PHI stands for "Protected Health Information" (Y = Yes, N = No)
| Display | Field | Phi | Field type | Condition choices | Field note | Header | |
|---|---|---|---|---|---|---|---|
| 1. Have you ever been bothered by thoughts that did not make any sense, that kept coming back to you even when you tried not to have them IF NO, SKIP TO Question 2 | ad_01 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: 1a. What were they? | ad_1a | Y | notes | - | - | - | |
| 1b. What did you do about them? | ad_1b | Y | text | - | - | - | |
| 1c. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code NO if thoughts, impulses, or images are simply excessive worries about real-life problems | ad_1c | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 1d. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if the person tries to ignore or suppress such thoughts or to neutralize them with some other thought or action | ad_1d | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 1e. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Does the person recognize that the obsessions are imposed from within (not from without as in thought insertion)? | ad_1e | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if the thoughts appear to be unrelated to other AXIS I disorders which are present (e.g. Major Depression, Mania, Eating Disorders, Substance Abuse Disorder) or a general medical condition | ad_1f | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 2. Have you ever had to repeat some act over and over which you could not resist repeating in order to feel less anxious - like washing your hands, continuing things, or checking things? | ad_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 2a. What was it you did over and over? | ad_2a | Y | notes | - | - | - | |
| 2b. What were you afraid would happen if you did not do it? | ad_2b | Y | notes | - | - | - | |
| 2c. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if the behavior is designed to neutralize or prevent something unwanted, yet is not realistically connected with what it is meant to neutralize or prevent. | ad_2c | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 2d. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if the thoughts appear to be unrelated to other AXIS I disorders which are present (e.g., Major Depression, Mania, Eating Disorder, Substance Abuse Disorder) or a general medical condition. | ad_2d | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 3. Did you feel that these behaviors were excessive or unreasonable? | ad_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 4. How much time did you spend doing (Compulsion) and or thinking about (Obsession) each day? | ad_4 | N | text | - | in hours | - | |
| 5. Did you seek help from anyone, like a doctor or other professional? | ad_5 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 6. Did you take any medication? | ad_6 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: Specify: | ad_6_spec | Y | text | - | - | - | |
| 7. What effect did these (Obsessions and/or Compulsions) have on your life? | ad_7 | Y | text | - | - | - | |
| 7a. Did these (Obsessions and/or Compulsions) bother you a lot? | ad_7a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 7b. Did they significantly interfere with how you managed your work, school, household tasks, or social relationships? | ad_7b | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 7c. Did these (Obsessions and/or Compulsions) cause you a lot of anxiety or distress? | ad_7c | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 8. How old were you the first time you were bothered by (Obsessions and/or Compulsion)? | ad_8 | N | text | - | - | - | |
| 9. How old were you the last time you were bothered by (Obsession and/or Compulsion) | ad_9 | N | text | - | - | - | |
| 10. Did you ever have (Obsession and/or Compulsion) at some time other than within two months of having (Depression/Psychosis)? | ad_10 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| DIAGNOSTIC CRITERIA FOR OBSESSIVE COMPULSIVE DISORDER | ad_diag_1 | N | checkbox | 1, Obsession - recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress | 2, Obsession - the thoughts, impulses, or images are simply excessive worries about real-life problems | 3, Obsession - the person attempts to ignore or suppress such thoughts, impulses or images, or to neutralize them with some other thought or action | 4, Obsession - the person recognizes that the obsessional thoughts, impulses, or images are the product of his or her own mind (not imposed from without as in thought insertion) | 5, Compulsion - repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly | 6, Compulsion - the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive | 7, At some point during the course of the disorder, the person has recognized that the obsession or compulsion are excessive or unreasonable | 8, The obsessions or compulsions cause marked distress, are time-consuming (take more than one hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships | 9, If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of Eating Disorder, hair pulling in the presence of Trichotillomania; concern about appearance in the presence of Body Dismorphic Disorder; preoccupation of drugs in the presence of Substance Use Disorder, preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder) | 10, The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. | - | - | |
| 11. Have you ever had panic attacks or anxiety attacks when you suddenly felt very frightened in situations that are usually not considered threatening? | ad_11 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 11a. If no: Have you ever had sudden unexplained episodes of physical symptoms such as rapid or loud heartbeat, feeling faint or light headed, sweating, trembling? How about sudden, unexplained episodes of chest tightness or a feeling of smothering | ad_11a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 12. Describe spells and situations in which (Symptoms indicated above) happen: (Are the attacks predictable) | ad_12 | Y | text | - | - | - | |
