LEGAL STATUS UPON ADMISSION
1 = VOLUNTARY
2 = INVOLUNTARY
3 = CRIMINAL
9 = DK

AXIS I ADMIT DX - DX# 1 - DX TYPE
1 = CHART DX
2 = R/O DX OR TRAIT

SESSION ONE-DATE-MONTH
0 = MISSING MONTH &/OR DAY ONLY
1 = JAN
2 = FEB
3 = MAR
4 = APR
5 = MAY
6 = JUNE
7 = JULY
8 = AUG
9 = SEP
10 = OCT
11 = NOV
12 = DEC

SESSION 1-START HOUR
99 = MISSING TIME

SESSION 1-# OF BREAKS
7 = 7 OR MORE
9 = DK

SESSION 2-# OF BREAKS
7 = 7 OR MORE
9 = MISSING

SESSION 1-TOTAL BREAK TIME
999 = MISSING

SESSION 6-NET SESSION TIME-HOURS
0 = LESS THAN 1
9 = DK

SESSION 1-NET SESSION TIME-MINUTES
99 = DK

DATE RECEIVED AT PRA-MONTH
0 = MISSING MONTH &/OR DAY ONLY
1 = JAN
2 = FEB
3 = MAR
4 = APR
5 = MAY
6 = JUNE
7 = JULY
8 = AUG
9 = SEP
10 = OCT
11 = NOV
12 = DEC
99 = MISSING DATE

DATE RECEIVED AT PRA-DAY
99 = MISSING DATE

SUBJECTS GENDER
1 = MALE
2 = FEMALE
7 = REFUSED
9 = DK

MARITAL STATUS
1 = SINGLE
2 = MARRIED
3 = DIVORCED
4 = WIDOWED
5 = SEPARATED
7 = REFUSED
9 = DK

SUBJECTS RACE
1 = WHITE
2 = BLACK
3 = HISPANIC
7 = REFUSED
9 = DK

SCHIZOPHRENIA (CURRENT)
1 = ABSENT
3 = PRESENT
4 = PRESENT - DUE TO ORGANIC DX/COND
5 = PRESENT - DUE TO OTHER DX/COND
7 = BEREAVEMENT-PROVIS
9 = UNCERTAIN

BRIEF REACTIVE PSYCHOSIS (CURRENT)
1 = ABSENT
3 = PRESENT
4 = PRESENT - DUE TO ORGANIC DX/COND
5 = PRESENT-OTHR DIAG
7 = BEREAVEMENT-PROVIS
9 = UNCERTAIN

SCHIZOPHRENIFORM DISORDER (CURRENT)
1 = ABSENT
3 = PRESENT
4 = PRESENT-ORGANIC DIAG
5 = PRESENT-OTHR DIAG
7 = BEREAVEMENT/PROVISIONAL
9 = UNCERTAIN

SCHIZOAFFECTIVE DISORDER (CURRENT)
1 = ABSENT
3 = PRESENT
4 = PRESENT-ORGANIC DIAG
5 = PRESENT - DUE TO OTHER DX/COND
7 = BEREAVEMENT-PROVIS
9 = UNCERTAIN

DEPRESSION (CURRENT)
1 = ABSENT
3 = PRESENT
4 = PRESENT - DUE TO ORGANIC DX/COND
5 = PRESENT - DUE TO OTHER DX/COND
7 = BEREAVEMENT/PROVISIONAL
9 = UNCERTAIN

CYCLOTHYMIA (CURRENT)
1 = ABSENT
3 = PRESENT
4 = PRESENT-ORGANIC DIAG
5 = PRESENT-OTHR DIAG
7 = BEREAVEMENT-PROVIS
8 = NA-OLD FORM USED
9 = UNCERTAIN

PSYCHOACTIVE SUBSTANCE DEPENDENCE (CURRENT)
1 = ABSENT
3 = PRESENT
4 = PRESENT-ORGANIC DIAG
5 = PRESENT-OTHR DIAG
7 = BEREAVEMENT-PROVIS
9 = UNCERTAIN

PRINCIPAL DIAGNOSIS
2 = SCHIZOPHRENIA
3 = BRIEF REACTIVE PSYCHOSIS
4 = SCHIZOPHRENIFORM DISO
5 = SCHIZOAFFECTIVE DISO
6 = DELUSIONAL (PARANOID) DISO
7 = ATYPICAL PSYCHOSIS
8 = DEPRESSION
9 = DYSTHYMIA
10 = MANIA
11 = BIPOLAR
12 = PSYCHOACTIVE SUB DEPENDENCE
13 = PSYCHOACTIVE SUB ABUSE
14 = ALCOHOL DEPENDENCE
15 = ALCOHOL ABUSE
16 = DRUG DEPENDENCE
17 = DRUG ABUSE
18 = CYCLOTHYMIA
33 = MINI-MENTAL STATUS
77 = PERSONALITY DISO
99 = CANT TELL

