sweating 6
\n", "
6
\n"], ["2747", "
Anxiety 2
\n", "
2
\n"], ["2748", "
Anxiety 3
\n", "
3
\n"], ["2749", "
Anxiety 5
\n", "
5
\n"], ["275", "
No, never
\n", "
1
\n"], ["2750", "
Anxiety 6
\n", "
6
\n"], ["2751", "
Agitation 2
\n", "
2
\n"], ["2752", "
Agitation 3
\n", "
3
\n"], ["2753", "
Agitation 5
\n", "
5
\n"], ["2754", "
Agitation 6
\n", "
6
\n"], ["2755", "
Moderate itching, pins and needles, burning or numbness
\n", "
3
\n"], ["2756", "
Question_0
\n", "
0
\n"], ["2757", "
Managing your day-to-day life?
\n", "
1
\n"], ["2758", "", "
2
\n"], ["2759", "
Question_1
\n", "
0
\n"], ["276", "
Sometimes
\n", "
2
\n"], ["2760", "
Coping with problems in your life?
\n", "
1
\n"], ["2761", "", "
2
\n"], ["2762", "
Question_2
\n", "
0
\n"], ["2763", "
Concentrating?
\n", "
1
\n"], ["2764", "", "
2
\n"], ["2765", "
Question_3
\n", "
0
\n"], ["2766", "
Get along with people in your family?
\n", "
1
\n"], ["2767", "", "
2
\n"], ["2768", "
Question_4
\n", "
0
\n"], ["2769", "
Get along with people outside your family?
\n", "
1
\n"], ["277", "
Often
\n", "
3
\n"], ["2770", "", "
2
\n"], ["2771", "
Question_5
\n", "
0
\n"], ["2772", "
Get along well in social situations?
\n", "
1
\n"], ["2773", "", "
2
\n"], ["2774", "
Question_6
\n", "
0
\n"], ["2775", "
Feel close to another person?
\n", "
1
\n"], ["2776", "", "
2
\n"], ["2777", "
Question_7
\n", "
0
\n"], ["2778", "
Feel like you had someone to turn to if you needed help?
\n", "
1
\n"], ["2779", "", "
2
\n"], ["278", "
Almost every time I drink
\n", "
4
\n"], ["2780", "
Question_8
\n", "
0
\n"], ["2781", "
Feel confident in yourself?
\n", "
1
\n"], ["2782", "", "
2
\n"], ["2783", "
Question_9
\n", "
0
\n"], ["2784", "
Feel sad or depressed?
\n", "
1
\n"], ["2785", "", "
2
\n"], ["2786", "
Question_10
\n", "
0
\n"], ["2787", "
Think about ending your life?
\n", "
1
\n"], ["2788", "", "
2
\n"], ["2789", "
Question_11
\n", "
0
\n"], ["279", "
Yes, almost every time I drink
\n", "
3
\n"], ["2790", "
Feel nervous?
\n", "
1
\n"], ["2791", "", "
2
\n"], ["2792", "
Question_12
\n", "
0
\n"], ["2793", "
Have thoughts racing through your head?
\n", "
1
\n"], ["2794", "", "
2
\n"], ["2795", "
Question_13
\n", "
0
\n"], ["2796", "
Think you had special powers?
\n", "
1
\n"], ["2797", "", "
2
\n"], ["2798", "
Question_14
\n", "
0
\n"], ["2799", "
Hear voices or see things?
\n", "
1
\n"], ["28", "", "
B
\n"], ["280", "
Up to 3 cans
\n", "
2
\n"], ["2800", "", "
2
\n"], ["2801", "
Question_15
\n", "
0
\n"], ["2802", "
Think people were watching you?
\n", "
1
\n"], ["2803", "", "
2
\n"], ["2804", "
Question_16
\n", "
0
\n"], ["2805", "
Think people were against you?
\n", "
1
\n"], ["2806", "", "
2
\n"], ["2807", "
Question_17
\n", "
0
\n"], ["2808", "
Have mood swings?
\n", "
1
\n"], ["2809", "", "
2
\n"], ["281", "
Up to 6 cans
\n", "
3
\n"], ["2810", "
Question_18
\n", "
0
\n"], ["2811", "
Feel short-tempered?
\n", "
1
\n"], ["2812", "", "
2
\n"], ["2813", "
Question_19
\n", "
0
\n"], ["2814", "
Think about hurting yourself?
\n", "
1
\n"], ["2815", "", "
2
\n"], ["2816", "
Question_20
\n", "
0
\n"], ["2817", "
Did you have an urge to drink alcohol or take street drugs?
\n", "
1
\n"], ["2818", "", "
2
\n"], ["2819", "
Question_21
\n", "
0
\n"], ["282", "
Up to 10 cans
\n", "
4
\n"], ["2820", "
Did anyone talk to you about your drinking or drug use?
\n", "
1
\n"], ["2821", "", "
2
\n"], ["2822", "
Question_22
\n", "
0
\n"], ["2823", "
Did you try to hide your drinking or drug use?
\n", "
1
\n"], ["2824", "", "
2
\n"], ["2825", "
Question_23
\n", "
0
\n"], ["2826", "
Did you have problems from your drinking or drug use?
\n", "
1
\n"], ["2827", "", "
2
\n"], ["2828", "
Question_25
\n", "
1
\n"], ["2829", "
What is your sex?
\n", "
2
\n"], ["283", "
Up to 16 cans
\n", "
5
\n"], ["2830", "", "
3
\n"], ["2831", "
Question_26
\n", "
1
\n"], ["2832", "
Are you . . .
\n", "
2
\n"], ["2833", "", "
3
\n"], ["2834", "
Question_27
\n", "
1
\n"], ["2835", "
What is your race?
\n", "
2
\n"], ["2836", "", "
3
\n"], ["2837", "
Question_28
\n", "
1
\n"], ["2838", "
What is your first language?
\n", "
2
\n"], ["2839", "", "
3
\n"], ["284", "
More than 16 cans
\n", "
6
\n"], ["2840", "
Question_29
\n", "
1
\n"], ["2841", "
How much school have you completed?
\n", "
2
\n"], ["2842", "", "
3
\n"], ["2843", "
Question_30
\n", "
1
\n"], ["2844", "
Are you now. . .
\n", "
2
\n"], ["2845", "", "
3
\n"], ["2846", "
Question_31
\n", "
0
\n"], ["2847", "
Outside of your treatment providers, what is your main source of social support?
\n", "
1
\n"], ["2848", "", "
2
\n"], ["2849", "
Question_32
\n", "
1
\n"], ["285", "
Very much so
\n", "
1
\n"], ["2850", "
Where did you sleep in the past 30 days? (Check one or more)
\n", "
2
\n"], ["2851", "", "
3
\n"], ["2852", "
47.
\n", "
8
\n"], ["2853", "
A little difficult
\n", "
1
\n"], ["2854", "
Wife, husband, or partner
\n", "
1
\n"], ["2855", "
Other family (parents, children, other relatives
\n", "
2
\n"], ["2856", "
Friends / roommates
\n", "
3
\n"], ["2857", "
Community / church
\n", "
4
\n"], ["2858", "
Yes, 1-10 hours per week
\n", "
1
\n"], ["2859", "
Yes, 11-30 hours per week
\n", "
2
\n"], ["286", "
Moderately so
\n", "
2
\n"], ["2860", "
1, Yes
\n", "
1
\n"], ["2861", "
Yes, I receive disability benefits for medical reasons
\n", "
1
\n"], ["2862", "
Yes, I receive disability benefits for psychiatric reasons
\n", "
2
\n"], ["2863", "
Yes, I receive disability benefits for substance abuse
\n", "
3
\n"], ["2864", "
High school graduate / GED
\n", "
3
\n"], ["2865", "
Seldom
\n", "
0
\n"], ["2866", "
Fairly Often
\n", "
1
\n"], ["2867", "
2 Moderately
\n", "
2
\n"], ["2868", "
Not difficult
\n", "
0
\n"], ["2869", "
Several days in the last two weeks
\n", "
1
\n"], ["287", "
Somewhat
\n", "
3
\n"], ["2870", "
More than half the days in the last two weeks
\n", "
2
\n"], ["2871", "
Almost daily in the last two weeks.
\n", "
3
\n"], ["2872", "
Needs help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing.
\n", "
0
\n"], ["2873", "
Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity.
\n", "
1
\n"], ["2874", "
Needs help with dressing self or needs to be completely dressed.
\n", "
0
\n"], ["2875", "
Get clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes.
\n", "
1
\n"], ["2876", "
Needs help transferring to the toilet, cleaning self or uses bedpan or commode.
\n", "
0
\n"], ["2877", "
Goes to toilet, gets on and off, arranges clothes, cleans genital area without help.
\n", "
1
\n"], ["2878", "
Needs help in moving from bed to chair or requires a complete transfer.
\n", "
0
\n"], ["2879", "
Moves in and out of bed or chair unassisted. Mechanical transfer aids are acceptable.
\n", "
1
\n"], ["288", "
Not at all
\n", "
4
\n"], ["2880", "
Is partially or totally incontinent of bowel or bladder.
\n", "
0
\n"], ["2881", "
Exercises complete self control over urination and defecation.
\n", "
1
\n"], ["2882", "
Needs partial or total help with feeding or requires parenteral feeding.
\n", "
0
\n"], ["2883", "
Gets food from plate into mouth without help. Preparation of food may be done by another person.
\n", "
1
\n"], ["2884", "
Seldom
\n", "
1
\n"], ["2885", "
Fairly often
\n", "
3
\n"], ["2886", "
Receives no assistance (gets in and out of tub by self, if tub is usual means of bathing).
\n", "
1
\n"], ["2887", "
Receives assistance in getting clothes, or dressing, or stays partly or completely undressed.
\n", "
3
\n"], ["2888", "
Goes to \"toilet room\", cleans self, and arranges clothes without assistance (may use object for support such as cane, walker, or wheelchair, and may manage own night bedpan or commode, emptying same next morning).
\n", "
1
\n"], ["2889", "
Receives assistance in going to \"toilet room\" or in cleansing self or in arranging clothes after elimination or in use of night bedpan or commode.
\n", "
2
\n"], ["289", "
Never
\n", "
1
\n"], ["2890", "
Does not go to \"toilet room\" for elimination procedure.
\n", "
3
\n"], ["2891", "
Moves in and out of bed, or chair, without assistance (may use support object like cane or walker).
\n", "
1
\n"], ["2892", "
Moves in and out of bed with assistance.
\n", "
2
\n"], ["2893", "
Has occasional \"accidents\" of urination or bowels.
\n", "
2
\n"], ["2894", "
Feed self except for geting assistance in cutting meat or buttering bread.
\n", "
2
\n"], ["2895", "
Receives assistance in feeding, or, is fed partly or completely by tubes or intravenous.
\n", "
3
\n"], ["2896", "
No assistance needed (may use object for support such as cane, walker, or wheelchair, and may manage own night bedpan or commode, emptying same next morning).
\n", "
1
\n"], ["2897", "
No assistance needed (may use cane, walker, or wheelchair, and may manage own night bedpan or commode, emptying same next morning).
\n", "
1
\n"], ["2898", "
No assistance needed (may use cane, walker, or wheelchair, and manage bedpan or commode, emptying same next morning).
\n", "
1
\n"], ["2899", "
Receives assistance in going to \"toilet room\" or in cleansing self or in arranging clothes or in use of night bedpan or commode.
\n", "
2
\n"], ["29", "", "
C
\n"], ["290", "
Occasionally
\n", "
2
\n"], ["2900", "
No assistance needed.
\n", "
1
\n"], ["2901", "
Receives assistance with at least one procedure above.
\n", "
2
\n"], ["2902", "
Operates telephone on own initiative; looks up and dials numbers, etc.
\n", "
1
\n"], ["2903", "
Dials a few well-known numbers.
\n", "
2
\n"], ["2904", "
Answers telephone but does not dial.
\n", "
3
\n"], ["2905", "
Does not use telephone at all.
\n", "
4
\n"], ["2906", "
Takes care of all shopping needs independently.
\n", "
1
\n"], ["2907", "
Shops independently for small purchases.
\n", "
2
\n"], ["2908", "
Needs to be accompanied on any shopping trip.
\n", "
3
\n"], ["2909", "
Completely unable to shop.
\n", "
4
\n"], ["291", "
Very often
\n", "
4
\n"], ["2910", "
Plans, prepares and serves adequate meals independently.
\n", "
1
\n"], ["2911", "
Prepares adequate meals if supplied with ingredients.
\n", "
2
\n"], ["2912", "
Heats, serves and prepares meals or prepares meals but does not maintain adequate diet.
\n", "
3
\n"], ["2913", "
Needs to have meals prepared and served.
\n", "
4
\n"], ["2914", "
Maintains house alone or with occasional assistance (e.g. heavy work domestic help).
\n", "
1
\n"], ["2915", "
Performs light daily tasks such as dishwashing, bed making.
\n", "
2
\n"], ["2916", "
Performs light daily tasks but cannot maintain acceptable level of cleanliness.
\n", "
3
\n"], ["2917", "
Needs help with all home maintenance tasks.
\n", "
4
\n"], ["2918", "
Does not participate in any housekeeping tasks.
\n", "
5
\n"], ["2919", "
Does personal laundry completely.
\n", "
1
\n"], ["292", "
No, I don't drink this way.
\n", "
1
\n"], ["2920", "
Launders small items; rinses stockings, etc.
\n", "
2
\n"], ["2921", "
All laundry must be done by others.
\n", "
3
\n"], ["2922", "
Travels independently on public transportation or drives own car.
\n", "
1
\n"], ["2923", "
Arranges own travel via taxi, but does not otherwise use public transportation.
\n", "
2
\n"], ["2924", "
Travels on public transportation when accompanied by another.
\n", "
3
\n"], ["2925", "
Travel limited to taxi or automobile with assistance of another.
\n", "
4
\n"], ["2926", "
Does not travel at all.
\n", "
5
\n"], ["2927", "
Is responsible for taking medication in correct dosages at correct time.
\n", "
1
\n"], ["2928", "
Takes responsibility if medication is prepared in advance in separate dosage.
\n", "
2
\n"], ["2929", "
Is not capable of dispensing own medication.
\n", "
3
\n"], ["293", "
Almost every weekend
\n", "
4
\n"], ["2930", "
Manages financial matters independently (budgets, writes checks, pays rent, bills, goes to bank), collects and keeps track of income.
\n", "
1
\n"], ["2931", "
Manages day-to-day purchases, but needs help with banking, major purchases, etc.
\n", "
2
\n"], ["2932", "
Incapable if handling money.
\n", "
3
\n"], ["2933", "
Not bothered at all
\n", "
0
\n"], ["2934", "
Bothered a little
\n", "
1
\n"], ["2935", "
Bothered a lot
\n", "
2
\n"], ["2936", "
Very seldom true
\n", "
2
\n"], ["2937", "
Seldon true
\n", "
3
\n"], ["2938", "
Never or very rarely true
\n", "
1
\n"], ["2939", "
Often true
\n", "
4
\n"], ["294", "
Enough to get high or less
\n", "
1
\n"], ["2940", "
Very often or always true
\n", "
5
\n"], ["2941", "
Manages financial matters independently (budgets, writes checks, goes to bank).
\n", "
1
\n"], ["2942", "
No correct answers
\n", "
0
\n"], ["2943", "
One correct answer
\n", "
1
\n"], ["2944", "
Two or three correct answers
\n", "
2
\n"], ["2945", "
No errors or four or more correct substractions
\n", "
3
\n"], ["2946", "
Correctly repeated
\n", "
1
\n"], ["2947", "
Correct: more than 10 words in one minute.
\n", "
1
\n"], ["2948", "
Incorrect: 10 or less words in a minute.
\n", "
2
\n"], ["2949", "
Correctly recalled
\n", "
1
\n"], ["295", "
Enough to get drunk
\n", "
2
\n"], ["2950", "
Correct circle
\n", "
1
\n"], ["2951", "
Correct clock numbers
\n", "
1
\n"], ["2952", "
Correct clock hands
\n", "
1
\n"], ["2953", "
Correctly named lion
\n", "
1
\n"], ["2954", "
Correctly named rhinoceros
\n", "
1
\n"], ["2955", "
Correctly named camel
\n", "
1
\n"], ["2956", "
Correct forward digit span
\n", "
1
\n"], ["2957", "
Correct backward digit span
\n", "
1
\n"], ["2958", "
Correct vigilance
\n", "
1
\n"], ["2959", "
No correct substractions
\n", "
0
\n"], ["296", "
Enough to pass out
\n", "
3
\n"], ["2960", "
One correct substraction
\n", "
1
\n"], ["2961", "
Two or three correct substractions
\n", "
2
\n"], ["2962", "
Twelve years or fewer.
\n", "
1
\n"], ["2963", "
More than twelve years.
\n", "
2
\n"], ["2964", "
No digits repeated
\n", "
0
\n"], ["2965", "
One digit correct
\n", "
1
\n"], ["2966", "
Two digits correct
\n", "
2
\n"], ["2967", "
Three digits correct
\n", "
3
\n"], ["2968", "
Four digits correct
\n", "
4
\n"], ["2969", "
Five digits correct
\n", "
5
\n"], ["297", "
One or 2 times
\n", "
2
\n"], ["2970", "
Six digits correct
\n", "
6
\n"], ["2971", "
Seven digits correct
\n", "
7
\n"], ["2972", "
One trial to learn all the words
\n", "
1
\n"], ["2973", "
Two trials
\n", "
2
\n"], ["2974", "
Three trials
\n", "
3
\n"], ["2975", "
Four trials or more
\n", "
4
\n"], ["2976", "
Correct (65)
\n", "
1
\n"], ["2977", "
Correct (58)
\n", "
1
\n"], ["2978", "
Correct (29)
\n", "
1
\n"], ["2979", "
Correct (40)
\n", "
1
\n"], ["298", "
Three or more times
\n", "
3
\n"], ["2980", "
Correct (Fruit)
\n", "
1
\n"], ["2981", "
Correct (Animals)
\n", "
1
\n"], ["2982", "
Correct (Furniture)
\n", "
1
\n"], ["2983", "
Correct drawing
\n", "
1
\n"], ["2984", "
Full credit
\n", "
1
\n"], ["2985", "
Partial credit
\n", "
2
\n"], ["2986", "
No credit for drawing
\n", "
3
\n"], ["2987", "
One trial
\n", "
1
\n"], ["2988", "
Yes, limited a lot
\n", "
1
\n"], ["2989", "
Yes, limited a little
\n", "
2
\n"], ["299", "
Up to 2 or 3 glasses
\n", "
2
\n"], ["2990", "
No, not limited at all
\n", "
3
\n"], ["2991", "
No, none of the time
\n", "
1
\n"], ["2992", "
Yes, a little of the tim
\n", "
2
\n"], ["2993", "
Yes, some of the time
\n", "
3
\n"], ["2994", "
Yes, most of the time
\n", "
4
\n"], ["2995", "
Yes, all of the time
\n", "
5
\n"], ["2996", "
A good bit of the time
\n", "
3
\n"], ["2997", "
Much better
\n", "
1
\n"], ["2998", "
Slightly better
\n", "
2
\n"], ["2999", "
Slightly worse
\n", "
4
\n"], ["3", "
Mild
\n", "
2
\n"], ["30", "", "
E
\n"], ["300", "
Up to 1 quart
\n", "
3
\n"], ["3000", "
Much worse
\n", "
5
\n"], ["3001", "
Yes, a little of the time
\n", "
2
\n"], ["3002", "
Correctly named giraffe
\n", "
1
\n"], ["3003", "
Correctly named bear
\n", "
1
\n"], ["3004", "
Correctly named hippopotamus
\n", "
1
\n"], ["3005", "
Correctly named donkey
\n", "
1
\n"], ["3006", "
Correctly named pig
\n", "
1
\n"], ["3007", "
Correctly named kangaroo
\n", "
1
\n"], ["3008", "
Incontinent (or needs to be given enema)
\n", "
0
\n"], ["3009", "
Occasional accident (once per week)
\n", "
1
\n"], ["301", "
Up to 2 quarts
\n", "
4
\n"], ["3010", "
Continent
\n", "
2
\n"], ["3011", "
Incontinent, or catheterized and unable to manage
\n", "
0
\n"], ["3012", "
Occasional accident (maximum, once per 24 hours)
\n", "
1
\n"], ["3013", "
Continent (for over 7 days)
\n", "
2
\n"], ["3014", "
Needs help with personal care
\n", "
0
\n"], ["3015", "
Independent face/hair/teeth/shaving (implements provided)
\n", "
1
\n"], ["3016", "
Dependent
\n", "
0
\n"], ["3017", "
Needs some help, but can do somethings alone
\n", "
1
\n"], ["3018", "
Independent (on and off, dressing, wiping)
\n", "
2
\n"], ["3019", "
Unable
\n", "
0
\n"], ["302", "
Up to 3 quarts
\n", "
5
\n"], ["3020", "
Needs help cutting, spreading butter, etc.
\n", "
1
\n"], ["3021", "
Independent (food provided within reach)
\n", "
2
\n"], ["3022", "
Unable, no sitting balance
\n", "
0
\n"], ["3023", "
Major help (one or two people, physical), can sit
\n", "
1
\n"], ["3024", "
Minor help (verbal or physical)
\n", "
2
\n"], ["3025", "
Independent
\n", "
3
\n"], ["3026", "
Immobile
\n", "
0
\n"], ["3027", "
Wheelchair independent, including corners, etc.
\n", "
1
\n"], ["3028", "
Walks with help of one person (verbal or physical)
\n", "
2
\n"], ["3029", "
Independent (but may use any aid, e.g., cane)
\n", "
3
\n"], ["303", "
More than 3 quarts
\n", "
6
\n"], ["3030", "
Needs help, but can do about half unaided
\n", "
1
\n"], ["3031", "
Independent (including buttons, zippers, laces, etc.)
\n", "
2
\n"], ["3032", "
Needs help (verbal, physical, carrying aid)
\n", "
1
\n"], ["3033", "
Independent, up and down
\n", "
2
\n"], ["3034", "
Independent (can perform all the steps)
\n", "
1
\n"], ["3035", "
Extreme or cannot do
\n", "
4
\n"], ["3036", "
Not applicable
\n", "
2
\n"], ["3037", "
I want to live in a hospital or other place where staff are there all the time and I rarely leave.
\n", "
1
\n"], ["3038", "
I want to live in a place (group home, or room or apartment or house) in the community that provides meals and staff to help me with my activities.
\n", "
2
\n"], ["3039", "
I want to live by myself or with other people getting mental health care, where I am responsible for taking care of my needs with occasional home visits from a mental health provider.
\n", "
3
\n"], ["304", "
Perhaps
\n", "
2
\n"], ["3040", "
I want to live by myself or with people I choose and only see mental health staff when I choose to go.
\n", "
4
\n"], ["3041", "
I live in a hospital or other place where staff are there all the time and I rarely leave.
\n", "
1
\n"], ["3042", "
I live in a place in the community (group home or room or apartment or house) that provides meals and staff to help me with my activities.
\n", "
2
\n"], ["3043", "
I live by myself or with other people getting mental health care, where I am responsible for taking care of my needs with occasional visits from a mental health provider.
\n", "
3
\n"], ["3044", "
I live by myself or with people I choose and only see mental health staff when I choose to go.
\n", "
4
\n"], ["3045", "
I am retired and do not wish to be employed.
\n", "
1
\n"], ["3046", "
I am not retired and I do not wish to be employed in a paid job at all.
\n", "
2
\n"], ["3047", "
I do not wish to be employed in a paid job due to concerns about losing my disability benefits.
\n", "
3
\n"], ["3048", "
I want to be employed in a part-time paid job. I need support from a vocational counselor to become employed.
\n", "
4
\n"], ["3049", "
I want to be employed in a full-time paid job. I need support from a vocational counselor to become employed.
\n", "
5
\n"], ["305", "
Surely
\n", "
3
\n"], ["3050", "
I want to be employed in a part-time paid job. I do not need support from a vocational counselor.
\n", "
6
\n"], ["3051", "
I want to be employed in a full-time paid job. I do not need support from a vocational counselor.
\n", "
7
\n"], ["3052", "
I am retired and pleased to not be employed.
\n", "
1
\n"], ["3053", "
I am not retired and I am currently not employed by choice.
\n", "
2
\n"], ["3054", "
I am currently not employed due to concerns about losing my disability benefits.
\n", "
3
\n"], ["3055", "
I am employed part-time in a paid job with support from a vocational counselor.
\n", "
4
\n"], ["3056", "
I am employed full-time in a paid job with support from a vocational counselor.
\n", "
5
\n"], ["3057", "
I am employed part-time in a paid job without support from a vocational counselor.
\n", "
6
\n"], ["3058", "
I am employed full-time in a paid job without support from a vocational counselor.
\n", "
7
\n"], ["3059", "
I don't want to participate in community activities in any way.
\n", "
1
\n"], ["306", "
Very much so
\n", "
4
\n"], ["3060", "
I only want to participate in community activities that my mental health providers recommend.
\n", "
2
\n"], ["3061", "
I want to be involved in a range of community activities in addition to, or instead of, those discussed with my mental health providers.
\n", "
3
\n"], ["3062", "
In addition to participating in community activities, I want to be a volunteer and contribute my time to some community activity.
\n", "
4
\n"], ["3063", "
I am not involved in community activities in any way.
\n", "
1
\n"], ["3064", "
I only participate in community activities that my mental health providers recommend.
\n", "
2
\n"], ["3065", "
I am involved in a range of community activities in addition to, or instead of, those discussed with my mental health providers.
\n", "
3
\n"], ["3066", "
In addition to participating in community activities, I am a volunteer and contribute my time to a community activity.
\n", "
4
\n"], ["3067", "
Normal activity & work, no evidence of disease
\n", "
1
\n"], ["3068", "
Normal activity & work, some evidence of disease
\n", "
2
\n"], ["3069", "
Normal activity with effort, some evidence of disease
\n", "
3
\n"], ["307", "
About once a month
\n", "
2
\n"], ["3070", "
Unable Normal Job/Work, significant disease
\n", "
4
\n"], ["3071", "
Unable hobby/house work, significant disease
\n", "
5
\n"], ["3072", "
Unable to do any work, extensive disease
\n", "
6
\n"], ["3073", "
Unable to do most activity, extensive disease
\n", "
7
\n"], ["3074", "
Unable to do any activity, extensive disease
\n", "
8
\n"], ["3075", "
Full
\n", "
0
\n"], ["3076", "
Reduced
\n", "
1
\n"], ["3077", "
Mainly Sit/Lie
\n", "
2
\n"], ["3078", "
Mainly in Bed
\n", "
3
\n"], ["3079", "
Totally Bed Bound
\n", "
4
\n"], ["308", "
Two or 3 times per month
\n", "
3
\n"], ["3080", "
Death
\n", "
5
\n"], ["3081", "
Occasional assistance necessary
\n", "
2
\n"], ["3082", "
Considerable assistance necessary
\n", "
3
\n"], ["3083", "
Mainly assistance
\n", "
4
\n"], ["3084", "
Total Care
\n", "
5
\n"], ["3085", "
Normal
\n", "
1
\n"], ["3086", "
Normal or reduced
\n", "
2
\n"], ["3087", "
Minimal to sips
\n", "
3
\n"], ["3088", "
Mouth care only
\n", "
4
\n"], ["3089", "
Full or Confusion
\n", "
2
\n"], ["309", "
More than 3 times per month
\n", "
4
\n"], ["3090", "
Full or Drowsy +/- Confusion
\n", "
3
\n"], ["3091", "
Drowsy or Coma +/- Confusion
\n", "
4
\n"], ["3092", "
Low pain
\n", "
0
\n"], ["3093", "
High pain
\n", "
1
\n"], ["3094", "
Low stress
\n", "
0
\n"], ["3095", "
High stress
\n", "
1
\n"], ["3096", "
Low agitation
\n", "
0
\n"], ["3097", "
High agitation
\n", "
1
\n"], ["3098", "
Low hopelessness
\n", "
0
\n"], ["3099", "
High hopelessness
\n", "
1
\n"], ["31", "", "
A
\n"], ["310", "
Usually
\n", "
3
\n"], ["3100", "
Low self-hate
\n", "
0
\n"], ["3101", "
High self-hate
\n", "
1
\n"], ["3102", "
Extremely low risk
\n", "
0
\n"], ["3103", "
Extremely high risk
\n", "
1
\n"], ["3104", "
High pain
\n", "
1
\n"], ["3105", "
High stress
\n", "
1
\n"], ["3106", "
High agitation
\n", "
1
\n"], ["3107", "
High hopelessness
\n", "
1
\n"], ["3108", "
High self-hate
\n", "
1
\n"], ["3109", "
Extremely high risk
\n", "
1
\n"], ["311", "
Almost always
\n", "
4
\n"], ["3110", "
Completely
\n", "
1
\n"], ["3111", "
Normal activity and work. No evidence of disease.
