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
A1 a

Have you ever gone on a diet to lose weight?

1
Yes
2
No
If yes,
qc_A1_a == 1
A1 b

how often?

1
1-2 times
2
3-5 times
3
6-10 times
4
more than 10 times
A1 c

how long do your diets usually last?

1
under 1 month
2
1-3 months
3
more than 3 months
A2 a

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
A2 b

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

(If less than one year put 00)

How many
A3 a

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
A3 b

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

(If less than one year put 00)

How many
A4

Were you breast fed as a baby?

1
Yes
2
No
9
Don't know
A5

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.
B1

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
B2

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
B3

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
B4

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
B5

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
B6

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
B7

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
B8

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
B9

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
B10

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
B11

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
B12

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
B13

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
B14

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
B15

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
B16

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
B17

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
B18

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
B19

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
B20

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
B21

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
B22

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
B23

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
B24

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
B25

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
B26

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
B27

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
B28

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
B29

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
B30

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
B31

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
B32

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
B33

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

How many
B34 i-iii
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
B35 a-b
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
B35 c

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
B35 c(i)

were you identical twins?

1
yes
2
no
3
not sure
B35 c(ii)

did you usually dress alike?

1
yes, usually
2
yes, sometimes
3
no, not at all
SECTION C: EDUCATION AND OCCUPATION
C1 i(a-n)
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
C1 i(p)

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
C1 ii(a-o)
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
C1 ii(p)

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
C1 iii(a-o)
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
C1 iii(p)

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
C1 iv(a-o)
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
C1 iv(p)

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]
C2 i(a-k)
What is the present employment situation of yourself and your partner? Yourself

Please tick all that apply.

-

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
C2 i(l)

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

Please tick all that apply.

1
Yes
Other
C2 ii(a-k)
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
C2 ii(l)

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

Please tick all that apply.

1
Yes
Other
C3

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

(If you are unsure, put an approximate date, e.g. March 1988)

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).
C4 a(i)

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

Generic text
C4 a(ii)

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

Hours per week
C4 a(iii)

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
C4 a(iv)

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

Generic text
C4 b(i)

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
C4 b(ii)

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

Generic text
C4 b(iii)

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

Hours per week
C4 b(iv)

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
C4 b(v)

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

Generic text
C4 b(vi)

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
C4 b(vi)

please describe:

Generic text
C5 a(i)

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
C5 a(ii)

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
C5 b

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

Age
C5 c

Is your natural mother still alive?

1
Yes
2
No
9
Don't know
C6 a(i)

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
C6 a(ii)

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
C6 a(iii)

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
C6 b

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

Age
C6 c

Is your natural father still alive?

1
Yes
2
No
9
Don't know
Problems
C7 a-f
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
C7 g

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
C8 i

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
C8 ii

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
C8 iii

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
C8 iv

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
D1

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

Generic date
D2

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.
E1

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
E1 i(a-g)
Who was involved?
-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
E1 i(h)

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
E1 ii(a-g)
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
E1 ii(h)

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

1
No
2
Yes
9
Unsure
Other
E1 iii

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

Age
E2

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
E2 i(a-g)
Who was involved?
-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
E2 i(h)

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
E2 ii(a-g)
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
E2 ii(h)

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

1
No
2
Yes
9
Unsure
Other
E2 iii

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

Age
E3

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
E3 i(a-g)
Who was involved?
-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
E3 i(h)

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
E3 ii(a-g)
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
E3 ii(h)

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

1
No
2
Yes
9
Unsure
Other
E3 iii

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

Age
E4

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
E4 i(a-g)
Who was involved?
-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
E4 i(h)

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
E4 ii(a-g)
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
E4 ii(h)

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

1
No
2
Yes
9
Unsure
Other
E4 iii

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

Age
E5

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
E5 i(a-g)
Who was involved?
-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
E5 i(h)

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
E5 ii(a-g)
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
E5 ii(h)

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

1
No
2
Yes
9
Unsure
Other
E5 iii

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

Age
E6

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
E6 i(a-g)
Who was involved?
-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
E6 i(h)

Who was involved? other person (please describe)

1
No
2
Yes
If yes,
qc_E6_i_a-g == 2 || qc_E6_i_h == 2
E6 ii(a-g)
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
E6 ii(h)

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

1
No
2
Yes
9
Unsure
Other
E6 iii

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

Age
E7

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
E7 i(a-f)
Who was involved?
-