REASON(S) FOR DX - ONLY DX
1 = NO
5 = YES
9 = DK

ASSESSMENT OF OVERALL SEVERITY OF PRINCIPAL DX
1 = MILD
2 = MODERATE
3 = SEVERE
4 = VERY SEVERE
9 = DK

PRINCIPAL DX AGREES W/CHART DX
0 = NO - NOT CHECKED
1 = YES - CHECKED
7 = REFUSED
8 = NA
9 = DK

BELIEVE PEOPLE ARE SPYING ON YOU
0 = NO
1 = YES
7 = REFUSED
8 = NA
9 = DK

BELIEVE PEOPLE SPYING ONLY WHEN HIGH
0 = NO
1 = YES
2 = DENIED ALL PREV DRUG & ALCOHOL USE
7 = REFUSED
8 = NA
9 = DK

DELUSIONAL BELIEF - INTERVIEWER RATING
0 = NO
1 = POSSIBLY
2 = YES
7 = REFUSED
8 = NA
9 = DK

BELIEVE TESTED/EXPERIMENTED ON
0 = NO
1 = YES
9 = DK

Delusions Present
0 = YES
1 = NO
9 = DK

MMDAS PARTS COMPLETED
1 = MMDAS PARTS 1 AND 2 COMPLETE
2 = ONLY PT 1 COMPLETE
3 = ONLY PT 2 COMPLETE
4 = NO DELUS ON SCREEN Qs/NO VIOL DEL & NO DELUS REPTD IN CHART
5 = NO DEL ON SCRN Qs/NO VIOL DEL & SUBJ DENIES DELs IN CHART
7 = REFUSED
8 = SHOULD HAVE COMPLETED BUT DID NOT
9 = DK/MISSING

CHOICE OF BELIEF
1 = DELUSIONAL BELIEF SUBJ SAYS HAS GREATEST IMPACT
2 = SUBJ DIDNT CHOOSE - INT SELECTED BELIEF
7 = REFUSED
9 = NO INFO

Delusions Present
0 = NO
1 = YES
7 = REFUSED
9 = DK

HOW LONG BELIEVED - YEARS
0 = NONE
97 = REFUSED
99 = DK

HOW LONG BELIEVED - WEEKS
0 = NONE
7 = REFUSED
9 = DK

HOW SURE ABOUT DELUSION - CURRENT
0 = NEVER CERTAIN, PROB IMAG
1 = MAYBE, PROB TRUE
2 = CERTAIN
7 = REFUSED
9 = DOESNT RESP, CANT ASCERTAIN

WHAT WOULD MAKE YOU UNSURE OF BELIEF
0 = OUTLINE EVIDENCE - OUTCOME LOGICAL
1 = OUTLINE EVIDENCE - OUTCOME ILLOGICAL
2 = UNABLE TO OUTLINE CONTRADICTORY EVIDENCE
7 = REFUSED
8 = NA
9 = DOESNT RESP, CANT ASCERTAIN

DO OTHERS BELIEVE IT - CURRENT
0 = ACCEPTS UNIQUENESS OF BELIEF
1 = OTHERS DONT OPENLY SHARE BUT MAY IN PRIVATE
2 = BELIEF SHARED BY MANY OTHERS
7 = REFUSED
9 = DOESNT RESP, CANT ASCERTAIN

DO OTHERS BELIEVE IT - WORST EVER
0 = ACCEPTS UNIQUENESS OF BELIEF
1 = OTHERS DONT OPENLY SHARE BUT MAY IN PRIVATE
2 = BELIEF SHARED BY MANY OTHERS
7 = REFUSED
8 = NA
9 = DOESNT RESP, CANT ASCERTAIN

WOULD OTHERS BELIEVE IT IF TOLD - CURRENT
0 = OTHR PERSON WOULD NOT BELIEVE
1 = OTHR PERSON MIGHT BELIEVE
2 = OTHR PERSON DEFINITELY BELIEVE
7 = REFUSED
9 = DOESNT RESP, CANT ASCERTAIN

EVER TALKED TO ANYONE ABOUT BELIEF
0 = NO
1 = YES
7 = REFUSED
9 = DOESNT RESPOND, CANT ASCERTAIN

TALKED ABOUT BELIEF IN PAST 2 MONTHS
0 = NO
1 = YES
7 = REFUSED
8 = NA
9 = DOESNT RESPOND, CANT ASCERTAIN

WHO EVER THOUGHT ABOUT HURTING B/C OF BELIEF
1 = ONLY KNOWN
2 = MIXED
3 = ONLY STRANGERS
7 = REFUSED
8 = NA
9 = DK

HOW HURT/TRIED TO HURT PERSON (EVER)
0 = NO VIOLENCE
1 = THROW OBJECT
2 = PUSH/SHOVE/GRAB
3 = SLAP
4 = KICK/BITE/CHOKE
5 = HIT WITH FIST/OBJECT
6 = SEXUAL ASSAULT
7 = THREATEN WITH WEAP
8 = USE GUN/KNIFE
9 = OTHER VIOLENCE
97 = REFUSED
98 = NA
99 = DK