\n", "
1
\n"], ["3112", "
Normal activity and work. Some evidence of disease.
\n", "
2
\n"], ["3113", "
Normal activity with effort. Some evidence of disease.
\n", "
3
\n"], ["3114", "
Unable normal job/work. Significant disease.
\n", "
1
\n"], ["3115", "
Unable hobby/house work. Significant disease.
\n", "
2
\n"], ["3116", "
Unable hobby/house work. Extensive disease.
\n", "
5
\n"], ["3117", "
Unable to do any work. Extensive disease.
\n", "
6
\n"], ["3118", "
Unable to do most activity. Extensive disease.
\n", "
7
\n"], ["3119", "
Unable to do any activity. Extensive disease.
\n", "
8
\n"], ["312", "
None, I drink steadily.
\n", "
1
\n"], ["3120", "
Consideratble assistance required
\n", "
3
\n"], ["3121", "
Extensive disease.
\n", "
0
\n"], ["3122", "
Drowsy +/- Confusion
\n", "
1
\n"], ["3123", "
1.
\n", "
1
\n"], ["3125", "
Considerable assistance required
\n", "
1
\n"], ["3126", "
Unable hobby/house work. Significant disease
\n", "
1
\n"], ["3127", "
Unable to do any work. Extensive disease
\n", "
2
\n"], ["3128", "
Unable to do most activity. Extensive disease
\n", "
3
\n"], ["3129", "
Unable to do any activity. Extensive disease
\n", "
4
\n"], ["313", "
Less than a week
\n", "
2
\n"], ["3130", "
Unable normal job/work. Significant disease
\n", "
0
\n"], ["3131", "
Not Important
\n", "
1
\n"], ["3132", "
Important
\n", "
2
\n"], ["3133", "
Extremely Important
\n", "
3
\n"], ["3134", "
A Little Dissatisfied
\n", "
3
\n"], ["3135", "
A Little Satisfied
\n", "
4
\n"], ["3136", "
I don't have a spouse or significant other
\n", "
2
\n"], ["3137", "
I don't have other family members
\n", "
2
\n"], ["3138", "
I don't have as many friends as I'd like
\n", "
2
\n"], ["3139", "
Yes, more support
\n", "
1
\n"], ["314", "
Up to a month
\n", "
3
\n"], ["3140", "
Yes, less support
\n", "
2
\n"], ["3141", "
I want to live in a place (group home, or room or apartment or house) in the community that provides meals and staff to help me with
\n", "
2
\n"], ["3142", "
my activities.
\n", "
3
\n"], ["3143", "
I want to live by myself or with other people getting mental health care, where I am responsible for taking care of my needs with
\n", "
4
\n"], ["3144", "
I live in a place in the community (group home or room or apartment or house) that provides meals and staff to help me with my
\n", "
2
\n"], ["3145", "
activities.
\n", "
3
\n"], ["3146", "
I live by myself or with other people getting mental health care, where I am responsible for taking care of my needs with occasional
\n", "
4
\n"], ["3147", "
I do not wish to be employed in a paid job because I'm concerned about losing my disability benefits.
\n", "
3
\n"], ["3148", "
I am retired and do not choose/wish to be employed.
\n", "
1
\n"], ["3149", "
I am not retired and I do not choose/wish to be employed.
\n", "
2
\n"], ["315", "
More than a month
\n", "
4
\n"], ["3150", "
I am currently not employed (or am employed part-time) because I'm concerned about losing my disability benefits.
\n", "
3
\n"], ["3151", "
I am employed part-time in a paid job and have support from a vocational counselor.
\n", "
4
\n"], ["3152", "
I am employed full-time in a paid job and have support from a vocational counselor.
\n", "
5
\n"], ["3153", "
I want to live by myself or with people I choose and only see mental health staff when I choose.
\n", "
4
\n"], ["3154", "
I live by myself or with people I choose and only see mental health staff when I choose.
\n", "
4
\n"], ["3155", "
Seldom true
\n", "
3
\n"], ["3156", "
Needs some help, but can do some things alone
\n", "
1
\n"], ["3157", "
One night
\n", "
1
\n"], ["3158", "
Two nights
\n", "
2
\n"], ["3159", "
Three nights
\n", "
3
\n"], ["316", "
About once a year
\n", "
2
\n"], ["3160", "
Four or more nights
\n", "
4
\n"], ["3161", "
One day
\n", "
1
\n"], ["3162", "
Two days
\n", "
2
\n"], ["3163", "
Three days
\n", "
3
\n"], ["3164", "
Four or more days
\n", "
4
\n"], ["3165", "
No correct subtractions
\n", "
0
\n"], ["3166", "
One correct subtraction
\n", "
1
\n"], ["3167", "
Two or three correct subtractions
\n", "
2
\n"], ["3168", "
No errors or four or more correct subtractions
\n", "
3
\n"], ["3169", "", "
6
\n"], ["317", "
Twice a year or more
\n", "
3
\n"], ["3170", "", "
1
\n"], ["3171", "", "
1
\n"], ["3172", "", "
1
\n"], ["3173", "", "
1
\n"], ["3174", "", "
2
\n"], ["3175", "", "
2
\n"], ["3176", "", "
2
\n"], ["3177", "", "
2
\n"], ["3178", "", "
2
\n"], ["3179", "", "
2
\n"], ["318", "
Yes, perhaps once or twice
\n", "
2
\n"], ["3180", "", "
3
\n"], ["3181", "
Minor Problem
\n", "
1
\n"], ["3182", "
Moderate Problem
\n", "
2
\n"], ["3183", "
Serious Problem
\n", "
3
\n"], ["3184", "
Not present at any time during interview
\n", "
0
\n"], ["3185", "
Present at some time during interview, but in mild form
\n", "
1
\n"], ["3186", "
Present at some time during interview, in marked form
\n", "
2
\n"], ["3187", "
Alert (normal)
\n", "
0
\n"], ["3188", "
Vigilant (hyperalert, overly sensitive to environmental stimuli, startled very easily)
\n", "
1
\n"], ["3189", "
Lethargic (drowsy, easily aroused)
\n", "
2
\n"], ["319", "
Yes, often
\n", "
3
\n"], ["3190", "
Stupor (difficult to arouse)
\n", "
3
\n"], ["3191", "
Coma (unarousable)
\n", "
4
\n"], ["3192", "
Strongly Agree
\n", "
1
\n"], ["3193", "
Neither poor nor good
\n", "
3
\n"], ["3194", "
Satisfied
\n", "
2
\n"], ["3195", "
Neither satisfied nor dissatisfied
\n", "
3
\n"], ["3196", "
Dissatisfied
\n", "
4
\n"], ["3197", "
A moderate amount
\n", "
3
\n"], ["3198", "
An extreme amount
\n", "
5
\n"], ["3199", "
Mostly
\n", "
4
\n"], ["32", "", "
B
\n"], ["320", "
Almost every time I drink
\n", "
3
\n"], ["3200", "
Quite often
\n", "
3
\n"], ["3201", "
Not at all noticeable
\n", "
1
\n"], ["3202", "
Much
\n", "
4
\n"], ["3203", "
Very much noticeable
\n", "
5
\n"], ["3204", "
Very much worried
\n", "
5
\n"], ["3205", "
Not at all interfering
\n", "
1
\n"], ["3206", "
Very much interfering
\n", "
5
\n"], ["3207", "
Not at all true for me.
\n", "
0
\n"], ["3208", "
Slightly true for me.
\n", "
1
\n"], ["3209", "
Moderately true for me.
\n", "
2
\n"], ["321", "
Twelve weeks or more
\n", "
1
\n"], ["3210", "
Very true for me.
\n", "
3
\n"], ["3211", "
Extremely true for me.
\n", "
4
\n"], ["3212", "
5:00-6:30 a.m.
\n", "
1
\n"], ["3213", "
6:30-7:45 a.m.
\n", "
2
\n"], ["3214", "
7:45-9:45 a.m.
\n", "
3
\n"], ["3215", "
9:45-11:00 a.m.
\n", "
4
\n"], ["3216", "
11:00 a.m. - 12:00 noon
\n", "
5
\n"], ["3217", "
8:00 - 9:00 p.m.
\n", "
1
\n"], ["3218", "
9:00 - 10:15 p.m.
\n", "
2
\n"], ["3219", "
10:15 p.m.- 12:30 a.m.
\n", "
3
\n"], ["322", "
Four to 11 weeks
\n", "
2
\n"], ["3220", "
12:30 - 1:45 a.m.
\n", "
4
\n"], ["3221", "
1:45 a.m. - 3:00 a.m.
\n", "
5
\n"], ["3222", "
Not at all easy
\n", "
1
\n"], ["3223", "
Slightly easy
\n", "
2
\n"], ["3224", "
Fairly easy
\n", "
3
\n"], ["3225", "
Not at all alert
\n", "
1
\n"], ["3226", "
Slightly alert
\n", "
2
\n"], ["3227", "
Fairly alert
\n", "
3
\n"], ["3228", "
Very alert
\n", "
4
\n"], ["3229", "
Very tired
\n", "
1
\n"], ["323", "
One to 4 weeks
\n", "
3
\n"], ["3230", "
Fairly tired
\n", "
2
\n"], ["3231", "
Slightly tired
\n", "
3
\n"], ["3232", "
Not at all tired
\n", "
4
\n"], ["3233", "
Would be in good form
\n", "
1
\n"], ["3234", "
Would be in reasonable form
\n", "
2
\n"], ["3235", "
Would find it difficult
\n", "
3
\n"], ["3236", "
Would find it very difficult
\n", "
4
\n"], ["3237", "
8:00 -9:00 p.m.
\n", "
1
\n"], ["3238", "
10:15 p.m. - 12:30 a.m.
\n", "
3
\n"], ["3239", "
8:00 - 10:00 a.m.
\n", "
1
\n"], ["324", "
No time at all (no problem)
\n", "
4
\n"], ["3240", "
11:00 a.m. - 1:00 p.m.
\n", "
2
\n"], ["3241", "
3:00 - 5:00 p.m.
\n", "
3
\n"], ["3242", "
7:00-9:00 p.m.
\n", "
4
\n"], ["3243", "
Definitely a morning type
\n", "
1
\n"], ["3244", "
More a morning than an evening type
\n", "
2
\n"], ["3245", "
More an evening than a morning type
\n", "
3
\n"], ["3246", "
Definitely an evening type
\n", "
4
\n"], ["3247", "
Before 6:30 a.m.
\n", "
1
\n"], ["3248", "
6:30 - 7:30 a.m.
\n", "
2
\n"], ["3249", "
7:30 - 8:30 a.m.
\n", "
3
\n"], ["325", "
Usually
\n", "
4
\n"], ["3250", "
8:30 a.m. or later
\n", "
4
\n"], ["3251", "
Very difficulty and unpleasant
\n", "
1
\n"], ["3252", "
Rather difficult and unpleasant
\n", "
2
\n"], ["3253", "
A little unpleasant but no great problem
\n", "
3
\n"], ["3254", "
Easy and not unpleasant
\n", "
4
\n"], ["3255", "
0-10 minutes
\n", "
1
\n"], ["3256", "
11-20 minutes
\n", "
2
\n"], ["3257", "
21-40 minutes
\n", "
3
\n"], ["3258", "
More than 40 minutes
\n", "
4
\n"], ["3259", "
Very morning active (morning alert & evening tired)
\n", "
1
\n"], ["326", "
Less than a day
\n", "
1
\n"], ["3260", "
To some extent, morning active
\n", "
2
\n"], ["3261", "
To some extent, evening active
\n", "
3
\n"], ["3262", "
Very evening active (morning tired & evening alert)
\n", "
4
\n"], ["3263", "
Very difficult and unpleasant
\n", "
1
\n"], ["3264", "
A little bit of the time
\n", "
5
\n"], ["3265", "
Only a little
\n", "
4
\n"], ["3266", "
Not at all bothersome
\n", "
0
\n"], ["3267", "
Extremely bothersome
\n", "
1
\n"], ["3268", "
Extremely bothersome
\n", "
1
\n"], ["3269", "
Very afraid
\n", "
1
\n"], ["327", "
Two to 3 days
\n", "
2
\n"], ["3270", "
Somewhat afraid
\n", "
2
\n"], ["3271", "
Not very afraid
\n", "
3
\n"], ["3272", "
Not afraid at all
\n", "
4
\n"], ["3273", "
Very good: could hardly have been better
\n", "
1
\n"], ["3274", "
Pretty good
\n", "
2
\n"], ["3275", "
Good & bad about equal
\n", "
3
\n"], ["3276", "
Pretty bad
\n", "
4
\n"], ["3277", "
Very bad: could hardly have been worse
\n", "
5
\n"], ["3278", "
Hospitalized (Specify location)
\n", "
2
\n"], ["3279", "
At lease one supportive relationship
\n", "
1
\n"], ["328", "
Four to 30 days (1 month)
\n", "
3
\n"], ["3280", "
Non-Suicidal SDV, Fatal
\n", "
0
\n"], ["3281", "
Non-Suicidal SDV Ideation
\n", "
1
\n"], ["3282", "
Non-Suicidal SDV, Preparatory
\n", "
2
\n"], ["3283", "
Non-Suicidal SDV, With Injury
\n", "
3
\n"], ["3284", "
Non-Suicidal SDV, With Injury, Interrupted by Self/Other
\n", "
4
\n"], ["3285", "
Non-Suicidal SDV, Without Injury
\n", "
5
\n"], ["3286", "
Non-Suicidal SDV, Without Injury, Interrupted by Self/Other
\n", "
6
\n"], ["3287", "
Suicidal Ideation, With Suicidal Intent
\n", "
7
\n"], ["3288", "
Suicidal Ideation, With Undetermined Suicidal Intent
\n", "
8
\n"], ["3289", "
Suicidal Ideation, Without Suicidal Intent
\n", "
9
\n"], ["329", "
A few times
\n", "
2
\n"], ["3290", "
Suicidal SDV, Preparatory
\n", "
1
\n"], ["3291", "
There is insufficient evidence to suggest SDV
\n", "
1
\n"], ["3292", "
Undetermined SDV, Preparatory
\n", "
1
\n"], ["3293", "
Drug use gets in my way very little
\n", "
4
\n"], ["3294", "
Drug use is not a factor in my functioning
\n", "
5
\n"], ["3295", "
Good
\n", "
1
\n"], ["3296", "
Enjoyable
\n", "
1
\n"], ["3297", "
Sturdy
\n", "
1
\n"], ["3298", "
Interesting
\n", "
1
\n"], ["3299", "
Strongly disagee
\n", "
4
\n"], ["33", "", "
C
\n"], ["330", "
Many times
\n", "
4
\n"], ["3300", "
Mild (less than an hour)
\n", "
1
\n"], ["3301", "
Moderate (1 -3 hours)
\n", "
2
\n"], ["3302", "
Severe (3-8 hours)
\n", "
3
\n"], ["3303", "
Extreme (more than 8 hours)
\n", "
4
\n"], ["3304", "
Extreme (disabling)
\n", "
4
\n"], ["3305", "
Complete control
\n", "
0
\n"], ["3306", "
Much control
\n", "
1
\n"], ["3307", "
Moderate control
\n", "
2
\n"], ["3308", "
Little control
\n", "
3
\n"], ["3309", "
No control
\n", "
4
\n"], ["331", "
Once
\n", "
2
\n"], ["3310", "
No avoidance
\n", "
0
\n"], ["3311", "
Occasional avoidance
\n", "
1
\n"], ["3312", "
Moderate avoidance
\n", "
2
\n"], ["3313", "
Frequent and extensive avoidance
\n", "
3
\n"], ["3314", "
Extreme avoidance (house-bound)
\n", "
4
\n"], ["3315", "
Slight interference
\n", "
1
\n"], ["3316", "
Definitely interferes with functioning
\n", "
2
\n"], ["3317", "
Much interference
\n", "
3
\n"], ["3318", "
Extreme interference (disabling)
\n", "
4
\n"], ["3319", "
Extremely satisfied
\n", "
1
\n"], ["332", "
Two or 3 times
\n", "
3
\n"], ["3320", "
A little bit satisfied
\n", "
3
\n"], ["3321", "
A little bit dissatisfied
\n", "
5
\n"], ["3322", "
Extremely dissatisfied
\n", "
7
\n"], ["3323", "
Extremely skilled
\n", "
1
\n"], ["3324", "
Skilled
\n", "
2
\n"], ["3325", "
A little bit skilled
\n", "
3
\n"], ["3326", "
Neither skilled nor unskilled
\n", "
4
\n"], ["3327", "
Unskilled
\n", "
6
\n"], ["3328", "
Extremely unskilled
\n", "
7
\n"], ["3329", "
Attend all scheduled appointments
\n", "
1
\n"], ["333", "
Four or more times
\n", "
4
\n"], ["3330", "
Attend most scheduled appointments
\n", "
2
\n"], ["3331", "
Attend less than half of all scheduled appointments
\n", "
3
\n"], ["3332", "
Rarely attend scheduled appointments
\n", "
4
\n"], ["3333", "
Does not apply - no appointments scheduled
\n", "
5
\n"], ["3334", "
I have reached my goal
\n", "
1
\n"], ["3335", "
I have made a lot of progress towards my goal
\n", "
2
\n"], ["3336", "
I have made a little progress towards my goal
\n", "
3
\n"], ["3337", "
I have made no progress towards my goal
\n", "
4
\n"], ["3338", "
Does not apply -- I am not trying to reach my goal anymore
\n", "
5
\n"], ["3339", "
Extremely helpful
\n", "
1
\n"], ["334", "
Several times
\n", "
3
\n"], ["3340", "
Helpful
\n", "
2
\n"], ["3341", "
A little bit helpful
\n", "
3
\n"], ["3342", "
Neither helpful nor unhelpful
\n", "
4
\n"], ["3343", "
A little bit unhelpful
\n", "
5
\n"], ["3344", "
Unhelpful
\n", "
6
\n"], ["3345", "
Extremely unhelpful
\n", "
7
\n"], ["3346", "
No! Strongly disagree
\n", "
1
\n"], ["3347", "
No Disagree
\n", "
2
\n"], ["3348", "
? Undecided or unsure
\n", "
3
\n"], ["3349", "
Yes Agree
\n", "
4
\n"], ["335", "
Not a thing (no problem)
\n", "
1
\n"], ["3350", "
Yes! Strongly agree
\n", "
5
\n"], ["3353", "
Almost never (0-10%)
\n", "
1
\n"], ["3354", "
Sometimes (11-35%)
\n", "
2
\n"], ["3355", "
About half the time (36-65%)
\n", "
3
\n"], ["3356", "
Most of the time (66 - 90%)
\n", "
4
\n"], ["3357", "
Almost always (91-100%)
\n", "
5
\n"], ["3358", "
Bathes self completely or needs help in bathing only a single part of the body such as the back, genital area or disabled extremity. (1 pt)
\n", "
1
\n"], ["3359", "
Needs help with bathing more than one part of the body, getting in or out of the tub or shower. Requires total bathing. (0 pt)
\n", "
0
\n"], ["336", "
As much as 1 week's income
\n", "
2
\n"], ["3360", "
Receives no assistance (gets in and out of tub by self if tub is usual means of bathing)
\n", "
3
\n"], ["3361", "
Receives assistance in getting clothes or in getting dressed, or stays partly or completely undressed
\n", "
1
\n"], ["3362", "
Needs help with dressing self or needs to be completely dressed. (0 pt)
\n", "
0
\n"], ["3363", "
Gets clothes from closets and drawers and puts on clothes and outer garments complete with fasteners. May have help tying shoes. (1 pt)
\n", "
1
\n"], ["3364", "
Doesn't go to room termed \"toilet\" for the elimination process
\n", "
1
\n"], ["3365", "
Receives assistance in going to \"toilet room\" or in cleaning self or in arranging clothes after elimination or in use of night bedpan or commode
\n", "
2
\n"], ["3366", "
Goes to \"toilet room,\" cleans self, and arranges clothes without assistance (may use object for support such as cane, walker, or wheelchair and may manage night bedpan or commode, emptying same in morning)
\n", "
3
\n"], ["3367", "
Moves in and out of bed or chair unassisted. Mechanical transferring aides are acceptable. (1 pt)
\n", "
1
\n"], ["3368", "
Needs help in moving from bed to chair or requires a complete transfer. (0 pt)
\n", "
0
\n"], ["3369", "
Moves in and out of bed as well as in and out of chair without assistance (may use object for support such as cane or walker)
\n", "
3
\n"], ["337", "
One to 4 weeks' income
\n", "
3
\n"], ["3370", "
Supervision helps keep urine or bowel control, catheter is used, or is incontinent
\n", "
1
\n"], ["3371", "
Has occasional \"accidents\"
\n", "
2
\n"], ["3372", "
Exercises complete self control over urination and defecation. (1 pt)
\n", "
1
\n"], ["3373", "
Needs partial or total help with feeding or requires parenteral feeding. (0 pt)
\n", "
0
\n"], ["3374", "
Feeds self with assistance
\n", "
2
\n"], ["3375", "
Gets food from plate into mouth without help. Preparation of food may be done by another person. (1 pt)
\n", "
1
\n"], ["3376", "
Goes to toilet, gets on and off, arranges clothes, cleans genital area without help. (1 pt)
\n", "
1
\n"], ["3377", "
Needs help transferring to the toilet, cleaning self or uses bedpan or commode. (0 pt)
\n", "
0
\n"], ["3378", "
Goes to 'toilet room', cleans self, and arranges clothes without assistance (may use object for support such as cane, walker, or wheelchair and may manage night bedpan or commode, emptying same in morning)
\n", "
3
\n"], ["3379", "
Is partially or totally incontinent of bowel or bladder. (0 pt)
\n", "
0
\n"], ["338", "
More than 4 weeks' income
\n", "
4
\n"], ["3380", "
Receives assistance in getting clothes or getting dressed, or stays partly or completely undressed
\n", "
1
\n"], ["3381", "
Mild (< 1hr)
\n", "
1
\n"], ["3382", "
Moderate (1-3 hrs)
\n", "
2
\n"], ["3383", "
Severe (3-8 hrs)
\n", "
3
\n"], ["3384", "
Very Severe (8-12 hrs)
\n", "
4
\n"], ["3385", "
Extreme (12h - constant)
\n", "
5
\n"], ["3386", "
Uninterrupted (No symptoms)
\n", "
0
\n"], ["3387", "
Long (>8 hrs)
\n", "
1
\n"], ["3388", "
Moderate (3-8 hrs)
\n", "
2
\n"], ["3389", "
Short (1-3 hrs)
\n", "
3
\n"], ["339", "
Perhaps (not sure)
\n", "
2
\n"], ["3390", "
Very short (minutes to < 1hr)
\n", "
4
\n"], ["3391", "
None (constant)
\n", "
5
\n"], ["3392", "
Some control
\n", "
3
\n"], ["3393", "
Minimal control
\n", "
4
\n"], ["3394", "
Mild (slightly disturbing)
\n", "
1
\n"], ["3395", "
Moderate (disturbing still manageable)
\n", "
2
\n"], ["3396", "
Severe (some difficult to manage and highly disturbing)
\n", "
3
\n"], ["3397", "
Very severe (most difficult to manage and highly disturbing)
\n", "
4
\n"], ["3398", "
Extreme (overwhelming)
\n", "
5
\n"], ["3399", "
Mild (slight)
\n", "
1
\n"], ["34", "", "
D
\n"], ["340", "
Probably
\n", "
3
\n"], ["3400", "
Moderate (definite interference still manageable)
\n", "
2
\n"], ["3401", "
Severe (substantial in one or more areas)
\n", "
3
\n"], ["3402", "
Very severe (substantial in all areas)
\n", "
4
\n"], ["3403", "
Extreme (incapacitated)
\n", "
5
\n"], ["3404", "
Always resists or no need to resist
\n", "
0
\n"], ["3405", "
Resists most of the time
\n", "
1
\n"], ["3406", "
Moderate effort
\n", "
2
\n"], ["3407", "
Some effort to resist
\n", "
3
\n"], ["3408", "
Yields to most
\n", "
4
\n"], ["3409", "
Completely yields to all
\n", "
5
\n"], ["341", "
Definitely
\n", "
4
\n"], ["3410", "
Mild (slight distress)
\n", "
1
\n"], ["3411", "
Severe (marked distress for some)
\n", "
3
\n"], ["3412", "
Very severe (marked distress for all)
\n", "
4
\n"], ["3413", "
Extreme (overwhelming anxiety if delayed)
\n", "
5
\n"], ["3414", "
Good (some lingering doubts)
\n", "
1
\n"], ["3415", "
Fair (many unrealistic fears)
\n", "
2
\n"], ["3416", "
Poor (overvalued ideas)
\n", "
3
\n"], ["3417", "
Absent (delusional
\n", "
4
\n"], ["3418", "
Current
\n", "
1
\n"], ["3419", "
Past
\n", "
2
\n"], ["342", "
Many times
\n", "
3
\n"], ["3420", "
Disgree
\n", "
2
\n"], ["3421", "
Good and bad about equal
\n", "
3
\n"], ["3422", "
Worse possible quality of life
\n", "
0
\n"], ["3423", "
Best possible quality of life
\n", "
1
\n"], ["3424", "
Very well: could hardly be better
\n", "
1
\n"], ["3425", "
Good and bad parts about equal
\n", "
3
\n"], ["3426", "
Very bad: could hardly be worse
\n", "
5
\n"], ["3427", "
Yes, a great deal
\n", "
1
\n"], ["3428", "
Yes, somewhat
\n", "
2
\n"], ["3429", "
Very fearful
\n", "
1
\n"], ["343", "
Yes, but not more than 2 or 3 times
\n", "
2
\n"], ["3430", "
Somewhat fearful
\n", "
2
\n"], ["3431", "
Not very fearful
\n", "
3
\n"], ["3432", "
Not fearful at all
\n", "
4
\n"], ["3433", "
Worry a lot
\n", "
1
\n"], ["3434", "
Occasionally worry
\n", "
2
\n"], ["3435", "
Don't worry at all
\n", "
3
\n"], ["3436", "
Very worried
\n", "
1
\n"], ["3437", "
Somewhat worried
\n", "
2
\n"], ["3438", "
Not very worried
\n", "
3
\n"], ["3439", "
Not worried at all
\n", "
4
\n"], ["344", "
Yes, about 4 to 10 times
\n", "
3
\n"], ["3440", "
Worst imaginable health state
\n", "
0
\n"], ["3441", "
Best imaginable health state
\n", "
1
\n"], ["3442", "
100 = Best Imaginable Health State
\n", "
1
\n"], ["3443", "", "
3
\n"], ["3444", "", "
5
\n"], ["3445", "", "
6
\n"], ["3446", "", "
7
\n"], ["3447", "
0 = Worst imaginable health state
\n", "
1
\n"], ["3448", "
None/not at all
\n", "
0
\n"], ["3449", "
Slight/rare, less than a day or two
\n", "
1
\n"], ["345", "
Yes, more than 10 times
\n", "
4
\n"], ["3450", "
Mild/several days
\n", "
2
\n"], ["3451", "
Moderate/more than half the days
\n", "
3
\n"], ["3452", "
Severe/nearly every day
\n", "
4
\n"], ["3453", "
Interesting
\n", "
1
\n"], ["3454", "
? Undecided or unsure
\n", "
3
\n"], ["3455", "
5:00-6:30 a.m
\n", "
1
\n"], ["3456", "
6:30-7:45 a.m
\n", "
2
\n"], ["3457", "
7:45-9:45 a.m
\n", "
3
\n"], ["3458", "
9:45-11:00 a.m
\n", "
4
\n"], ["3459", "
8:00 - 9:00 p.m
\n", "
1
\n"], ["346", "
Very eager
\n", "
4
\n"], ["3460", "
9:00 - 10:15 p.m
\n", "
2
\n"], ["3461", "
10:15 p.m.- 12:30 a.m
\n", "
3
\n"], ["3462", "
12:30 - 1:45 a.m
\n", "
4
\n"], ["3463", "
1:45 a.m. - 3:00 a.m
\n", "
5
\n"], ["3464", "
8:00 - 10:00 a.m
\n", "
1
\n"], ["3465", "
11:00 a.m. - 1:00 p.m
\n", "
2
\n"], ["3466", "
3:00 - 5:00 p.m
\n", "
3
\n"], ["3467", "
7:00-9:00 p.m
\n", "
4
\n"], ["3468", "
Before 6:30 a.m
\n", "
1
\n"], ["3469", "
6:30 - 7:30 a.m
\n", "
2
\n"], ["347", "
Rarely or never
\n", "
1
\n"], ["3470", "
7:30 - 8:30 a.m
\n", "
3
\n"], ["3471", "
Very evening active (morning tired & evening alert)
\n", "
4
\n"], ["3472", "
5:00 - 6:30 am
\n", "
1
\n"], ["3473", "
6:30 - 7:45 am
\n", "
2
\n"], ["3474", "
7:45 - 9:45 am
\n", "
3
\n"], ["3475", "
9:45 - 11:00 am
\n", "
4
\n"], ["3476", "
11:00 am - 12:00 noon
\n", "
5
\n"], ["3477", "
8:00 - 9:00 pm
\n", "
1
\n"], ["3478", "
9:00 - 10:15 pm
\n", "
2
\n"], ["3479", "
10:15 pm - 12:30 am
\n", "
3
\n"], ["348", "
Always or almost always
\n", "
4
\n"], ["3480", "
12:30 - 1:45 am
\n", "
4
\n"], ["3481", "
1:45 am - 3:00 am
\n", "
5
\n"], ["3482", "
8:00 - 10:00 am
\n", "
1
\n"], ["3483", "
11:00 am - 1:00 pm
\n", "
2
\n"], ["3484", "
3:00 - 5:00 pm
\n", "
3
\n"], ["3485", "
7:00-9:00 pm
\n", "
4
\n"], ["3486", "
Before 6:30 am
\n", "
1
\n"], ["3487", "
6:30 - 7:30 am
\n", "
2
\n"], ["3488", "
7:30 - 8:30 am
\n", "
3
\n"], ["3489", "
8:30 am or later
\n", "
4
\n"], ["349", "
Don't drink
\n", "
1
\n"], ["3490", "
Very morning active (morning alert and evening tired)
\n", "
1
\n"], ["3491", "
Very evening active (morning tired and evening alert)
\n", "
4
\n"], ["3492", "
Never or almost never
\n", "
1
\n"], ["3493", "
Few people (0-20 percent)
\n", "
1
\n"], ["3494", "
Some people (20-40 percent)
\n", "
2
\n"], ["3495", "
Many people (40-60 percent)
\n", "
3
\n"], ["3496", "
Most people (60-80 percent)
\n", "
4
\n"], ["3497", "
Almost everyone (80-100 percent)
\n", "
5
\n"], ["3498", "
Never or almost never true
\n", "
1
\n"], ["3499", "
Always or almost always true
\n", "
5
\n"], ["35", "", "
E
\n"], ["350", "
Drink alone
\n", "
2
\n"], ["3500", "
7:00 - 9:00 pm
\n", "
4
\n"], ["3501", "
Sometimes, such as when things are starting to go badly
\n", "
3
\n"], ["3502", "
A little bit unskilled
\n", "
5
\n"], ["3503", "
Baseline (just beginning)
\n", "
1
\n"], ["3504", "
Click here if no psychiatric medications have been prescribed for you.
