Participate and Evaluate

Assessing Attitudes and Behaviors

* 1. Instructions: Thank you for volunteering to complete this survey. Please make no answers that could identify you individually. Using the scale provided, please indicate how much each of the following statements reflects how you were during the last seven days.

	1 Not at all	2	3	4	5	6	7 Very much
1. Within the last seven days, I have been good at resisting temptation.	1. Within the last seven days, I have been good at resisting temptation. 1 Not at all	1. Within the last seven days, I have been good at resisting temptation. 2	1. Within the last seven days, I have been good at resisting temptation. 3	1. Within the last seven days, I have been good at resisting temptation. 4	1. Within the last seven days, I have been good at resisting temptation. 5	1. Within the last seven days, I have been good at resisting temptation. 6	1. Within the last seven days, I have been good at resisting temptation. 7 Very much
2. Within the last seven days, I have had a hard time breaking bad habits.	2. Within the last seven days, I have had a hard time breaking bad habits. 1 Not at all	2. Within the last seven days, I have had a hard time breaking bad habits. 2	2. Within the last seven days, I have had a hard time breaking bad habits. 3	2. Within the last seven days, I have had a hard time breaking bad habits. 4	2. Within the last seven days, I have had a hard time breaking bad habits. 5	2. Within the last seven days, I have had a hard time breaking bad habits. 6	2. Within the last seven days, I have had a hard time breaking bad habits. 7 Very much
3. Within the last seven days, I have felt lazy.	3. Within the last seven days, I have felt lazy. 1 Not at all	3. Within the last seven days, I have felt lazy. 2	3. Within the last seven days, I have felt lazy. 3	3. Within the last seven days, I have felt lazy. 4	3. Within the last seven days, I have felt lazy. 5	3. Within the last seven days, I have felt lazy. 6	3. Within the last seven days, I have felt lazy. 7 Very much
4. Within the last seven days, I have said the wrong thing at the wrong time.	4. Within the last seven days, I have said the wrong thing at the wrong time. 1 Not at all	4. Within the last seven days, I have said the wrong thing at the wrong time. 2	4. Within the last seven days, I have said the wrong thing at the wrong time. 3	4. Within the last seven days, I have said the wrong thing at the wrong time. 4	4. Within the last seven days, I have said the wrong thing at the wrong time. 5	4. Within the last seven days, I have said the wrong thing at the wrong time. 6	4. Within the last seven days, I have said the wrong thing at the wrong time. 7 Very much
5. In the past seven days, I have not let myself lose control.	5. In the past seven days, I have not let myself lose control. 1 Not at all	5. In the past seven days, I have not let myself lose control. 2	5. In the past seven days, I have not let myself lose control. 3	5. In the past seven days, I have not let myself lose control. 4	5. In the past seven days, I have not let myself lose control. 5	5. In the past seven days, I have not let myself lose control. 6	5. In the past seven days, I have not let myself lose control. 7 Very much
6. During the past week, I have done things that were bad for me because they are fun.	6. During the past week, I have done things that were bad for me because they are fun. 1 Not at all	6. During the past week, I have done things that were bad for me because they are fun. 2	6. During the past week, I have done things that were bad for me because they are fun. 3	6. During the past week, I have done things that were bad for me because they are fun. 4	6. During the past week, I have done things that were bad for me because they are fun. 5	6. During the past week, I have done things that were bad for me because they are fun. 6	6. During the past week, I have done things that were bad for me because they are fun. 7 Very much
7. In the past week, people have been able to count on me to keep on schedule.	7. In the past week, people have been able to count on me to keep on schedule. 1 Not at all	7. In the past week, people have been able to count on me to keep on schedule. 2	7. In the past week, people have been able to count on me to keep on schedule. 3	7. In the past week, people have been able to count on me to keep on schedule. 4	7. In the past week, people have been able to count on me to keep on schedule. 5	7. In the past week, people have been able to count on me to keep on schedule. 6	7. In the past week, people have been able to count on me to keep on schedule. 7 Very much
8. For the past week, it has been hard to get up in the mornings.	8. For the past week, it has been hard to get up in the mornings. 1 Not at all	8. For the past week, it has been hard to get up in the mornings. 2	8. For the past week, it has been hard to get up in the mornings. 3	8. For the past week, it has been hard to get up in the mornings. 4	8. For the past week, it has been hard to get up in the mornings. 5	8. For the past week, it has been hard to get up in the mornings. 6	8. For the past week, it has been hard to get up in the mornings. 7 Very much