SUMMARY OF POSITIVE ACTION ON BELIEFS - EVER - INTERVIEWER RATING
0 = NO ACTIONS
1 = NON AGGRESS ACTIONS ONLY
2 = AGGRESSIVE THOUGHTS NOT DIRECTED AT OTHRS
3 = LEVEL 2 VIOL
4 = LEVEL 1 VIOL
5 = VIOL, DK LEVEL
7 = REFUSED
8 = NA
9 = NO INFO

HOW OFTEN DO YOU THINK ABOUT BELIEF
0 = NEVER THINK ABOUT BELIEF
1 = SOMETIMES THINK ABOUT BELIEF
2 = THINK ABOUT BELIEF BUT CAN GET OUT OF HEAD TO THINK OF OTHER
3 = HARD TIME GETTING IT OUT OF MY HEAD
4 = CAN HARDLY THINK ABOUT ANYTHING BUT THIS BELIEF
7 = REFUSED
8 = NA
9 = DK

EVER THINK ABOUT BELIEF MORE THAN THAT
0 = DONT THINK ABOUT THIS BELIEF AT ALL
1 = SOMETIMES THINK ABOUT BELIEF
2 = THINK ABOUT BELIEF BUT CAN GET OUT OF HEAD TO THINK OF OTHER
3 = HARD TIME GETTING IT OUT OF MY HEAD
4 = CAN HARDLY THINK ABOUT ANYTHING BUT THIS BELIEF
7 = REFUSED
8 = NA
9 = DK

ARE YOU PSYCH UNWELL
0 = ACCEPT HAS MENT PROB INCL DELUS BELIEF
1 = ACCEPT HAS MENT PROB NOT INCL DELUS BELIEF
2 = NOT ILL
7 = REFUSED
9 = DK

DO YOU THINK TREATMENT MIGHT HELP/HAS HELPED YOU
0 = ACCEPTS BENEFIT FROM TX
1 = UNCERTAIN ABOUT BENEFIT FROM TX
2 = NO BENEFIT FROM TX
7 = REFUSED
9 = DK

REACTION TO HYPOTHETICAL QUESTION
0 = DISMISSES BELIEF
1 = CHANGES LEV OF CONVICTION
2 = ACCOMODATES INTO SYSTEM
3 = IGNORES RELEVANCE
7 = REFUSED
8 = NA
9 = DK

PERVASIVENESS OF CHOSEN BELIEF
0 = NONE
1 = DELUS LTD TO DISCRETE AREA OF LIFE
2 = SOME SPREAD TO SUBJ LIFE, BUT SUBSTANTIAL AREAS NOT AFFECTED
3 = ALL EXPERIENCE RELATE TO DELUS
7 = REFUSED
9 = DK

FLUIDITY OF CHOSEN BELIEF
0 = NO VARIATION IN PRESENT OF DEL
1 = SOME CHANGE IN PRESENT OF DELUS
2 = FREQUENT CHANGE IN PRESENT OF DELUS
7 = REFUSED
9 = DK

SUBJ REPORTING BELIEFS ACCURATELY - INTERVIEWER RATING
0 = ACCURATE
1 = SOME QUESTIONS OF ACCURACY
2 = SUBSTANTIAL DOUBTS ABOUT ACCURACY
7 = REFUSED
9 = DK

CHOICE OF BELIEF FOR RATING OF THE DELUSION ASSOC W/VIOLENT INCIDENT
1 = PT 2 COMPLETED ON DIFF DELUS THAN PT 1
2 = PART 2 COMPLETED - DELUS IS SAME AS PT 1
3 = NO DELUS REL TO VIOL INC
4 = SUBJ DENIES DELUS REL TO VIOL INC
5 = SUBJ DENIES VIOL INC REL TO DELUS
7 = REFUSED
8 = NA
9 = NO INFO

WHAT WOULD HAVE HAD TO HAPPEN AT TIME TO MAKE YOU UNSURE ABOUT DELUS
0 = OUTLINE EVIDENCE - OUTCOME LOGICAL
1 = OUTLINE EVIDENCE - OUTCOME ILLOGICAL
2 = UNABLE TO OUTLINE CONTRADICTORY EVIDENCE
7 = REFUSED
9 = DOESNT RESP, CANT ASCERTAIN