\n", "
6
\n"], ["3505", "
Hopeful
\n", "
1
\n"], ["3506", "
0 Miserable
\n", "
0
\n"], ["3507", "
5 Enjoyable
\n", "
5
\n"], ["351", "
Drink alone or with one other
\n", "
3
\n"], ["3516", "
Best imaginable health state
\n", "
1
\n"], ["3517", "
Feeds self except for getting assistance in cutting meat or buttering bread
\n", "
2
\n"], ["3518", "
3, Weekly
\n", "
3
\n"], ["3519", "
Mild, less than 1 hr/day.
\n", "
1
\n"], ["352", "
Drink with several people
\n", "
4
\n"], ["3520", "
Moderate, 1 to 3 hrs/day.
\n", "
2
\n"], ["3521", "
Severe, greater than 3 and up to 8 hrs/day.
\n", "
3
\n"], ["3522", "
Very severe, greater than 8 and up to 12 hrs/day.
\n", "
4
\n"], ["3523", "
Extreme, greater than 12 hrs/day, constant or nearly constant intrusions.
\n", "
5
\n"], ["3524", "
No symptoms.
\n", "
0
\n"], ["3525", "
Long symptom-free interval, more than 8 consecutive hours/day symptom-free.
\n", "
1
\n"], ["3526", "
Moderately long symptom-free interval, more than 3 and up to 8 consecutive hours/day symptom free.
\n", "
2
\n"], ["3527", "
Short symptom-free interval, from 1 to 3 consecutive hours/day symptom-free.
\n", "
3
\n"], ["3528", "
Very short symptom-free interval, from less than 1 consecutive hour/day to a few minutes symptom-free; freedom from obsessions measured in minutes.
\n", "
4
\n"], ["3529", "
Extremely short (or no) symptom-free interval, constant to near constant (less than a minute symptom-free); freedom from obsessions measured in seconds. May experience only momentary relief.
\n", "
5
\n"], ["353", "
A week or less (0-6 days)
\n", "
1
\n"], ["3530", "
Complete control.
\n", "
0
\n"], ["3531", "
Much control, usually able to stop or ignore obsessions.
\n", "
1
\n"], ["3532", "
Moderate control, often able to stop or ignore obsessions with some effort and concentration.
\n", "
2
\n"], ["3533", "
Some control, sometimes able to stop or ignore obsessions.
\n", "
3
\n"], ["3534", "
Minimal or little control, infrequently able to stop or ignore obsessions, can only divert attention with difficulty.
\n", "
4
\n"], ["3535", "
No control, experienced as completely involuntary, rarely able to even momentarily alter or let go of obsessive thinking.
\n", "
5
\n"], ["3536", "
Mild, slightly disturbing.
\n", "
1
\n"], ["3537", "
Moderate, definitely disturbing but manageable.
\n", "
2
\n"], ["3538", "
Severe, sometimes to frequently the thoughts are highly disturbing and difficult to manage.
\n", "
3
\n"], ["3539", "
Very severe, most if not all thoughts are highly disturbing and difficult to manage.
\n", "
4
\n"], ["354", "
One to 2 weeks (7-14 days)
\n", "
2
\n"], ["3540", "
Extreme, overwhelming and disabling distress whenever a thought occurs.
\n", "
5
\n"], ["3541", "
None. No deliberate avoidance.
\n", "
0
\n"], ["3542", "
Mild, slight interference with social or occupational activities, but overall performance not impaired. Minimal avoidance.
\n", "
1
\n"], ["3543", "
Moderate, definite interference with social or occupational performance, but still manageable. Some avoidance.
\n", "
2
\n"], ["3544", "
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["3545", "
Very severe, causes significant impairment in ALL major areas of functioning. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["3546", "
Extreme, incapacitating. May be housebound
\n", "
5
\n"], ["3547", "
Mild, spends less than 1 hr/day or occasional performance of compulsive behaviors.
\n", "
1
\n"], ["3548", "
Moderate, spends from 1 to 3 hrs/day or frequent performance of compulsive behaviors.
\n", "
2
\n"], ["3549", "
Severe, spends more than 3 and up to 8 hrs/day or very frequent performance of compulsive behaviors.
\n", "
3
\n"], ["355", "
Three weeks to 2 months (15-60 days)
\n", "
3
\n"], ["3550", "
Very severe, spends more than 8 and up to 12 hrs/day performing compulsive; majority of waking hours filled by rituals.
\n", "
4
\n"], ["3551", "
Extreme, greater than 12 hrs/day performing compulsive behavior, constant or nearly constant performance of rituals.
\n", "
5
\n"], ["3552", "
Makes an effort to always resist, or symptoms so minimal doesn't need to actively resist.
\n", "
0
\n"], ["3553", "
Tries to resist most of the time.
\n", "
1
\n"], ["3554", "
Makes moderate effort to resist.
\n", "
2
\n"], ["3555", "
Makes some effort to resist.
\n", "
3
\n"], ["3556", "
Yields to almost all compulsions without attempting to control them, but does so with some hesitation.
\n", "
4
\n"], ["3557", "
Completely yields to all compulsions; experienced as almost involuntary.
\n", "
5
\n"], ["3558", "
Much control, usually able to resist compulsions.
\n", "
1
\n"], ["3559", "
Moderate control, pressure to perform behavior, but often able to control it.
\n", "
2
\n"], ["356", "
More than 2 months
\n", "
4
\n"], ["3560", "
Some control, strong drive to perform behaviors, sometimes able to control them.
\n", "
3
\n"], ["3561", "
Minimal or little control, infrequently able to stop behaviors, once started, must be carried to completion; can only delay with difficulty.
\n", "
4
\n"], ["3562", "
No control, drive to carry out compulsions experienced as completely involuntary and overpowering, rarely able to even momentarily delay activity.
\n", "
5
\n"], ["3563", "
Mild; becomes only slightly anxious if compulsions (or avoidance) prevented.
\n", "
1
\n"], ["3564", "
Moderate; reports that anxiety definitely increases but remains manageable if compulsions (or avoidance) prevented.
\n", "
2
\n"], ["3565", "
Severe (marked distress for some).
\n", "
3
\n"], ["3566", "
Very severe; experiences marked anxiety if almost any compulsion (or avoidance) is prevented.
\n", "
4
\n"], ["3567", "
Extreme; overwhelming anxiety from any attempt to delay or modify compulsions (or avoidance).
\n", "
5
\n"], ["3568", "
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["3569", "
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["357", "
No, or don't know
\n", "
1
\n"], ["3570", "
Extreme, incapacitating. Abnormal behaviors are virtually impossible to conceal. May be housebound.
\n", "
5
\n"], ["3571", "
Excellent insight, fully rational.
\n", "
0
\n"], ["3572", "
Good insight. Readily acknowledges absurdity or excessiveness of thoughts or behaviors but does not seem completely convinced that there isn't something besides anxiety to be concerned about (i.e., has lingering doubts).
\n", "
1
\n"], ["3573", "
Fair insight. Reluctantly admits thoughts or behavior seem unreasonable or excessive, but wavers. May have some unrealistic fears, but no fixed convictions.
\n", "
2
\n"], ["3574", "
Poor insight. Maintains that thoughts or behaviors are not unreasonable or excessive, but acknowledges validity of contrary evidence (i.e., overvalued ideas present).
\n", "
3
\n"], ["3575", "
Lacks insight, delusional. Definitely convinced that concerns and behavior are reasonable, unresponsive to contrary evidence.
\n", "
4
\n"], ["3576", "
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["3577", "
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["3578", "
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["3579", "
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["358", "
Yes, slight
\n", "
2
\n"], ["3580", "
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["3581", "
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["3582", "
Excellent, no reason to suspect data unreliable
\n", "
0
\n"], ["3583", "
Good, factor(s) present that may adversely affect reliability
\n", "
1
\n"], ["3584", "
Fair, factor(s) present that definitely reduce reliability
\n", "
2
\n"], ["3585", "
Poor, very low reliability
\n", "
3
\n"], ["3586", "
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["3587", "
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["3588", "
No illness
\n", "
0
\n"], ["3589", "
Illness slight, doubtful, transient; no functional impairment
\n", "
1
\n"], ["359", "
Yes, moderate
\n", "
3
\n"], ["3590", "
Mild symptoms, little functional impairment
\n", "
2
\n"], ["3591", "
Moderate symptoms, functions with effort
\n", "
3
\n"], ["3592", "
Moderate - Severe symptoms, limited functioning
\n", "
4
\n"], ["3593", "
Severe symptoms, functions mainly with assistance
\n", "
5
\n"], ["3594", "
Extremely Severe symptoms, completely nonfunctional
\n", "
6
\n"], ["3595", "
Minimally worse
\n", "
2
\n"], ["3596", "
Minimally improved
\n", "
4
\n"], ["3597", "
Much improved
\n", "
5
\n"], ["3598", "
Very much improved
\n", "
6
\n"], ["3599", "
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times. Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["36", "
Indulge
\n", "
A
\n"], ["360", "
Yes, severe
\n", "
4
\n"], ["3600", "
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["3601", "
Severe; experiences marked anxiety if some compulsions (or avoidance) are prevented.
\n", "
3
\n"], ["3602", "
Severe, causes significant impairment in one or more (but not all) functional domains. Compulsions are noticeable to careful observers at times. Much avoidance, but at least one area of functioning is relatively free from avoidance.
\n", "
3
\n"], ["3603", "
Very severe, causes significant impairment in ALL domains of functioning. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
\n", "
4
\n"], ["3604", "
7.0
\n", "
7
\n"], ["3605", "
8.0
\n", "
8
\n"], ["3606", "
9.0
\n", "
9
\n"], ["3607", "
10.0
\n", "
1
\n"], ["3608", "
Showing mild nausea and no vomiting
\n", "
1
\n"], ["3609", "
Somewhat strongly disagree
\n", "
2
\n"], ["361", "
Yes
\n", "
1
\n"], ["3610", "
Somewhat mildly agree
\n", "
6
\n"], ["3611", "
More than mildly agree
\n", "
8
\n"], ["3612", "
Somewhat strongly agree
\n", "
9
\n"], ["3613", "
Severe (3 to 8 hours per 24 hours)
\n", "
3
\n"], ["3614", "
Very poor
\n", "
1
\n"], ["3615", "
Poor
\n", "
2
\n"], ["3616", "
Good
\n", "
4
\n"], ["3617", "
Very good
\n", "
5
\n"], ["3618", "
Very dissatisfied
\n", "
1
\n"], ["3619", "
Dissatisfied
\n", "
2
\n"], ["362", "
No
\n", "
3
\n"], ["3620", "
Satisfied
\n", "
4
\n"], ["3621", "
Very satisfied
\n", "
5
\n"], ["3622", "
Extremely
\n", "
5
\n"], ["3623", "
Moderately
\n", "
3
\n"], ["3624", "
Completely
\n", "
5
\n"], ["363", "
No (or have no problem)
\n", "
1
\n"], ["3632", "
Yes
\n", ""], ["3633", "
No
\n", ""], ["3635", "
Within the past 24 hours (including today)
\n", "
1
\n"], ["3636", "
Within the last month (but not today)
\n", "
1
\n"], ["3637", "
Between 1 and 6 months ago
\n", "
1
\n"], ["3638", "
More than 6 months ago
\n", ""], ["3639", "
I Don't Know
\n", "
0
\n"], ["364", "
Yes, surely
\n", "
4
\n"], ["3640", "
YES
\n", "
1
\n"], ["3641", "
NO
\n", "
0
\n"], ["3642", "
Not at all
\n", "
1
\n"], ["3643", "
Several days
\n", "
2
\n"], ["3644", "
More than half the days
\n", "
3
\n"], ["3645", "
Nearly every day
\n", "
4
\n"], ["365", "
No times
\n", "
1
\n"], ["3650", "
Yes
\n", ""], ["3651", "
No
\n", ""], ["3652", "
None
\n", "
0
\n"], ["3653", "
Mild
\n", "
1
\n"], ["3654", "
Moderate
\n", "
2
\n"], ["3655", "
Severe
\n", "
3
\n"], ["3656", "
Extreme or cannot do
\n", "
4
\n"], ["3657", "
YES
\n", ""], ["3658", "
NO
\n", ""], ["3659", "
Not at All
\n", ""], ["366", "
One to 3 times
\n", "
2
\n"], ["3661", "
Several Days
\n", ""], ["3662", "
More Than Half the Days
\n", ""], ["3663", "
Nearly Every Day
\n", ""], ["3664", "
Very mild - Occasionally feels somewhat anxious.
\n", "
1
\n"], ["3665", "
Mild - Occasionally feels moderately anxious, or often feels somewhat anxious.
\n", "
2
\n"], ["3666", "
Moderate - Occasionally feels very anxious, or often feels moderately anxious.
\n", "
3
\n"], ["3667", "
Moderately severe - Often feels very anxious.
\n", "
4
\n"], ["3668", "
Severe - Feels anxious most of the time.
\n", "
5
\n"], ["3669", "
Very severe - Feels very anxious nearly all of the time.
\n", "
6
\n"], ["367", "
Four to 6 times
\n", "
3
\n"], ["3670", "
Very mild - Occasionally exhibits poor eye contact.
\n", "
1
\n"], ["3671", "
Mild- As above, but more frequent.
\n", "
2
\n"], ["3672", "
Moderate - Little eye contact, but still seems engaged in the interview and appropriately responsive to all questions.
\n", "
3
\n"], ["3673", "
Moderately severe - Stares at floor or orients self away from interviewer, but seems moderately engaged.
\n", "
4
\n"], ["3674", "
Severe - As above, but more persistent or pervasive.
\n", "
5
\n"], ["3675", "
Very severe - Appeared \"spacey\" or \"out of it\" (total absence of emotional relatedness) and is disproportionately uninvolved or unengaged in the interview.
\n", "
6
\n"], ["3676", "
Very mild - Somewhat vague, but of doubtful clinical significance.
\n", "
1
\n"], ["3677", "
Mild - Frequently vague, but the interview is able to progress.
\n", "
2
\n"], ["3678", "
Moderate - Occasional irrelevant statements, infrequent use of neologisms, or moderate loosening of associations.
\n", "
3
\n"], ["3679", "
Moderately severe - As above, but more frequent.
\n", "
4
\n"], ["368", "
More than 6 times
\n", "
4
\n"], ["3680", "
Severe - Formal thought disorder is present for most of the interview, and the interview is severely strained.
\n", "
5
\n"], ["3681", "
Very severe - Very little coherent information can be obtained.
\n", "
6
\n"], ["3682", "
Very mild - Occasionally feels somewhat guilty.
\n", "
1
\n"], ["3683", "
Mild - Occasionally feels moderately guilty, or often feels somewhat guilty.
\n", "
2
\n"], ["3684", "
Moderate - Occasional feels very guilty, or often feels moderately guilty.
\n", "
3
\n"], ["3685", "
Moderately severe - Often feels very guilty.
\n", "
4
\n"], ["3686", "
Severe - Feels guilty most of the time or encapsulated delusions of guilt.
\n", "
5
\n"], ["3687", "
Very severe - Agonizing, constant feeling of guilt, or pervasive delusion(s) of guilt.
\n", "
6
\n"], ["3688", "
Very mild - Occasionally fidgets.
\n", "
1
\n"], ["3689", "
Mild - frequently fidgets.
\n", "
2
\n"], ["369", "
One to 7 days
\n", "
2
\n"], ["3690", "
Moderate - constantly fidgets, or frequently fidgets, wrings hands and pulls clothing.
\n", "
3
\n"], ["3691", "
Moderately severe - Constantly fidgets. Wrings hands and pulls clothing.
\n", "
4
\n"], ["3692", "
Severe - Cannot remain seated. (i.e., must pace).
\n", "
5
\n"], ["3693", "
Very severe - Paces in a frantic manner.
\n", "
6
\n"], ["3694", "
Very mild - Odd behavior but doubtful clinical significance, e.g., occasional unprompted smiling, infrequent lip movements.
\n", "
1
\n"], ["3695", "
Mild - Strange behavior but not obviously bizarre, e.g., infrequent head-tilting (from side to side) in a rhythmic fashion, intermittent abnormal finger movements.
\n", "
2
\n"], ["3696", "
Moderate - Assumes yoga position for a brief period of time, infrequent tongue protrusions, rocking.
\n", "
3
\n"], ["3697", "
Moderately severe - Assumes and maintains yoga position throughout interview, unusual movements in several body areas.
\n", "
4
\n"], ["3698", "
Severe - As above, but more frequent, intense, or pervasive.
\n", "
5
\n"], ["3699", "
Very severe - Bizarre posturing throughout most of the interview. Continuous abnormal movements in several body areas.
\n", "
6
\n"], ["37", "
Acclaim
\n", "
B
\n"], ["370", "
From 8 to 20 days
\n", "
3
\n"], ["3700", "
Very mild - Is more confident than most people, but of only possible clinical significance.
\n", "
1
\n"], ["3701", "
Mild - Definitely inflated self-esteem or exaggerates talents somewhat out of proportion to the circumstances.
\n", "
2
\n"], ["3702", "
Moderate - Inflated self-esteem clearly out of proportion to the circumstances or suspected grandiose delusion(s).
\n", "
3
\n"], ["3703", "
Moderately severe - A single (definite) encapsulated grandiose delusion, or multiple (definite) fragmentary grandiose delusions.
\n", "
4
\n"], ["3704", "
Severe - A single (definite) grandiose delusion/delusional system, or multiple (definite) grandiose delusions that the patient seems preoccupied with.
\n", "
5
\n"], ["3705", "
Very severe - As above, but nearly all conversation is directed towards the patient's grandiose delusion(s).
\n", "
6
\n"], ["3706", "
Very mild - Occasionally feels somewhat depressed.
\n", "
1
\n"], ["3707", "
Mild - Occasionally feels moderately depressed, or often feels somewhat depressed.
\n", "
2
\n"], ["3708", "
Moderate - Occasionally feels very depressed, or often feels moderately depressed.
\n", "
3
\n"], ["3709", "
Moderately severe - Often feels very depressed.
\n", "
4
\n"], ["371", "
Almost every day
\n", "
4
\n"], ["3710", "
Severe - Feels very depressed most of the time.
\n", "
5
\n"], ["3711", "
Very severe - Feels very depressed nearly all of the time.
\n", "
6
\n"], ["3712", "
Very mild - Occasionally feels somewhat angry.
\n", "
1
\n"], ["3713", "
Mild - Occasionally feels somewhat angry, or occasionally feels moderately angry.
\n", "
2
\n"], ["3714", "
Moderate - Occasionally feels very angry, or often feels moderately angry.
\n", "
3
\n"], ["3715", "
Moderately severe - Often feels very angry.
\n", "
4
\n"], ["3716", "
Severe - Has acted on his anger by becoming verbally or physically abusive on one or two occasions.
\n", "
5
\n"], ["3717", "
Very severe - Has acted on their anger on several occasions.
\n", "
6
\n"], ["3718", "
Very mild- Rare instances of distrustfulness which may or may not be warranted by the situation.
\n", "
1
\n"], ["3719", "
Mild - Occasional instances of suspiciousness that are definitely not warranted by the situation.
\n", "
2
\n"], ["372", "
I have never had a blackout.
\n", "
1
\n"], ["3720", "
Moderate - More frequent suspiciousness, or transient ideas of reference.
\n", "
3
\n"], ["3721", "
Moderately severe - Pervasive suspiciousness, or frequent ideas of reference.
\n", "
4
\n"], ["3722", "
Severe - Definite delusion(s) of reference or persecution that is (are) not wholly pervasive (e.g., an encapsulated delusion).
\n", "
5
\n"], ["3723", "
Very severe - As above, but more widespread, frequent, or intense.
\n", "
6
\n"], ["3724", "
Very mild - Suspected hallucinations only.
\n", "
1
\n"], ["3725", "
Mild - Definite hallucinations, but insignificant, infrequent, or transient (e.g., occasional formless visual hallucinations, a voice calling the patient's name).
\n", "
2
\n"], ["3726", "
Moderate - As above, but more frequent or extensive (e.g., frequently sees the devil's face, two voices carry on a lengthy conversation).
\n", "
3
\n"], ["3727", "
Moderately severe - Hallucinations are experienced nearly every day, or are a source of extreme distress.
\n", "
4
\n"], ["3728", "
Severe - As above and has had a moderate impact on the patient's behavior (e.g., concentration difficulties leading to impaired work functioning).
\n", "
5
\n"], ["3729", "
Very severe - As above, and has had a severe impact (e.g., attempts suicide in response to command hallucinations).
\n", "
6
\n"], ["373", "
I have had blackouts that last less than an hour.
\n", "
2
\n"], ["3730", "
Very mild - Of doubtful clinical significance.
\n", "
1
\n"], ["3731", "
Mild - Conversation is somewhat retarded, movements somewhat slowed.
\n", "
2
\n"], ["3732", "
Moderate - Conversation is notably retarded but not strained.
\n", "
3
\n"], ["3733", "
Moderately severe - Conversation is strained, moves very slowly.
\n", "
4
\n"], ["3734", "
Severe - Conversation is difficult to maintain, hardly moves at all.
\n", "
5
\n"], ["3735", "
Very severe - Conversation is almost impossible, does not move at all throughout the interview.
\n", "
6
\n"], ["3736", "
Very mild - Does not seem motivated.
\n", "
1
\n"], ["3737", "
Mild - Seems evasive in certain areas.
\n", "
2
\n"], ["3738", "
Moderate - As above, but evasive in many areas.
\n", "
3
\n"], ["3739", "
Moderately severe - Expresses resentment and is unfriendly throughout the interview.
\n", "
4
\n"], ["374", "
I have had blackouts that last for several hours.
\n", "
3
\n"], ["3740", "
Severe - Refuses to answer a number of questions.
\n", "
5
\n"], ["3741", "
Very severe - Refuses to answer most questions.
\n", "
6
\n"], ["3742", "
Very mild - Delusion(s) suspected or likely.
\n", "
1
\n"], ["3743", "
Mild - At times, patient questions his or her belief(s) (partial delusion).
\n", "
2
\n"], ["3744", "
Moderate - Full delusional conviction, but delusion(s) has little or no influence on behavior.
\n", "
3
\n"], ["3745", "
Moderately severe - Full delusional conviction, but delusion(s) has only occasional impact on behavior.
\n", "
4
\n"], ["3746", "
Severe - Delusion(s) has significant effect, e.g., neglects responsibilities because of preoccupation with belief that he/she is God.
\n", "
5
\n"], ["3747", "
Very severe - Delusion(s) has major impact, e.g., stops eating because believes food is poisoned.
\n", "
6
\n"], ["3748", "
Very mild - Occasionally seems indifferent to material that is usually accompanied by some show of emotion.
\n", "
1
\n"], ["3749", "
Mild - Somewhat diminished facial expression or somewhat monotonous voice or somewhat restricted gestures.
\n", "
2
\n"], ["375", "
I have had blackouts that last for a day or more.
\n", "
4
\n"], ["3750", "
Moderate - As above, but more intense, prolonged, or frequent.
\n", "
3
\n"], ["3751", "
Moderately severe - Flattening of affect, including at least two of the three features: Severe lack of facial expression, monotonous voice, or restricted body gestures.
