1 How often have you experienced the death of a spouse (or comparable relationship)?

	0
	1
	2

2. How often did you go through a divorce (or comparable breakup) over the last two years?

	0
	1
	2

3. During this same time period, were you legally seperated from your spouse?

	no
	yes

4. Did you serve time in jail or prison anytime during the last two years?

	yes
	no

5. How many close family members (pets included) have died during the past two years?

	0
	1
	2
	3
	4
	5 or more

6. Have you experienced personal injury or illness during that same time frame?

	no
	yes

7. How many times were you married over the last two years?

	0
	1
	2
	3+

8. During the past two years, how often were you fired or laid-off from work?

	no
	once
	twice
	three
	four
	five or more

9. Over the past two years, have you experienced marital seperation?

	no
	yes

10. Did you retire sometime during the past two years?

	no
	yes

11. In the last two years has a family member experienced a change in their health?

	no
	yes

12. How often did you become pregnant (or were part of a pregnant couple) over the last two years?

	0
	1
	2
	3 or more

13. Have you experienced problems in sexual performance over the last two years?

	no
	yes

14. Did you acquire a new family member at any time over the last two years?

	no
	yes

15. Over the past two years, did you experience a business readjustment (e.g., worker in a merger, shift change)?

	no
	yes

16. Did you experience a significant change in finances over the past two years?

	no
	yes

17. Did you experience the death of a close friend over the last two years?

	no
	yes

18. Over the past 2 years, have you changed careers or go into a different line of work?

	no
	yes

Over the past 2 years, have you and your spouse (or other long-term relatioship partner) argued more often?

	no
	yes

20. Over the last two years did you take out a loan for a major purchase (such as a home)?

	no
	yes

21. Did you go through home foreclosure of a mortgage or loan at any time over the last two years?

	no
	yes

22. Over the last two years, have you experienced a significant change in work duties or responsibility?

	no
	yes

23. Over the last two years, how many children moved away from home?

	0
	1
	2
	3
	4 or more

24. Were there troubles with your in-laws (or parents of significant other in a long-term relationship) at any time over the last two years?

	no
	yes

25. How many instances of outstanding personal achievement have you acquired during the last two years?

	0
	1
	2
	3
	4+

26. Over the last two years, did your spouse (or comparable other) begin or stop working?

	no
	yes

27. Did you begin or finish school over the last two years?

	yes
	no

28. Have you experienced a change in living conditions over the last two years?

	yes
	no

29. Did you revise any particular habits over the last two years?

	no
	yes

30. Over the last two years, did you experience trouble with your boss or supervisor?

	yes
	no

31. Over the last two years did you change schools?

	no
	yes

32. Over the last two years, did you have a change in residence?

	no
	yes

33. Was there a change in work hours or conditions to adapt to over the last two years?

	yes
	no

34. Did you experience a change in social activities?

	no
	yes

35. Did you change your usual church activities over the last two years?

	yes
	no

36. Did you experience a change in what you do for recreation over the last two years?

	no
	yes

37. During this same two year time period, did you take out a mortgage or loan for a lesser purchase (such as a car or TV)?

	no
	yes

38. Have you experienced a change in sleeping habits over the last two years?

	yes
	no

39. Did you notice a change in the number of family get-togethers you had to attend during the same time frame?

	no
	yes

Over this same last two year period, did you change your eating habits significantly?

	no
	yes

41. Over the last two years, how often did you plan and/or go on vaction?

	0
	1
	2
	3
	4+

42. Did you prepare for and help celebrate a major winter holiday (e.g., Christmas) over the last two years?

	no
	yes

43. Over the last two years, were you guilty of any minor law violations (i.e., speeding, parking)?

	yes
	no