- How important is each of the following to you in your life? Mark one answer (Not Important, Somewhat Important, Not Sure, Quite Important, Extremely Important) for each.
- 9. Being religious or spiritual.
- 11. Getting to know people of a different race than I am.
- 12. Speaking up for equality (everyone should have the same rights and opportunities).
- 13. Giving time or money to make life better for other people.
- 31. During the last four weeks, how many days of school have you missed because you skipped or "ditched"?
- How much do you agree or disagree with the following? (Strongly Agree, Agree, Not Sure, Disagree, Strongly Disagree)
- 36. On the whole, I like myself.
- 38. I like to do exciting things, even if they are dangerous.
- 39. At times, I think I am no good at all.
- 48. My parents often tell me they love me.
- During the last 12 months, how many times have you . . . ?
- 56. Stolen something from a store
- 57. Gotten into trouble with the police
- 58. Hit or beat up someone
- 59. Damaged property just for fun (such as breaking windows, scratching a car, putting paint on walls, etc.)
- People who know me would say that this is (Not at all like me, A little like me, Somewhat like me, Quite like me, Very much like me) . . .
- 68. Knowing how to say "no" when someone wants me to do things I know are wrong or dangerous.
- 72. Respecting the values and beliefs of people who are of a different race or culture than I am.
- 73. Giving up when things get hard for me.
- 78. Enjoying being with people who are of a different race than I am.
- 84. Think back over the last two weeks. How many times have you had five or more drinks in a row? (A "drink" is a glass of wine, a bottle or can of beer, a shot glass of liquor, or a mixed drink.)
- 85. If you came home from a party and your parents found out that you had been drinking, how upset do you think they would be?
- 86. How many times, if any, have you smoked cigarettes in your lifetime?
- 89. During the last two weeks, how many cigarettes have you smoked?
- 93. How many times have you used cocaine (crack, coke, snow, rock) during the last 12 months?
- 95. During the last 12 months, how many times have you driven a car after you had been drinking?
- 99. In an average week, how many times do all of the people in your family who live with you eat dinner together?
- 100. How often did you feel sad or depressed during the last month?
- 101. Have you ever tried to kill yourself?
- 102. Have you ever had sexual intercourse ("gone all the way," "made love")?
- 103. When you have sex, how often do you and/or your partner use a birth control method such as birth control pills, a condom (rubber), foam, diaphragm, or IUD?
- How much do you agree or disagree with the following?
- 110. Sometimes I feel like my life has no purpose.
- 113. Adults in my town or city make me feel important.
- During the last 12 months, how many times have you . . . ?
- 119. Hurt someone badly enough to need bandages or a doctor
- 120. Used a knife, gun or other weapon to get something from a person
- 121. If you had an important concern about drugs, alcohol, sex, or some other serious issue, would you talk to your parents about it?
- 122. How much of the time do your parents ask you where you are going or with whom you will be?
- Among the people you consider to be your closest friends, how many . . . ?
- 123. Drink alcohol once a week or more
- 124. Have used drugs such as marijuana or cocaine
- 126. Get into trouble at school
- 129. How often do you feel afraid of getting hurt by someone in your home?
- How much do you agree or disagree with the following? (Strongly agree, Agree, Not sure, Disagree, Strongly disagree)
- 134. I don't care how I do in school.
- 135. I have lots of good conversations with my parents.
- During the last 12 months, how many times have you . . . ?
- 139. Carried a knife or gun to protect yourself
- 140. Threatened to physically hurt someone
- 141. Gambled (for example, bought lottery tickets or tabs, bet money on sports teams or card games, etc.)
- 153. How often do you binge eat (eat a lot of food in a short period of time) and then make yourself throw up or use laxatives to get rid of the food you have eaten?
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