\n", "
4
\n"], ["3752", "
Severe - Profound flattening affect.
\n", "
5
\n"], ["3753", "
Very severe - Totally monotonous voice and total lack of expressive gestures throughout the evaluation.
\n", "
6
\n"], ["3754", "
Very Mild - Of doubtful clinical significance.
\n", "
1
\n"], ["3755", "
Mild - irritable or expansive at times.
\n", "
2
\n"], ["3756", "
Moderate - Frequently irritable or expansive.
\n", "
3
\n"], ["3757", "
Moderately Severe - Constantly irritable or expansive; or, at times, enraged or euphoric.
\n", "
4
\n"], ["3758", "
Severe - Enraged or euphoric throughout most of the interview.
\n", "
5
\n"], ["3759", "
Very Severe - As above, but to such a degree that the interview must be terminated prematurely.
\n", "
6
\n"], ["376", "
Three to 4 times
\n", "
3
\n"], ["3760", "
Very mild - Seems somewhat confused.
\n", "
1
\n"], ["3761", "
Mild - e.g., Indicated 2013 when, in fact, it is 2014.
\n", "
2
\n"], ["3762", "
Moderate - e.g., Indicates 1978.
\n", "
3
\n"], ["3763", "
Moderately severe - Is unsure where he/she is.
\n", "
4
\n"], ["3764", "
Severe - Has no idea where he/she is.
\n", "
5
\n"], ["3765", "
Very severe - Does not know who he/she is.
\n", "
6
\n"], ["3766", "
Not at all
\n", ""], ["3767", "
A little bit
\n", ""], ["3768", "
Moderately
\n", ""], ["3769", "
Quite a bit
\n", ""], ["377", "
Five to 10 times
\n", "
4
\n"], ["3770", "
Extremely
\n", ""], ["3771", "
Strongly Disagree
\n", ""], ["3772", "
Disagree
\n", ""], ["3773", "
Not Sure
\n", ""], ["3774", "
Agree
\n", ""], ["3775", "
Strongly Agree
\n", ""], ["3776", "
Excellent
\n", "
1
\n"], ["3777", "
Very good
\n", "
2
\n"], ["3778", "
Good
\n", "
3
\n"], ["3779", "
Fair
\n", "
4
\n"], ["378", "
Almost every day
\n", "
5
\n"], ["3780", "
Poor
\n", "
5
\n"], ["3781", "
Most of the time
\n", "
2
\n"], ["3782", "
Some of the time
\n", "
4
\n"], ["3783", "
Some of the time
\n", "
3
\n"], ["3784", "
A little of the time
\n", "
4
\n"], ["3785", "
None of the time
\n", "
5
\n"], ["3786", "
None of the time
\n", "
6
\n"], ["3787", "
A little of the time
\n", "
5
\n"], ["3788", "
All of the time
\n", "
1
\n"], ["3789", "
YES, a change
\n", ""], ["379", "
Eat regular meals
\n", "
1
\n"], ["3790", "
NO, no change
\n", ""], ["3791", "
N/A, don't know
\n", ""], ["3792", "
As much as I always could
\n", ""], ["3793", "
Not quite so much now
\n", ""], ["3794", "
Definitely not so much now
\n", ""], ["3795", "
Not at all
\n", ""], ["3796", "
As much as I ever did
\n", ""], ["3797", "
Rather less than I used to
\n", ""], ["3798", "
Definitely less than I used to
\n", ""], ["3799", "
Hardly at all
\n", ""], ["38", "
Fear
\n", "
C
\n"], ["380", "
Eat occasionally
\n", "
2
\n"], ["3800", "
Yes, most of the time
\n", ""], ["3801", "
Yes, some of the time
\n", ""], ["3802", "
Not very often
\n", ""], ["3803", "
No, never
\n", ""], ["3804", "
No, not at all
\n", ""], ["3805", "
Hardly ever
\n", ""], ["3806", "
Yes, sometimes
\n", ""], ["3807", "
Yes, very often
\n", ""], ["3809", "
Yes, quite a lot
\n", ""], ["381", "
Eat nothing at all
\n", "
3
\n"], ["3810", "
Yes, sometimes
\n", ""], ["3811", "
No, not much
\n", ""], ["3812", "
No, not at all
\n", ""], ["3813", "
Yes, most of the time I haven't been able to cope at all
\n", ""], ["3814", "
Yes, sometimes I haven't been coping as well as usual
\n", ""], ["3815", "
No, most of the time I have coped quite well
\n", ""], ["3816", "
No, I have been coping as well as ever
\n", ""], ["3817", "
Yes, most of the time
\n", ""], ["3818", "
Yes, sometimes
\n", ""], ["3819", "
Not very often
\n", ""], ["382", "
Three times or more
\n", "
4
\n"], ["3820", "
No, not at all
\n", ""], ["3821", "
Yes, most of the time
\n", ""], ["3822", "
Yes, quite often
\n", ""], ["3823", "
Not very often
\n", ""], ["3824", "
No, not at all
\n", ""], ["3825", "
Yes, most of the time
\n", ""], ["3826", "
Yes, quite often
\n", ""], ["3827", "
Only occasionally
\n", ""], ["3828", "
No, never
\n", ""], ["3829", "
Yes, quite often
\n", ""], ["383", "
No (or do not need)
\n", "
1
\n"], ["3830", "
Sometimes
\n", ""], ["3831", "
Hardly ever
\n", ""], ["3832", "
Never
\n", ""], ["384", "
Seven to 8 hours or more
\n", "
1
\n"], ["385", "
Five to 6 hours
\n", "
2
\n"], ["386", "
Three to 4 hours
\n", "
3
\n"], ["3863", "
No
\n", "
1
\n"], ["3864", "
1-3 times
\n", "
2
\n"], ["3865", "
4-12 times
\n", "
3
\n"], ["3866", "
13-50 times
\n", "
4
\n"], ["3867", "
51+ times
\n", "
5
\n"], ["3868", "
Never
\n", "
1
\n"], ["3869", "
<1 month
\n", "
2
\n"], ["387", "
Less than 2 hours
\n", "
4
\n"], ["3870", "
1-3 months
\n", "
3
\n"], ["3871", "
4-6 months
\n", "
4
\n"], ["3872", "
7+ months
\n", "
5
\n"], ["3873", "
1-2 times
\n", "
2
\n"], ["3874", "
3-12 times
\n", "
3
\n"], ["3875", "
13-25 times
\n", "
4
\n"], ["3876", "
26+ times
\n", "
5
\n"], ["3877", "
None
\n", "
1
\n"], ["3878", "
1-25%
\n", "
2
\n"], ["3879", "
26-50%
\n", "
3
\n"], ["388", "
Three to 10 times
\n", "
3
\n"], ["3880", "
51-75%
\n", "
4
\n"], ["3881", "
76% or more
\n", "
5
\n"], ["3882", "
Less than 5 min.
\n", "
3
\n"], ["3883", "
6-30 min.
\n", "
2
\n"], ["3884", "
31-60 min.
\n", "
1
\n"], ["3885", "
After 1 hr.
\n", "
0
\n"], ["3886", "
Yes
\n", "
1
\n"], ["3887", "
No
\n", "
0
\n"], ["3888", "
Yes
\n", "
1
\n"], ["3889", "
No
\n", "
0
\n"], ["389", "
More than 10 times
\n", "
4
\n"], ["3890", "
First one in the morning
\n", "
1
\n"], ["3891", "
Any other one
\n", "
0
\n"], ["3892", "
10 or less
\n", "
0
\n"], ["3893", "
11-20
\n", "
1
\n"], ["3894", "
21-30
\n", "
2
\n"], ["3895", "
31 or more
\n", "
3
\n"], ["3896", "
Yes
\n", "
1
\n"], ["3897", "
No
\n", "
0
\n"], ["3898", "
Never
\n", "
0
\n"], ["3899", "
Rarely
\n", "
1
\n"], ["39", "
Insult
\n", "
D
\n"], ["390", "
Only slightly
\n", "
2
\n"], ["3900", "
Sometimes
\n", "
2
\n"], ["3901", "
Often
\n", "
3
\n"], ["3902", "
Always
\n", "
4
\n"], ["3903", "
No interference
\n", "
0
\n"], ["3904", "
Extreme interference
\n", "
6
\n"], ["3905", "
No change
\n", "
0
\n"], ["3906", "
Extreme change
\n", "
6
\n"], ["3907", "
Yes
\n", "
1
\n"], ["3908", "
No
\n", "
0
\n"], ["3909", "
Strongly Agree
\n", "
4
\n"], ["391", "
To some notable extent
\n", "
3
\n"], ["3910", "
Somewhat Agree
\n", "
3
\n"], ["3911", "
Somewhat Disagree
\n", "
2
\n"], ["3912", "
Strongly Disagree
\n", "
1
\n"], ["3913", "
Not at all
\n", "
0
\n"], ["3914", "
Several days
\n", "
1
\n"], ["3915", "
More than half the days
\n", "
2
\n"], ["3916", "
Nearly every day
\n", "
3
\n"], ["3917", "
Yes
\n", "
1
\n"], ["3918", "
No
\n", "
2
\n"], ["3919", "
True
\n", "
1
\n"], ["392", "
To a great extent
\n", "
4
\n"], ["3920", "
False
\n", "
2
\n"], ["3921", "
Very Poor
\n", ""], ["3922", "
Poor
\n", ""], ["3923", "
Fair
\n", ""], ["3924", "
Good
\n", ""], ["3925", "
Very Good
\n", ""], ["3926", "
Click here if the patient is not taking any medication.
\n", ""], ["3927", "", "
0
\n"], ["3928", "", "
1
\n"], ["3929", "
No Problem if the symptom has not been a concern for you
\n", "
0
\n"], ["393", "
Less than 1 week
\n", "
2
\n"], ["3930", "
Small Problem if the symptom has caused you occasional or mild concern
\n", "
1
\n"], ["3931", "
Moderate Problem if the symptom has caused you periodic or significant concern
\n", "
2
\n"], ["3932", "
Big Problem if the symptom has caused you frequent or great concern
\n", "
3
\n"], ["3933", "
Strongly Disagree if the statement is not at all true
\n", "
0
\n"], ["3934", "
Disagree if the statement is mostly not true
\n", "
1
\n"], ["3935", "
Agree if the statement is mostly true
\n", "
2
\n"], ["3936", "
Strongly Agree if the statement is very true
\n", "
3
\n"], ["3937", "
Without any difficulty
\n", "
5
\n"], ["3938", "
With a little difficulty
\n", "
4
\n"], ["3939", "
With some difficulty
\n", "
3
\n"], ["394", "
One to 2 weeks
\n", "
3
\n"], ["3940", "
With much difficulty
\n", "
2
\n"], ["3941", "
Unable to do
\n", "
1
\n"], ["3942", "
Never
\n", "
1
\n"], ["3943", "
Rarely
\n", "
2
\n"], ["3944", "
Sometimes
\n", "
3
\n"], ["3945", "
Often
\n", "
4
\n"], ["3946", "
Always
\n", "
5
\n"], ["3947", "
Not at all
\n", "
1
\n"], ["3948", "
A little bit
\n", "
2
\n"], ["3949", "
Somewhat
\n", "
3
\n"], ["395", "
Three or more weeks
\n", "
4
\n"], ["3950", "
Quite a bit
\n", "
4
\n"], ["3951", "
Very much
\n", "
5
\n"], ["3952", "
Very poor
\n", "
5
\n"], ["3953", "
Poor
\n", "
4
\n"], ["3954", "
Fair
\n", "
3
\n"], ["3955", "
Good
\n", "
2
\n"], ["3956", "
Very good
\n", "
1
\n"], ["3957", "
No Pain
\n", ""], ["3958", "
Worst Imaginable Pain
\n", ""], ["3959", "", "
0
\n"], ["396", "
Three or more times
\n", "
4
\n"], ["3960", "", "
10
\n"], ["3961", "", "
20
\n"], ["3962", "", "
30
\n"], ["3963", "", "
40
\n"], ["3964", "", "
50
\n"], ["3965", "", "
60
\n"], ["3966", "", "
70
\n"], ["3967", "", "
80
\n"], ["3968", "", "
90
\n"], ["3969", "", "
100
\n"], ["397", "
Daily for 2 years or more
\n", "
1
\n"], ["3971", "
No personal goals
\n", "
1
\n"], ["3972", "
A personal goal, but have not done anything to finish my goal
\n", "
2
\n"], ["3973", "
A personal goal and made it a little way towards finishing it
\n", "
3
\n"], ["3974", "
A personal goal and have gotten pretty far in finishing my goal
\n", "
4
\n"], ["3975", "
A personal goal and have finished it
\n", "
5
\n"], ["3976", "
Not very much
\n", "
1
\n"], ["3977", "
A little
\n", "
2
\n"], ["3978", "
Some
\n", "
3
\n"], ["3979", "
Quite a bit
\n", "
4
\n"], ["398", "
Daily for 1 to 2 years
\n", "
2
\n"], ["3980", "
A great deal
\n", "
5
\n"], ["3981", "
Not at all
\n", "
1
\n"], ["3982", "
Only when there is a serious problem
\n", "
2
\n"], ["3983", "
Sometimes, like when things are starting to go badly
\n", "
3
\n"], ["3984", "
Much of the time
\n", "
4
\n"], ["3985", "
A lot of the time and they really help me with my mental health
\n", "
5
\n"], ["3986", "
0 times/week
\n", "
1
\n"], ["3987", "
1-2 times/week
\n", "
2
\n"], ["3988", "
3-4 times/week
\n", "
3
\n"], ["3989", "
6-7 times/week
\n", "
4
\n"], ["399", "
Daily for over a part of the last year
\n", "
3
\n"], ["3990", "
8 or more times/week
\n", "
5
\n"], ["3991", "
2 hours or less/week
\n", "
1
\n"], ["3992", "
3-5 hours/week
\n", "
2
\n"], ["3993", "
6-15 hours/week
\n", "
3
\n"], ["3994", "
16-30 hours/week
\n", "
4
\n"], ["3995", "
More than 30 hours/week
\n", "
5
\n"], ["3996", "
My symptoms really bother me a lot
\n", "
1
\n"], ["3997", "
My symptoms bother me quite a bit
\n", "
2
\n"], ["3998", "
My symptoms bother me somewhat
\n", "
3
\n"], ["3999", "
My symptoms bother me very little
\n", "
4
\n"], ["4", "
Moderate
\n", "
3
\n"], ["40", "
Cowl
\n", "
E
\n"], ["400", "
Have not drunk daily
\n", "
4
\n"], ["4000", "
My symptoms don't bother me at all
\n", "
5
\n"], ["4001", "
My symptoms really get in my way a lot
\n", "
1
\n"], ["4002", "
My symptoms get in my way quite a bit
\n", "
2
\n"], ["4003", "
My symptoms get in my way somewhat
\n", "
3
\n"], ["4004", "
My symptoms get in my way very little
\n", "
4
\n"], ["4005", "
My symptoms don't get in my way at all
\n", "
5
\n"], ["4006", "
I don't know how to prevent relapses
\n", "
1
\n"], ["4007", "
I know a little, but I haven't made a relapse prevention plan
\n", "
2
\n"], ["4008", "
I know 1 or 2 things I can do, but I don't have a written plan
\n", "
3
\n"], ["4009", "
I have several things that I can do, but I don't have a written plan
\n", "
4
\n"], ["401", "
No, not at all
\n", "
1
\n"], ["4010", "
I have a written plan that I have shared with others
\n", "
5
\n"], ["4011", "
Within the last month
\n", "
1
\n"], ["4012", "
In the past 2 to 3 months
\n", "
2
\n"], ["4013", "
In the past 4 to 6 months
\n", "
3
\n"], ["4014", "
In the past 7 to 12 months
\n", "
4
\n"], ["4015", "
I haven't had a relapse in the past year
\n", "
5
\n"], ["4016", "
Within the last month
\n", "
1
\n"], ["4017", "
In the past 2 to 3 months
\n", "
2
\n"], ["4018", "
In the past 4 to 6 months
\n", "
3
\n"], ["4019", "
In the past 7 to 12 months
\n", "
4
\n"], ["402", "
Possibly, but not certain
\n", "
2
\n"], ["4020", "
I haven't been hospitalized for mental health or substance abuse reasons in the past year.
\n", "
5
\n"], ["4021", "
Not well at all
\n", "
1
\n"], ["4022", "
Not very well
\n", "
2
\n"], ["4023", "
Alright
\n", "
3
\n"], ["4024", "
Well
\n", "
4
\n"], ["4025", "
Very well
\n", "
5
\n"], ["4026", "
I don't know about any self-help activities
\n", "
1
\n"], ["4027", "
I know about some self-help activities, but I'm not interested
\n", "
2
\n"], ["4028", "
I'm interested in self-help activities but I have not participated in the past year
\n", "
3
\n"], ["4029", "
I participate in self-help activities occasionally
\n", "
4
\n"], ["403", "
Yes, probably
\n", "
3
\n"], ["4030", "
I participate in self-help activities regularly
\n", "
5
\n"], ["4031", "
Never
\n", "
1
\n"], ["4032", "
Occasionally
\n", "
2
\n"], ["4033", "
About half the time
\n", "
3
\n"], ["4034", "
Most of the time
\n", "
4
\n"], ["4035", "
Every day
\n", "
5
\n"], ["4036", "
Alcohol use really gets in my way a lot
\n", "
1
\n"], ["4037", "
Alcohol use gets in my way quite a bit
\n", "
2
\n"], ["4038", "
Alcohol use gets in my way somewhat
\n", "
3
\n"], ["4039", "
Alcohol use gets in my way very little
\n", "
4
\n"], ["404", "
Yes, definitely
\n", "
4
\n"], ["4040", "
Alcohol use is not a factor in my functioning
\n", "
5
\n"], ["4041", "
Drug use really gets in my way a lot
\n", "
1
\n"], ["4042", "
Drug use gets in my way quite a bit
\n", "
2
\n"], ["4043", "
Drug use gets in my way somewhat
\n", "
3
\n"], ["4044", "
Drug use gets in my way very little
\n", "
4
\n"], ["4045", "
Drug use is not a factor in my functioning
\n", "
5
\n"], ["4046", "
Not at all
\n", "
5
\n"], ["4047", "
A little
\n", "
4
\n"], ["4048", "
Very much
\n", "
2
\n"], ["4049", "
An extreme amount
\n", "
1
\n"], ["405", "
One or 2 drinks
\n", "
1
\n"], ["4050", "
Never
\n", "
5
\n"], ["4051", "
Seldom
\n", "
4
\n"], ["4052", "
Very often
\n", "
2
\n"], ["4053", "
Always
\n", "
1
\n"], ["4054", "
Strongly Agree
\n", "
1
\n"], ["4055", "
Somewhat Agree
\n", "
2
\n"], ["4056", "
Somewhat Disagree
\n", "
3
\n"], ["4057", "
Strongly Disagree
\n", "
4
\n"], ["406", "
Three to 5 drinks
\n", "
2
\n"], ["4060", "
Not at all
\n", "
5
\n"], ["4061", "
A little bit
\n", "
4
\n"], ["4062", "
Somewhat
\n", "
3
\n"], ["4063", "
Quite a bit
\n", "
2
\n"], ["4064", "
Very much
\n", "
1
\n"], ["4067", "
Absent
\n", "
0
\n"], ["4068", "
Mild to Intermittent
\n", "
1
\n"], ["4069", "
Severe
\n", "
2
\n"], ["407", "
Five or more drinks
\n", "
3
\n"], ["4070", "
Unable to evaluate
\n", "
0
\n"], ["4071", "
Symptoms result from physical disability or illness
\n", "
0
\n"], ["4072", "
I have no phlegm (mucus) in my chest at all
\n", ""], ["4074", "
0 Never
\n", "
0
\n"], ["4075", "", "
1
\n"], ["4076", "", "
2
\n"], ["4077", "", "
3
\n"], ["4078", "", "
4
\n"], ["4079", "
5 All the Time
\n", "
5
\n"], ["408", "
Only mild, hardly noticeable
\n", "
2
\n"], ["4084", "
I have lots of energy
\n", ""], ["4085", "
I have no energy at all
\n", ""], ["4086", "", "
2
\n"], ["4087", "", "
3
\n"], ["4088", "", "
4
\n"], ["4089", "", "
5
\n"], ["409", "
Bad but bearable
\n", "
3
\n"], ["4090", "", "
6
\n"], ["4091", "", "
7
\n"], ["4092", "", "
8
\n"], ["4093", "", "
9
\n"], ["4094", "", "
10
\n"], ["4095", "
Inpatient
\n", ""], ["4096", "
Outpatient
\n", ""], ["4097", "
Day Hospital/Day Center
\n", ""], ["4098", "
Other
\n", ""], ["4099", "
Absent
\n", "
0
\n"], ["41", "
Fleetness
\n", "
A
\n"], ["410", "
Dreadful, very severe
\n", "
4
\n"], ["4100", "
Mild or Intermittent
\n", "
1
\n"], ["4101", "
Moderate
\n", "
2
\n"], ["4102", "
Severe
\n", "
3
\n"], ["4103", "
Unable to Evaluate
\n", "
0
\n"], ["4104", "
Almost never (0-10%)
\n", "
5
\n"], ["4105", "
Sometimes (11-35%)
\n", "
4
\n"], ["4106", "
About half the time (36-65%)
\n", "
3
\n"], ["4107", "
Most of the time (66 - 90%)
\n", "
2
\n"], ["4108", "
Almost always (91-100%)
\n", "
1
\n"], ["4109", "
Very Satisfied
\n", "
1
\n"], ["411", "
Mainly because it was required
\n", "
1
\n"], ["4110", "
Very Dissatisfied
\n", "
5
\n"], ["4111", "
Symptom due to physical disability or illness
\n", "
0
\n"], ["4112", "", "
0
\n"], ["4113", "", "
1
\n"], ["4114", "", "
2
\n"], ["4115", "", "
3
\n"], ["4116", "", "
4
\n"], ["4117", "", "
5
\n"], ["4119", "", "
6
\n"], ["412", "
Mainly because it was strongly recommended
\n", "
2
\n"], ["4120", "", "
7
\n"], ["4121", "", "
8
\n"], ["4122", "", "
9
\n"], ["4123", "", "
10
\n"], ["4125", "
Head/Headache
\n", "
1
\n"], ["4126", "
Neck
\n", "
2
\n"], ["4127", "
Upper Body
\n", "
3
\n"], ["4128", "
Back/Lower Body
\n", "
4
\n"], ["4129", "
Legs/Feet
\n", "
5
\n"], ["413", "
Mainly because it was encouraged
\n", "
3
\n"], ["4130", "
0 No Phlegm
\n", "
0
\n"], ["4131", "
5 Full of Phlegm
\n", "
5
\n"], ["4132", "
0 Not Tight
\n", "
0
\n"], ["4133", "
5 Very Tight
\n", "
5
\n"], ["414", "
Mainly because I wanted to do it myself
\n", "
4
\n"], ["4144", "
0 Not Breathless
\n", "
0
\n"], ["4145", "
5 Very Breathless
\n", "
5
\n"], ["4146", "
0 Not Limited
\n", "
0
\n"], ["4147", "
5 Very Limited
\n", "
5
\n"], ["4148", "
0 Confident
\n", "
0
\n"], ["4149", "
5 Not Confident
\n", "
5
\n"], ["415", "
Open and frank on almost all items
\n", "
1
\n"], ["4150", "
0 Sleep Soundly
\n", "
0
\n"], ["4151", "
5 Don't Sleep Soundly
\n", "
5
\n"], ["4152", "
0 Lots of Energy
\n", "
0
\n"], ["4153", "
5 No Energy
\n", "
5
\n"], ["416", "
Usually open and frank
\n", "
2
\n"], ["417", "
Guarded on some items
\n", "
3
\n"], ["418", "
Couldn't be open and frank
\n", "
4
\n"], ["419", "
Yes, very well
\n", "
1
\n"], ["42", "
Fleetly
\n", "
B
\n"], ["420", "
Yes, moderately well
\n", "
2
\n"], ["421", "
No, not very well
\n", "
3
\n"], ["422", "
No, hardly at all
\n", "
4
\n"], ["423", "
Very accurate
\n", "
1
\n"], ["424", "
Somewhat accurate
\n", "
2
\n"], ["425", "
Rather inaccurate
\n", "
3
\n"], ["426", "
Not at all accurate
\n", "
4
\n"], ["427", "
In a frank and open manner
\n", "
1
\n"], ["428", "
In a somewhat open manner
\n", "
2
\n"], ["429", "
In a somewhat guarded manner
\n", "
3
\n"], ["43", "
Ship
\n", "
C
\n"], ["430", "
In a very guarded manner
\n", "
4
\n"], ["431", "
Twice
\n", "
3
\n"], ["432", "
Not at all
\n", "
0
\n"], ["433", "
Mildly (it did not bother me much.)
\n", "
1
\n"], ["434", "
Moderately (it was very unpleasant; but I could stand it.)
\n", "
2
\n"], ["435", "
Severely (I could barely stand it.)
\n", "
3
\n"], ["436", "
I do not feel sad.
\n", "
0
\n"], ["437", "
I feel sad.
\n", "
1
\n"], ["438", "
I am sad all the time and I can't snap out of it.
\n", "
2
\n"], ["439", "
I am so sad or unhappy that I can't stand it.
\n", "
3
\n"], ["44", "
Swift
\n", "
D
\n"], ["440", "
I am not particularly discouraged about the future.
\n", "
0
\n"], ["441", "
I feel discouraged about the future.
\n", "
1
\n"], ["442", "
I feel I have nothing to look forward to.
\n", "
2
\n"], ["443", "
I feel that the future is hopeless and that things
\n", "
3
\n"], ["444", "
I do not feel like a failure.
\n", "
0
\n"], ["445", "
I feel I have failed more than the average person.
\n", "
1
\n"], ["446", "
As I look back on my life, all I can see is a lot of failures.
\n", "
2
\n"], ["447", "
I feel I am a complete failure as a person.
\n", "
3
\n"], ["448", "
I get as much satisfaction out of things as I used to.
\n", "
0
\n"], ["449", "
I don't enjoy things the way I used to.
\n", "
1
\n"], ["45", "
Rapidly
\n", "
E
\n"], ["450", "
I don't get real satisfaction out of anything anymore.
\n", "
2
\n"], ["451", "
I am dissatisfied or bored with everything.
\n", "
3
\n"], ["452", "
I don't feel particularly guilty.
\n", "
0
\n"], ["453", "
I feel guilty a good part of the time.
\n", "
1
\n"], ["454", "
I feel quite guilty most of the time.
\n", "
2
\n"], ["455", "
I feel guilty all of the time.
\n", "
3
\n"], ["456", "
I don't feel I am being punished.
\n", "
0
\n"], ["457", "
I feel I may be punished.
\n", "
1
\n"], ["458", "
I expect to be punished.
\n", "
2
\n"], ["459", "
I feel I am being punished.
\n", "
3
\n"], ["46", "
He who begs timidly courts a refusal
\n", "
A
\n"], ["460", "
I don't feel disappointed in myself.
\n", "
0
\n"], ["461", "
I am disappointed in myself.
\n", "
1
\n"], ["462", "
I am disgusted with myself.
\n", "
2
\n"], ["463", "
I hate myself.
\n", "
3
\n"], ["464", "
I don't feel I am any worse than anybody else.
\n", "
0
\n"], ["465", "
I am critical of myself for my weaknesses or mistakes.
\n", "
1
\n"], ["466", "
I blame myself all the time for my faults.
\n", "
2
\n"], ["467", "
I blame myself for everything bad that happens.
\n", "
3
\n"], ["468", "
I don't have any thoughts of killing myself.
