| 62945-1 |
PhenX - exposures to violence - child protocol 181402 |
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| Indent66886-3 |
Have you ever been involved in a natural disaster, such as a tornado, hurricane, flood, or earthquake? |
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| Indent66887-1 |
How old were you the first time it happened? |
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a |
| Indent66926-7 |
Were you afraid that you might die or get hurt really badly? |
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| Indent66927-5 |
Were you very scared? |
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| Indent66928-3 |
Did you feel like there was nothing you could do to stop what was happening? |
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| Indent66890-5 |
Was there another time this happened [LTVH] |
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| Indent66891-3 |
Have you ever been involved in a man-made disaster, such as a fire, train crash, car accident, or building collapse? |
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| Indent67107-3 |
Have you ever fought in a war? |
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| Indent66893-9 |
Have you ever lived in a war zone? (For example, the Persian Gulf or Bosnia). |
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| Indent67108-1 |
Have you ever had a serious accident at home, at school, or somewhere else? |
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| Indent66895-4 |
Have you ever been exposed to dangerous chemicals or radioactivity? |
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| Indent67109-9 |
Has anyone ever shot at you, stabbed you, hit you, kicked you, beaten you, punched you, slapped you around, or hurt your body in some other way? |
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| Indent66897-0 |
How many times did this person do this to you? |
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{#} |
| Indent66898-8 |
How old were you the last time this person did this to you? |
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a |
| Indent67110-7 |
Has anyone ever threatened to hurt you with any kind of a weapon, like a knife, a gun, a baseball bat, a frying pan, scissors, a stick, a rock or a bottle? |
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| Indent67111-5 |
Has anyone ever threatened to hurt you when they were standing right in front of you? |
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| Indent67112-3 |
Has anyone ever actually hurt you with any kind of a weapon, like a knife, a gun, a baseball bat, a frying pan, scissors, a stick, a rock, or a bottle? |
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| Indent66929-1 |
Before you turned 12 years old (when you were in grade school), did anyone ever hit you, kick you, beat you, punch you, slap you around, or hurt your body in some other way [LTVH] |
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| Indent67113-1 |
Before you turned 12 years old (when you were in grade school), were you ever physically abused? |
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| Indent67114-9 |
Has anyone--male or female--ever forced or pressured you into doing something sexual that you didn't want to do? |
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| Indent66932-5 |
Was there any other time when anyone, male or female, tried to force or bully you into doing something sexual that you didn't want to do, but it didn't end up happening? |
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| Indent67115-6 |
Other than what we just talked about, have there been any other times when anyone, male or female, ever tried to force or bully you into doing something sexual that you didn't want to do, but it didn't end up happening (for example, you stopped them or someone else stopped them)? |
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| Indent66930-9 |
Did anyone else ever do this to you [LTVH] |
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| Indent66933-3 |
Have you ever known someone who was murdered; that is, a parent, a brother, a sister, a very close friend, a boyfriend or girlfriend, or someone who lived with you? |
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| Indent67116-4 |
Have you ever known someone who was murdered; that is, a parent, a brother, a sister, a very close friend, a boyfriend or girlfriend, or someone who lived with you? |
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| Indent66918-4 |
Has anyone ever tried to or actually broken in to your house, garage, shed, or storage room when you were not there? |
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| Indent67117-2 |
Have you ever seen or been present when someone was murdered or hurt very badly? |
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| Indent67118-0 |
Have you ever known someone who committed suicide or killed themselves; that is, a parent, a sister, a brother, a very close friend, a boyfriend or girlfriend, or someone who lived with you? |
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| Indent67119-8 |
Have you ever seen a dead body? Don't include at a funeral, on TV, in the movies, or in a newspaper. |
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| Indent67120-6 |
Have you ever seen or heard another person be threatened with a weapon (for example, a gun or a knife)? |
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| Indent67121-4 |
Have you ever seen or heard another person be raped, sexually attacked, or made to do something sexual that they didn't want to do? |
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| Indent67122-2 |
Has anyone ever damaged or destroyed something on purpose that belonged to you or to someone who you lived with? |
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| Indent67123-0 |
Has anyone ever stolen something from you by using force or threatening to hurt you, like in a stick-up, a mugging, or a car-jacking? |
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| Indent67124-8 |
Has anyone ever tried to steal something from you by using force or threatening to hurt you? |
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| Indent66918-4 |
Has anyone ever tried to or actually broken in to your house, garage, shed, or storage room when you were not there? |
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| Indent66919-2 |
Has anyone ever tried to or actually broken in to your house, garage, shed, or storage room when you were there? |
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| Indent66934-1 |
Has anyone ever stolen something from you without your knowing it? This could be taking something from your pocket or backpack. |
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| Indent66922-6 |
Have you ever been kidnapped or held captive? |
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| Indent67091-9 |
How long were you held or not allowed to leave? |
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d;wk;mo;a |
| Indent66923-4 |
Have you ever been stalked by anyone? |
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| Indent66935-8 |
Have you ever been in any other situation in which you were afraid you might die or get really badly hurt, or when you were very scared or felt like there was nothing you could do to stop what was happening? |
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| Indent67125-5 |
Have you ever been in any other situation in which you were afraid you might die or get really badly hurt, or when you were very scared or felt like there was nothing you could do to stop what was happening? SPECIFY: |
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