Start
alspac_91_ftg
FILLING THE GAPS
Unfortunately there are some questions that we did not get to you during your pregnancy. We would therefore be very grateful if you could complete this questionnaire as soon as you can. It asks about diet, your childhood, and the occupations of yourself and your family.
The last section asks about early sexual experiences but this is optional. If you would rather not even read the questions. stop at page 15, and send the questionnaire back to us.
THANK YOU VERY MUCH FOR YOUR HELP
SECTION A: YOUR DIET AND OTHER MATTERS

Have you ever gone on a diet to lose weight?

1
Yes
2
No
If yes,
qc_A1_a == 1

how often?

1
1-2 times
2
3-5 times
3
6-10 times
4
more than 10 times

how long do your diets usually last?

1
under 1 month
2
1-3 months
3
more than 3 months

Are you, or have you ever been a vegetarian?

1
yes, I am now
2
yes,in past not now
3
no,never
If yes,
qc_A2_a == 1 || qc_A2_a == 2

how many years of your life have you been vegetarian? ... years

How many

Are you, or have you ever been, a vegan (i.e. do not eat meat, poultry, fish, eggs, butter, milk or cheese)?

1
yes, I am now
2
yes,in past not now
3
no,never
If yes,
qc_A3_a == 1 || qc_A3_a == 2

how many years of your life have you been vegan? ... years

How many

Were you breast fed as a baby?

1
Yes
2
No
9
Don't know

Do you ever take homeopathic medicines?

1
Yes often
2
Yes sometimes
3
No
SECTION B: YOUR OWN CHILDHOOD
Please indicate if any of the following events happened to you before you were 17 and how much it affected you.

Before you were 17: Your parent died

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A brother or sister died

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A relative died

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A friend died

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent had a serious illness

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent was in hospital

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You had a serious physical illness

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You were in hospital

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Brother or sister had a serious illness

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Brother or sister was in hospital

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent had a serious accident

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You had a serious accident

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Brother or sister had a serious accident

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You acquired a physical deformity

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You became pregnant

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent was imprisoned

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent was physically cruel to you

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Your parents separated

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Your parents divorced

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent remarried

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent was emotionally cruel to you

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Your parents had serious arguments

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You were sexually abused

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: A parent was mentally ill

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You discovered you were adopted

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Your family moved to a new district

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You were in trouble with the police

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You were expelled or suspended from school

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You failed an important exam

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Your family's financial circumstances got worse

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: You acquired a stepbrother or stepsister

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen

Before you were 17: Other important happening (please tick & describe)

1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Other

How many schools did you attend between the ages of 5 and 16?

How many
Looking back would you call your childhood happy? Please indicate for each age range:
-

1 - Yes very happy

2 - Yes moderately happy

3 - Not really happy

4 - No quite unhappy

5 - No very unhappy

6 - Can't remember

0-5 years
6-11 years
12-15 years
How many brothers and sisters did you have:
Brothers Sisters
How manyHow manyHow manyHow many How manyHow manyHow manyHow many
older than you
younger than you

did you have a twin?

1
yes, twin brother
2
yes, twin sister
3
no
If you had a twin sister:
qc_B35_c == 2

were you identical twins?

1
yes
2
no
3
not sure

did you usually dress alike?

1
yes, usually
2
yes, sometimes
3
no, not at all
SECTION C: EDUCATION AND OCCUPATION
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your self
-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your self Other (please describe)

1
Yes
Other
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your partner
-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known
Not applicable, no such person

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your partner Other (please describe)

1
Yes
Other
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your mother*
-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known
Not applicable, no such person

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your mother* Other (please describe)

1
Yes
Other
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your father*
-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known
Not applicable, no such person

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your father* Other (please describe)

1
Yes
Other
[* by this we mean the mother figure or father figure who was mostly responsible for bringing you up]
What is the present employment situation of yourself and your partner? Yourself
-

1 - Yes

Working for an employer full-time (more than 30 hours a week)
Working for an employer part-time (one hour or more a week)
Self-employed, employing other people
Self-employed, not employing other people
On a government employment or training scheme
Waiting to start a job already accepted
Unemployed and looking for a job
At school or in other full-time education
Unable to work because of long-term sickness or disability
Retired from paid work
Looking after the home or family

What is the present employment situation of yourself and your partner? Yourself Other (please describe)