\n", "
0
\n"], ["469", "
I have thoughts of killing myself, but I would not carry them out.
\n", "
1
\n"], ["47", "
Thrice dowered he whose riches are great thoughts
\n", "
B
\n"], ["470", "
I would like to kill myself.
\n", "
2
\n"], ["471", "
I would kill myself if I had the chance.
\n", "
3
\n"], ["472", "
I don't cry any more than usual.
\n", "
0
\n"], ["473", "
I cry more now than I used to.
\n", "
1
\n"], ["474", "
I cry all the time now.
\n", "
2
\n"], ["475", "
I used to be able to cry but now I can't cry
\n", "
3
\n"], ["476", "
I am no more irritated now than I ever am.
\n", "
0
\n"], ["477", "
I get annoyed or irritated more easily than I used to.
\n", "
1
\n"], ["478", "
I feel irritated all the time now.
\n", "
2
\n"], ["479", "
I don't get irritated at all by the things
\n", "
3
\n"], ["48", "
All is not gold that glitters
\n", "
C
\n"], ["480", "
I have not lost interest in other people.
\n", "
0
\n"], ["481", "
I am less interested in other people than I used to be.
\n", "
1
\n"], ["482", "
I have lost most of my interest in other people.
\n", "
2
\n"], ["483", "
I have lost all of my interest in other people.
\n", "
3
\n"], ["484", "
I make decisions about as well as I ever could.
\n", "
0
\n"], ["485", "
I put off making decisions more than I used to.
\n", "
1
\n"], ["486", "
I have greater difficulty in making decisions than before.
\n", "
2
\n"], ["487", "
I can't make decisions at all any more.
\n", "
3
\n"], ["488", "
I don't feel I look any worse than I used to.
\n", "
0
\n"], ["489", "
I am worried that I am looking old or unattractive.
\n", "
1
\n"], ["49", "
When the lion's skin falls short, it must be eked out with the fox's
\n", "
D
\n"], ["490", "
I feel that there are permanent changes in my appearance
\n", "
2
\n"], ["491", "
I believe that I look ugly.
\n", "
3
\n"], ["4912", "
Mild
\n", "
1
\n"], ["4913", "
Moderate
\n", "
2
\n"], ["4914", "
Severe
\n", "
3
\n"], ["4915", "
Yes
\n", "
1
\n"], ["4916", "
No
\n", "
0
\n"], ["4917", "
None of the time
\n", "
1
\n"], ["4918", "
Rarely
\n", "
2
\n"], ["4919", "
Some of the time
\n", "
3
\n"], ["492", "
I can work about as well as before.
\n", "
0
\n"], ["4920", "
Often
\n", "
4
\n"], ["4921", "
All of the time
\n", "
5
\n"], ["4922", "
Strongly Disagree
\n", "
0
\n"], ["4923", "
Disagree
\n", "
1
\n"], ["4924", "
Not Sure
\n", "
2
\n"], ["4925", "
Agree
\n", "
3
\n"], ["4926", "
Strongly Agree
\n", "
4
\n"], ["4927", "
Always
\n", "
3
\n"], ["4928", "
Usually
\n", "
2
\n"], ["4929", "
Often
\n", "
1
\n"], ["493", "
It takes extra effort to get started at doing something.
\n", "
1
\n"], ["4930", "
Sometimes
\n", "
0
\n"], ["4931", "
Rarely
\n", "
0
\n"], ["4932", "
Never
\n", "
0
\n"], ["4933", "
Never
\n", "
0
\n"], ["4934", "
Once a month or less
\n", "
1
\n"], ["4935", "
2-3 times a month
\n", "
2
\n"], ["4936", "
Once a week
\n", "
3
\n"], ["4937", "
2-6 times a week
\n", "
4
\n"], ["4938", "
Once a day or more
\n", "
5
\n"], ["4939", "
Yes
\n", "
1
\n"], ["494", "
I have to push myself very hard to do anything.
\n", "
2
\n"], ["4940", "
No
\n", "
0
\n"], ["495", "
I can't do any work at all.
\n", "
3
\n"], ["4952", "
Always
\n", "
0
\n"], ["4953", "
Usually
\n", "
0
\n"], ["4954", "
Often
\n", "
0
\n"], ["4955", "
Sometimes
\n", "
1
\n"], ["4956", "
Rarely
\n", "
2
\n"], ["4957", "
Never
\n", "
3
\n"], ["4958", "
Yes
\n", "
1
\n"], ["4959", "
No
\n", "
0
\n"], ["496", "
I can sleep as well as usual.
\n", "
0
\n"], ["4960", "
5:00-6:30 a.m.
\n", "
5
\n"], ["4961", "
6:30- 7:45 a.m.
\n", "
4
\n"], ["4962", "
7:45-9:45 a.m.
\n", "
3
\n"], ["4963", "
9:45-11:00 a.m.
\n", "
2
\n"], ["4964", "
11:00 a.m.- 12:00 (noon)
\n", "
1
\n"], ["4965", "
8:00-9:00 p.m.
\n", "
5
\n"], ["4966", "
9:00-10:15 p.m.
\n", "
4
\n"], ["4967", "
10:15 p.m.- 12:30 a.m.
\n", "
3
\n"], ["4968", "
12:30-1:45 a.m.
\n", "
2
\n"], ["4969", "
1:45- 3:00 a.m.
\n", "
1
\n"], ["497", "
I don't sleep as well as I used to.
\n", "
1
\n"], ["4970", "
Not at all easy
\n", "
1
\n"], ["4971", "
Slightly easy
\n", "
2
\n"], ["4972", "
Fairly easy
\n", "
3
\n"], ["4973", "
Very easy
\n", "
4
\n"], ["4974", "
Not at all alert
\n", "
1
\n"], ["4975", "
Slightly alert
\n", "
2
\n"], ["4976", "
Fairly alert
\n", "
3
\n"], ["4977", "
Very alert
\n", "
4
\n"], ["4978", "
Very tired
\n", "
1
\n"], ["4979", "
Fairly tired
\n", "
2
\n"], ["498", "
I wake up 1-2 hours earlier than usual and find it hard
\n", "
2
\n"], ["4980", "
Fairly refreshed
\n", "
3
\n"], ["4981", "
Very refreshed
\n", "
4
\n"], ["4982", "
Would be in good form
\n", "
4
\n"], ["4983", "
Would be in reasonable form
\n", "
3
\n"], ["4984", "
Would find it difficult
\n", "
2
\n"], ["4985", "
Would find it very difficult
\n", "
1
\n"], ["4986", "
8:00-9:00 p.m.
\n", "
5
\n"], ["4987", "
9:00-10:15 p.m.
\n", "
4
\n"], ["4988", "
10:15 p.m.-12:30 a.m.
\n", "
3
\n"], ["4989", "
12:30-1:45 a.m.
\n", "
2
\n"], ["499", "
I wake up several hours earlier than I used to
\n", "
3
\n"], ["4990", "
1:45-3:00 a.m.
\n", "
1
\n"], ["4991", "
8:00-10:00 a.m.
\n", "
4
\n"], ["4992", "
11:00 a.m.-1:00 p.m.
\n", "
3
\n"], ["4993", "
3:00-5:00 p.m.
\n", "
2
\n"], ["4994", "
7:00-9:00 p.m.
\n", "
1
\n"], ["4995", "
Definitely a morning type
\n", "
4
\n"], ["4996", "
More a morning than an evening type
\n", "
3
\n"], ["4997", "
More an evening than a morning type
\n", "
2
\n"], ["4998", "
Definitely an evening type
\n", "
1
\n"], ["4999", "
Before 6:30 a.m.
\n", "
4
\n"], ["5", "
Severe
\n", "
4
\n"], ["50", "
A bird in the hand is worth two in the bush
\n", "
E
\n"], ["500", "
I don't get any more tired than usual.
\n", "
0
\n"], ["5000", "
6:30-7:30 a.m.
\n", "
3
\n"], ["5001", "
7:30-8:30 a.m.
\n", "
2
\n"], ["5002", "
8:30 a.m. or later
\n", "
1
\n"], ["5003", "
Very difficult and unpleasant
\n", "
1
\n"], ["5004", "
Rather difficult and unpleasant
\n", "
2
\n"], ["5005", "
A little unpleasant but no great problem
\n", "
3
\n"], ["5006", "
Easy and not unpleasant
\n", "
4
\n"], ["5007", "
0-10 minutes
\n", "
4
\n"], ["5008", "
11-20 minutes
\n", "
3
\n"], ["5009", "
21-40 minutes
\n", "
2
\n"], ["501", "
I get tired more easily than I used to.
\n", "
1
\n"], ["5010", "
More than 40 minutes
\n", "
1
\n"], ["5011", "
Pronounced morning active (morning alert and evening tired)
\n", "
4
\n"], ["5012", "
To some extent, morning active
\n", "
3
\n"], ["5013", "
To some extent, evening active
\n", "
2
\n"], ["5014", "
Pronounced evening active (morning tired and evening alert)
\n", "
1
\n"], ["5015", "
Never
\n", "
0
\n"], ["5016", "
Once or a few times
\n", "
1
\n"], ["5017", "
Once or twice a week
\n", "
2
\n"], ["5018", "
Daily or almost daily
\n", "
3
\n"], ["5019", "
No
\n", "
0
\n"], ["502", "
I get tired from doing almost anything.
\n", "
2
\n"], ["5020", "
Yes
\n", "
1
\n"], ["5021", "
Never
\n", "
0
\n"], ["5022", "
Once or a few times
\n", "
1
\n"], ["5023", "
Once or twice a week
\n", "
2
\n"], ["5024", "
Daily or almost daily
\n", "
3
\n"], ["5025", "
Not at all
\n", "
0
\n"], ["5026", "
A little
\n", "
1
\n"], ["5027", "
Rather
\n", "
2
\n"], ["5028", "
Much
\n", "
3
\n"], ["5029", "
Very strong
\n", "
4
\n"], ["503", "
I am too tired to do anything.
\n", "
3
\n"], ["5030", "
Not at all
\n", "
0
\n"], ["5031", "
A little
\n", "
1
\n"], ["5032", "
Rather
\n", "
2
\n"], ["5033", "
Much
\n", "
3
\n"], ["5034", "
Very strong
\n", "
4
\n"], ["5035", "
Absent. No signs of item present. Patient is orientated to time place and person.
\n", "
0
\n"], ["5036", "
Mild to moderate. Barely expressed and noticeable through to being present/undeniable. Pt still can provide some orientating information to time, place and/or person.
\n", "
1
\n"], ["5037", "
Moderate to severe. Pt not orientated to time/place; i.e., not able to tell you the date, month, day, year, season, floor, name of hospital, city, state, country.
\n", "
2
\n"], ["5038", "
Absent. No signs of item present.
\n", "
0
\n"], ["5039", "
Mild to moderate. Hyperactivity is barely noticeable or appears as simple restlessness, to undeniable, subject moves frequently.
\n", "
1
\n"], ["504", "
My appetite is no worse than usual.
\n", "
0
\n"], ["5040", "
Moderate to severe. Hyperactivity is severe; patient is constantly moving, overreacts to stimuli, requires surveillance and/or restraint.
\n", "
2
\n"], ["5041", "
Absent. No sign of items present. Patient's speech is coherent and goal-directed.
\n", "
0
\n"], ["5042", "
Mild to moderate. Patient's speech is slightly difficult to follow; responses to questions are slightly off target, to disorganized speech being clearly present.
\n", "
1
\n"], ["5043", "
Mod to severe. Conversation impossible due to disorganized thinking or speech (e.g., irrelevant, incoherent speech, or tangential, circumstantial, or faulty reasoning).
\n", "
2
\n"], ["5044", "
Absent. No sign of items present.
\n", "
0
\n"], ["5045", "
Mild to moderate. Misperceptions or illusions related to sleep, fleeting hallucinations.
\n", "
1
\n"], ["5046", "
Moderate to severe. Frequent or intense illusions or hallucinations that disrupts care, function or is associated with inappropriate behavior.
\n", "
2
\n"], ["5047", "
Absent. No sign of items present.
\n", "
0
\n"], ["5048", "
Mild to moderate. Hypoactivity is barely noticeable, expressed as slightly slowing of movement, to moderate slowing of movements.
\n", "
1
\n"], ["5049", "
Moderate to severe. Hypoactivity is severe; patient does not move or speak without prodding or is catatonic.
\n", "
2
\n"], ["505", "
My appetite is not as good as it used to be.
\n", "
1
\n"], ["5050", "
Zero drinks
\n", "
0
\n"], ["5051", "
One or two drinks
\n", "
0
\n"], ["5052", "
Three or four drinks
\n", "
1
\n"], ["5053", "
Five or six drinks
\n", "
2
\n"], ["5054", "
Seven to nine drinks
\n", "
3
\n"], ["5055", "
Ten or more drinks
\n", "
4
\n"], ["5056", "
Can dress without help of any kind?
\n", "
0
\n"], ["5057", "
Need and get minimal supervision or reminding?
\n", "
1
\n"], ["5058", "
* Need some help from another person to put your clothes on?
\n", "
2
\n"], ["5059", "
* Cannot dress yourself and somebody dresses you?
\n", "
3
\n"], ["506", "
My appetite is much worse now.
\n", "
2
\n"], ["5060", "
* Are never dressed?
\n", "
4
\n"], ["5061", "
Can comb your hair, wash your face, shave or brush your teeth without help of any kind?
\n", "
0
\n"], ["5062", "
Need and get supervision or reminding or grooming activities?
\n", "
1
\n"], ["5063", "
* Needs and get daily help from another person?
\n", "
2
\n"], ["5064", "
* Are completely groomed by somebody else?
\n", "
3
\n"], ["5065", "
Can bathe or shower without any help?
\n", "
0
\n"], ["5066", "
Need and get minimal supervision or reminding?
\n", "
1
\n"], ["5067", "
Need and get supervision only?
\n", "
2
\n"], ["5068", "
Need and get help getting in and out of the tub?
\n", "
3
\n"], ["5069", "
* Need and get help washing and drying your body?
\n", "
4
\n"], ["507", "
I have no appetite at all any more.
\n", "
3
\n"], ["5070", "
* Cannot bathe or shower, need complete help?
\n", "
5
\n"], ["5071", "
Can eat without help of any kind?
\n", "
0
\n"], ["5072", "
Need and get minimal reminding or supervision?
\n", "
1
\n"], ["5073", "
* Need and get help in cutting food, buttering bread or arranging food?
\n", "
2
\n"], ["5074", "
* Need and get some personal help with feeding or someone needs to be sure that you don't choke?
\n", "
3
\n"], ["5075", "
* Need to be fed completely or tube feeding or IV feeding?
\n", "
4
\n"], ["5076", "
Can move in bed without any help?
\n", "
0
\n"], ["5077", "
Need and get help sometimes to sit up?
\n", "
1
\n"], ["5078", "
* Always need and get help to sit up?
\n", "
2
\n"], ["5079", "
* Always need and get help to be turned or change positions?
\n", "
3
\n"], ["508", "
I haven't lost much weight, if any, lately.
\n", "
0
\n"], ["5080", "
Can get in and out of a bed or chair without help of any kind?
\n", "
0
\n"], ["5081", "
Need somebody to be there to guide you but can move in and out of a bed or chair?
\n", "
1
\n"], ["5082", "
* Need one other person to help you?
\n", "
2
\n"], ["5083", "
* Need two other people or a mechanical aid to help you?
\n", "
3
\n"], ["5084", "
* Never get out of a bed or chair?
\n", "
4
\n"], ["5085", "
Walk without help of any kind?
\n", "
0
\n"], ["5086", "
Can walk with help of a cane, walker, crutch, or push wheelchair?
\n", "
1
\n"], ["5087", "
* Need and get help from one person to help you walk?
\n", "
2
\n"], ["5088", "
* Need and get help from two people to help you walk?
\n", "
3
\n"], ["5089", "
* Cannot walk at all?
\n", "
4
\n"], ["509", "
I have lost more than 5 pounds.
\n", "
1
\n"], ["5090", "
Behavior requires no intervention.
\n", "
0
\n"], ["5091", "
Occasional staff intervention / anxious, irritable, lethargic, demanding / responds to cues.
\n", "
1
\n"], ["5092", "
* Regular staff intervention / disorientation, hallucinates, wanders / resistive but responds.
\n", "
2
\n"], ["5093", "
* Behavior management / disruptive behavior / may be resistant to redirection.
\n", "
3
\n"], ["5094", "
* Behavior management / physically abusive to self and others / may physically resist.
\n", "
4
\n"], ["5095", "
Understood?
\n", "
0
\n"], ["5096", "
Usually Understood?
\n", "
1
\n"], ["5097", "
Sometimes Understood?
\n", "
2
\n"], ["5098", "
Rarely/Never Understood?
\n", "
3
\n"], ["5099", "
Can use the toilet without help, including adjusting clothing?
\n", "
0
\n"], ["51", "", "
A
\n"], ["510", "
I have lost more than 10 pounds.
\n", "
2
\n"], ["5100", "
* Need some help to get to and on the toilet but don't have accidents?
\n", "
1
\n"], ["5101", "
* Have accidents sometimes, but not more than once a week?
\n", "
2
\n"], ["5102", "
* Only have accidents at night?
\n", "
3
\n"], ["5103", "
* Have accidents more than once a week?
\n", "
4
\n"], ["5104", "
* Have bowel movements in your clothes more than once a week?
\n", "
5
\n"], ["5105", "
* Wet your pants and have bowel movements in your clothes very often?
\n", "
6
\n"], ["5106", "
* Are enrolled in VA Bowel and Bladder Program?
\n", "
7
\n"], ["5107", "
Independent - decisions consistent/reasonable.
\n", "
0
\n"], ["5108", "
Modified Independence - some difficulty in new situations only.
\n", "
1
\n"], ["5109", "
Moderately Impaired - decisions poor; cues/supervision required.
\n", "
2
\n"], ["511", "
I have lost more than 15 pounds.
\n", "
3
\n"], ["5110", "
Severely Impaired - never/rarely made decisions.
\n", "
3
\n"], ["5111", "
Short-term memory okay- seems/appears to recall after 5 minutes
\n", "
0
\n"], ["5112", "
Memory problem
\n", "
1
\n"], ["5113", "
No TX
\n", "
0
\n"], ["5114", "
Tube Feedings
\n", "
1
\n"], ["5115", "
One or more TX such as:
\n", "
2
\n"], ["5116", "
Intravenous Fluid
\n", "
0
\n"], ["5117", "
Intravenous Medications
\n", "
0
\n"], ["5118", "
Drainage Tubes
\n", "
0
\n"], ["5119", "
Symptom Control for Terminal Illness
\n", "
0
\n"], ["512", "
Yes
\n", "
Y
\n"], ["5120", "
Isolation Precautions
\n", "
0
\n"], ["5121", "
Hyperalimentation/Hickman Catheter
\n", "
0
\n"], ["5122", "
Oxygen & Respiratory Therapy
\n", "
0
\n"], ["5123", "
Ostomies & Catheters
\n", "
0
\n"], ["5124", "
Wound Care/Decubiti
\n", "
0
\n"], ["5125", "
Skin Care
\n", "
0
\n"], ["5126", "
Other
\n", "
0
\n"], ["5127", "
Less than once a day
\n", "
0
\n"], ["5128", "
1-2 shifts a day
\n", "
1
\n"], ["5129", "
All shifts
\n", "
2
\n"], ["513", "
No
\n", "
N
\n"], ["5130", "
Yes
\n", "
1
\n"], ["5131", "
No
\n", "
0
\n"], ["5132", "
Yes
\n", "
1
\n"], ["5133", "
No
\n", "
0
\n"], ["5134", "
Person
\n", "
0
\n"], ["5135", "
Informant
\n", "
0
\n"], ["5136", "
Medical Record
\n", "
0
\n"], ["5137", "
Observation
\n", "
0
\n"], ["514", "
I am no more worried about my health than usual.
\n", "
0
\n"], ["5144", "
Click here to acknowledge you've read this statement.
\n", "
0
\n"], ["5145", "
1 (Low)
\n", "
1
\n"], ["5146", "", "
2
\n"], ["5147", "", "
3
\n"], ["5148", "", "
4
\n"], ["5149", "
5 (High)
\n", "
5
\n"], ["515", "
I am worried about physical problems such as aches and pains;
\n", "
1
\n"], ["5150", "
1 (Not so good)
\n", "
1
\n"], ["5151", "", "
2
\n"], ["5152", "", "
3
\n"], ["5153", "", "
4
\n"], ["5154", "
5 (Great)
\n", "
5
\n"], ["5155", "
Initial
\n", "
0
\n"], ["5156", "
6 month
\n", "
0
\n"], ["5157", "
Annual
\n", "
0
\n"], ["5158", "
Change in level of care
\n", "
0
\n"], ["5159", "
Less than 90 days
\n", "
0
\n"], ["516", "
I am very worried about physical problems and it's hard to
\n", "
2
\n"], ["5160", "
3 months
\n", "
0
\n"], ["5161", "
6 months
\n", "
0
\n"], ["5162", "
12 months
\n", "
0
\n"], ["5163", "
Without any difficulty
\n", "
5
\n"], ["5164", "
With a little difficulty
\n", "
4
\n"], ["5165", "
With some difficulty
\n", "
3
\n"], ["5166", "
With much difficulty
\n", "
2
\n"], ["5167", "
Unable to do
\n", "
1
\n"], ["5168", "
Never
\n", "
1
\n"], ["5169", "
Rarely
\n", "
2
\n"], ["517", "
I am so worried about my physical problems that I cannot think
\n", "
3
\n"], ["5170", "
Sometimes
\n", "
3
\n"], ["5171", "
Often
\n", "
4
\n"], ["5172", "
Always
\n", "
5
\n"], ["5173", "
Not at all
\n", "
1
\n"], ["5174", "
A little bit
\n", "
2
\n"], ["5175", "
Somewhat
\n", "
3
\n"], ["5176", "
Quite a bit
\n", "
4
\n"], ["5177", "
Very much
\n", "
5
\n"], ["5178", "
Very Poor
\n", "
5
\n"], ["5179", "
Poor
\n", "
4
\n"], ["518", "
I have not noticed any recent change in my interest in sex.
\n", "
0
\n"], ["5180", "
Fair
\n", "
3
\n"], ["5181", "
Good
\n", "
2
\n"], ["5182", "
Very good
\n", "
1
\n"], ["5183", "
Not at all
\n", "
5
\n"], ["5184", "
A little bit
\n", "
4
\n"], ["5185", "
Somewhat
\n", "
3
\n"], ["5186", "
Quite a bit
\n", "
2
\n"], ["5187", "
Very much
\n", "
1
\n"], ["5188", "
Never
\n", "
5
\n"], ["5189", "
Rarely
\n", "
4
\n"], ["519", "
I am less interested in sex than I used to be.
\n", "
1
\n"], ["5190", "
Sometimes
\n", "
3
\n"], ["5191", "
Usually
\n", "
2
\n"], ["5192", "
Always
\n", "
1
\n"], ["5193", "
0 - No pain
\n", "
0
\n"], ["5194", "", "
1
\n"], ["5195", "", "
2
\n"], ["5196", "", "
3
\n"], ["5197", "", "
4
\n"], ["5198", "", "
5
\n"], ["5199", "", "
6
\n"], ["52", "", "
B
\n"], ["520", "
I am much less interested in sex now.
\n", "
2
\n"], ["5200", "", "
7
\n"], ["5201", "", "
8
\n"], ["5202", "", "
9
\n"], ["5203", "
10 - Worst pain imaginable
\n", "
10
\n"], ["5204", "
Strongly Disagree
\n", "
0
\n"], ["5205", "
Somewhat Disagree
\n", "
1
\n"], ["5206", "
Unsure
\n", "
2
\n"], ["5207", "
Somewhat Agree
\n", "
3
\n"], ["5208", "
Strongly Agree
\n", "
4
\n"], ["5209", "
Strongly Disagree
\n", "
4
\n"], ["521", "
I have lost interest in sex completely.
\n", "
3
\n"], ["5210", "
Somewhat Disagree
\n", "
3
\n"], ["5211", "
Unsure
\n", "
2
\n"], ["5212", "
Somewhat Agree
\n", "
1
\n"], ["5213", "
Strongly Agree
\n", "
0
\n"], ["5214", "
not at all true of me
\n", "
1
\n"], ["5215", "
slightly true
\n", "
2
\n"], ["5216", "
moderately true
\n", "
3
\n"], ["5217", "
very true
\n", "
4
\n"], ["5218", "
extremely true of me
\n", "
5
\n"], ["5219", "
0 (Not at All)
\n", "
0
\n"], ["522", "
I do not feel sad.
\n", "
0
\n"], ["5220", "", "
1
\n"], ["5221", "", "
2
\n"], ["5222", "
3 (Somewhat)
\n", "
3
\n"], ["5223", "", "
4
\n"], ["5224", "", "
5
\n"], ["5225", "
6 (Very Much)
\n", "
6
\n"], ["5226", "
7 -- Not Applicable in the Past 30 Days
\n", "
99
\n"], ["523", "
I feel sad much of the time.
\n", "
1
\n"], ["524", "
I am sad all the time.
\n", "
2
\n"], ["5244", "
Strongly disagree
\n", "
0
\n"], ["5245", "
Neutral
\n", "
5
\n"], ["5246", "
Strongly agree
\n", "
10
\n"], ["5247", "
Not a barrier
\n", "
1
\n"], ["5248", "
Neutral
\n", "
3
\n"], ["5249", "
Strong barrier
\n", "
5
\n"], ["525", "
I am so sad or unhappy that I can't stand it.
\n", "
3
\n"], ["5250", "
0%
\n", "
0
\n"], ["5251", "
10%
\n", "
10
\n"], ["5252", "
20%
\n", "
20
\n"], ["5253", "
30%
\n", "
30
\n"], ["5254", "
40%
\n", "
40
\n"], ["5255", "
50%
\n", "
50
\n"], ["5256", "
60%
\n", "
60
\n"], ["5257", "
70%
\n", "
70
\n"], ["5258", "
80%
\n", "
80
\n"], ["5259", "
90%
\n", "
90
\n"], ["526", "
I am not discouraged about my future.
\n", "
0
\n"], ["5260", "
100%
\n", "
100
\n"], ["5261", "
Declined to answer
\n", ""], ["5262", "
Never
\n", "
0
\n"], ["5263", "
Rarely
\n", "
2
\n"], ["5264", "
Sometimes
\n", "
3
\n"], ["5265", "
Often
\n", "
4
\n"], ["5266", "
Very Often
\n", "
5
\n"], ["5267", "
Never
\n", "
0
\n"], ["5268", "
Rarely
\n", "
2
\n"], ["5269", "
Sometimes
\n", "
3
\n"], ["527", "
I feel more discouraged about my future than I used to be.
\n", "
1
\n"], ["5270", "
Often
\n", "
4
\n"], ["5271", "
Very Often
\n", "
5
\n"], ["5272", "
Never
\n", "
0
\n"], ["5273", "
Rarely
\n", "
3
\n"], ["5274", "
Sometimes
\n", "
4
\n"], ["5275", "
Often
\n", "
5
\n"], ["5276", "
Very Often
\n", "
6
\n"], ["5277", "
Never
\n", "
0
\n"], ["5278", "
Rarely
\n", "
0
\n"], ["5279", "
Sometimes
\n", "
0
\n"], ["528", "
I do not expect things to work out for me.
\n", "
2
\n"], ["5280", "
Often
\n", "
1
\n"], ["5281", "
Very Often
\n", "
2
\n"], ["5282", "
Never
\n", "
0
\n"], ["5283", "
Rarely
\n", "
1
\n"], ["5284", "
Sometimes
\n", "
2
\n"], ["5285", "
Often
\n", "
3
\n"], ["5286", "
Very Often
\n", "
4
\n"], ["5287", "
Never
\n", "
0
\n"], ["5288", "
Rarely
\n", "
0
\n"], ["5289", "
Sometimes
\n", "
1
\n"], ["529", "
I feel my future is hopeless and will only get worse.