HOW HURT/TRIED TO HURT PERSON
0 = NO VIOLENCE
1 = THROW OBJECT
2 = PUSH-SHOVE-GRAB
3 = SLAP
4 = KICK-BITE-CHOKE
5 = HIT w FIST/OBJECT
6 = SEXUAL ASSAULT
7 = THREATEN W/WEAPON
8 = USE GUN/KNIFE
9 = OTHER VIOLENCE
97 = REFUSED
98 = NA
99 = DK

SUMMARY OF POSITIVE ACTION ON BELIEFS - INTERVIEWER RATING
0 = NO ACTIONS
1 = NON AGGRESS ACT ONLY
2 = AGGRESSIVE THOUGHTS NOT DIRECTED AT OTHRS
3 = LEVEL 2 VIOL
4 = LEVEL 1 VIOL
5 = VIOL, DK LEVEL
7 = REFUSED
8 = NA
9 = NO INFO

FLUIDITY OF CHOSEN BELIEF
0 = NO VARIATION IN PRESENT OF DEL
1 = SOME CHANGE IN PRESENT OF DELUS
2 = FREQUENT CHANGE IN PRESENT OF DELUS
7 = REFUSED
8 = NA
9 = DK

SUBJ REPORTING BELIEFS ACCURATELY - INTERVIEWER RATING
0 = ACCURATE
1 = SOME QUESTIONS OF ACCURACY
2 = SUBSTANTIAL DOUBTS ABOUT ACCURACY
7 = REFUSED
8 = NA
9 = DK

HOW LONG HEARING THINGS - YEARS
97 = REFUSED
98 = NA
99 = DK

HOW LONG HEARING THINGS - WEEKS
7 = REFUSED
8 = NA
9 = DK

WHAT DO YOU DO TO STOP VOICES
1 = MENTAL
2 = BEHAVIORAL
3 = BOTH
7 = REFUSED
8 = NA
9 = DK

HIGHEST LEVEL OF VIOLENCE
0 = NO VIOLENCE
1 = LEVEL1
2 = LEVEL 2
3 = VIOLENT, DK LEVEL
4 = SUICIDE OR SELF HARM
7 = REFUSED
8 = NA
9 = DK

EVER DONE WHAT VOICES SAY
0 = NEVER
1 = ONCE
2 = 2-5 TIMES
3 = 5+ TIMES
7 = REFUSED
8 = NA
9 = DK

LAST TIME DID WHAT VOICES SAID
1 = LAST WEEK
2 = IN LAST 2 MONTHS
3 = BEFORE THE LAST 2 MONTHS
7 = REFUSED
8 = NA
9 = DK

HIGHEST LEVEL OF VIOLENCE
0 = NO VIOLENCE
1 = LEVEL 1
2 = LEVEL 2
3 = VIOLENT, DK LEVEL
4 = SUICIDE OR SELF HARM
7 = REFUSED
8 = NA
9 = DK

OBEY VOICES IN FUTURE
1 = YES
2 = NO
7 = REFUSED
8 = NA
9 = UNSURE

EVER USED ALCOHOL
0 = NO
1 = YES, <5 TIMES
2 = YES, >5 TIMES
9 = DK

USED ALCOHOL IN LAST 2 MONTHS
0 = NO
1 = YES, <5 TIMES
2 = YES, >5 TIMES
8 = NA, NEVER USED
9 = DK

# DAYS ALCOHOL LAST WEEK
8 = NA, NEVER USED
9 = DK

EVER TALKED TO DR ABOUT MEMORY PROBLEMS
1 = NO
5 = YES
7 = REFUSED
9 = DK

WHAT IS THE YEAR
1 = ERROR
5 = CORRECT
7 = REFUSED
9 = MISSING

COUNT BACKWARDS: 100-7 (93)
1 = ERROR
5 = CORRECT
7 = SAYS CANT DO
8 = MISSING
9 = OTHR REFUSAL

SPELL WORLD BACKWARDS
0 = NO ERRORS
1 = 1 ERROR
2 = 2 ERRORS
3 = 3 ERRORS
4 = 4 ERRORS
5 = 5 ERRORS
7 = REFUSED
9 = MISSING

READ WORDS ON PAGE AND DO WHAT THEY SAY
1 = ERROR
5 = CORRECT
7 = CANT READ
9 = MISSING

WRITE COMPLETE SENTENCE
1 = ERROR
5 = CORRECT
7 = CANT WRITE
9 = MISSING

EVER BEEN KNOCKED OUT/FAINTED
0 = NO
1 = YES
2 = NO
7 = REFUSED
9 = DK

ACCIDENT #1: TYPE
1 = BICYCLE
2 = AUTO
3 = MOTORCYCLE
4 = FALL
5 = FALL/STAIRS
6 = DROWNING
7 = PUNCHED/HIT
8 = SPORTS-SPECIFY
9 = OTHER-SPECIFY