9. During the past week, I have had trouble saying no.	9. During the past week, I have had trouble saying no. 1 Not at all	9. During the past week, I have had trouble saying no. 2	9. During the past week, I have had trouble saying no. 3	9. During the past week, I have had trouble saying no. 4	9. During the past week, I have had trouble saying no. 5	9. During the past week, I have had trouble saying no. 6	9. During the past week, I have had trouble saying no. 7 Very much
10. During the past seven days, I have changed my mind often.	10. During the past seven days, I have changed my mind often. 1 Not at all	10. During the past seven days, I have changed my mind often. 2	10. During the past seven days, I have changed my mind often. 3	10. During the past seven days, I have changed my mind often. 4	10. During the past seven days, I have changed my mind often. 5	10. During the past seven days, I have changed my mind often. 6	10. During the past seven days, I have changed my mind often. 7 Very much
11. In the past seven days, I have blurted out whatever was on my mind.	11. In the past seven days, I have blurted out whatever was on my mind. 1 Not at all	11. In the past seven days, I have blurted out whatever was on my mind. 2	11. In the past seven days, I have blurted out whatever was on my mind. 3	11. In the past seven days, I have blurted out whatever was on my mind. 4	11. In the past seven days, I have blurted out whatever was on my mind. 5	11. In the past seven days, I have blurted out whatever was on my mind. 6	11. In the past seven days, I have blurted out whatever was on my mind. 7 Very much
12. During the past week, people would say that my behavior has been impulsive.	12. During the past week, people would say that my behavior has been impulsive. 1 Not at all	12. During the past week, people would say that my behavior has been impulsive. 2	12. During the past week, people would say that my behavior has been impulsive. 3	12. During the past week, people would say that my behavior has been impulsive. 4	12. During the past week, people would say that my behavior has been impulsive. 5	12. During the past week, people would say that my behavior has been impulsive. 6	12. During the past week, people would say that my behavior has been impulsive. 7 Very much
13. In the past seven days, I have refused things that were bad for me.	13. In the past seven days, I have refused things that were bad for me. 1 Not at all	13. In the past seven days, I have refused things that were bad for me. 2	13. In the past seven days, I have refused things that were bad for me. 3	13. In the past seven days, I have refused things that were bad for me. 4	13. In the past seven days, I have refused things that were bad for me. 5	13. In the past seven days, I have refused things that were bad for me. 6	13. In the past seven days, I have refused things that were bad for me. 7 Very much
14. In the past seven days, I have spent too much money needlessly.	14. In the past seven days, I have spent too much money needlessly. 1 Not at all	14. In the past seven days, I have spent too much money needlessly. 2	14. In the past seven days, I have spent too much money needlessly. 3	14. In the past seven days, I have spent too much money needlessly. 4	14. In the past seven days, I have spent too much money needlessly. 5	14. In the past seven days, I have spent too much money needlessly. 6	14. In the past seven days, I have spent too much money needlessly. 7 Very much
15. In the past seven days, I have kept everything neat.	15. In the past seven days, I have kept everything neat. 1 Not at all	15. In the past seven days, I have kept everything neat. 2	15. In the past seven days, I have kept everything neat. 3	15. In the past seven days, I have kept everything neat. 4	15. In the past seven days, I have kept everything neat. 5	15. In the past seven days, I have kept everything neat. 6	15. In the past seven days, I have kept everything neat. 7 Very much
16. In the past seven days, I have gone to extremes.	16. In the past seven days, I have gone to extremes. 1 Not at all	16. In the past seven days, I have gone to extremes. 2	16. In the past seven days, I have gone to extremes. 3	16. In the past seven days, I have gone to extremes. 4	16. In the past seven days, I have gone to extremes. 5	16. In the past seven days, I have gone to extremes. 6	16. In the past seven days, I have gone to extremes. 7 Very much
17. In the past seven days, I have felt like I needed to be more self-disciplined.	17. In the past seven days, I have felt like I needed to be more self-disciplined. 1 Not at all	17. In the past seven days, I have felt like I needed to be more self-disciplined. 2	17. In the past seven days, I have felt like I needed to be more self-disciplined. 3	17. In the past seven days, I have felt like I needed to be more self-disciplined. 4	17. In the past seven days, I have felt like I needed to be more self-disciplined. 5	17. In the past seven days, I have felt like I needed to be more self-disciplined. 6	17. In the past seven days, I have felt like I needed to be more self-disciplined. 7 Very much
18. In the past week, I have been dependable.	18. In the past week, I have been dependable. 1 Not at all	18. In the past week, I have been dependable. 2	18. In the past week, I have been dependable. 3	18. In the past week, I have been dependable. 4	18. In the past week, I have been dependable. 5	18. In the past week, I have been dependable. 6	18. In the past week, I have been dependable. 7 Very much