\n", "
3
\n"], ["5290", "
Often
\n", "
2
\n"], ["5291", "
Very Often
\n", "
3
\n"], ["5292", "
None or almost none of the time
\n", "
1
\n"], ["5293", "
A little of the time
\n", "
2
\n"], ["5294", "
Some of the time
\n", "
3
\n"], ["5295", "
Most of the time
\n", "
4
\n"], ["5296", "
All or almost all of the time
\n", "
5
\n"], ["5297", "
0 (No days)
\n", "
0
\n"], ["5298", "
1 (1-5 days)
\n", "
1
\n"], ["5299", "
2 (6-12 days)
\n", "
2
\n"], ["53", "", "
C
\n"], ["530", "
I do not feel like a failure.
\n", "
0
\n"], ["5300", "
3 (13-15 days)
\n", "
3
\n"], ["5301", "
4 (16-22 days)
\n", "
4
\n"], ["5302", "
5 (23-27 days)
\n", "
5
\n"], ["5303", "
6 (Every day)
\n", "
6
\n"], ["5304", "
0 (None of the times)
\n", "
0
\n"], ["5305", "
1 (A few of the times)
\n", "
1
\n"], ["5306", "
2 (Less than half)
\n", "
2
\n"], ["5307", "
3 (Half of the times)
\n", "
3
\n"], ["5308", "
4 (More than half)
\n", "
4
\n"], ["5309", "
5 (Most of the time)
\n", "
5
\n"], ["531", "
I have failed more than I should have.
\n", "
1
\n"], ["5310", "
6 (Every time)
\n", "
6
\n"], ["5311", "
0 (Not at all)
\n", "
0
\n"], ["5312", "", "
1
\n"], ["5313", "
2 (Slightly)
\n", "
2
\n"], ["5314", "", "
3
\n"], ["5315", "
4 (Moderately)
\n", "
4
\n"], ["5316", "", "
5
\n"], ["5317", "
6 (Markedly)
\n", "
6
\n"], ["5318", "
Yes
\n", "
1
\n"], ["5319", "
No
\n", "
0
\n"], ["532", "
As I look back, I see a lot of failures.
\n", "
2
\n"], ["5320", "
Not applicable
\n", "
2
\n"], ["5321", "
Not at all
\n", "
0
\n"], ["5322", "
A little
\n", "
1
\n"], ["5323", "
Quite a bit
\n", "
2
\n"], ["5324", "
A lot
\n", "
3
\n"], ["533", "
I feel I am a total failure as a person.
\n", "
3
\n"], ["5330", "
UNSCORED - Patient not interested in activity
\n", "
0
\n"], ["5331", "
NOT difficult
\n", "
1
\n"], ["5332", "
SLIGHTLY/MODERATELY difficult
\n", "
2
\n"], ["5333", "
EXTREMELY difficult
\n", "
3
\n"], ["5334", "
IMPOSSIBLE
\n", "
4
\n"], ["5335", "
1 No difficulty, either subjectively or objectively.
\n", "
1
\n"], ["5336", "
2 Complains of forgetting location of objects. Subjective work difficulties.
\n", "
2
\n"], ["5337", "
3 Decreased job functioning evident to co-workers. Difficulty in traveling to new locations. Decreased organizational capacity.
\n", "
3
\n"], ["5338", "
4 Decreased ability to perform complex tasks, e.g. planning dinner for guests, handling personal finances (such as forgetting to pay bills), difficulty marketing, etc.
\n", "
4
\n"], ["5339", "
5 Requires assistance in choosing proper clothing to wear for the day, season, or occasion, e.g. patient may wear the same clothing repeatedly, unless supervised.
\n", "
5
\n"], ["534", "
I get as much pleasure as I ever did from the things I enjoy.
\n", "
0
\n"], ["5340", "
6a Improperly putting on clothes without assistance or cuing (e.g. may put street clothes on over night clothes, or put shoes on wrong feet, or have difficulty buttoning clothing) occasionally or more frequently over the past weeks.
\n", "
6
\n"], ["5341", "
6b Unable to bathe (shower) properly (e.g., difficulty adjusting bath-water (shower) temperature) occasionally or more frequently over the past weeks.
\n", "
6
\n"], ["5342", "
6c Inability to handle mechanics of toileting (e.g., forgets to flush the toilet, does not wipe properly or properly dispose of toilet tissue) occasionally or more frequently over the past weeks.
\n", "
6
\n"], ["5343", "
6d Urinary incontinence (occasionally or more frequently over the past weeks).
\n", "
6
\n"], ["5344", "
6e Fecal incontinence (occasionally or more frequently over the past weeks).
\n", "
6
\n"], ["5345", "
7a Ability to speak limited to approximately a half a dozen intelligible different words or fewer, in the course of an average day or in the course of an intensive interview.
\n", "
7
\n"], ["5346", "
7b Speech ability limited to the use of a single intelligible word in an average day or in the course of an interview (the person may repeat the word over and over).
\n", "
7
\n"], ["5347", "
7c Ambulatory ability lost (cannot walk without personal assistance).
\n", "
7
\n"], ["5348", "
7d Cannot sit up without assistance (e.g., the individual will fall over if there are no lateral rests [arms] on the chair).
\n", "
7
\n"], ["5349", "
7e Loss of ability to smile.
\n", "
7
\n"], ["535", "
I don't enjoy things as much as I used to.
\n", "
1
\n"], ["5350", "
7f Loss of ability to hold up head independently.
\n", "
7
\n"], ["5351", "
Excellent
\n", "
5
\n"], ["5352", "
Very Good
\n", "
4
\n"], ["5353", "
Good
\n", "
3
\n"], ["5354", "
Fair
\n", "
2
\n"], ["5355", "
Poor
\n", "
1
\n"], ["5356", "
Completely
\n", "
5
\n"], ["5357", "
Mostly
\n", "
4
\n"], ["5358", "
Moderately
\n", "
3
\n"], ["5359", "
A little
\n", "
2
\n"], ["536", "
I get very little pleasure from the things I used to enjoy.
\n", "
2
\n"], ["5360", "
Not At All
\n", "
1
\n"], ["5361", "
Never
\n", "
5
\n"], ["5362", "
Rarely
\n", "
4
\n"], ["5363", "
Sometimes
\n", "
3
\n"], ["5364", "
Often
\n", "
2
\n"], ["5365", "
Always
\n", "
1
\n"], ["5366", "
None
\n", "
5
\n"], ["5367", "
Mild
\n", "
4
\n"], ["5368", "
Moderate
\n", "
3
\n"], ["5369", "
Severe
\n", "
2
\n"], ["537", "
I can't get any pleasure from the things I used to enjoy.
\n", "
3
\n"], ["5370", "
Very Severe
\n", "
1
\n"], ["5371", "
No Pain
\n", "
10
\n"], ["5372", "
Worst Pain Imaginable
\n", "
0
\n"], ["5373", "
Never
\n", "
0
\n"], ["5374", "
Once
\n", "
1
\n"], ["5375", "
A few times
\n", "
2
\n"], ["5376", "
Everyday
\n", "
3
\n"], ["5377", "
not at all
\n", "
1
\n"], ["5378", "
very much
\n", "
10
\n"], ["5379", "
No
\n", "
0
\n"], ["538", "
I don't feel particularly guilty.
\n", "
0
\n"], ["5380", "
Yes
\n", "
3
\n"], ["539", "
I feel guilty over many things I have done or should have done.
\n", "
1
\n"], ["54", "", "
D
\n"], ["540", "
I feel quite guilty most of the time.
\n", "
2
\n"], ["541", "
I feel guilty all of the time.
\n", "
3
\n"], ["542", "
I don't feel I am being punished.
\n", "
0
\n"], ["543", "
I feel I may be punished.
\n", "
1
\n"], ["544", "
I expect to be punished.
\n", "
2
\n"], ["545", "
I feel I am being punished.
\n", "
3
\n"], ["546", "
I feel the same about myself as ever.
\n", "
0
\n"], ["5461", "
Never
\n", "
0
\n"], ["5462", "
Sometimes
\n", "
1
\n"], ["5463", "
Often
\n", "
2
\n"], ["5464", "
Always
\n", "
3
\n"], ["5465", "
Never
\n", "
0
\n"], ["5466", "
Sometimes
\n", "
1
\n"], ["5467", "
Often
\n", "
2
\n"], ["5468", "
Always
\n", "
3
\n"], ["547", "
I have lost confidence in myself.
\n", "
1
\n"], ["548", "
I am disappointed in myself.
\n", "
2
\n"], ["549", "
I dislike myself.
\n", "
3
\n"], ["5490", "
Not Applicable
\n", "
0
\n"], ["5491", "
Yes
\n", "
1
\n"], ["5492", "
No
\n", "
0
\n"], ["5493", "
(A) Did something (or failed to do something) that went against your moral code or values.
\n", "
1
\n"], ["5494", "
(B) You saw someone (or people) do something or fail to do something that went against your moral code or values.
\n", "
2
\n"], ["5495", "
(C) You were directly affected by someone doing something or failing to do something that went against your moral code or values (e.g., being betrayed by someone you trusted).
\n", "
3
\n"], ["5496", "
Strongly Disagree
\n", "
0
\n"], ["5497", "
Disagree
\n", "
1
\n"], ["5498", "
Neither Agree or Disagree
\n", "
2
\n"], ["5499", "
Agree
\n", "
3
\n"], ["55", "", "
E
\n"], ["550", "
I don't criticize or blame myself more than usual.
\n", "
0
\n"], ["5500", "
Strongly Agree
\n", "
4
\n"], ["5501", "
0 (Not at all)
\n", "
0
\n"], ["5502", "", "
1
\n"], ["5503", "", "
2
\n"], ["5504", "
3 (Somewhat)
\n", "
3
\n"], ["5505", "", "
4
\n"], ["5506", "", "
5
\n"], ["5507", "
6 (Very Much)
\n", "
6
\n"], ["5508", "
7 -- Not applicable
\n", "
99
\n"], ["5509", "
no pain at all
\n", "
0
\n"], ["551", "
I am more critical of myself than I used to be.
\n", "
1
\n"], ["5510", "
pain as bad as it can be
\n", "
10
\n"], ["5511", "
never
\n", "
6
\n"], ["5512", "
rarely
\n", "
8
\n"], ["5513", "
sometimes
\n", "
10
\n"], ["5514", "
very often
\n", "
11
\n"], ["5515", "
always
\n", "
13
\n"], ["552", "
I criticize myself for all my faults.
\n", "
2
\n"], ["553", "
I blame myself for everything bad that happens.
\n", "
3
\n"], ["5531", "
1 (Strongly Disagree)
\n", "
1
\n"], ["5532", "", "
2
\n"], ["5533", "", "
3
\n"], ["5534", "
4 (Neither Agree Nor Disagree)
\n", "
4
\n"], ["5535", "", "
5
\n"], ["5536", "", "
6
\n"], ["5537", "
7 (Strongly Agree)
\n", "
7
\n"], ["5538", "
Yes
\n", "
1
\n"], ["5539", "
No
\n", "
0
\n"], ["554", "
I don't have any thoughts of killing myself.
\n", "
0
\n"], ["5540", "
None; no problem
\n", "
0
\n"], ["5541", "
Mild problem; does not affect daily life
\n", "
1
\n"], ["5542", "
Moderate problem; affects daily life to a certain extent
\n", "
2
\n"], ["5543", "
Severe problem; affects all aspects of daily life; life-disturbing
\n", "
3
\n"], ["5544", "
None; no problem
\n", "
0
\n"], ["5545", "
Mild problem; does not affect daily life
\n", "
1
\n"], ["5546", "
Moderate problem; affects daily life to a certain extent
\n", "
2
\n"], ["5547", "
Severe problem; affects all aspects of daily life; life-disturbing
\n", "
3
\n"], ["5548", "
Don't know
\n", "
4
\n"], ["5549", "
Fever
\n", ""], ["555", "
I have thoughts of killing myself, but I would not carry them out.
\n", "
1
\n"], ["5550", "
Skin rash / discoloration of skin
\n", ""], ["5551", "
New allergy such as medication, food etc.
\n", ""], ["5552", "
Hair loss
\n", ""], ["5553", "
Skin sensation (numbness / tingling / itching / nerve pain)
\n", ""], ["5554", "
Dry eyes / redness of eyes
\n", ""], ["5555", "
Swelling of feet / swelling of hands
\n", ""], ["5556", "
Easy bruising / bleeding
\n", ""], ["5557", "
Visual changes
\n", ""], ["5558", "
Difficulty swallowing solids
\n", ""], ["5559", "
Difficulty swallowing liquids
\n", ""], ["556", "
I would like to kill myself.
\n", "
2
\n"], ["5560", "
Balance problems or falls
\n", ""], ["5561", "
Weakness or movement problems or coordination problems in limbs
\n", ""], ["5562", "
Tinnitus
\n", ""], ["5563", "
Nausea
\n", ""], ["5564", "
Dry mouth / mouth ulcers
\n", ""], ["5565", "
Acid Reflux / heartburn
\n", ""], ["5566", "
Change in appetite
\n", ""], ["5567", "
Unintentional weight loss
\n", ""], ["5568", "
Unintentional weight gain
\n", ""], ["5569", "
Bladder frequency, urgency or incontinence
\n", ""], ["557", "
I would kill myself if I had the chance.
\n", "
3
\n"], ["5570", "
Constipation, diarrhea or bowel incontinence
\n", ""], ["5571", "
Change in menstrual cycles or flow
\n", ""], ["5572", "
Waking up at night gasping for air (also called sleep apnea)
\n", ""], ["5573", "
Thoughts about harming yourself
\n", ""], ["5574", "
WORST HEALTH
\n", "
0
\n"], ["5575", "
BEST HEALTH
\n", "
10
\n"], ["5576", "
No change
\n", ""], ["5577", "
On reduced working hours
\n", ""], ["5578", "
On sickness leave
\n", ""], ["5579", "
Changes made to role / working arrangements (such as working from home or lighter duties)
\n", ""], ["558", "
I don't cry anymore than I used to.
\n", "
0
\n"], ["5580", "
Had to retire / change job
\n", ""], ["5581", "
Lost job
\n", ""], ["5582", "
I have no problems walking
\n", "
1
\n"], ["5583", "
I have slight problems walking
\n", "
2
\n"], ["5584", "
I have moderate problems walking
\n", "
3
\n"], ["5585", "
I have severe problems walking
\n", "
4
\n"], ["5586", "
I am unable to walk
\n", "
5
\n"], ["5587", "
I have no problems washing or dressing myself
\n", "
1
\n"], ["5588", "
I have slight problems washing or dressing myself
\n", "
2
\n"], ["5589", "
I have moderate problems washing or dressing myself
\n", "
3
\n"], ["559", "
I cry more than I used to.
\n", "
1
\n"], ["5590", "
I have severe problems washing or dressing myself
\n", "
4
\n"], ["5591", "
I am unable to wash or dress myself
\n", "
5
\n"], ["5592", "
I have no problems doing my usual activities
\n", "
1
\n"], ["5593", "
I have slight problems doing my usual activities
\n", "
2
\n"], ["5594", "
I have moderate problems doing my usual activities
\n", "
3
\n"], ["5595", "
I have severe problems doing my usual activities
\n", "
4
\n"], ["5596", "
I am unable to do my usual activities
\n", "
5
\n"], ["5597", "
I have no pain or discomfort
\n", "
1
\n"], ["5598", "
I have slight pain or discomfort
\n", "
2
\n"], ["5599", "
I have moderate pain or discomfort
\n", "
3
\n"], ["56", "
Grief
\n", "
A
\n"], ["560", "
I cry over every little thing.
\n", "
2
\n"], ["5600", "
I have severe pain or discomfort
\n", "
4
\n"], ["5601", "
I have extreme pain or discomfort
\n", "
5
\n"], ["5602", "
I am not anxious or depressed
\n", "
1
\n"], ["5603", "
I am slightly anxious or depressed
\n", "
2
\n"], ["5604", "
I am moderately anxious or depressed
\n", "
3
\n"], ["5605", "
I am severely anxious or depressed
\n", "
4
\n"], ["5606", "
I am extremely anxious or depressed
\n", "
5
\n"], ["5607", "
Yes
\n", "
0
\n"], ["5608", "
No
\n", "
4
\n"], ["5609", "
Yes
\n", "
3
\n"], ["561", "
I feel like crying, but I can't.
\n", "
3
\n"], ["5610", "
No
\n", "
0
\n"], ["5611", "
Yes
\n", "
0
\n"], ["5612", "
No
\n", "
0
\n"], ["5613", "
Yes
\n", "
2
\n"], ["5614", "
No
\n", "
1
\n"], ["562", "
I am no more restless or wound up than usual.
\n", "
0
\n"], ["563", "
I feel more restless or wound up than usual.
\n", "
1
\n"], ["564", "
I am so restless or agitated that it sometimes hard to stay still.
\n", "
2
\n"], ["565", "
I am so restless or agitated that I have to keep moving or doing something.
\n", "
3
\n"], ["5654", "
Yes
\n", "
1
\n"], ["5655", "
No
\n", "
0
\n"], ["5656", "
No problems
\n", "
0
\n"], ["5657", "
Minor problem
\n", "
1
\n"], ["5658", "
Moderate problem
\n", "
2
\n"], ["5659", "
Serious problem
\n", "
3
\n"], ["566", "
I have not lost interest in other people or activities.
\n", "
0
\n"], ["567", "
I am less interested in other people or things than before.
\n", "
1
\n"], ["5671", "
No pain
\n", "
0
\n"], ["5672", "
Pain as bad as you can imagine
\n", "
10
\n"], ["5673", "
Does not interfere
\n", "
0
\n"], ["5674", "
Unable to carry on any activities
\n", "
10
\n"], ["5675", "
Does not interfere
\n", "
0
\n"], ["5676", "
Completely interferes
\n", "
10
\n"], ["5677", "
Never
\n", "
1
\n"], ["5678", "
Less than once a week
\n", "
2
\n"], ["5679", "
Once or several times a week
\n", "
3
\n"], ["568", "
I have lost most of my interest in other people or things.
\n", "
2
\n"], ["5680", "
Once or several times a day
\n", "
4
\n"], ["5681", "
A few times an hour or continuous for half an hour or more
\n", "
5
\n"], ["5682", "", "
1
\n"], ["5683", "", "
2
\n"], ["5684", "", "
3
\n"], ["5685", "", "
4
\n"], ["5686", "", "
5
\n"], ["5687", "", "
6
\n"], ["5688", "
Not at all confident
\n", "
0
\n"], ["5689", "
Completely confident
\n", "
6
\n"], ["569", "
It's hard to get interested in anything.
\n", "
3
\n"], ["5690", "
Yes
\n", "
1
\n"], ["5691", "
No
\n", "
0
\n"], ["5692", "
Mild (noticeable, but not a significant change)
\n", "
1
\n"], ["5693", "
Moderate (significant, but not a dramatic change)
\n", "
2
\n"], ["5694", "
Severe (very marked or prominent, a dramatic change)
\n", "
3
\n"], ["5695", "
Not distressing at all
\n", "
0
\n"], ["5696", "
Minimal (slightly distressing, not a problem to cope with)
\n", "
1
\n"], ["5697", "
Mild (not very distressing, generally easy to cope with)
\n", "
2
\n"], ["5698", "
Moderate (fairly distressing, not always easy to cope with)
\n", "
3
\n"], ["5699", "
Severe (very distressing, difficult to cope with)
\n", "
4
\n"], ["57", "
Success
\n", "
B
\n"], ["570", "
I make decisions about as well as ever.
\n", "
0
\n"], ["5700", "
Extreme or Very Severe (extremely distressing, unable to cope with)
\n", "
5
\n"], ["5707", "
None
\n", "
0
\n"], ["5708", "
Mild
\n", "
1
\n"], ["5709", "
Moderate
\n", "
2
\n"], ["571", "
I find it more difficult to make decisions than usual.
\n", "
1
\n"], ["5710", "
Severe
\n", "
3
\n"], ["5711", "
Extreme
\n", "
4
\n"], ["5712", "
None
\n", "
0
\n"], ["5713", "
Once
\n", "
1
\n"], ["5714", "
Two to three times
\n", "
2
\n"], ["5715", "
Several to many times
\n", "
3
\n"], ["5716", "
Constant or near constant
\n", "
4
\n"], ["5717", "
None
\n", "
0
\n"], ["5718", "
1 hr or less
\n", "
1
\n"], ["5719", "
1-7 hr
\n", "
2
\n"], ["572", "
I have much greater difficulty in making decisions than I used to.
\n", "
2
\n"], ["5720", "
7-21 hr
\n", "
3
\n"], ["5721", "
Over 21 hr
\n", "
4
\n"], ["5722", "
Complete
\n", "
0
\n"], ["5723", "
Much
\n", "
1
\n"], ["5724", "
Minimal
\n", "
3
\n"], ["5725", "
No control
\n", "
4
\n"], ["5726", "
None
\n", "
0
\n"], ["5727", "
Once
\n", "
1
\n"], ["5728", "
Two to four times
\n", "
2
\n"], ["5729", "
Several to many times
\n", "
3
\n"], ["573", "
I have trouble making any decisions.
\n", "
3
\n"], ["5730", "
Constantly or near constantly
\n", "
4
\n"], ["5731", "
None
\n", "
0
\n"], ["5732", "
1 hr or less
\n", "
1
\n"], ["5733", "
1-7 hr
\n", "
2
\n"], ["5734", "
7-21 hr
\n", "
3
\n"], ["5735", "
over 21 hr
\n", "
4
\n"], ["5736", "
Moderate
\n", "
2
\n"], ["574", "
I do not feel I am worthless.
\n", "
0
\n"], ["5742", "
None
\n", "
0
\n"], ["5743", "
2 hr or less
\n", "
1
\n"], ["5744", "
2-7 hr
\n", "
2
\n"], ["5745", "
7-21 hr
\n", "
3
\n"], ["5746", "
over 21 hr
\n", "
4
\n"], ["5747", "
None
\n", "
0
\n"], ["5748", "
Minimal
\n", "
1
\n"], ["5749", "
Moderate
\n", "
2
\n"], ["575", "
I don't consider myself as worthwhile and useful as I used to.
\n", "
1
\n"], ["5750", "
Much
\n", "
3
\n"], ["5751", "
Extreme
\n", "
4
\n"], ["5755", "
Complete
\n", "
0
\n"], ["5756", "
Much
\n", "
1
\n"], ["5757", "
Moderate
\n", "
2
\n"], ["5758", "
Minimal
\n", "
3
\n"], ["5759", "
None
\n", "
4
\n"], ["576", "
I feel more worthless as compared to other people.
\n", "
2
\n"], ["5760", "
Yes
\n", "
1
\n"], ["5761", "
No
\n", "
0
\n"], ["5762", "
Yes
\n", "
1
\n"], ["5763", "
No
\n", "
0
\n"], ["5764", "
Not at all
\n", "
0
\n"], ["5765", "
A little bit
\n", "
1
\n"], ["5766", "
Moderately
\n", "
2
\n"], ["5767", "
Quite a bit
\n", "
3
\n"], ["5768", "
Extremely
\n", "
4
\n"], ["5769", "", "
0
\n"], ["577", "
I feel utterly worthless.
\n", "
3
\n"], ["5770", "", "
1
\n"], ["5771", "", "
2
\n"], ["5772", "", "
3
\n"], ["5773", "", "
4
\n"], ["5774", "", "
5
\n"], ["5775", "", "
6
\n"], ["5776", "", "
7
\n"], ["5777", "", "
8
\n"], ["5778", "", "
9
\n"], ["5779", "", "
10
\n"], ["578", "
I have as much energy as ever.
\n", "
0
\n"], ["5780", "
Absent
\n", "
0
\n"], ["5781", "
Mild - Expresses some sadness or discouragement on questioning.
\n", "
1
\n"], ["5782", "
Moderate - Distinct depressed mood persisting up to half the time over last two weeks: present daily.
\n", "
2
\n"], ["5783", "
Severe - Markedly depressed mood persisting daily over half the time interfering with normal motor and social functioning.
\n", "
3
\n"], ["5784", "
Absent
\n", "
0
\n"], ["5785", "
Mild - Has at times felt hopeless over the last two weeks but still has some degree of hope for the future.
\n", "
1
\n"], ["5786", "
Moderate - Persistent, moderate sense of hopelessness over the last two weeks. Can be persuaded to acknowledge possibility of things being better.
\n", "
2
\n"], ["5787", "
Severe - Persisting and distressing sense of hopelessness.
\n", "
3
\n"], ["5788", "
Absent
\n", "
0
\n"], ["5789", "
Mild - Some inferiority; not amounting to feeling of worthlessness.
\n", "
1
\n"], ["579", "
I have less energy than I used to have.
\n", "
1
\n"], ["5790", "
Moderate - Subject feels worthless, but less than 50% of the time.
\n", "
2
\n"], ["5791", "
Severe - Subject feels worthless more than 50% of the time. May be challenged to acknowledge otherwise.
\n", "
3
\n"], ["5792", "
Absent
\n", "
0
\n"], ["5793", "
Mild - Subject feels blamed but not accused less than 50% of the time.
\n", "
1
\n"], ["5794", "
Moderate - Persisting sense of being blamed, and/or occasional sense of being accused.
\n", "
2
\n"], ["5795", "
Severe - Persistent sense of being accused. When challenged, acknowledges that it is not so.
\n", "
3
\n"], ["5796", "
Absent
\n", "
0
\n"], ["5797", "
Mild - Subject sometimes feels overly guilty about some minor peccadillo, but less than 50% of time.
\n", "
1
\n"], ["5798", "
Moderate - Subject usually (over 50% of time) feels guilty about past actions the significance of which s/he exaggerates.
\n", "
2
\n"], ["5799", "
Severe - Subject usually feels s/he is to blame for everything that has gone wrong, even when not his/her fault.
\n", "
3
\n"], ["58", "
Happiness
\n", "
C
\n"], ["580", "
I don't have enough energy to do very much.
\n", "
2
\n"], ["5800", "
Absent - No depression.
\n", "
0
\n"], ["5801", "
Mild - Depression present but no diurnal variation.
\n", "
1
\n"], ["5802", "
Moderate - Depression spontaneously mentioned to be worse in the a.m. hours.
\n", "
2
\n"], ["5803", "
Severe - Depression markedly worse in the a.m. hours, with impaired functioning which improves in the p.m. hours.
\n", "
3
\n"], ["5804", "
Absent - No early wakening.
\n", "
0
\n"], ["5805", "
Mild - Occasionally wakes (up to twice weekly) 1 hour or more before normal time to wake or alarm time.
\n", "
1
\n"], ["5806", "
Moderate - Often wakes early (up to 5 times weekly) 1 hour or more before normal time to wake or alarm.
\n", "
2
\n"], ["5807", "
Severe - Daily wakes 1 hour or more before normal time.
\n", "
3
\n"], ["5808", "
Absent
\n", "
0
\n"], ["5809", "
Mild - Frequent thoughts of being better off dead, or occasional thoughts of suicide.
\n", "
1
\n"], ["581", "
I don't have enough energy to do anything.
\n", "
3
\n"], ["5810", "
Moderate - Deliberately considered suicide with a plan but made no attempt.
\n", "
2
\n"], ["5811", "
Severe - Suicidal attempt apparently designed to end in death (i.e., accidental discovery or inefficient means).
\n", "
3
\n"], ["5812", "
Absent
\n", "
0
\n"], ["5813", "
Mild - Subject appears sad and mournful even during parts of the interview involving affectively neutral discussion.
\n", "
1
\n"], ["5814", "
Moderate - Subject appears sad and mournful throughout the interview, with gloomy monotonous voice and is tearful or close to tears at times.