WAS SUBJECT INJURED: ACCIDENT #1
0 = NO INJURY
1 = YES, BUT NO HEAD INJURY
2 = YES, HEAD INJURY
9 = DK

AGE AT TIME OF HEAD INJURY-ACCIDENT #2
0 = LESS THAN 1
97 = REFUSED
98 = NA
99 = DK

# MIN LOST CONSCIOUSNESS-ACCIDENT 1
0 = LESS THAN 1
96 = DURATION UNKNOWN
97 = REFUSED
98 = NA
99 = DK

# DAYS LOST CONSCIOUSNESS-ACCIDENT 1
0 = LESS THAN 1
996 = DURATION UNKNOWN
997 = REFUSED
998 = NA
999 = DK

HOSPITALIZED-ACCIDENT 1
1 = YES
2 = NO
7 = REFUSED
8 = NA
9 = DK

HOW OLD WHEN FIRST HAPPENED - ABUSIVE PERSON #1
95 = CHILD-AGE UNK
96 = ADULT-AGE UNK
97 = REFUSED
98 = NA
99 = DK

WHICH BEST DESCRIBES WHAT HAPPENED - ABUSIVE PERSON #1
1 = INAPPROPRIATE TOUCHING
2 = HUGGING/KISSING
3 = ORAL SEX
4 = ATTEMPTED INTERCOURSE
5 = INTERCOURSE
6 = SODOMY
7 = OTHR-SPECIFY
8 = REFUSED
9 = DK
97 = REFUSED
98 = NA
99 = DK

WHICH BEST DESCRIBES WHAT HAPPENED - ABUSIVE PERSON #2
1 = INAPPROPRIATE TOUCHING
2 = HUGGING/KISSING
3 = ORAL SEX
4 = ATTEMPTED INTERCOURSE
5 = INTERCOURSE
6 = SODOMY
7 = OTHR-SPECIFY
97 = REFUSED
98 = NA
99 = DK

HOW OFTEN DID ABUSE OCCUR - ABUSIVE PERSON #1
0 = NEVER
1 = ONCE
2 = TWICE
3 = SOMETIMES
4 = FREQUENTLY
5 = TOO MANY TO COUNT
7 = REFUSED
8 = NA-NO SEX ABUSE
9 = DK
98 = NA-NO SEX ABUSE

HOW OFTEN DID ABUSE OCCUR - ABUSIVE PERSON #2
1 = ONCE
2 = TWICE
3 = SOMETIMES
4 = FREQUENTLY
5 = TOO MANY TO COUNT
7 = REFUSED
8 = NA-NO SEX ABUSE
9 = DK

SOMATIC CONCERN (BPRS-A)
1 = NOT REPORTED
2 = VERY MILD
3 = MILD
4 = MODERATE
5 = MODERATELY SEVERE
6 = SEVERE
7 = VERY SEVERE
8 = NA
9 = DK

EMOTIONAL WITHDRAWAL (BPRS-A)
1 = NOT OBSERVED
2 = VERY MILD
3 = MILD
4 = MODERATE
5 = MODERATELY SEVERE
6 = SEVERE
7 = VERY SEVERE
8 = NA
9 = DK

GAF SCORE - INTERVIEWER RATING
99 = MISSING/DK

DID SUBJ SEEM TO UNDERSTAND QUES - INTERVIEWER RATING
0 = NO
1 = SOME
2 = YES
9 = DK

SUBJ HONEST (1-5 SCALE) - DELUSIONS SECT
1 = HONEST
5 = UNTRUTHFUL
8 = NA
9 = DK

SUBJ HONEST (1-5 SCALE) - SEXUAL ABUSE SCREEN SECT
1 = HONEST
5 = UNTRUTHFUL
7 = REFUSED
8 = NA
9 = DK

TYPE OF RELEASE
1 = DISCHARGE
2 = CONDITIONAL RELEASE
3 = FAMILY VISIT/ TRIAL VISIT
4 = LEAVE W/OUT CONSENT
5 = ESCAPE
6 = RETURN TO COURT
7 = OTHER, SPECIFY
9 = NO INFO

WHERE RELEASED TO
1 = COMMUNITY/ OWN HOME/ NO DESIGNATION
2 = FAMILY/ FRIEND
3 = COMMUNITY RESIDENCE PROGRAM
4 = COURT/ JAIL
5 = OTHR HOSPITAL
6 = OTHER, SPECIFY
9 = NO INFO