19. In the past week, I have been carried away by my feelings.	19. In the past week, I have been carried away by my feelings. 1 Not at all	19. In the past week, I have been carried away by my feelings. 2	19. In the past week, I have been carried away by my feelings. 3	19. In the past week, I have been carried away by my feelings. 4	19. In the past week, I have been carried away by my feelings. 5	19. In the past week, I have been carried away by my feelings. 6	19. In the past week, I have been carried away by my feelings. 7 Very much
20. In the past week, I have done many things on the spur of the moment.	20. In the past week, I have done many things on the spur of the moment. 1 Not at all	20. In the past week, I have done many things on the spur of the moment. 2	20. In the past week, I have done many things on the spur of the moment. 3	20. In the past week, I have done many things on the spur of the moment. 4	20. In the past week, I have done many things on the spur of the moment. 5	20. In the past week, I have done many things on the spur of the moment. 6	20. In the past week, I have done many things on the spur of the moment. 7 Very much
21. In the past seven days, I have not kept secrets very well.	21. In the past seven days, I have not kept secrets very well. 1 Not at all	21. In the past seven days, I have not kept secrets very well. 2	21. In the past seven days, I have not kept secrets very well. 3	21. In the past seven days, I have not kept secrets very well. 4	21. In the past seven days, I have not kept secrets very well. 5	21. In the past seven days, I have not kept secrets very well. 6	21. In the past seven days, I have not kept secrets very well. 7 Very much
22. In the past week, people would say that I have had strong self-discipline.	22. In the past week, people would say that I have had strong self-discipline. 1 Not at all	22. In the past week, people would say that I have had strong self-discipline. 2	22. In the past week, people would say that I have had strong self-discipline. 3	22. In the past week, people would say that I have had strong self-discipline. 4	22. In the past week, people would say that I have had strong self-discipline. 5	22. In the past week, people would say that I have had strong self-discipline. 6	22. In the past week, people would say that I have had strong self-discipline. 7 Very much
23. In the past week, I have worked or studied all night at the last minute.	23. In the past week, I have worked or studied all night at the last minute. 1 Not at all	23. In the past week, I have worked or studied all night at the last minute. 2	23. In the past week, I have worked or studied all night at the last minute. 3	23. In the past week, I have worked or studied all night at the last minute. 4	23. In the past week, I have worked or studied all night at the last minute. 5	23. In the past week, I have worked or studied all night at the last minute. 6	23. In the past week, I have worked or studied all night at the last minute. 7 Very much
24. In the past seven days, I have not been easily discouraged.	24. In the past seven days, I have not been easily discouraged. 1 Not at all	24. In the past seven days, I have not been easily discouraged. 2	24. In the past seven days, I have not been easily discouraged. 3	24. In the past seven days, I have not been easily discouraged. 4	24. In the past seven days, I have not been easily discouraged. 5	24. In the past seven days, I have not been easily discouraged. 6	24. In the past seven days, I have not been easily discouraged. 7 Very much
25. In the past seven days, I should have stopped to think before acting.	25. In the past seven days, I should have stopped to think before acting. 1 Not at all	25. In the past seven days, I should have stopped to think before acting. 2	25. In the past seven days, I should have stopped to think before acting. 3	25. In the past seven days, I should have stopped to think before acting. 4	25. In the past seven days, I should have stopped to think before acting. 5	25. In the past seven days, I should have stopped to think before acting. 6	25. In the past seven days, I should have stopped to think before acting. 7 Very much
26. In the past seven days, I have engaged in healthy practices.	26. In the past seven days, I have engaged in healthy practices. 1 Not at all	26. In the past seven days, I have engaged in healthy practices. 2	26. In the past seven days, I have engaged in healthy practices. 3	26. In the past seven days, I have engaged in healthy practices. 4	26. In the past seven days, I have engaged in healthy practices. 5	26. In the past seven days, I have engaged in healthy practices. 6	26. In the past seven days, I have engaged in healthy practices. 7 Very much
27. In the past seven days, I have eaten healthy food mostly.	27. In the past seven days, I have eaten healthy food mostly. 1 Not at all	27. In the past seven days, I have eaten healthy food mostly. 2	27. In the past seven days, I have eaten healthy food mostly. 3	27. In the past seven days, I have eaten healthy food mostly. 4	27. In the past seven days, I have eaten healthy food mostly. 5	27. In the past seven days, I have eaten healthy food mostly. 6	27. In the past seven days, I have eaten healthy food mostly. 7 Very much