\n", "
2
\n"], ["5815", "
Severe - Subject chokes on distressing topics, frequently sighs deeply and cries openly, or is persistently in a state of frozen misery if examiner is sure that this is present.
\n", "
3
\n"], ["5816", "
Happened to me
\n", "
1
\n"], ["5817", "
Witnessed it
\n", "
2
\n"], ["5818", "
Learned about it
\n", "
3
\n"], ["5819", "
Part of my job
\n", "
4
\n"], ["582", "
I have not experienced any change in my sleeping pattern.
\n", "
0
\n"], ["5820", "
Not sure
\n", "
5
\n"], ["5821", "
Doesn't apply
\n", "
6
\n"], ["5822", "
I did something (or failed to do something) that went against my moral code or values.
\n", "
1
\n"], ["5823", "
I saw something (or people) do something or fail to do something that went against my moral code or values.
\n", "
2
\n"], ["5824", "
I was directly affected by someone doing something or failing to do something that went against my moral code or values.
\n", "
3
\n"], ["5825", "
None of these apply. (If so, for the remaining items, please think about another type of very stressful event that is currently distressing and answer questions while keeping in mind the worst and most currently distressing event.)
\n", "
4
\n"], ["5826", "
Strongly Disagree
\n", "
0
\n"], ["5827", "
Disagree
\n", "
1
\n"], ["5828", "
Neither Agree or Disagree
\n", "
2
\n"], ["5829", "
Agree
\n", "
3
\n"], ["583", "
I sleep somewhat more than usual.
\n", "
1
\n"], ["5830", "
Strongly Agree
\n", "
4
\n"], ["5832", "
0 - Not at all
\n", "
0
\n"], ["5833", "", "
1
\n"], ["5834", "", "
2
\n"], ["5835", "
3 - Somewhat
\n", "
3
\n"], ["5836", "", "
4
\n"], ["5837", "", "
5
\n"], ["5838", "
6 - Very much
\n", "
6
\n"], ["5839", "
7 - Not applicable in the past 30 days
\n", "
7
\n"], ["584", "
I sleep somewhat less than usual.
\n", "
2
\n"], ["5840", "
OK
\n", "
1
\n"], ["5841", "
Not at all or very slightly
\n", "
0
\n"], ["5842", "
Mildly
\n", "
1
\n"], ["5843", "
Moderately
\n", "
2
\n"], ["5844", "
Quite a bit
\n", "
3
\n"], ["5845", "
Very much
\n", "
4
\n"], ["5846", "
Never
\n", "
0
\n"], ["5847", "
Rarely
\n", "
1
\n"], ["5848", "
Sometimes
\n", "
2
\n"], ["5849", "
Often
\n", "
3
\n"], ["585", "
I sleep a lot more than usual.
\n", "
3
\n"], ["5850", "
Very Often
\n", "
4
\n"], ["5851", "
Never
\n", "
0
\n"], ["5852", "
Once or a few times
\n", "
1
\n"], ["5853", "
Once or twice a week
\n", "
2
\n"], ["5854", "
Daily or almost daily
\n", "
3
\n"], ["5855", "
No
\n", "
0
\n"], ["5856", "
Yes
\n", "
1
\n"], ["5857", "
Never
\n", "
0
\n"], ["5858", "
Once or a few times
\n", "
1
\n"], ["5859", "
Once or twice a week
\n", "
2
\n"], ["586", "
I sleep a lot less than usual.
\n", "
4
\n"], ["5860", "
Daily or almost daily
\n", "
3
\n"], ["5861", "
Not at all
\n", "
0
\n"], ["5862", "
A little
\n", "
1
\n"], ["5863", "
Somewhat
\n", "
2
\n"], ["5864", "
Very much
\n", "
3
\n"], ["5865", "
Not at all
\n", "
0
\n"], ["5866", "
A little
\n", "
1
\n"], ["5867", "
Somewhat
\n", "
2
\n"], ["5868", "
Very much
\n", "
3
\n"], ["5869", "
0 Absent
\n", "
0
\n"], ["587", "
I sleep most of the day.
\n", "
5
\n"], ["5870", "
0.5
\n", "
0.5
\n"], ["5871", "
1 Mildly or possibly increased on questioning
\n", "
1
\n"], ["5872", "", "
1.5
\n"], ["5873", "
2 Definite subjective elevation; optimistic, self-confident; cheerful; appropriate to content
\n", "
2
\n"], ["5874", "", "
2.5
\n"], ["5875", "
3 Elevated, inappropriate to content; humorous
\n", "
3
\n"], ["5876", "", "
3.5
\n"], ["5877", "
4 Euphoric; inappropriate laughter; singing
\n", "
4
\n"], ["5878", "
Absent
\n", "
0
\n"], ["5879", "", "
1
\n"], ["588", "
I wake up 1-2 hours early and can't get back to sleep.
\n", "
6
\n"], ["5880", "
Subjectively increased
\n", "
2
\n"], ["5881", "", "
3
\n"], ["5882", "
Irritable at times during interview; recent episodes of anger or annoyance on ward
\n", "
4
\n"], ["5883", "", "
5
\n"], ["5884", "
Frequently irritable during interview; short, curt throughout
\n", "
6
\n"], ["5885", "", "
7
\n"], ["5886", "
Hostile, uncooperative; interview impossible
\n", "
8
\n"], ["5887", "
0 Absent
\n", "
0
\n"], ["5888", "
0.5
\n", "
0.5
\n"], ["5889", "
1 Subjectively increased
\n", "
1
\n"], ["589", "
I am no more irritable than usual.
\n", "
0
\n"], ["5890", "
2 Animated; gestures increased
\n", "
2
\n"], ["5891", "", "
1.5
\n"], ["5892", "", "
2.5
\n"], ["5893", "
3 Excessive energy; hyperactive at times; restless (can be calmed)
\n", "
3
\n"], ["5894", "", "
3.5
\n"], ["5895", "
4 Motor excitement; continuous hyperactivity (cannot be calmed)
\n", "
4
\n"], ["5896", "
0 Normal; not increased
\n", "
0
\n"], ["5897", "
0.5
\n", "
0.5
\n"], ["5898", "
1 Mildly or possibly increased
\n", "
1
\n"], ["5899", "", "
1.5
\n"], ["59", "
Hatred
\n", "
D
\n"], ["590", "
I am more irritable than usual.
\n", "
1
\n"], ["5900", "
2 Definite subjective increase on questioning
\n", "
2
\n"], ["5901", "", "
2.5
\n"], ["5902", "
3 Spontaneous sexual content; elaborates on sexual matters; hypersexual by self-report
\n", "
3
\n"], ["5903", "", "
3.5
\n"], ["5904", "
4 Overt sexual acts (toward patients, staff, or interviewer)
\n", "
4
\n"], ["5905", "
0 Reports no decrease in sleep
\n", "
0
\n"], ["5906", "
0.5
\n", "
0.5
\n"], ["5907", "
1 Sleeping less than normal amount by up to one hour
\n", "
1
\n"], ["5908", "", "
1.5
\n"], ["5909", "
2 Sleeping less than normal by more than one hour
\n", "
2
\n"], ["591", "
I am much more irritable than usual.
\n", "
2
\n"], ["5910", "", "
2.5
\n"], ["5911", "
3 Reports decreased need for sleep
\n", "
3
\n"], ["5912", "", "
3.5
\n"], ["5913", "
4 Denies need for sleep
\n", "
4
\n"], ["5914", "
No increase
\n", "
0
\n"], ["5915", "", "
1
\n"], ["5916", "
Feels talkative
\n", "
2
\n"], ["5917", "", "
3
\n"], ["592", "
I am irritable all the time.
\n", "
3
\n"], ["5920", "
Increased rate or amount at times, verbose at times
\n", "
4
\n"], ["5921", "", "
5
\n"], ["5922", "
Push; consistently increased rate and amount; difficult to interrupt
\n", "
6
\n"], ["5923", "", "
7
\n"], ["5924", "
Pressured; uninterruptible, continuous speech
\n", "
8
\n"], ["5925", "
0 Absent
\n", "
0
\n"], ["5926", "
0.5
\n", "
0.5
\n"], ["5927", "
1 Circumstantial; mild distractibility; quick thoughts
\n", "
1
\n"], ["5928", "", "
1.5
\n"], ["5929", "
2 Distractible; loses goal of thought; change topics frequently; racing thoughts
\n", "
2
\n"], ["593", "
I have not experienced any change in my appetite.
\n", "
0
\n"], ["5930", "", "
2.5
\n"], ["5931", "
3 Flight of ideas; tangentiality; difficult to follow; rhyming, echolalia
\n", "
3
\n"], ["5932", "", "
3.5
\n"], ["5933", "
4 Incoherent; communication impossible
\n", "
4
\n"], ["5934", "
Normal
\n", "
0
\n"], ["5935", "", "
1
\n"], ["5936", "
Questionable plans, new interests
\n", "
2
\n"], ["5937", "", "
3
\n"], ["5938", "
Special project(s); hyperreligious
\n", "
4
\n"], ["5939", "", "
5
\n"], ["594", "
My appetite is somewhat less than usual.
\n", "
1
\n"], ["5940", "
Grandiose or paranoid ideas; ideas of reference
\n", "
6
\n"], ["5941", "", "
7
\n"], ["5942", "
Delusions; hallucinations
\n", "
8
\n"], ["5943", "
Absent, cooperative
\n", "
0
\n"], ["5944", "", "
1
\n"], ["5945", "
Sarcastic; loud at times, guarded
\n", "
2
\n"], ["5946", "", "
3
\n"], ["5947", "
Demanding; threats on ward
\n", "
4
\n"], ["5948", "", "
5
\n"], ["5949", "
Threatens interviewer; shouting; interview difficult
\n", "
6
\n"], ["595", "
My appetite is somewhat greater than usual.
\n", "
2
\n"], ["5950", "", "
7
\n"], ["5951", "
Assaultive; destructive; interview impossible
\n", "
8
\n"], ["5952", "
0 Appropriate dress and grooming
\n", "
0
\n"], ["5953", "
0.5
\n", "
0.5
\n"], ["5954", "
1 Minimally unkempt
\n", "
1
\n"], ["5955", "", "
1.5
\n"], ["5956", "
2 Poorly groomed; moderately dishevelled; overdressed
\n", "
2
\n"], ["5957", "", "
2.5
\n"], ["5958", "
3 Dishevelled; partly clothed; garish make-up
\n", "
3
\n"], ["5959", "", "
3.5
\n"], ["596", "
My appetite is much less than before.
\n", "
3
\n"], ["5960", "
4 Completely unkempt; decorated; bizarre garb
\n", "
4
\n"], ["5961", "
0 Present; admits illness; agrees with need for treatment
\n", "
0
\n"], ["5962", "
0.5
\n", "
0.5
\n"], ["5963", "
1 Possibly ill
\n", "
1
\n"], ["5964", "", "
1.5
\n"], ["5965", "
2 Admits behavior change, but denies illness
\n", "
2
\n"], ["5966", "", "
2.5
\n"], ["5967", "
3 Admits possible change in behavior, but denies illness
\n", "
3
\n"], ["5968", "", "
3.5
\n"], ["5969", "
4 Denies any behavior change
\n", "
4
\n"], ["597", "
My appetite is much greater than usual.
\n", "
4
\n"], ["5970", "
Correct
\n", "
1
\n"], ["5971", "
Incorrect
\n", "
0
\n"], ["5972", "
Correct circle
\n", "
1
\n"], ["5973", "
Incorrect
\n", "
0
\n"], ["5974", "
Correct clock numbers
\n", "
1
\n"], ["5975", "
Incorrect
\n", "
0
\n"], ["5976", "
Correct clock hands
\n", "
1
\n"], ["5977", "
Incorrect
\n", "
0
\n"], ["5978", "
Correctly named lion
\n", "
1
\n"], ["5979", "
Incorrect
\n", "
0
\n"], ["598", "
I have no appetite at all.
\n", "
5
\n"], ["5980", "
Correctly named rhinoceros
\n", "
1
\n"], ["5981", "
Incorrect
\n", "
0
\n"], ["5982", "
Correctly named camel
\n", "
1
\n"], ["5983", "
Incorrect
\n", "
0
\n"], ["5984", "
Correct forward digit span
\n", "
1
\n"], ["5985", "
Incorrect
\n", "
0
\n"], ["5986", "
Correct backward digit span
\n", "
1
\n"], ["5987", "
Incorrect
\n", "
0
\n"], ["5988", "
Correct vigilance
\n", "
1
\n"], ["5989", "
Incorrect
\n", "
0
\n"], ["599", "
I crave food all the time.
\n", "
6
\n"], ["5990", "
No correct subtractions
\n", "
0
\n"], ["5991", "
One correct subtraction
\n", "
1
\n"], ["5992", "
Two or three correct subtraction
\n", "
2
\n"], ["5993", "
No errors or four or more correct subtractions
\n", "
3
\n"], ["5994", "
Correct: more than 10 words in one minute.
\n", "
1
\n"], ["5995", "
Incorrect: 10 or less words in a minute.
\n", "
0
\n"], ["5997", "
Correctly recalled - No Cue
\n", "
3
\n"], ["5998", "
Correct with Category Cue
\n", "
2
\n"], ["5999", "
Correct with Multiple Choice Cue
\n", "
1
\n"], ["6", "
none, normal
\n", "
0
\n"], ["60", "
Pride
\n", "
E
\n"], ["600", "
I can concentrate as well as ever.
\n", "
0
\n"], ["6000", "
Could not recall - Incorrect
\n", "
0
\n"], ["6001", "
Twelve years or fewer.
\n", "
1
\n"], ["6002", "
More than twelve years.
\n", "
0
\n"], ["6003", "
Correct
\n", "
1
\n"], ["6004", "
Incorrect
\n", "
0
\n"], ["6005", "
Correct circle
\n", "
1
\n"], ["6006", "
Incorrect
\n", "
0
\n"], ["6007", "
Correct clock numbers
\n", "
1
\n"], ["6008", "
Incorrect
\n", "
0
\n"], ["6009", "
Correct clock hands
\n", "
1
\n"], ["601", "
I can't concentrate as well as usual.
\n", "
1
\n"], ["6010", "
Incorrect
\n", "
0
\n"], ["6011", "
Correctly named snake
\n", "
1
\n"], ["6012", "
Incorrect
\n", "
0
\n"], ["6013", "
Correctly named elephant
\n", "
1
\n"], ["6014", "
Incorrect
\n", "
0
\n"], ["6015", "
Correctly named crocodile
\n", "
1
\n"], ["6016", "
Incorrect
\n", "
0
\n"], ["6017", "
Correct forward digit span
\n", "
1
\n"], ["6018", "
Incorrect
\n", "
0
\n"], ["6019", "
Correct backward digit spa
\n", "
1
\n"], ["602", "
It's hard to keep my mind on anything for very long.
\n", "
2
\n"], ["6020", "
Incorrect
\n", "
0
\n"], ["6021", "
Correct vigilance
\n", "
1
\n"], ["6022", "
Incorrect
\n", "
0
\n"], ["6023", "
No correct subtractions
\n", "
0
\n"], ["6024", "
One correct subtraction
\n", "
1
\n"], ["6025", "
Two or three correct subtractions
\n", "
2
\n"], ["6026", "
No errors or four or more correct subtractions
\n", "
3
\n"], ["6027", "
Correctly repeated
\n", "
1
\n"], ["6028", "
Incorrect
\n", "
0
\n"], ["6029", "
Correct: more than 10 words in one minute
\n", "
1
\n"], ["603", "
I find I can't concentrate on anything.
\n", "
3
\n"], ["6030", "
Incorrect: 10 or less words in a minute.
\n", "
0
\n"], ["6031", "
Correctly recalled - No Cue
\n", "
3
\n"], ["6032", "
Correct with Category Cue
\n", "
2
\n"], ["6033", "
Correct with Multiple Choice Cue
\n", "
1
\n"], ["6034", "
Could not recall - Incorrect
\n", "
0
\n"], ["6035", "
Twelve years or fewer.
\n", "
1
\n"], ["6036", "
More than twelve years.
\n", "
0
\n"], ["6037", "
Correct
\n", "
1
\n"], ["6038", "
Incorrect
\n", "
0
\n"], ["6039", "
Correct clock numbers
\n", "
1
\n"], ["604", "
I am no more tired or fatigued than usual.
\n", "
0
\n"], ["6040", "
Incorrect
\n", "
0
\n"], ["6041", "
Correct clock hands
\n", "
1
\n"], ["6042", "
Incorrect
\n", "
0
\n"], ["6043", "
Correctly named horse
\n", "
1
\n"], ["6044", "
Incorrect
\n", "
0
\n"], ["6045", "
Correctly named tiger
\n", "
1
\n"], ["6046", "
Incorrect
\n", "
0
\n"], ["6047", "
Correctly named duck
\n", "
1
\n"], ["6048", "
Incorrect
\n", "
0
\n"], ["6049", "
Correct forward digit span
\n", "
1
\n"], ["605", "
I get more tired or fatigued more easily than usual.
\n", "
1
\n"], ["6050", "
Incorrect
\n", "
0
\n"], ["6053", "
Correct backward digit span
\n", "
1
\n"], ["6054", "
Incorrect
\n", "
0
\n"], ["6055", "
Correct vigilance
\n", "
1
\n"], ["6056", "
Incorrect
\n", "
0
\n"], ["6057", "
No correct subtractions
\n", "
0
\n"], ["6058", "
One correct subtraction
\n", "
1
\n"], ["6059", "
Two or three correct subtractions
\n", "
2
\n"], ["606", "
I am too tired or fatigued to do a lot of the things I used to do.
\n", "
2
\n"], ["6060", "
No errors or four or more correct subtractions
\n", "
3
\n"], ["6061", "
Correctly repeated
\n", "
1
\n"], ["6062", "
Incorrect
\n", "
0
\n"], ["6063", "
Correct: more than 10 words in one minute
\n", "
1
\n"], ["6064", "
Incorrect: 10 or less words in a minute.
\n", "
0
\n"], ["6065", "
Correctly recalled - No Cue
\n", "
3
\n"], ["6066", "
Correct with Category Cue
\n", "
2
\n"], ["6067", "
Correct with Multiple Choice Cue
\n", "
1
\n"], ["6068", "
Could not recall - Incorrect
\n", "
0
\n"], ["6069", "
Twelve years or fewer.
\n", "
1
\n"], ["607", "
I am too tired or fatigued to do most of the things I used to do.
\n", "
3
\n"], ["6070", "
More than twelve years.
\n", "
0
\n"], ["6071", "
Correct forward digit span
\n", "
1
\n"], ["6072", "
Incorrect
\n", "
0
\n"], ["6073", "
Correct backward digit span
\n", "
1
\n"], ["6074", "
Incorrect
\n", "
0
\n"], ["6075", "
Correct vigilance
\n", "
1
\n"], ["6076", "
Incorrect
\n", "
0
\n"], ["6077", "
No correct subtractions
\n", "
0
\n"], ["6078", "
One correct subtraction
\n", "
1
\n"], ["6079", "
Two or three correct subtraction
\n", "
2
\n"], ["608", "
I have not noticed any recent changes in my interest in sex.
\n", "
0
\n"], ["6080", "
No errors or four or more correct subtractions
\n", "
3
\n"], ["6081", "
Correctly repeated
\n", "
1
\n"], ["6082", "
Incorrect
\n", "
0
\n"], ["6083", "
Correct: more than 10 words in one minute
\n", "
1
\n"], ["6084", "
Incorrect: 10 or less words in a minute.
\n", "
0
\n"], ["6085", "
Correct
\n", "
1
\n"], ["6086", "
Incorrect
\n", "
0
\n"], ["6087", "
Correctly recalled - No Cue
\n", "
3
\n"], ["6088", "
Correct with Category Cue
\n", "
2
\n"], ["6089", "
Correct with Multiple Choice Cue
\n", "
1
\n"], ["609", "
I am less interested in sex than I used to be.
\n", "
1
\n"], ["6090", "
Could not recall - Incorrect
\n", "
0
\n"], ["6091", "
Twelve years or fewer.
\n", "
1
\n"], ["6092", "
More than twelve years.
\n", "
0
\n"], ["6093", "
Incorrect year
\n", "
2
\n"], ["6094", "
Incorrect time
\n", "
3
\n"], ["6095", "
4 - Normal speech process
\n", "
4
\n"], ["6096", "
3 - Detectable speech disturbance
\n", "
3
\n"], ["6097", "
2 - Intelligible with repeating
\n", "
2
\n"], ["6098", "
1 - Speech combined with nonvocal communication
\n", "
1
\n"], ["6099", "
0 - Loss of useful speech
\n", "
0
\n"], ["61", "", "
A
\n"], ["610", "
I am much less interested in sex now
\n", "
2
\n"], ["6100", "
4 - Normal
\n", "
4
\n"], ["6101", "
3 - Slight but definite excess of saliva in mouth; may have nighttime drooling
\n", "
3
\n"], ["6102", "
2 - Moderately excessive saliva; may have minimal drooling
\n", "
2
\n"], ["6103", "
1 - Marked excess of saliva with some drooling
\n", "
1
\n"], ["6104", "
0 - Marked drooling; requires constant tissue or handkerchief
\n", "
0
\n"], ["6105", "
4 - Normal eating habits
\n", "
4
\n"], ["6106", "
3 - Early eating problems - occasional choking
\n", "
3
\n"], ["6107", "
2 - Dietary consistency changes
\n", "
2
\n"], ["6108", "
1 - Needs supplemental tube feedings
\n", "
1
\n"], ["6109", "
0 - NPO (exclusively parenteral or enteral feeding)
\n", "
0
\n"], ["611", "
I have lost interest in sex completely.
\n", "
3
\n"], ["6110", "
4 - Normal
\n", "
4
\n"], ["6111", "
3 - Slow or sloppy; all words are legible
\n", "
3
\n"], ["6112", "
2 - Not all words are legible
\n", "
2
\n"], ["6113", "
1 - Able to grip pen but unable to write
\n", "
1
\n"], ["6114", "
0 - Unable to grip pen
\n", "
0
\n"], ["6115", "
No
\n", "
0
\n"], ["6116", "
Yes
\n", "
1
\n"], ["6117", "
4 - Normal
\n", "
4
\n"], ["6118", "
3 - Somewhat slow and clumsy, but no help needed
\n", "
3
\n"], ["6119", "
2 - Can cut most foods, although slow and clumsy; some help needed
\n", "
2
\n"], ["612", "
True
\n", "
T
\n"], ["6120", "
1 - Food must be cut by someone, but can still feed slowly
\n", "
1
\n"], ["6121", "
0 - Needs to be fed
\n", "
0
\n"], ["6122", "
4 - Normal
\n", "
4
\n"], ["6123", "
3 - Clumsy but able to perform all manipulations independently
\n", "
3
\n"], ["6124", "
2 - Some help needed with closures and fasteners
\n", "
2
\n"], ["6125", "
1 - Provides minimal assistance to caregiver
\n", "
1
\n"], ["6126", "
0 - Unable to perform any aspect of task
\n", "
0
\n"], ["6127", "
4 - Normal function
\n", "
4
\n"], ["6128", "
3 - Independent and complete self-care with effort or decreased efficiency
\n", "
3
\n"], ["6129", "
2 - Intermittent assistance or substitute methods
\n", "
2
\n"], ["613", "
False
\n", "
F
\n"], ["6130", "
1 - Needs attendant for self-care
\n", "
1
\n"], ["6131", "
0 - Total dependence
\n", "
0
\n"], ["6132", "
4 - Normal
\n", "
4
\n"], ["6133", "
3 - Somewhat slow and clumsy, but no help needed
\n", "
3
\n"], ["6134", "
2 - Can turn alone or adjust sheets, but with great difficulty
\n", "
2
\n"], ["6135", "
1 - Can initiate, but not turn or adjust sheets alone
\n", "
1
\n"], ["6136", "
0 - Helpless
\n", "
0
\n"], ["6137", "
4 - Normal
\n", "
4
\n"], ["6138", "
3 - Early ambulation difficulties
\n", "
3
\n"], ["6139", "
2 - Walks with assistance
\n", "
2
\n"], ["614", "
Not present
\n", "
0
\n"], ["6140", "
1 - Nonambulatory functional movement
\n", "
1
\n"], ["6141", "
0 - No purposeful leg movement
\n", "
0
\n"], ["6142", "
4 - Normal
\n", "
4
\n"], ["6143", "
3 - Slow
\n", "
3
\n"], ["6144", "
2 - Mild unsteadiness or fatigue
\n", "
2
\n"], ["6145", "
1 - Needs assistance
\n", "
1
\n"], ["6146", "
0 - Cannot do
\n", "
0
\n"], ["6147", "
4 - None
\n", "
4
\n"], ["6148", "
3 - Occurs when walking
\n", "
3
\n"], ["6149", "
2 - Occurs with one or more of the following: eating, bathing, dressing (ADL)
\n", "
2
\n"], ["615", "
Very mild
\n", "
1
\n"], ["6150", "
1 - Occurs at rest, difficulty breathing when either sitting or lying
\n", "
1
\n"], ["6151", "
0 - Significant difficulty; considering using mechanical respiratory support
\n", "
0
\n"], ["6152", "
4 - None
\n", "
4
\n"], ["6153", "
3 - Some difficulty sleeping at night due to shortness of breath, does not routinely use more than two pillows
\n", "
3
\n"], ["6154", "
2 - Needs extra pillows in order to sleep (more than two)
\n", "
2
\n"], ["6155", "
1 - Can only sleep sitting up
\n", "
1
\n"], ["6156", "
0 - Unable to sleep
\n", "
0
\n"], ["6157", "
4 - None
\n", "
4
\n"], ["6158", "
3 - Intermittent use of NIV (e.g., BiPAP)
\n", "
3
\n"], ["6159", "
2 - Continuous use of NIV (e.g., BiPAP) during the night
\n", "
2
\n"], ["616", "
Mild
\n", "
2
\n"], ["6160", "
1 - Continuous use of NIV (e.g., BiPAP) during the night and day
\n", "
1
\n"], ["6161", "
0 - Invasive mechanical ventilation by intubation or tracheostomy
\n", "
0
\n"], ["6162", "
Strongly Disagree
\n", "
0
\n"], ["6163", "
Strongly Agree
\n", "
10
\n"], ["6164", "
Never True
\n", "
1
\n"], ["6165", "
Very Seldom True
\n", "
2
\n"], ["6166", "
Seldom True
\n", "
3
\n"], ["6167", "
Sometimes True
\n", "
4
\n"], ["6168", "
Frequently True
\n", "
5
\n"], ["6169", "
Almost Always True
\n", "
6
\n"], ["617", "
Moderate
\n", "
3
\n"], ["6170", "
Always True
\n", "
7
\n"], ["6171", "
Very bad
\n", "
0
\n"], ["6172", "
Excellent
\n", "
10
\n"], ["6173", "
No
\n", "
0
\n"], ["6174", "
Yes
\n", "
1
\n"], ["6175", "
None - Rarely if ever present; not a problem at all
\n", "
0
\n"], ["6176", "
Mild - Occasionally present, but it does not disrupt my activities; I can usually continue what I'm doing; doesn't really concern me.
\n", "
1
\n"], ["6177", "
Moderate - Often present, occasionally disrupts my activities; I can usually continue what I'm doing with some effort; I feel somewhat concerned.
\n", "
2
\n"], ["6178", "
Severe - Frequently present and disrupts activities; I can only do things that are fairly simple or take little effort; I feel I need help.
\n", "
3
\n"], ["6179", "
Very Severe - Almost always present and I have been unable to perform at work, school or home due to this.