1
Yes
Other
What is the present employment situation of yourself and your partner? Your partner
-

1 - Yes

Working for an employer full-time (more than 30 hours a week)
Working for an employer part-time (one hour or more a week)
Self-employed, employing other people
Self-employed, not employing other people
On a government employment or training scheme
Waiting to start a job already accepted
Unemployed and looking for a job
At school or in other full-time education
Unable to work because of long-term sickness or disability
Retired from paid work
Looking after the home or family

What is the present employment situation of yourself and your partner? Your partner Other (please describe)

1
Yes
Other

If your partner is not currently in paid employment when did his last job end? Date your partner stopped working

Generic date
The questions below ask about your current occupation and that of your partner.
As far as you can, please describe the actual job, occupation, trade or profession. (Use precise terms such as radio mechanic, woodworking machinist, toolroom foreman. If the occupation is known by a special name, please use that name. If in H.M. Forces, give the rank in addition to the actual job. Please also describe the type of industry or service given: i.e. Give details of what is made, materials used, or services given).

Your present job or last main job. Actual job, occupation, trade or profession

Generic text

Your present job or last main job. Hours worked per week:

Hours per week

Your present job or last main job. Please tick which of the following apply to you:

1
foreman
2
manager
3
supervisor
4
leading hand
5
self-employed
6
none of these

Your present job or last main job. Type of industry or service given (main things done in job):

Generic text

Your partner - present job or last main job. Do you currently have a partner?

1
Yes
2
No
If no, go to C5.
If yes,
qc_C4_b_i == 1

Your partner - present job or last main job. what is/was his actual job, occupation, trade or profession?

Generic text

Your partner - present job or last main job. Hours worked per week:

Hours per week

Your partner - present job or last main job. Please tick which of the following apply to him:

1
foreman
2
manager
3
supervisor
4
leading hand
5
self-employed
6
none of these
9
not known

Your partner - present job or last main job. Type of industry or service given (main things done in job):

Generic text

Your partner - present job or last main job. Is he in contact with particular fumes or chemicals in his job?

1
always
2
often
3
sometimes
4
rarely
5
never
9
don't know
If yes,
qc_C4_b_vi == 1 || qc_C4_b_vi == 2 || qc_C4_b_vi == 3 || qc_C4_b_vi == 4

please describe:

Generic text

The main job your mother or mother figure did at around the time you left school. (Please put HW if she was a housewife) Actual job, occupation, trade or profession:

Generic text

The main job your mother or mother figure did at around the time you left school. (Please put HW if she was a housewife) Type of industry or service given (main things done in job):

Generic text

How old was your natural mother when you were born? (If you don't know, put 99) ... years

Age

Is your natural mother still alive?

1
Yes
2
No
9
Don't know

The main job your father or father figure did at around the time you left school. (If not known put NK) Actual job, occupation, trade or profession:

Generic text

The main job your father or father figure did at around the time you left school. (If not known put NK) Please tick which of the following applied to him:

1
foreman
2
manager
3
supervisor
4
leading hand
5
self-employed
6
none of these

The main job your father or father figure did at around the time you left school. (If not known put NK) Type of Industry or service given (main things done in job):

Generic text

How old was your natural father when you were born? (If you don't know, put 99) ... years

Age

Is your natural father still alive?

1
Yes
2
No
9
Don't know
Problems
Do you think you have been unfairly/unjustly treated in the last 12 months because of:
-

1 - Yes often

2 - Yes sometimes

3 - No not at all

your sex
your skin colour
the way you dress
your family background
the way you speak
your religion

Do you think you have been unfairly/unjustly treated in the last 12 months because of: other (please describe)

1
Yes often
2
Yes sometimes
3
No not at all
Other

How would you describe the race or ethnic group of yourself, your partner and your parents? Yourself

1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other

How would you describe the race or ethnic group of yourself, your partner and your parents? Partner

1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other

How would you describe the race or ethnic group of yourself, your partner and your parents? Your mother*

1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other

How would you describe the race or ethnic group of yourself, your partner and your parents? Your father*

1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other
(* by this we mean the mother or father figure who was mostly responsible for bringing you up)
SECTION D

Please put the date of completing this part of the questionnaire:

Generic date

Please give your date of birth:

Generic date
Thank you for your help so far.
These next pages are concerned with early sexual experience.
IF YOU WOULD RATHER NOT ANSWER THEM, WE QUITE UNDERSTAND. JUST STOP NOW AND SEND THE QUESTIONNAIRE BACK AS USUAL.
But it is possible that whether or not such events have taken place they may be a vital clue in understanding some of the problems we are trying to solve - even though they may appear to be unconnected. If you feel you can help, we would be very grateful.
SECTION E
As we are growing up we all have sexual experiences. These are a normal part of development and learning. Some people also have unwanted experiences to which they do not agree. These experiences can be important and may affect how you feel about yourself, your partner and your baby. Below are questions which ask about your sexual experiences from childhood until the present time.