| 12a. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code NO if the attacks were predictable.Code YES if attacks were at least initially unexpected and seemed to be coming out of the blue even if they later became triggered by one particular stimulus. | ad_12a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 12b. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code NO if the attacks were associated exclusively with physical exertion or life threatening situations | ad_12b | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| sudden rapid heatbeat, you heart pounding loudly | sudden_rapid_heatbeat_you | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| choking | choking | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| sudden sweating | sudden_sweating | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| sudden trembling or shaking | sudden_trembling_or_shakin | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| hot flashes or chills | hot_flashes_or_chills | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| chest tightness or pain | chest_tightness_or_pain | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| shortness of breath, or a feeling of smothering | shortness_of_breath_or_a_f | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| dizziness, lightheadedness, feeling unsteady or faint | dizziness_lightheadedness | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| numbness or tingling | numbness_or_tingling | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| fear of dying during the attack | fear_of_dying_during_the_a | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| nausea or abdominal distress | nausea_or_abdominal_distre | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| feeling that you or the world around you was strane or unreal | feeling_that_you_or_the_wo | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| fear of going crazy or doing something uncontrolled | fear_of_going_crazy_or_doi | N | checkbox | 0, Ever - Yes | 1, Ever - No | 2, Ever - Unknown | 3, Most Attacks - Yes | 4, Most Attacks - No | 5, Most Attacks - Unknown | - | - | |
| 14. Count positive symptoms from Most Attacks and enter here | ad_14 | N | text | - | - | - | |
| 15. Was there ever a time when four of these symptoms occurred together? IF NO, SKIP TO PHOBIC DISORDER (Starting question 28) | ad_15 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: | ad_15_yes | N | descriptive | - | - | - | |
| 15a. Did these symptoms develop and become intense within 10 minutes | ad_15a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 15a1. If yes: Did this happen more than once? | ad_15a1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 16. How many panic attacks like this have you had? | ad_16 | N | text | - | - | - | |
| 17. Have you ever had at least four of these attacks within a four-week period? | ad_17 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 18a. After having an attack, have you been afraid of having another one? | ad_18a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 18b. Have you been worried about the implications or consequences of the attack? | ad_18b | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 18c. Have you changed your behavior because of the attack? | ad_18c | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: Specify: | ad_18c_spec | Y | text | - | - | - | |
| 18c1. If yes to questioon 18 a,b,c: How long did you fear, worry or change in your behavior last? | ad_18c1 | N | text | - | in Weeks | - | |
| 19. Did you seek help from anyone, like a doctor or other professional? | ad_19 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 20. Did you take any medications for these attacks? | ad_20 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: Specify. | ad_20_yes | Y | text | - | - | - | |
| 21. Did you only have the attacks when you were consuming a lot of caffeine or alcohol or taking drugs like amphetamines? | ad_21 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: Specify: | ad_21_yes | Y | text | - | - | - | |
| 22a. Did a doctor ever tell you that you had a medical condition (e.g. overactive thyroid?) that might have been responsible for these attacks? | ad_22a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 22b. Did a doctor ever tell you that you had a psychiatric condition (e.g. phobias, OCD, PTSD) that might have been responsible for these attacks? | ad_22b | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 23. How old were you when you first time had a panic attack? | ad_24 | N | text | - | - | - | |
| 24. How old were you when you last time had a panic attack? | ad_23 | N | text | - | - | - | |
| 25. What proportion of panic attacks have occurred during depression? | ad_25 | N | radio | 0, None | 1, Some | 2, Most | 3, All | 9, Unknown | - | - | |
| 26. What proportion of panic attacks have occurred during mania? | ad_26 | N | radio | 0, None | 1, Some | 2, Most | 3, All | 9, Unknown | - | - | |
| 27. What proportion of panic attacks have occurred at other times? | ad_27 | N | radio | 0, None | 1, Some | 2, Most | 3, All | 9, Unknown | - | - | |
| DIAGNOSTIC CRITERIA FOR PANIC DISORDER | ad_diag_po | N | checkbox | 1, 1A. palpitations, pounding heart, or accelerated heart rate | 2, 1B. sweating | 3, 1C. trembling or shaking | 4, 1D. sensations of shortness of breath or smothering | 5, 1E. feeling of choking | 6, 1F. chest pain or discomfort | 7, 1G. nausea or abdominal distress | 8, 1H. feeling dizzy, unsteady, lightheaded, or faint | 9, 1I. derealization (feeling of unreality) or depersonalization (being detached from oneself) | 10, 1J. fear of losing control or going crazy | 11, 1K. fear of dying | 12, 1L. parasthesias (numbness or tingling sensations) | 13, 1M. chills or hot flushes | 14, 2A. persistent concern about having additional attacks | 15, 2B. worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy") | 16, 2C. a significant change in behavior related to the attacks | 17, A. Both (1) and (2) | 18, B. Absence of Agoraphobia | 19, C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or general medical condition (e.g. hyperthyroidism). | 20, D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations); Specific Phobia (e.g., on exposure to specific phobic situations); Obsessive Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination); Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor); or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives). | - | - | |