FOLLOW UP
0 = NO
1 = YES
9 = NO INFO

AXIS I DISCHARGE DX - DX# 1
0 = NO INFO

AXIS I D/C DX - DX# 1 - DX TYPE
1 = CHART DIAGNOSIS
2 = RULE OUT DIAGNOSIS OR TRAIT
8 = NA

AXIS II DISCHARGE DX - DX# 1
0 = NO INFO
99999 = DK

AXIS II D/C DX - DX# 1 - DX TYPE
1 = CHART DIAGNOSIS
2 = RULE OUT DIAGNOSIS OR TRAIT
8 = NA
9 = DK

AXIS V DX (GAF)
0 = NO INFO
98 = NA
99 = DK

D/C MEDICATION #1 (SEE MED CODES)
0 = NONE LISTED
999 = DK

D/C MEDICATION #1 - DOSAGE (MG)
9998 = NA
9999 = DK

D/C MEDICATION #1 - FREQUENCY
0 = NO MEDS
1 = 1X/DAY
2 = 2X/DAY
3 = 3X/DAY
4 = 4X/DAY
5 = EVERY OTHER DAY
6 = 1X/WEEK
7 = 1X/2 WEEKS
8 = AS NEEDED
9 = 1X/NIGHT
10 = IN THE MORNING
11 = IMMEDIATELY
12 = 1X/3 WEEKS
13 = 1X/MONTH
96 = OTHER
98 = NA
99 = NO INFO

TYPE OF INSURANCE
0 = NONE
1 = PRIVATE
2 = PUBLIC (MEDICARE/ MEDICAID)
9 = DK

LEGAL STATUS AT DISCHARGE
1 = VOLUNTARY
2 = INVOLUNTARY-EMERGENCY
3 = INVOLUNTARY-NON-EMERGENCY
4 = CRIMINAL
9 = NO INFO

REASON(S) FOR COMMITTMENT - DANGER TO SELF
0 = NO
1 = YES
8 = NA
9 = DK

ALCOHOL RESULTS
0 = NO - NEGATIVE
1 = YES - POSITIVE
8 = NA
9 = DK

HOW MANY PRIOR HOSP IN M/H FACILITIES (EVER)
0 = NONE
92 = 3-5 PRIOR
93 = 6-10 PRIOR
95 = MORE THAN 20
96 = SOME PRIOR, DK #
99 = DK

TOTAL # DAYS HOSPITALIZED LAST YEAR
0 = NONE
995 = MORE THAN 20 DAYS
996 = SOME, DK #
998 = NA
999 = DK

HISTORY OF VIOLENCE BY SUBJ TOWARD FAMILY
0 = NO
1 = YES, SOME
2 = YES, EXTENSIVE
9 = DK

WAS SUBJ IN SECLUSION/RESTRAINT DURING THIS HOSP
0 = NO
1 = YES, SECLUSION
2 = YES, RESTRAINT
3 = YES, BOTH
9 = DK

NUMBER OF TIMES SECLUDED OR RESTRAINED
0 = NONE
95 = MORE THAN 20
96 = SOME, DK #
98 = NA
99 = DK

COMPLETED BY (RATER #)
99 = DK RATER

DAY FORM COMPLETED
0 = MISSING DAY ONLY
99 = MISSING DATE

SESSION ONE-DATE-MONTH
0 = MISSING MONTH &/OR DAY ONLY
1 = JAN
2 = FEB
3 = MAR
4 = APR
5 = MAY
6 = JUNE
7 = JUL
8 = AUG
9 = SEP
10 = OCT
11 = NOV
12 = DEC

SESSION 1-# OF BREAKS
7 = 7 OR MORE

REASON(S) FOR CURRENT ADMIT (FROM CHART) - DEPRESSION
0 = NO - NOT CHECKED
1 = YES - CHECKED

OTHER VIOLENT AGGRESSIVE BEHAVIOR - SPECIFY
1 = HIT w CAR
2 = ARSON/FIRE
3 = SCRATCH
4 = STRANGLE
5 = ASSAULT NON-SPECIFIC
7 = OTHER
8 = NA
9 = DK

CHART SUGGEST DELUSIONAL AT ADMISSION
0 = NO
1 = YES-NOT ASSOC W VIOL
2 = YES-ASSOC W VIOL
9 = DK

VIOLENCE ASSOCIATED W/DELUSION(S) - FIRST TYPE
22 = OBJECT THROWN
23 = PUSH, GRAB
24 = SLAPPING
25 = KICK, BITE, CHOKE
26 = HIT W/FIST, OBJECT
27 = SEXUAL ASSAULT
28 = THREAT W/WEAPON
29 = USE GUN/KNIFE
30 = OTHER VIOLENT
98 = NA
99 = DK

LAST RELEASE DATE FROM HOSP-MONTH
0 = MISSING MONTH ONLY
1 = JAN
2 = FEB
3 = MAR
4 = APR
5 = MAY
6 = JUNE
7 = JUL
8 = AUG
9 = SEP
10 = OCT
11 = NOV
12 = DEC
98 = NA
99 = DK