Did anyone ever purposefully expose/flash themselves to you before you were 16?

1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen
If yes,
qc_E1 == 1 || qc_E1 == 2
Who was involved?
-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

Who was involved? other person (please describe)

1
No
2
Yes
Other
If yes,
qc_E1_i_a-g == 2 || qc_E1_i_h == 2
did you want this to happen with this person?
-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

did you want this to happen with this person? other person (please describe)

1
No
2
Yes
9
Unsure
Other

how old were you when this first happened: ... years

Age

Did anyone masturbate in front of you before you were 16?

1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen
If yes,
qc_E2 == 1 || qc_E2 == 2
Who was involved?
-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

Who was involved? other person (please describe)

1
No
2
Yes
Other
If yes,
qc_E2_i_a-g == 2 || qc_E2_i_h == 2
did you want this to happen with this person?
-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

did you want this to happen with this person? other person (please describe)

1
No
2
Yes
9
Unsure
Other

how old were you when this first happened: ... years

Age

Did anyone ever touch or fondle your body, including your breast or genitals, or attempt to arouse you sexually before you were 16?

1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen
If yes,
qc_E3 == 1 || qc_E3 == 2
Who was involved?
-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

Who was involved? other person (please describe)

1
No
2
Yes
Other
If yes,
qc_E3_i_a-g == 2 || qc_E3_i_h == 2
did you want this to happen with this person?
-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

did you want this to happen with this person? other person (please describe)

1
No
2
Yes
9
Unsure
Other

how old were you when this first happened: ... years

Age

Did anyone try to have you arouse them, or touch their body in a sexual way before you were 16?

1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen
If yes,
qc_E4 == 1 || qc_E4 == 2
Who was involved?
-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

Who was involved? other person (please desceibe)

1
No
2
Yes
9
Unsure
Other
If yes,
qc_E4_i_a-g == 2 || qc_E4_i_h == 2
did you want this to happen with this person?
-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

did you want this to happen with this person? other person (please describe)

1
No
2
Yes
9
Unsure
Other

how old were you when this first happened: ... years

Age

Did anybody rub their genitals against your body in a sexual way before you were 16?

1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen
If yes,
qc_E5 == 1 || qc_E5 == 2
Who was involved?
-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

Who was involved? other person (please describe)

1
No
2
Yes
Other
If yes,
qc_E5_i_a-g == 2 || qc_E5_i_h == 2
did you want this to happen with this person?
-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

did you want this to happen with this person? other person (please describe)

1
No
2
Yes
9
Unsure
Other

how old were you when this first happened: ... years

Age

Did anyone have sexual intercourse with you before you were 16?

1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen
If yes,
qc_E6 == 1 || qc_E6 == 2
Who was involved?
-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

Who was involved? other person (please describe)

1
No
2
Yes
If yes,
qc_E6_i_a-g == 2 || qc_E6_i_h == 2
did you want this to happen with this person?
-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger

did you want this to happen with this person? other person (please describe)

1
No
2
Yes
9
Unsure
Other

how old were you when this first happened: ... years

Age

Did anyone ever try to put their penis into your mouth before you were 16?

1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen
If yes,
qc_E7 == 1 || qc_E7 == 2
Who was involved?
-

1 - No

2 - Yes

boy friend
father or father figure
brother
other relative
family friend
stranger

Who was involved? other person (please describe)

1
No
2
Yes
If yes,
qc_E7_i_a-f == 2 || qc_E7_i_g == 2
did you want this to happen with this person?
-

1 - No

2 - Yes

9 - Unsure

boy friend
father or father figure
brother
other relative
family friend
stranger

did you want this to happen with this person? other person (please describe)

1
No
2
Yes
9
Unsure
Other

how old were you when this first happened: ... years

Age

Thank you for answering these questions which we realise may be difficult to answer. If there are any comments you'd like to make please write them below.