| 28. Have you ever been excessively afraid of.... (If no to all, skip to Eating Disorders) | ad_28 | N | descriptive | - | - | - | |
| Agoraphobic: going out alone, being alone in a crowd or in stores, or being in places where you feel you cannot escape or get help? | ad_28a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| DIAGNOSTIC CRITERIA FOR AGORAPHOBIA WITHOUT HISTORY OF PANIC DISORDER | ad_diag_po2 | N | checkbox | 1, Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or which help might not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic like symptoms.Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, in car | 2, The situations are avoided (e.g., travel is restricted), or else endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion | 3, The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as Social Phobia (e.g., avoidance limited to social situations because of fear of embarrassment); Specific Phobia (e.g., avoidance limited to a single situation like elevators); Obsessive Compulsive Disorder (e.g., avoidance of dirt in someone with an obsession with contamination); Posttraumatic Stress Disorder (e.g., avoidance of stimuli associated with a severe stressor); or Separation Anxiety Disorder (e.g., avoidance of leaving home or relatives) | 4, B. Criteria have never been met for Panic Disorder | 5, C. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse. a medication) or a general medical condition. | 6, D. If an associated general medical condition is present, the fear described in Criterion A is clearly in excess of that usually associated with the condition. | - | - | |
| DIAGNOSTIC CRITERIA FOR PANIC DISORDER WITH AGORAPHOBIA | ad_diag_agphb | N | checkbox | 1, 1. recurrent and unexpected panic attacks | 2, 2A. persistent concern about having additional attacks | 3, 2B. worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy") | 4, 2C. a significant change in behavior related to the attacks | 5, A. Both (1) and (2) | 6, B.1. Presence of Agoraphobia - Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help might not be available in the event of having an unexpected or situationally predisposed Panic Attack or panic-like symptoms.Agoraphobic fears typically involve characteristic clusters of situations that include being outside the home alone; being in a crowd or standing in a line; being on a bridge; and traveling in a bus, train, or automobile | 7, B.2. Presence of Agoraphobia - The situations are avoided (e.g., travel is restricted), or else endured with marked distress or with anxiety about having a Panic Attack or panic-like symptoms, or require the presence of a companion | 8, B.3. The anxiety or phobic avoidance is not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations); Specific Phobia (e.g., on exposure to specific phobic situations); Obsessive Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination); Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor); or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives). | 9, C. The Panic Attacks are not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or general medical condition (e.g. hyperthyroidism). | 10, D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations); Specific Phobia (e.g., on exposure to specific phobic situations); Obsessive Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination); Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor); or Separation Anxiety Disorder (e.g., in response to being away from home or close relatives). | - | - | |
| Social: doing certain things in front of people like speaking, eating or writing? | ad_28b | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| DIAGNOSTIC CRITERIA FOR SOCIAL PHOBIA | diag_scphb | N | checkbox | 1, A marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others.The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing | 2, Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally predisposed Panic Attack | 3, The person recognizes that this fear is excessive or unreasonable | 4, The feared social or performance situations are avoided or else endured with intense anxiety or distressed | 5, The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. | 6, In individuals under age 18 years, the duration is at least six months | 7, The fear or avoidance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or general medical conditions and is not better accounted for by another mental disorder (e.g., Panic Disorder With or Without Agoraphobic, Separation Anxiety Disorder, Body Dysmorphic Disorder, a Pervasive Developmental Disorder, or Schizoid Personality Disorder). | 8, If a general medical condition or another mental disorder is present, the fear in criterion A is unrelated to it, e.g., the fear is not of stuttering, trembling in Parkinson's disease or exhibiting abnormal eating behavior in Anorexia Nervosa or Bulimia Nervosa. | - | - | |
| Simple/Specific: certain animals, height, or being closed in | ad_28c | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| DIAGNOSTIC CRITERIA FOR SPECIFIC PHOBIA | ad_diag_spphb | N | checkbox | 1, Marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., flying, heights, animals, receiving an injection, seeing blood) | 2, Exposure to the phobic stimulus almost invariably provokes an immediate anxiety response, which may take the form of a situationally bound or situationally predisposed Panic Attack | 3, The person recognizes that the fear is excessive or unreasonable | 4, The phobic situation(s) is avoided or else endured with intense anxiety and distress | 5, The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person's normal routine, occupational (or academic) functioning, or social activities or relationships, or there is a marked distress about having the phobia | 6, In individuals under 18 years of age, the duration is at least 6 months | 7, The anxiety, Panic Attacks, or phobic avoidance associated with he specific object or situation are not better accounted for by another mental disorder, such as Obsessive Compulsive Disorder (e.g., avoidance of school); Social Phobia (e.g., avoidance of social situations because of fear of embarrassment); Panic Disorder With Agoraphobia, or Agoraphobia Without History of Panic Disorder. | - | - | |