28. In the past seven days, pleasure and fun sometimes have kept me from getting work done.	28. In the past seven days, pleasure and fun sometimes have kept me from getting work done. 1 Not at all	28. In the past seven days, pleasure and fun sometimes have kept me from getting work done. 2	28. In the past seven days, pleasure and fun sometimes have kept me from getting work done. 3	28. In the past seven days, pleasure and fun sometimes have kept me from getting work done. 4	28. In the past seven days, pleasure and fun sometimes have kept me from getting work done. 5	28. In the past seven days, pleasure and fun sometimes have kept me from getting work done. 6	28. In the past seven days, pleasure and fun sometimes have kept me from getting work done. 7 Very much
29. In the past week, I have had trouble concentrating.	29. In the past week, I have had trouble concentrating. 1 Not at all	29. In the past week, I have had trouble concentrating. 2	29. In the past week, I have had trouble concentrating. 3	29. In the past week, I have had trouble concentrating. 4	29. In the past week, I have had trouble concentrating. 5	29. In the past week, I have had trouble concentrating. 6	29. In the past week, I have had trouble concentrating. 7 Very much
30. In the past seven days, I have worked effectively toward long-term goals.	30. In the past seven days, I have worked effectively toward long-term goals. 1 Not at all	30. In the past seven days, I have worked effectively toward long-term goals. 2	30. In the past seven days, I have worked effectively toward long-term goals. 3	30. In the past seven days, I have worked effectively toward long-term goals. 4	30. In the past seven days, I have worked effectively toward long-term goals. 5	30. In the past seven days, I have worked effectively toward long-term goals. 6	30. In the past seven days, I have worked effectively toward long-term goals. 7 Very much
31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong.	31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong. 1 Not at all	31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong. 2	31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong. 3	31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong. 4	31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong. 5	31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong. 6	31. In the past seven days, sometimes I could not stop myself from doing something, even if I knew it was wrong. 7 Very much
32. In the past seven days, I often acted without thinking through all the alternatives.	32. In the past seven days, I often acted without thinking through all the alternatives. 1 Not at all	32. In the past seven days, I often acted without thinking through all the alternatives. 2	32. In the past seven days, I often acted without thinking through all the alternatives. 3	32. In the past seven days, I often acted without thinking through all the alternatives. 4	32. In the past seven days, I often acted without thinking through all the alternatives. 5	32. In the past seven days, I often acted without thinking through all the alternatives. 6	32. In the past seven days, I often acted without thinking through all the alternatives. 7 Very much
33. In the past week, I have lost my temper too easily.	33. In the past week, I have lost my temper too easily. 1 Not at all	33. In the past week, I have lost my temper too easily. 2	33. In the past week, I have lost my temper too easily. 3	33. In the past week, I have lost my temper too easily. 4	33. In the past week, I have lost my temper too easily. 5	33. In the past week, I have lost my temper too easily. 6	33. In the past week, I have lost my temper too easily. 7 Very much
34. In the past week, I often interrupted people.	34. In the past week, I often interrupted people. 1 Not at all	34. In the past week, I often interrupted people. 2	34. In the past week, I often interrupted people. 3	34. In the past week, I often interrupted people. 4	34. In the past week, I often interrupted people. 5	34. In the past week, I often interrupted people. 6	34. In the past week, I often interrupted people. 7 Very much
35. In the past seven days, I sometimes have used drugs or alcohol excessively.	35. In the past seven days, I sometimes have used drugs or alcohol excessively. 1 Not at all	35. In the past seven days, I sometimes have used drugs or alcohol excessively. 2	35. In the past seven days, I sometimes have used drugs or alcohol excessively. 3	35. In the past seven days, I sometimes have used drugs or alcohol excessively. 4	35. In the past seven days, I sometimes have used drugs or alcohol excessively. 5	35. In the past seven days, I sometimes have used drugs or alcohol excessively. 6	35. In the past seven days, I sometimes have used drugs or alcohol excessively. 7 Very much
36. In the past seven days, I always have been on time.	36. In the past seven days, I always have been on time. 1 Not at all	36. In the past seven days, I always have been on time. 2	36. In the past seven days, I always have been on time. 3	36. In the past seven days, I always have been on time. 4	36. In the past seven days, I always have been on time. 5	36. In the past seven days, I always have been on time. 6	36. In the past seven days, I always have been on time. 7 Very much

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