Read each item thoroughly. This questionnaire has 5 pages. Please print your responses by darkening or ticking in the circle.
Ethnicity
African descent
East Indian descent
African + East Indian (mixed)
Chinese
Hispanic or Latino
Other
Sex
Male
Female
Age
Below 18
18-25
26-35
36-45
46-55
Over 55
Marital Status
Single, never married
Living together
Married
Widowed
Separated
Divorced
Do you have any children?
No
Yes
Are your parents divorced?
No
Yes
Have you experienced domestic abuse or family violence?
No
Yes
Has a parent or close family relative died in the last 12 months?
No
Yes
Have you recently ended a romantic relationship?
No
Yes
Please indicate the highest level of schooling completed by your mother
Less than high school
Highschool or equivalent (CXC)
Vocational/ technical school
Associate degree (eg. AS)
Bachelor’s degree (eg. BS)
Master’s degree (eg. MS)
Professional degree (eg, MD)
Doctorate (eg. PhD, EdD)
Please indicate the highest level of schooling completed by your father
Less than high school
Highschool or equivalent (CXC)
Vocational/ technical school
Associate degree (eg. AS)
Bachelor’s degree (eg. BS)
Master’s degree (eg. MS)
Professional degree (eg, MD)
Doctorate (eg. PhD, EdD)
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How often do you exercise?
1 – 2 times a week
2 – 3 times a week
3 - 5 times a week
5 - 6 times a week
everyday
1
Has anyone in your family been diagnosed with depression?
No
Yes
If yes, what was the outcome? (Select all that apply)
Admission into mental health hospital/clinic
Prescribed an antidepressant
There was no intervention
Committed suicide
With whom do you live during the school year? (Select all that apply)
I live alone
One or more students
My spouse or partner
My child or children
My parents
Other relatives
Friends who are not students at USC
Other
What is your level of satisfaction with your living arrangement?
Very low
Low
High
Very high
Please indicate your year of study.
1st (Freshman)
2nd (Sophomore)
3rd (Junior)
4th (Senior)
In which School are you registered?
School of Business
School of Education and Humanities
School of Science and Technology and Allied Health
School of Social Sciences
School of Theology and Religion
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Are you satisfied with your choice to pursue this degree program?
No
Yes
How many credit hours are you registered for this semester?
6 or fewer
7 – 11
12-14
15-16
17 or more
Do you consider your course load stressful?
No
Yes
Do you feel stressed about your current financial situation?
No
Yes
How do you meet your expenses for university? Select the response that best approximates the amount of support from each various source.
None
Very
Little
Less
than
Half
About
Half
More
Than
Half
All or
Nearly
All
Self (job, savings, etc)
2
3
4
5
6
7
Parents
8
9
10
11
12
13
Spouse/partner
14
15
16
17
18
19
Employer support
20
21
22
23
24
25
Government
Assistance for Tuition
Expenses Programme
(GATE)
26
27
28
29
30
31
Scholarships and
grants
32
33
34
35
36
37
Loan
38
39
40
41
42
43
Other sources
44
45
46
47
48
49
There is little I can do to change many of the important things in my life
Strongly disagree
Disagree
Neither agree or disagree
Agree
Strongly agree
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Part II
Please tick of shade the response that best describes you.
50
I do not feel sad.
I feel sad
I am sad all the time and I can't snap out of it.
I am so sad and unhappy that I can't stand it
51
I am not particularly discouraged about the future.
I feel discouraged about the future.
I feel I have nothing to look forward to.
I feel the future is hopeless and that things cannot improve
52
I do not feel like a failure.
I feel I have failed more than the average person.
As I look back on my life, all I can see is a lot of failures.
I feel I am a complete failure as a person.
53
I get as much satisfaction out of things as I used to.
I don't enjoy things the way I used to.
I don't get real satisfaction out of anything anymore.
I am dissatisfied or bored with everything.
54
I don't feel particularly guilty.
I feel guilty a good part of the time.
I feel quite guilty most of the time.
I feel guilty all of the time.
55
I don't feel I am being punished.
I feel I may be punished.
I expect to be punished.
I feel I am being punished.
56
I don't feel disappointed in myself.
I am disappointed in myself.
I am disgusted with myself.
I hate myself
57
I don't feel I am any worse than anybody else.
I am critical of myself for my weaknesses or mistakes.
I blame myself all the time for my faults.
I blame myself for everything bad that happens.
58
I don't have any thoughts of killing myself.
I have thoughts of killing myself, but I would not carry them out.
I would like to kill myself.
I would kill myself if I had the chance.
59
I don't cry any more than usual.
I cry more now than I used to.
I cry all the time now.
I used to be able to cry, but now I can't cry even though I want to
60
I am no more irritated by things than I ever was.
I am slightly more irritated now than usual.
I am quite annoyed or irritated a good deal of the time.
I feel irritated all the time
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61
I have not lost interest in other people.
I am less interested in other people than I used to be.
I have lost most of my interest in other people.
I have lost all of my interest in other people
62
I make decisions about as well as I ever could.
I put off making decisions more than I used to.
I have greater difficulty in making decisions more than I used to.
I can't make decisions at all anymore
63
I don't feel that I look any worse than I used to.
I am worried that I am looking old or unattractive.
I feel there are permanent changes in my appearance that make me look unattractive
I believe that I look ugly
64
I can work about as well as before.
It takes an extra effort to get started at doing something.
I have to push myself very hard to do anything.
I can't do any work at all.
65
I can sleep as well as usual.
I don't sleep as well as I used to.
I wake up 1-2 hours earlier than usual and find it hard to get back to sleep.
I wake up several hours earlier than I used to and cannot get back to sleep.
66
I don't get more tired than usual.
I get tired more easily than I used to.
I get tired from doing almost anything.
I am too tired to do anything.
67
My appetite is no worse than usual.
My appetite is not as good as it used to be.
My appetite is much worse now.
I have no appetite at all anymore
68
I haven't lost much weight, if any, lately.
I have lost more than five pounds.
I have lost more than ten pounds.
I have lost more than fifteen pounds
69
I am no more worried about my health than usual.
I am worried about physical problems like aches, pains, upset stomach, or constipation.
I am very worried about physical problems and it's hard to think of much else.
I am so worried about my physical problems that I cannot think of anything else.
70
I have not noticed any recent change in my interest in sex.
I am less interested in sex than I used to be.
I have almost no interest in sex.
I have lost interest in sex completely
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