PHI stands for "Protected Health Information" (Y = Yes, N = No)
| Display | Field | Phi | Field type | Condition choices | Field note | Header | |
|---|---|---|---|---|---|---|---|
| 1. When you were 13 or younger, was there ever a time when you had a lot of trouble paying attention in the school or a time when little distractions made it very hard for you to keep your mind on what you were doing? IF NO, SKIP TO Question 12 | adhd_1 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 2. Did you make a lot of careless mistakes in school, like not reading the instructions or leaving questions blank by accident | adhd_2 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 3. Were you easily distracted when trying to complete a task while playing a game? | adhd_3 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 3a. Did you have trouble sticking to one activity or when you were playing or doing one thing, did you often stop what you were doing because you'd think of something else you'd rather do | adhd_3a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 4. Did you tune people out or did your parents or teachers complain that you didn't listen to them when they talked to you? | adhd_4 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 5. Did you often leave projects incomplete or did you have a hard time following through on things? | adhd_5 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 5a. Did your parents or teachers complain that you didn't follow instructions? | adhd_5a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 6. Did you often have trouble organizing tasks and activities or did other people tell you that you were disorganized? | adhd_6 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 6a. Was your desk or locker at school a mess, to the point you had difficulty finding the things you needed or did your teachers complain that your assignments were messy and disorganized? | adhd_6a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 7. Did you dislike tasks or activities that required a lot of attention? | adhd_7 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 8. Did you lose a lot like homework assignments or things around your home? | adhd_8 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 9. Were you easily distracted by things going on around you? | adhd_9 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 10. Did you often leave your homework at home or leave things outside by accident? | adhd_10 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 10a. Were you often forgetful throughout your day or did other people tell you that you were forgetful? | adhd_10a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 11. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Count number of boxes with at least one Yes response and enter here | adhd_11 | N | text | - | - | - | |
| 12. When you were age 13 or younger, was there ever a time when you had a lot of difficulty staying seated when you were supposed to or a time when you got into trouble because you didn't think before you acted? | adhd_12 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If BOTH Q.1 and Q.12 are NO, skip to T.Global Assessment Scale If Q.1 is YES and Q.12 is NO, skip to question 123 | if_both_q_1_and_q_12_are_n | N | descriptive | - | - | - | |
| 13. Did you have a hard time keeping your arms and legs still or did people often tell you to sit still, to stop moving or to stop squirming in your seat? | adhd_13 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 14. Did you often leave your seat when you were not supposed to in school or in other places where being seated was required? | adhd_14 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| If yes: Did you often get into trouble for this? | adhd_14a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 15. Did your parents often remind you to walk instead of run when you were out together or did your parents or teachers complain about you climbing things you shouldn't? | adhd_15 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 16. Did you have a hard time playing quietly or did your parents or teachers often tell you to quiet down when you were playing? | adhd_16 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 17. Was it hard for you to slow down or stay in one place for very long, or did people tell you to slow down a lot? | adhd_17 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 18. Did people say you talked too much or did you get into trouble at school for talking when you were not supposed to? | adhd_18 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 19. Did you talk out of turn at home or did you sometimes call out the answer before you were called out at school? | ahdd_19 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 20. Was it hard for you to wait for your turn at game or in line at the water fountain or in the cafeteria? | adhd_20 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 21. Did your parents, teachers or kids you knew complain that you cut them off when they were talking? | adhd_21 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 22. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Count the number of Yes response | adhd_22 | N | text | - | - | - | |
| 23. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: Is the total for either question 11 or 22 six or more? If NO, skip to Global Assessment Scale | adhd_23 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 24. Did you experience any of these experiences to the point it caused problem for you and/or your family before you were seven years old? | adhd_24 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 25. If yes: Did these behaviors cause problems for you in at least two areas of your life (like at school and at home) | adhd_25 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 25a. <h6 style="background-color:#DA70D6">INTERVIEWER</h6>: If NO to the previous question, is there any other evidence of clinically significant impairment in social, academic or occupational functioning? | adhd_25a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 26. How did these behaviors impact your functioning? | adhd_26 | Y | notes | - | - | - | |
| 27. Did you seek or receive help from a doctor or other professional for these problems? | adhd_27 | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| 27a. If yes: Did you receive medication? | adhd_27a | N | radio | 1, Yes | 0, No | 9, Unknown | - | - | |
| Specify: | specify | Y | notes | - | - | - | |
| 28. How old were you the last time you had any of these experiences to the point that it caused problems for you and/or your family? | adhd_28 | N | text | - | - | - | |
| Notes: | attention_deficit_hyperactivity_disordercsv_notes | Y | notes | - | - | - |