1 - No

2 - Yes
boy friend
father or father figure
brother
other relative
family friend
stranger
E7 i(g)

Who was involved? other person (please describe)

1
No
2
Yes
If yes,
qc_E7_i_a-f == 2 || qc_E7_i_g == 2
E7 ii(a-f)
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
E7 ii(g)

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

1
No
2
Yes
9
Unsure
Other
E7 iii

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

Age
E i

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

s_intro_i
FILLING THE GAPS
s_intro_ii
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.
s_intro_iii
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.
s_intro_iv
THANK YOU VERY MUCH FOR YOUR HELP

SECTION A: YOUR DIET AND OTHER MATTERS

A1 a
Have you ever gone on a diet to lose weight?
1
Yes
2
No
A1 b
how often?
1
1-2 times
2
3-5 times
3
6-10 times
4
more than 10 times
If yes,
A1 c
how long do your diets usually last?
1
under 1 month
2
1-3 months
3
more than 3 months
If yes,
A2 a
Are you, or have you ever been a vegetarian?
1
yes, I am now
2
yes,in past not now
3
no,never
A2 b
how many years of your life have you been vegetarian? ... years
How many
If yes,
A3 a
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
A3 b
how many years of your life have you been vegan? ... years
How many
If yes,
A4
Were you breast fed as a baby?
1
Yes
2
No
9
Don't know
A5
Do you ever take homeopathic medicines?
1
Yes often
2
Yes sometimes
3
No

SECTION B: YOUR OWN CHILDHOOD

s_qB1
Please indicate if any of the following events happened to you before you were 17 and how much it affected you.
B1
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
B2
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
B3
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
B4
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
B5
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
B6
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
B7
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
B8
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
B9
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
B10
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
B11
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
B12
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
B13
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
B14
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
B15
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
B16
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
B17
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
B18
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
B19
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
B20
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
B21
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
B22
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
B23
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
B24
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
B25
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
B26
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
B27
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
B28
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
B29
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
B30
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
B31
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
B32
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
B33
How many schools did you attend between the ages of 5 and 16?
How many
B34 i-iii

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
B35 a-b

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
B35 c
did you have a twin?
1
yes, twin brother
2
yes, twin sister
3
no
B35 c(i)
were you identical twins?
1
yes
2
no
3
not sure
If you had a twin sister:
B35 c(ii)
did you usually dress alike?
1
yes, usually
2
yes, sometimes
3
no, not at all
If you had a twin sister:

SECTION C: EDUCATION AND OCCUPATION

C1 i(a-n)

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
C1 i(p)
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
C1 ii(a-o)

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
C1 ii(p)
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
C1 iii(a-o)

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
C1 iii(p)
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
C1 iv(a-o)

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
C1 iv(p)
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
s_qC1
[* by this we mean the mother figure or father figure who was mostly responsible for bringing you up]
C2 i(a-k)

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
C2 i(l)
What is the present employment situation of yourself and your partner? Yourself Other (please describe)
1
Yes
Other
C2 ii(a-k)

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
C2 ii(l)
What is the present employment situation of yourself and your partner? Your partner Other (please describe)
1
Yes
Other
C3
If your partner is not currently in paid employment when did his last job end? Date your partner stopped working
Generic date
s_qC4_i
The questions below ask about your current occupation and that of your partner.
s_qC4_ii
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).
C4 a(i)
Your present job or last main job. Actual job, occupation, trade or profession
Generic text
C4 a(ii)
Your present job or last main job. Hours worked per week:
Hours per week
C4 a(iii)
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
C4 a(iv)
Your present job or last main job. Type of industry or service given (main things done in job):
Generic text
C4 b(i)
Your partner - present job or last main job. Do you currently have a partner?
1
Yes
2
No
s_qC4bi
If no, go to C5.
C4 b(ii)
Your partner - present job or last main job. what is/was his actual job, occupation, trade or profession?
Generic text
If yes,
C4 b(iii)
Your partner - present job or last main job. Hours worked per week:
Hours per week
If yes,
C4 b(iv)
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
If yes,
C4 b(v)
Your partner - present job or last main job. Type of industry or service given (main things done in job):
Generic text
If yes,
C4 b(vi)
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,
C4 b(vi)
please describe:
Generic text
If yes,
If yes,
C5 a(i)
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
C5 a(ii)
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
C5 b
How old was your natural mother when you were born? (If you don't know, put 99) ... years
Age
C5 c
Is your natural mother still alive?
1
Yes
2
No
9
Don't know
C6 a(i)
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
C6 a(ii)
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
C6 a(iii)
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
C6 b
How old was your natural father when you were born? (If you don't know, put 99) ... years
Age
C6 c
Is your natural father still alive?
1
Yes
2
No
9
Don't know
s_qC7
Problems
C7 a-f