LAST RELEASE DATE FROM HOSP-DAY
0 = MISSING DAY ONLY
98 = NA
99 = DK

LAST RELEASE DATE FROM HOSP-YEAR
98 = NA
99 = DK

# TIMES HOSPITALIZED
96 = 96 OR MORE
97 = REFUSED
98 = NA
99 = DK

REASON(S) FOR CURRENT ADMIT (FROM INT) - DEPRESSION
0 = NO - NOT CHECKED
1 = YES - CHECKED
9 = DK

INCIDENT TYPE - INCIDENT 1
1 = THREW SOMETHING
2 = PUSHED/GRABBED/ SHOVED
3 = SLAPPED
4 = KICKED/BITTEN/ CHOKED
5 = HIT w FIST/OBJECT
6 = FORCED SEX
7 = THREAT w KNIFE/GUN
8 = USED KNIFE/GUN
9 = OTHR VIOL
22 = OBJECT THROWN
23 = PUSH, GRAB
24 = SLAPPING
25 = KICK, BITE, CHOKE
26 = HIT W/FIST, OBJECT
27 = SEXUAL ASSAULT
28 = THREAT W/WEAPON
29 = USE GUN/KNIFE
30 = OTHER VIOLENT
98 = NA
99 = DK

# TIMES - INCIDENT 1
96 = 96 OR MORE
98 = NA
99 = DK

MONTH - INCIDENT 1
0 = MISSING
1 = JAN
2 = FEB
3 = MAR
4 = APR
5 = MAY
6 = JUNE
7 = JUL
8 = AUG
9 = SEP
10 = OCT
11 = NOV
12 = DEC
97 = REFUSED
98 = NA
99 = DK

MONTH - INCIDENT 8
0 = MISSING
97 = REFUSED
98 = NA
99 = DK

YEAR - INCIDENT 1
0 = MISSING
98 = NA
99 = DK

LOCATION - INCIDENT 1
1 = SUBJECTS HOME
2 = OTHER RESIDENCE
3 = STORE/BANK
4 = FAST FOOD REST
5 = BAR/TAVERN
6 = OTHER COMM
7 = WORK
8 = SCHOOL
9 = OUTDOORS
10 = OUTPATIENT TX
95 = INSTITUTION
96 = OTHER
97 = OTHER
99 = DK

LOCATION - INCIDENT 2
1 = SUBJECTS HOME
2 = OTHER RESIDENCE
3 = STORE/BANK
4 = FAST FOOD REST.
5 = BAR/TAVERN
6 = OTHER COMM.
7 = WORK
8 = SCHOOL
9 = OUTDOORS
10 = OUTPATIENT TX
95 = INSTITUTION
97 = OTHER
99 = DK

FIRST VICTIM - INCIDENT 1
0 = NO VICTIMS
1 = SPOUSE/COHAB/EX
2 = GIRL/BOYFRIEND/EX
3 = CHILD-NONSPANK
4 = CHILD-SPANK
5 = PARENT
6 = OTHER FAMILY
7 = OTHER KNOWN
8 = STRANGER
9 = DK

SEX OF FIRST VICTIM - INCIDENT 1
1 = MALE
2 = FEMALE
8 = NA
9 = DK

MOST SERIOUS INJURY TO VICTIM - INCIDENT 1
0 = NO INJURY
1 = BRUISES, CUTS
2 = UNCON, INTERNAL INJ, BROKEN BONES/TEETH
3 = STAB/GUNSHOT
4 = DEATH
7 = OTHER
9 = DK

DELUSIONAL AT TIME - INCIDENT 1
0 = NO
1 = POSSIBLY
2 = YES
9 = DK

DELUSIONAL AT TIME - INCIDENT 2
0 = NO
1 = POSSIBLY
2 = YES

WEAPON TYPE - INCIDENT 1
1 = GUN
2 = KNIFE
3 = OTHER
8 = NA
9 = DK

WEAPON THREAT - INCIDENT 1
1 = IN HAND
2 = IN ROOM
3 = IN BUILDING
4 = ELSEWHERE
5 = WILL OBTAIN
8 = NA
9 = DK

LEVEL 1 VIOLENCE - INCIDENT 1
0 = NO
1 = YES
8 = N/A
9 = DK

LEVEL 1 INCIDENT
0 = BOX NOT CHECKED - CONTINUE
1 = BOX CHECKED - NO INCIDENT

WHAT BROUGHT SUBJ AND VICTIM TOGETHER
1 = HAPPENED TO BE THERE
2 = REG SCHED ACTIVITY
3 = IRREG SCHED ACTIVITY
4 = SUBJ SOUGHT VICTIM OUT - NOT PLANNED
5 = VICTIM SOUGHT SUBJ OUT - NOT PLANNED
6 = OTHER
7 = REFUSED
9 = DK