| 29. Did you go out of your way to avoid (If no to any, skip to Eating Disorders) | ad_29 | N | descriptive | - | - | - | |
| Agoraphobic fear? | ad_29a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Social fear? | ad_29b | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Simple/Specific fear? | ad_29c | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Agoraphobic Fears | ad_30a | Y | notes | - | - | - | |
| 30a1. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Did the avoidant behavior begin during or just after a panic attack? | ad_30a1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 30b. Social Fears | ad_30b | Y | notes | - | - | - | |
| 30b1. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Did the avoidant behavior begin during or just after a panic attack? | ad_30b1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 30c. Simple/Specific Fears | ad_30c | Y | notes | - | - | - | |
| 30c1. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Did the avoidant behavior begin during or just after a panic attack? | ad_30c1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 31. Did you almost always become anxious when you were experiencing (Feared object/situation) | ad_31 | N | descriptive | - | Check if 'Yes' | - | |
| Agoraphobic | ad_31_1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Social | ad_31_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Simple/Specific | ad_31_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 32. Were you more anxious than you should have been? | ad_32 | N | descriptive | - | Check if 'Yes' | - | |
| Agoraphobic | ad_32_1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Social | ad_32_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Simple/Social | ad_32_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 33. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if there is persistent fear of an object, activity, or situation which the subject tends to avoid or else endures with intense anxiety | ad_33 | N | descriptive | - | Check if 'Yes' | - | |
| Agoraphobic | ad_33_1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Social | ad_33_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Simple/Specific | ad_33_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 33a. Were you greatly upset about having the fear? | ad_33a | N | descriptive | - | Check if 'Yes' | - | |
| Agoraphobic | ad_33a_1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Social | ad_33a_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Simple/Specific | ad_33a_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 34. Because of (Feared object/situation), was there a difference in your social life or in how you managed your work, school or in household tasks? | ad_34 | N | descriptive | - | - | - | |
| Agoraphobic | ad_34_1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Social | ad_34_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Simple/Specific | ad_34_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: Specify: | ad_34_if_yes | Y | text | - | - | - | |
| Agoraphobic: | ad_34a | Y | notes | - | - | - | |
| Social | ad_34b | Y | notes | - | - | - | |
| Simple/Specific | ad_34c | Y | notes | - | - | - | |
| 35a. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if the fear is unrelated to substance use, medication effects or a preexisting medical disorder | ad_35a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 35b. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if the fear is unrelated to substance use, medication effects or a preexisting medical disorder | ad_35b | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 35c. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Code YES if the fear is unrelated to substance use, medication effects or a preexisting medical disorder | ad_35c | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 36. AGORAPHOBIC - Did you seek help from anyone, like a doctor or other professional? | ad_36_agoraphobic | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 36. SOCIAL - Did you seek help from anyone, like a doctor or other professional? | ad_36_social | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 36. SIMPLE/SPECIFIC - Did you seek help from anyone, like a doctor or other professional? | ad_36_simple | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 37. AGORAPHOBIC - Did you take any medications? | ad_37_agoraphobic | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 37. SOCIAL - Did you take any medications? | ad_37_social | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 37. SIMPLE - Did you take any medications? | ad_37_simple | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| AGORAPHOBIC - If yes:Specify: | ad_37_yes_agoraphobic | Y | text | - | - | - | |
| SOCIAL - If yes:Specify: | ad_37_yes_social | Y | text | - | - | - | |
| SIMPLE - If yes:Specify: | ad_37_yes_simple | Y | text | - | - | - | |
| 38. Did you ever have this problem at some time other than two months before or after having (Depression/Psychosis)? | ad_38 | N | descriptive | - | Check if 'Yes' | - | |
| Agoraphobic | ad_38_1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Social | ad_38_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Simple/Specific | ad_38_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Agoraphobic Onset Age | ad_39a | N | text | - | - | - | |
| Social Phobia Onset Age | ad_39b | N | text | - | - | - | |
| Simple/Specific Onset Age | ad_39c | N | text | - | - | - | |
| Agoraphobic | ad_40a | N | text | - | - | - | |
| Social | ad_40b | N | text | - | - | - | |
| Simple/Specific | ad_40c | N | text | - | - | - | |
| Social Phobia only | ad_84 | N | descriptive | - | - | - | |
| 41. If question 40 is 17 or less, Code YES if phobia lasted at least 6 months. | ad_41 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Notes | anxiety_disordercsv_notes | Y | notes | - | - | - |