\n", "
4
\n"], ["618", "
Moderately severe
\n", "
4
\n"], ["619", "
Severe
\n", "
5
\n"], ["62", "", "
B
\n"], ["620", "
Extremely severe
\n", "
6
\n"], ["621", "
I have a moderate to strong wish to live.
\n", "
0
\n"], ["622", "
I have a weak wish to live.
\n", "
1
\n"], ["623", "
I have no wish to live.
\n", "
2
\n"], ["624", "
I have no wish to die.
\n", "
0
\n"], ["625", "
I have a weak wish to die.
\n", "
1
\n"], ["626", "
I have a moderate to strong wish to die.
\n", "
2
\n"], ["627", "
My reasons for living outweigh my reasons for dying.
\n", "
0
\n"], ["628", "
My reasons for living or dying are about equal.
\n", "
1
\n"], ["629", "
My reasons for dying outweigh my reasons for living.
\n", "
2
\n"], ["63", "", "
D
\n"], ["630", "
I have no desire to kill myself.
\n", "
0
\n"], ["631", "
I have a weak desire to kill myself.
\n", "
1
\n"], ["632", "
I have a moderate to strong desire to kill myself.
\n", "
2
\n"], ["633", "
I would try to save my life if I found myself in a life-threatening situation.
\n", "
0
\n"], ["634", "
I would take a chance on life or death if I found myself in a life-threatening situation.
\n", "
1
\n"], ["635", "
I would not take the steps necessary to avoid death if I found myself in a life-threatening situation.
\n", "
2
\n"], ["636", "
I have brief periods of thinking about killing myself which pass quickly.
\n", "
0
\n"], ["637", "
I have periods of thinking about killing myself which last for moderate amounts of time.
\n", "
1
\n"], ["638", "
I have long periods of thinking about killing myself.
\n", "
2
\n"], ["639", "
I rarely or only occasionally think about killing myself.
\n", "
0
\n"], ["64", "", "
E
\n"], ["640", "
I have frequent thoughts about killing myself.
\n", "
1
\n"], ["641", "
I continuously think about killing myself.
\n", "
2
\n"], ["642", "
I do not accept the idea of killing myself.
\n", "
0
\n"], ["643", "
I neither accept nor reject the idea of killing myself.
\n", "
1
\n"], ["644", "
I accept the idea of killing myself.
\n", "
2
\n"], ["645", "
I can keep myself from committing suicide.
\n", "
0
\n"], ["646", "
I am unsure that I can keep myself from committing suicide.
\n", "
1
\n"], ["647", "
I cannot keep myself from committing suicide.
\n", "
2
\n"], ["648", "
I would not kill myself because of my family, friends, religion, possible injury from an unsuccessful attempt, etc.
\n", "
0
\n"], ["649", "
I am somewhat concerned about killing myself because of my family, friends, religion, possible injury from an unsuccessful attempt, etc.
\n", "
1
\n"], ["65", "", "
A
\n"], ["650", "
I am not or only a little concerned about killing myself because of family, friends, religion, possible injury from an unsuccessful attempt, etc.
\n", "
2
\n"], ["651", "
My reasons for wanting to commit suicide are primarily aimed at influencing other people, such as getting even with people, making people pay attention to me, etc.
\n", "
0
\n"], ["652", "
My reasons for wanting to commit suicide are not only aimed at influencing other people, but also represent a way of solving my problems.
\n", "
1
\n"], ["653", "
My reasons for wanting to commit suicide are primarily based upon escaping from my problems.
\n", "
2
\n"], ["654", "
I have no specific plan about how to kill myself.
\n", "
0
\n"], ["655", "
I have considered ways of killing myself, but have not worked out the details.
\n", "
1
\n"], ["656", "
I have a specific plan for killing myself.
\n", "
2
\n"], ["657", "
I do not have access to a method or an opportunity to kill myself.
\n", "
0
\n"], ["658", "
The method that I would use for committing suicide takes time, and I really do not have a good opportunity to use this method.
\n", "
1
\n"], ["659", "
I have access or anticipate having access to the method that I would choose for killing myself and also have opportunity to use it.
\n", "
2
\n"], ["66", "", "
B
\n"], ["660", "
I do not have the courage or the ability to commit suicide.
\n", "
0
\n"], ["661", "
I am unsure that I have the courage or the ability to commit suicide.
\n", "
1
\n"], ["662", "
I have the courage and the ability to commit suicide.
\n", "
2
\n"], ["663", "
I do not expect to make a suicide attempt.
\n", "
0
\n"], ["664", "
I am unsure that I shall make a suicide attempt.
\n", "
1
\n"], ["665", "
I am sure that I shall make a suicide attempt.
\n", "
2
\n"], ["666", "
I have made no preparations for committing suicide.
\n", "
0
\n"], ["667", "
I have made some preparations for committing suicide.
\n", "
1
\n"], ["668", "
I have almost finished or completed my preparations for committing suicide.
\n", "
2
\n"], ["669", "
I have not written a suicide note.
\n", "
0
\n"], ["67", "", "
C
\n"], ["670", "
I have thought about writing a suicide note or have started to write one, but have not completed it.
\n", "
1
\n"], ["671", "
I have completed a suicide note.
\n", "
2
\n"], ["672", "
I have made no arrangements for what will happen after I have committed suicide.
\n", "
0
\n"], ["673", "
I have thought about making some arrangements for what will happen after I have committed suicide.
\n", "
1
\n"], ["674", "
I have made definite arrangements for what will happen after I have committed suicide.
\n", "
2
\n"], ["675", "
I have not hidden my desire to kill myself from people.
\n", "
0
\n"], ["676", "
I have held back telling people about wanting to kill myself.
\n", "
1
\n"], ["677", "
I have attempted to hide, conceal, or lie about wanting to commit suicide.
\n", "
2
\n"], ["678", "
I have never attempted suicide.
\n", "
0
\n"], ["679", "
I have attempted suicide once.
\n", "
1
\n"], ["68", "", "
D
\n"], ["680", "
I have attempted suicide two or more times.
\n", "
2
\n"], ["681", "
My wish to die during the last suicide attempt was low.
\n", "
0
\n"], ["682", "
My wish to die during the last suicide attempt was moderate.
\n", "
1
\n"], ["683", "
My wish to die during the last suicide attempt was high.
\n", "
2
\n"], ["684", "
A little bit
\n", "
1
\n"], ["685", "
Moderately
\n", "
2
\n"], ["686", "
Quite a bit
\n", "
3
\n"], ["687", "
Extremely
\n", "
4
\n"], ["688", "
True
\n", "
T
\n"], ["689", "
False
\n", "
F
\n"], ["69", "", "
E
\n"], ["690", "
Before Session #1
\n", "
1
\n"], ["691", "
After Session #4
\n", "
2
\n"], ["692", "
<1 day
\n", "
0
\n"], ["693", "
1-2 days
\n", "
1
\n"], ["694", "
3-4 days
\n", "
2
\n"], ["695", "
5-7 days
\n", "
3
\n"], ["696", "
less than 12 years old
\n", "
1
\n"], ["697", "
12-18 years old
\n", "
2
\n"], ["698", "
19-35 years old
\n", "
3
\n"], ["699", "
36-64 years old
\n", "
4
\n"], ["7", "
minimal
\n", "
1
\n"], ["70", "
Mammal
\n", "
A
\n"], ["700", "
65 years or older
\n", "
5
\n"], ["701", "", "
1
\n"], ["702", "", "
2
\n"], ["703", "", "
3
\n"], ["704", "", "
4
\n"], ["705", "
4 0r more
\n", "
5
\n"], ["706", "
I have always felt sad
\n", "
6
\n"], ["707", "", "
5
\n"], ["708", "", "
6
\n"], ["709", "
>5
\n", "
7
\n"], ["71", "
Fish
\n", "
B
\n"], ["710", "
1-2
\n", "
2
\n"], ["711", "
3-4
\n", "
3
\n"], ["712", "
5-7
\n", "
4
\n"], ["713", "
8-14
\n", "
5
\n"], ["714", "
15-21
\n", "
6
\n"], ["715", "
22-28
\n", "
7
\n"], ["716", "
Not at all
\n", "
1
\n"], ["717", "
Slightly
\n", "
2
\n"], ["718", "
Moderately
\n", "
3
\n"], ["719", "
Quite a bit
\n", "
4
\n"], ["72", "
Mite
\n", "
C
\n"], ["720", "
Extremely
\n", "
5
\n"], ["721", "
Yes, more than once
\n", "
1
\n"], ["722", "
Yes, but only once
\n", "
2
\n"], ["723", "
7 or more drinks, or 7 or more glasses of wine?
\n", "
7
\n"], ["724", "
1 to 3 days a week
\n", "
2
\n"], ["725", "
Most days a week
\n", "
3
\n"], ["726", "
Nearly every day for at least 2 weeks
\n", "
4
\n"], ["727", "
Yes, a little weight
\n", "
2
\n"], ["728", "
Yes, some weight
\n", "
3
\n"], ["729", "
Yes, a lot of weight
\n", "
4
\n"], ["73", "
Reptile
\n", "
D
\n"], ["730", "
Yes, a little slowed or speeded up
\n", "
2
\n"], ["731", "
Yes, somewhat slowed or speeded up
\n", "
3
\n"], ["732", "
Yes, very slowed or speeded up
\n", "
4
\n"], ["733", "
Yes, a little tired out
\n", "
2
\n"], ["734", "
Yes, somewhat tired out
\n", "
3
\n"], ["735", "
Yes, very tired out
\n", "
4
\n"], ["736", "
Yes, a little trouble thinking
\n", "
2
\n"], ["737", "
Yes, some trouble thinking
\n", "
3
\n"], ["738", "
Yes, a lot of trouble thinking
\n", "
4
\n"], ["739", "
American indian or Alaskan native
\n", "
1
\n"], ["74", "
Amphibian
\n", "
E
\n"], ["740", "
Asian/oriental or Pacific Islander
\n", "
2
\n"], ["741", "
Black/African-American
\n", "
3
\n"], ["742", "
White/Caucasian
\n", "
4
\n"], ["743", "
Other
\n", "
5
\n"], ["744", "
Married
\n", "
1
\n"], ["745", "
Widowed
\n", "
2
\n"], ["746", "
Separated
\n", "
3
\n"], ["747", "
Divorced
\n", "
4
\n"], ["748", "
Never married
\n", "
5
\n"], ["749", "
8th grade or less
\n", "
1
\n"], ["75", "", "
A
\n"], ["750", "
Some high school
\n", "
2
\n"], ["751", "
High school graduate
\n", "
3
\n"], ["752", "
Some college
\n", "
4
\n"], ["753", "
College graduate
\n", "
5
\n"], ["754", "
Any post-graduate work
\n", "
6
\n"], ["755", "
>3
\n", "
5
\n"], ["756", "
Less than $20,000
\n", "
1
\n"], ["757", "
$20,000 - $39,999
\n", "
2
\n"], ["758", "
$40,000 - $59,999
\n", "
3
\n"], ["759", "
$60,000 - $79,999
\n", "
4
\n"], ["76", "", "
B
\n"], ["760", "
$80,000 or more
\n", "
5
\n"], ["761", "
Major depression (single episode or recurrent)
\n", "
1
\n"], ["762", "
Mood disorder secondary to a general medical condition
\n", "
2
\n"], ["763", "
Posttraumatic stress disorder (ptsd)
\n", "
3
\n"], ["764", "
Substance use disorder(s)
\n", "
4
\n"], ["765", "
No major depression or dysthymia
\n", "
5
\n"], ["766", "
No
\n", "
2
\n"], ["767", "
Unsure
\n", "
3
\n"], ["768", "
Rarely or none of the time (less than one day)
\n", "
0
\n"], ["769", "
Some or little of the time (1 to 2 days)
\n", "
1
\n"], ["77", "", "
C
\n"], ["770", "
Moderately or much of the time (3 to 4 days)
\n", "
2
\n"], ["771", "
Most of the time (5 to 7 days)
\n", "
3
\n"], ["772", "
Most of the time
\n", "
0
\n"], ["773", "
Moderately or much of the time
\n", "
1
\n"], ["774", "
Some of the time
\n", "
2
\n"], ["775", "
Rarely
\n", "
3
\n"], ["776", "
This is true for me all the time
\n", "
4
\n"], ["777", "
This is usually true for me
\n", "
3
\n"], ["778", "
This is usually not true for me
\n", "
2
\n"], ["779", "
This is not true for me at all
\n", "
1
\n"], ["78", "", "
D
\n"], ["780", "
Strongly disagree
\n", "
1
\n"], ["781", "
Moderately disagree
\n", "
2
\n"], ["782", "
Disagree
\n", "
3
\n"], ["783", "
Agree
\n", "
4
\n"], ["784", "
Moderately agree
\n", "
5
\n"], ["785", "
Strongly agree
\n", "
6
\n"], ["786", "
No RLS symptoms to be relieved
\n", "
0
\n"], ["787", "
Either complete or almost complete relief
\n", "
1
\n"], ["788", "
Moderate relief
\n", "
2
\n"], ["789", "
People's misfortunes result from the mistakes they make.
\n", "
2
\n"], ["79", "", "
E
\n"], ["790", "
Mild relief
\n", "
3
\n"], ["791", "
No relief
\n", "
4
\n"], ["792", "
Occasionally (1 day in 1 week)
\n", "
1
\n"], ["793", "
Sometimes (2 to 3 days in a week)
\n", "
2
\n"], ["794", "
The idea that teachers are unfair to students is nonsense.
\n", "
1
\n"], ["795", "
Often (4 to 5 days in 1 week)
\n", "
3
\n"], ["796", "
Without the right breaks one cannot be an effective leader.
\n", "
1
\n"], ["797", "
Very often (6 to 7 days in a week)
\n", "
4
\n"], ["798", "
No matter how hard you try some people just don't like you.
\n", "
1
\n"], ["799", "
Mild (less than 1 hour per 24 hours)
\n", "
1
\n"], ["8", "
mild
\n", "
2
\n"], ["80", "
7 boxes
\n", "
A
\n"], ["800", "
Heredity plays the major role in determining one's personality.
\n", "
1
\n"], ["801", "
It is one's experiences in life which determine what they're like.
\n", "
2
\n"], ["802", "
I have often found that what is going to happen will happen.
\n", "
1
\n"], ["803", "
No difficulty
\n", ""], ["804", "
A little difficulty
\n", ""], ["805", "
Moderate difficulty
\n", ""], ["806", "
Quite a bit of difficulty
\n", ""], ["807", "
Extreme difficulty
\n", ""], ["808", "
The average citizen can have an influence in government decisions.
\n", "
1
\n"], ["809", "
This world is run by the few people in power, and there is not much the little guy can do about it.
\n", "
2
\n"], ["81", "
9 boxes
\n", "
B
\n"], ["810", "
When I make plans, I am almost certain that I can make them work.
\n", "
1
\n"], ["811", "
It is not always wise to plan too far ahead because many things turn out to be a matter of good or bad fortune anyhow.
\n", "
2
\n"], ["812", "
There are certain people who are just no good.
\n", "
1
\n"], ["813", "
There is some good in everybody.
\n", "
2
\n"], ["814", "
None of the time
\n", ""], ["815", "
A little of the time
\n", ""], ["816", "
Who gets to be the boss often depends on who was lucky enough to be in the right place first.
\n", "
1
\n"], ["817", "
All of the time
\n", ""], ["818", "
Male
\n", ""], ["819", "
Female
\n", ""], ["82", "
11 boxes
\n", "
C
\n"], ["820", "
Most people don't realize the extent to which their lives are controlled by accidental happenings.
\n", "
1
\n"], ["821", "
There really is no such thing as \"luck.\"
\n", "
2
\n"], ["822", "
One should always be willing to admit mistakes.
\n", "
1
\n"], ["823", "
It is usually best to cover up one's mistakes.
\n", "
2
\n"], ["824", "
It is hard to know whether or not a person really likes you.
\n", "
1
\n"], ["825", "
How many friends you have depends upon how nice a person you are.
\n", "
2
\n"], ["826", "
Hispanic or Latino
\n", ""], ["827", "
Most misfortunes are the result of lack of ability, ignorance, laziness, or all three.
\n", "
2
\n"], ["828", "
With enough effort we can wipe out political corruption.
\n", "
1
\n"], ["829", "
It is difficult for people to have much control over the things politicians do in office.
\n", "
2
\n"], ["83", "
13 boxes
\n", "
D
\n"], ["830", "
Sometimes I can't understand how teachers arrive at the grades they give.
\n", "
1
\n"], ["831", "
There is a direct connection between how hard I study and the grades I get.
\n", "
2
\n"], ["832", "
not Hispanic or Latino
\n", ""], ["833", "
A good leader makes it clear to everybody what their jobs are.
\n", "
2
\n"], ["834", "
Many times I feel that I have little influence over the things that happen to me.
\n", "
1
\n"], ["835", "
African-American/Black
\n", ""], ["836", "
People are lonely because they don't try to be friendly.
\n", "
1
\n"], ["837", "
Other/Multiracial
\n", ""], ["838", "
There is too much emphasis on athletics in high school.
\n", "
1
\n"], ["839", "
Team sports are an excellent way to build character.
\n", "
2
\n"], ["84", "
15 boxes
\n", "
E
\n"], ["840", "
What happens to me is my own doing.
\n", "
1
\n"], ["841", "
Sometimes I feel that I don't have enough control over the direction my life is taking.
\n", "
2
\n"], ["842", "
English
\n", ""], ["843", "
Spanish
\n", ""], ["844", "
Almost always
\n", "
3
\n"], ["845", "
Less often than most college students
\n", "
1
\n"], ["846", "
About average
\n", "
2
\n"], ["847", "
More often than most college students
\n", "
3
\n"], ["848", "
Problems needing solution
\n", "
1
\n"], ["849", "
Challenges needing to be met
\n", "
2
\n"], ["85", "
Caressing
\n", "
A
\n"], ["850", "
A rather predictable routine of events
\n", "
3
\n"], ["851", "
Not enough things to keep me interested or busy
\n", "
4
\n"], ["852", "
Several times a day
\n", "
1
\n"], ["853", "
About once a day
\n", "
2
\n"], ["854", "
A few times a week
\n", "
3
\n"], ["855", "
Once a week
\n", "
4
\n"], ["856", "
Once a month or less
\n", "
5
\n"], ["857", "
Do something about it immediately
\n", "
1
\n"], ["858", "
Plan carefully before taking any action
\n", "
2
\n"], ["859", "
I'm usually the first one finished
\n", "
1
\n"], ["86", "
Hate
\n", "
B
\n"], ["860", "
I eat a little faster than average
\n", "
2
\n"], ["861", "
I eat at about the same speed as most people
\n", "
3
\n"], ["862", "
I eat more slowly than most people
\n", "
4
\n"], ["863", "
Yes, often
\n", "
1
\n"], ["864", "
Yes, once or twice
\n", "
2
\n"], ["865", "
No, no one has told me this
\n", "
3
\n"], ["866", "
I do two things at once whenever practical
\n", "
1
\n"], ["867", "
I do this only when I'm short of time
\n", "
2
\n"], ["868", "
I rarely or never do more than one thing at a time
\n", "
3
\n"], ["869", "
Frequently
\n", "
1
\n"], ["87", "
Temper
\n", "
C
\n"], ["870", "
Almost never
\n", "
3
\n"], ["871", "
Once in a while
\n", "
1
\n"], ["872", "
I am never late
\n", "
3
\n"], ["873", "
Often
\n", "
1
\n"], ["874", "
Rarely or never
\n", "
3
\n"], ["875", "
10 minutes late. will you:
\n", "
1
\n"], ["876", "
Sit and wait?
\n", "
1
\n"], ["877", "
Walk about while waiting?
\n", "
2
\n"], ["878", "
Usually carry some reading matter or writing paper so you can
\n", "
3
\n"], ["879", "
Accept it calmly?
\n", "
1
\n"], ["88", "
Hope
\n", "
D
\n"], ["880", "
Feel impatient but do not show it?
\n", "
2
\n"], ["881", "
Feel so impatient that someone watching could tell
\n", "
3
\n"], ["882", "
Refuse to wait in line, and find ways to avoid such delays?
\n", "
4
\n"], ["883", "
Most of the time
\n", "
1
\n"], ["884", "
Half of the time
\n", "
2
\n"], ["885", "
Only occasionally
\n", "
3
\n"], ["886", "
Never
\n", "
4
\n"], ["887", "
Definitely hard-driving and competitive?
\n", "
1
\n"], ["888", "
Probably hard-driving and competitive?
\n", "
2
\n"], ["889", "
Probably more relaxed and easy going?
\n", "
3
\n"], ["89", "
Happiness
\n", "
E
\n"], ["890", "
Definitely more relaxed and easy going?
\n", "
4
\n"], ["891", "
Definitely hard-driving and competitive
\n", "
1
\n"], ["892", "
Probably hard-driving and competitive
\n", "
2
\n"], ["893", "
Probably relaxed and easy going
\n", "
3
\n"], ["894", "
Definitely relaxed and easy going
\n", "
4
\n"], ["895", "
Too slow. should be more active
\n", "
1
\n"], ["896", "
About average. is busy much of the time
\n", "
2
\n"], ["897", "
Too active. needs to slow down
\n", "
3
\n"], ["898", "
Definitely yes
\n", "
1
\n"], ["899", "
Probably yes
\n", "
2
\n"], ["9", "
moderate
\n", "
3
\n"], ["90", "
Misfortune is a cheap teacher
\n", "
A
\n"], ["900", "
Probably no
\n", "
3
\n"], ["901", "
Definitely no
\n", "
4
\n"], ["902", "
Fiery and hard to control
\n", "
1
\n"], ["903", "
Strong, but controllable
\n", "
2
\n"], ["904", "
No problem
\n", "
3
\n"], ["905", "
I almost never got angry
\n", "
4
\n"], ["906", "
I almost never get angry
\n", "
4
\n"], ["907", "
I feel ok because I work better after an occasional break
\n", "
1
\n"], ["908", "
I feel only mildly annoyed
\n", "
2
\n"], ["909", "
I really feel irritated because most such interruptions
\n", "
3
\n"], ["91", "
We learn by doing
\n", "
B
\n"], ["910", "
Daily or more often
\n", "
1
\n"], ["911", "
Weekly
\n", "
2
\n"], ["912", "
Monthly
\n", "
3
\n"], ["913", "
Carry minor pressure because of their routine nature?
\n", "
1
\n"], ["914", "
Carry considerable pressure, since delay would upset
\n", "
2
\n"], ["915", "
No
\n", "
1
\n"], ["916", "
Yes, but only occasionally
\n", "
2
\n"], ["917", "
Yes, once per week or more often
\n", "
3
\n"], ["918", "
Better?
\n", "
1
\n"], ["919", "
Worse?
\n", "
2
\n"], ["92", "
Experience is a dear teacher
\n", "
C
\n"], ["920", "
The same? (pressure makes no difference)
\n", "
3
\n"], ["921", "
No, never
\n", "
1
\n"], ["922", "
Yes, but only in emergencies
\n", "
2
\n"], ["923", "
Yes, regularly
\n", "
3
\n"], ["924", "
No
\n", "
2
\n"], ["925", "
Rarely or never
\n", "
1
\n"], ["926", "
Once a week or less often
\n", "
2
\n"], ["927", "
More than once a week
\n", "
3
\n"], ["928", "
Not possible
\n", "
1
\n"], ["929", "
Rarely or never
\n", "
2
\n"], ["93", "
A good seaman is known in bad weather
\n", "
D
\n"], ["930", "
Occasionally (less than once a week)
\n", "
3
\n"], ["931", "
Once or more a week
\n", "
4
\n"], ["932", "
Slow down for a while until your strength comes back.
\n", "
1
\n"], ["933", "
Keep pushing yourself at the same pace in spite
\n", "
2
\n"], ["934", "
Rarely
\n", "
1
\n"], ["935", "
About as often as they look to others
\n", "
2
\n"], ["936", "
More often than they look to others
\n", "
3
\n"], ["937", "
Frequently
\n", "
3
\n"], ["938", "
Much more effort
\n", "
1
\n"], ["939", "
A little more effort
\n", "
2
\n"], ["94", "
Mistakes occur in the best regulated families
\n", "
E
\n"], ["940", "
A little less effort
\n", "
3
\n"], ["941", "
Much less effort
\n", "
4
\n"], ["942", "
Much more responsible
\n", "
1
\n"], ["943", "
A little more responsible
\n", "
2
\n"], ["944", "
A little less responsible
\n", "
3
\n"], ["945", "
Much less responsible
\n", "
4
\n"], ["946", "
Much more of the time
\n", "
1
\n"], ["947", "
A little more of the time
\n", "
2
\n"], ["948", "
A little less of the time
\n", "
3
\n"], ["949", "
Much less of the time
\n", "
4
\n"], ["95", "
50 minutes
\n", "
A
\n"], ["950", "
Much more precise
\n", "
1
\n"], ["951", "
A little more precise
\n", "
2
\n"], ["952", "
A little less precise
\n", "
3
\n"], ["953", "
Much less precise
\n", "
4
\n"], ["954", "
Much more seriously
\n", "
1
\n"], ["955", "
A little more seriously
\n", "
2
\n"], ["956", "
A little less seriously
\n", "
3
\n"], ["957", "
Much less seriously
\n", "
4
\n"], ["958", "
Definitely not true
\n", "
1
\n"], ["959", "
Not true
\n", "
2
\n"], ["96", "
1 hour and 20 minutes
\n", "
B
\n"], ["960", "
Tends not to be true
\n", "
3
\n"], ["961", "
Tends to be true
\n", "
4
\n"], ["962", "
True
\n", "
5
\n"], ["963", "
Especially true
\n", "
6
\n"], ["964", "
Slightly disagree
\n", "
3
\n"], ["965", "
Slightly agree
\n", "
4
\n"], ["966", "
V. programs about illness make me very upset.
\n", "
T
\n"], ["967", "
Not at all true
\n", "
1
\n"], ["968", "
Slightly true
\n", "
2
\n"], ["969", "
Somewhat true
\n", "
3
\n"], ["97", "
1 hour and 30 minutes
\n", "
C
\n"], ["970", "
Very true
\n", "
4
\n"], ["971", "
Extremely true
\n", "
5
\n"], ["972", "
Never true
\n", "
1
\n"], ["973", "
Rarely true
\n", "
2
\n"], ["974", "
Sometimes true
\n", "
3
\n"], ["975", "
Usually true
\n", "
4
\n"], ["976", "
Always true
\n", "
5
\n"], ["977", "
Very unlikely
\n", "
1
\n"], ["978", "
Unlikely
\n", "
2
\n"], ["979", "
Somewhat unlikely
\n", "
3
\n"], ["98", "
1 hour and 40 minutes
\n", "
D
\n"], ["980", "
Very likely
\n", "
4
\n"], ["981", "
Extremely likely
\n", "
5
\n"], ["982", "
Never
\n", "
1
\n"], ["983", "
Rarely
\n", "
2
\n"], ["984", "
Sometimes
\n", "
3
\n"], ["985", "
Frequently
\n", "
4
\n"], ["986", "
Very frequently
\n", "
5
\n"], ["987", "
Frequently true
\n", "
4
\n"], ["988", "
Very frequently true
\n", "
5
\n"], ["989", "
Almost always true
\n", "
5
\n"], ["99", "
2 hours and 15 minutes
\n", "
E
\n"], ["990", "
Usually
\n", "
4
\n"], ["991", "
Very much so
\n", "
5
\n"], ["992", "
True
\n", "
4
\n"], ["993", "
Very true
\n", "
5
\n"], ["994", "
Infrequently
\n", "
2
\n"], ["995", "
Always
\n", "
5
\n"], ["996", "
Almost always
\n", "
5
\n"], ["997", "
Strongly disagree
\n", "
1
\n"], ["998", "
Disagree
\n", "
2
\n"], ["999", "
Neutral
\n", "
3
\n"]]}