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
C7 g
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
C8 i
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
C8 ii
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
C8 iii
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
C8 iv
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
s_qC8
(* by this we mean the mother or father figure who was mostly responsible for bringing you up)

SECTION D

D1
Please put the date of completing this part of the questionnaire:
Generic date
D2
Please give your date of birth:
Generic date
s_section_D_i
Thank you for your help so far.
s_section_D_ii
These next pages are concerned with early sexual experience.
s_section_D_iii
IF YOU WOULD RATHER NOT ANSWER THEM, WE QUITE UNDERSTAND. JUST STOP NOW AND SEND THE QUESTIONNAIRE BACK AS USUAL.
s_section_D_iv
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

s_section_E_i
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.
E1
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
E1 i(a-g)

Who was involved?

-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
If yes,
E1 i(h)
Who was involved? other person (please describe)
1
No
2
Yes
Other
If yes,
E1 ii(a-g)

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
If yes,
If yes,
E1 ii(h)
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
If yes,
If yes,
E1 iii
how old were you when this first happened: ... years
Age
If yes,
E2
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
E2 i(a-g)

Who was involved?

-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
If yes,
E2 i(h)
Who was involved? other person (please describe)
1
No
2
Yes
Other
If yes,
E2 ii(a-g)

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
If yes,
If yes,
E2 ii(h)
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
If yes,
If yes,
E2 iii
how old were you when this first happened: ... years
Age
If yes,
E3
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
E3 i(a-g)

Who was involved?

-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
If yes,
E3 i(h)
Who was involved? other person (please describe)
1
No
2
Yes
Other
If yes,
E3 ii(a-g)

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
If yes,
If yes,
E3 ii(h)
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
If yes,
If yes,
E3 iii
how old were you when this first happened: ... years
Age
If yes,
E4
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
E4 i(a-g)

Who was involved?

-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
If yes,
E4 i(h)
Who was involved? other person (please desceibe)
1
No
2
Yes
9
Unsure
Other
If yes,
E4 ii(a-g)

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
If yes,
If yes,
E4 ii(h)
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
If yes,
If yes,
E4 iii
how old were you when this first happened: ... years
Age
If yes,
E5
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
E5 i(a-g)

Who was involved?

-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
If yes,
E5 i(h)
Who was involved? other person (please describe)
1
No
2
Yes
Other
If yes,
E5 ii(a-g)

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
If yes,
If yes,
E5 ii(h)
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
If yes,
If yes,
E5 iii
how old were you when this first happened: ... years
Age
If yes,
E6
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
E6 i(a-g)

Who was involved?

-

1 - No

2 - Yes
boy friend
girl friend
parent or parent figure
brother or sister
other relative
family friend
stranger
If yes,
E6 i(h)
Who was involved? other person (please describe)
1
No
2
Yes
If yes,
E6 ii(a-g)

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
If yes,
If yes,
E6 ii(h)
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
If yes,
If yes,
E6 iii
how old were you when this first happened: ... years
Age
If yes,
E7
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
E7 i(a-f)

Who was involved?

-

1 - No

2 - Yes
boy friend
father or father figure
brother
other relative
family friend
stranger
If yes,
E7 i(g)
Who was involved? other person (please describe)
1
No
2
Yes
If yes,
E7 ii(a-f)

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
If yes,
If yes,
E7 ii(g)
did you want this to happen with this person? other person (please describe)
1
No
2
Yes
9
Unsure
Other
If yes,
If yes,
E7 iii
how old were you when this first happened: ... years
Age
If yes,
E i
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
s_outro_i
VERY MANY THANKS FOR ALL YOUR HELP
s_outro_ii
When completed, put in the envelope provided and either bring to the clinic or post to:
s_outro_iii
Dr. Jean Golding, Children of the Nineties - ALSPAC, Institute of Child Health, 24 Tyndall Avenue, Bristol. BS8 1BR.
s_outro_iv
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.