Long text
VERY MANY THANKS FOR ALL YOUR HELP
When completed, put in the envelope provided and either bring to the clinic or post to:
Dr. Jean Golding, Children of the Nineties - ALSPAC, Institute of Child Health, 24 Tyndall Avenue, Bristol. BS8 1BR.
Please remember, because this is strictly confidential, the people who look at this booklet will not know your name. They will be unable to give you any help or contact anyone after reading what you have written. If you feel you need advice, please feel free to contact our special information line (Bristol 256260 during office hours). Alternatively your Midwife or General Practitioner should be able to advise you.
End

alspac_91_ftg

FILLING THE GAPS
Unfortunately there are some questions that we did not get to you during your pregnancy. We would therefore be very grateful if you could complete this questionnaire as soon as you can. It asks about diet, your childhood, and the occupations of yourself and your family.
The last section asks about early sexual experiences but this is optional. If you would rather not even read the questions. stop at page 15, and send the questionnaire back to us.
THANK YOU VERY MUCH FOR YOUR HELP

SECTION A: YOUR DIET AND OTHER MATTERS

Have you ever gone on a diet to lose weight?
1
Yes
2
No
how often?
1
1-2 times
2
3-5 times
3
6-10 times
4
more than 10 times
how long do your diets usually last?
1
under 1 month
2
1-3 months
3
more than 3 months
Are you, or have you ever been a vegetarian?
1
yes, I am now
2
yes,in past not now
3
no,never
how many years of your life have you been vegetarian? ... years
How many
Are you, or have you ever been, a vegan (i.e. do not eat meat, poultry, fish, eggs, butter, milk or cheese)?
1
yes, I am now
2
yes,in past not now
3
no,never
how many years of your life have you been vegan? ... years
How many
Were you breast fed as a baby?
1
Yes
2
No
9
Don't know
Do you ever take homeopathic medicines?
1
Yes often
2
Yes sometimes
3
No

SECTION B: YOUR OWN CHILDHOOD

Please indicate if any of the following events happened to you before you were 17 and how much it affected you.
Before you were 17: Your parent died
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A brother or sister died
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A relative died
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A friend died
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent had a serious illness
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent was in hospital
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You had a serious physical illness
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You were in hospital
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Brother or sister had a serious illness
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Brother or sister was in hospital
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent had a serious accident
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You had a serious accident
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Brother or sister had a serious accident
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You acquired a physical deformity
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You became pregnant
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent was imprisoned
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent was physically cruel to you
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Your parents separated
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Your parents divorced
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent remarried
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent was emotionally cruel to you
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Your parents had serious arguments
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You were sexually abused
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: A parent was mentally ill
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You discovered you were adopted
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Your family moved to a new district
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You were in trouble with the police
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You were expelled or suspended from school
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You failed an important exam
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Your family's financial circumstances got worse
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: You acquired a stepbrother or stepsister
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Before you were 17: Other important happening (please tick & describe)
1
Yes affected me a lot
2
Yes moderately affected
3
Yes mildly affected
4
Yes but did not affect me
5
No did not happen
Other
How many schools did you attend between the ages of 5 and 16?
How many

Looking back would you call your childhood happy? Please indicate for each age range:

-

1 - Yes very happy

2 - Yes moderately happy

3 - Not really happy

4 - No quite unhappy

5 - No very unhappy

6 - Can't remember

0-5 years
6-11 years
12-15 years

How many brothers and sisters did you have:

Brothers Sisters
How manyHow manyHow manyHow many How manyHow manyHow manyHow many
older than you
younger than you
did you have a twin?
1
yes, twin brother
2
yes, twin sister
3
no
were you identical twins?
1
yes
2
no
3
not sure
did you usually dress alike?
1
yes, usually
2
yes, sometimes
3
no, not at all

SECTION C: EDUCATION AND OCCUPATION

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your self

-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your self Other (please describe)
1
Yes
Other

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your partner

-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known
Not applicable, no such person
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your partner Other (please describe)
1
Yes
Other

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your mother*

-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known
Not applicable, no such person
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your mother* Other (please describe)
1
Yes
Other

What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your father*

-

1 - Yes

CSE or GCSE (D, E, F or G)
O-level or GCSE (A, B or C)
A-level
Qualifications in shorthand/typing/or other skills, e.g hairdressing
Apprenticeship
State enrolled nurse
State registered nurse
City & Guilds intermediate technical
City & Guilds final technical
City & Guilds full technical
Teaching qualification
University degree
No qualifications
Qualifications not known
Not applicable, no such person
What educational qualifications do you, your partner, your mother, and your father have? Please tick all that apply? Your father* Other (please describe)
1
Yes
Other
[* by this we mean the mother figure or father figure who was mostly responsible for bringing you up]

What is the present employment situation of yourself and your partner? Yourself

-

1 - Yes

Working for an employer full-time (more than 30 hours a week)
Working for an employer part-time (one hour or more a week)
Self-employed, employing other people
Self-employed, not employing other people
On a government employment or training scheme
Waiting to start a job already accepted
Unemployed and looking for a job
At school or in other full-time education
Unable to work because of long-term sickness or disability
Retired from paid work
Looking after the home or family
What is the present employment situation of yourself and your partner? Yourself Other (please describe)
1
Yes
Other

What is the present employment situation of yourself and your partner? Your partner

-

1 - Yes

Working for an employer full-time (more than 30 hours a week)
Working for an employer part-time (one hour or more a week)
Self-employed, employing other people
Self-employed, not employing other people
On a government employment or training scheme
Waiting to start a job already accepted
Unemployed and looking for a job
At school or in other full-time education
Unable to work because of long-term sickness or disability
Retired from paid work
Looking after the home or family
What is the present employment situation of yourself and your partner? Your partner Other (please describe)
1
Yes
Other
If your partner is not currently in paid employment when did his last job end? Date your partner stopped working
Generic date
The questions below ask about your current occupation and that of your partner.
As far as you can, please describe the actual job, occupation, trade or profession. (Use precise terms such as radio mechanic, woodworking machinist, toolroom foreman. If the occupation is known by a special name, please use that name. If in H.M. Forces, give the rank in addition to the actual job. Please also describe the type of industry or service given: i.e. Give details of what is made, materials used, or services given).
Your present job or last main job. Actual job, occupation, trade or profession
Generic text
Your present job or last main job. Hours worked per week:
Hours per week
Your present job or last main job. Please tick which of the following apply to you:
1
foreman
2
manager
3
supervisor
4
leading hand
5
self-employed
6
none of these
Your present job or last main job. Type of industry or service given (main things done in job):
Generic text
Your partner - present job or last main job. Do you currently have a partner?
1
Yes
2
No
If no, go to C5.
Your partner - present job or last main job. what is/was his actual job, occupation, trade or profession?
Generic text
Your partner - present job or last main job. Hours worked per week:
Hours per week
Your partner - present job or last main job. Please tick which of the following apply to him:
1
foreman
2
manager
3
supervisor
4
leading hand
5
self-employed
6
none of these
9
not known
Your partner - present job or last main job. Type of industry or service given (main things done in job):
Generic text
Your partner - present job or last main job. Is he in contact with particular fumes or chemicals in his job?
1
always
2
often
3
sometimes
4
rarely
5
never
9
don't know
please describe:
Generic text
The main job your mother or mother figure did at around the time you left school. (Please put HW if she was a housewife) Actual job, occupation, trade or profession:
Generic text
The main job your mother or mother figure did at around the time you left school. (Please put HW if she was a housewife) Type of industry or service given (main things done in job):
Generic text
How old was your natural mother when you were born? (If you don't know, put 99) ... years
Age
Is your natural mother still alive?
1
Yes
2
No
9
Don't know
The main job your father or father figure did at around the time you left school. (If not known put NK) Actual job, occupation, trade or profession:
Generic text
The main job your father or father figure did at around the time you left school. (If not known put NK) Please tick which of the following applied to him:
1
foreman
2
manager
3
supervisor
4
leading hand
5
self-employed
6
none of these
The main job your father or father figure did at around the time you left school. (If not known put NK) Type of Industry or service given (main things done in job):
Generic text
How old was your natural father when you were born? (If you don't know, put 99) ... years
Age
Is your natural father still alive?
1
Yes
2
No
9
Don't know
Problems

Do you think you have been unfairly/unjustly treated in the last 12 months because of:

-

1 - Yes often

2 - Yes sometimes

3 - No not at all

your sex
your skin colour
the way you dress
your family background
the way you speak
your religion
Do you think you have been unfairly/unjustly treated in the last 12 months because of: other (please describe)
1
Yes often
2
Yes sometimes
3
No not at all
Other
How would you describe the race or ethnic group of yourself, your partner and your parents? Yourself
1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other
How would you describe the race or ethnic group of yourself, your partner and your parents? Partner
1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other
How would you describe the race or ethnic group of yourself, your partner and your parents? Your mother*
1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other
How would you describe the race or ethnic group of yourself, your partner and your parents? Your father*
1
white
2
black/caribbean
3
black/African
4
black/other (please describe below)
5
Indian
6
Pakistani
7
Bangladeshi
8
Chinese
9
any other ethnic group (please describe)
Other
(* by this we mean the mother or father figure who was mostly responsible for bringing you up)

SECTION D

Please put the date of completing this part of the questionnaire:
Generic date
Please give your date of birth:
Generic date
Thank you for your help so far.
These next pages are concerned with early sexual experience.
IF YOU WOULD RATHER NOT ANSWER THEM, WE QUITE UNDERSTAND. JUST STOP NOW AND SEND THE QUESTIONNAIRE BACK AS USUAL.
But it is possible that whether or not such events have taken place they may be a vital clue in understanding some of the problems we are trying to solve - even though they may appear to be unconnected. If you feel you can help, we would be very grateful.

SECTION E

As we are growing up we all have sexual experiences. These are a normal part of development and learning. Some people also have unwanted experiences to which they do not agree. These experiences can be important and may affect how you feel about yourself, your partner and your baby. Below are questions which ask about your sexual experiences from childhood until the present time.
Did anyone ever purposefully expose/flash themselves to you before you were 16?
1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen

Who was involved?

-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
Who was involved? other person (please describe)
1
No
2
Yes
Other

did you want this to happen with this person?

-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
how old were you when this first happened: ... years
Age
Did anyone masturbate in front of you before you were 16?
1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen

Who was involved?

-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
Who was involved? other person (please describe)
1
No
2
Yes
Other

did you want this to happen with this person?

-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
how old were you when this first happened: ... years
Age
Did anyone ever touch or fondle your body, including your breast or genitals, or attempt to arouse you sexually before you were 16?
1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen

Who was involved?

-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
Who was involved? other person (please describe)
1
No
2
Yes
Other

did you want this to happen with this person?

-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
how old were you when this first happened: ... years
Age
Did anyone try to have you arouse them, or touch their body in a sexual way before you were 16?
1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen

Who was involved?

-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
Who was involved? other person (please desceibe)
1
No
2
Yes
9
Unsure
Other

did you want this to happen with this person?

-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
how old were you when this first happened: ... years
Age
Did anybody rub their genitals against your body in a sexual way before you were 16?
1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen

Who was involved?

-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
Who was involved? other person (please describe)
1
No
2
Yes
Other

did you want this to happen with this person?

-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
how old were you when this first happened: ... years
Age
Did anyone have sexual intercourse with you before you were 16?
1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen

Who was involved?

-

1 - No

2 - Yes

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
Who was involved? other person (please describe)
1
No
2
Yes

did you want this to happen with this person?

-

1 - No

2 - Yes

9 - Unsure

boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
how old were you when this first happened: ... years
Age
Did anyone ever try to put their penis into your mouth before you were 16?
1
Yes, happened once only
2
Yes, happened more than once
3
No, did not happen

Who was involved?

-

1 - No

2 - Yes

boy friend
father or father figure
brother
other relative
family friend
stranger
Who was involved? other person (please describe)
1
No
2
Yes

did you want this to happen with this person?

-

1 - No

2 - Yes

9 - Unsure

boy friend
father or father figure
brother
other relative
family friend
stranger
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
how old were you when this first happened: ... years
Age
Thank you for answering these questions which we realise may be difficult to answer. If there are any comments you'd like to make please write them below.
Long text
VERY MANY THANKS FOR ALL YOUR HELP
When completed, put in the envelope provided and either bring to the clinic or post to:
Dr. Jean Golding, Children of the Nineties - ALSPAC, Institute of Child Health, 24 Tyndall Avenue, Bristol. BS8 1BR.
Please remember, because this is strictly confidential, the people who look at this booklet will not know your name. They will be unable to give you any help or contact anyone after reading what you have written. If you feel you need advice, please feel free to contact our special information line (Bristol 256260 during office hours). Alternatively your Midwife or General Practitioner should be able to advise you.