PROBLEM THAT LED TO INCIDENT
0 = CLEARLY UNPROVOKED
1 = TX OF CHILDREN
2 = INFIDELITY
3 = PERS REJECTION
4 = FAMILY MATTERS
5 = MONEY
6 = POSS OF GOODS
7 = DESTR/VIOLATION OF PROP
8 = STEAL GOODS
9 = ALC OR DRUGS
10 = EMBARRASSING
11 = PERS/BUS OBLIG
12 = WHAT TO DO
13 = PHYS VIOLATION
14 = PHYS ASSAULT
15 = MEDS
16 = VERBAL ASSAULT
17 = SOMEONES DEF.
96 = OTHER
97 = REFUSED
98 = DELUSIONAL AT TIME
99 = DK

INCIDENT BECAUSE PERSON HAD SOMETHING YOU WANTED
0 = NO
1 = YES
7 = REFUSED
8 = N/A
9 = DK

DRUG CODE
1 = MARIJUANA
2 = STIMULANTS
3 = SEDATIVES
4 = OTHR PRESCR.DRUGS
5 = COCAINE
6 = HEROIN
7 = COCAINE/HEROIN COMBO
8 = OPIATES
9 = PCP
10 = PSYCHEDELICS
11 = INHALANTS/OTHER
13 = PCP AND OTHR DRUG
14 = MULTIPLE - COCAINE/CRACK AND OTHER DRUG
97 = REFUSED
98 = NA
99 = DK

WHAT THINKING BEFORE INCIDENT
0 = NO - NOT DELUS
1 = YES - DELUSIONAL
7 = REFUSED
8 = N/A
9 = DK

HEARING VOICES BEFORE INCIDENT
0 = NO - NOT HALLUC
1 = YES - HALLUCINATING
7 = REFUSED
8 = N/A
9 = DK

ANYONE TAKE TIME OFF WORK/SCHOOL AFTER INCIDENT
0 = NO
1 = YES
7 = REFUSED
8 = NA - NO JOB/SCHOOL
9 = DK

HOW DID INCIDENT END
1 = SUBJECT LEFT
2 = OTHER LEFT
3 = SOMEONE INTERVENED - NOT POLICE
4 = STOPPED
5 = SUBJ KNOCKED OUT/PASSED OUT/FELL ASLEEP
6 = OTHR PERS KNOCKED OUT/PASSED OUT/FELL ASLEEP
8 = POLICE
9 = I LEFT HIM/HER ALONE
10 = THEY LEFT ME ALONE
11 = S APOLOGIZED
12 = V APOLOGIZED
96 = OTHER
97 = REFUSED
99 = DK

REASON WHY INCIDENT NOT WORSE
0 = NO ADDL RESPONSE
1 = DIDNT WANT TO HURT
2 = DIDNT WANT TO FIGHT
3 = HURT ENOUGH/SATISFIED/ SELF-DEFENSE
4 = RELATIONSHIP
5 = SUBJ AFRAID OF HARM TO SELF
6 = SUBJ CONCERNED w CONSEQUENCES
7 = VICTIM BACKED OFF
8 = ACCOUNT GIVING
9 = DELUS/HALLUC RELATED
10 = 3RD PARTY INTERVENTION
11 = LACK MEANS/ABILITY
12 = MISCELLANEOUS
97 = REFUSED
98 = NA
99 = DK

WAS MOST SERIOUSLY INJURED VICTIM THE INTENDED VICTIM
1 = YES
2 = NO
8 = NA/NO INJURY
9 = DK

THIS ADMIT - FELT FREE TO DO WHAT WANTED ABOUT COMING TO HOSP (IRS-A)
0 = FALSE
1 = TRUE
9 = DK

WHERE LIVING BEFORE ADMITTED TO HOSPITAL
1 = AT HOME
2 = INPATIENT
3 = REST HOME
4 = SUPERV LIVING ARR
5 = COOPERATIVE APT
6 = BOARDING HOUSE
7 = SHELTER
8 = DORM
9 = JAIL
96 = OTHER (SPECIFY)
97 = REFUSED
99 = DK

HOW LONG LIVED THERE - YEARS
0 = NONE
99 = DK

HOW LONG LIVED THERE - WEEKS
0 = NONE
9 = DK

LIVED THERE OFF AND ON OR STEADILY
1 = OFF AND ON
2 = STEADILY
9 = DK

# PEOPLE IN HOUSE (INCL SELF)
997 = REFUSED
998 = NA
999 = DK

SUBJECTS AGE
96 = 96 OR MORE
97 = REFUSED
99 = DK

SUBJECTS RACE
1 = WHITE
2 = BLACK
3 = HISPANIC
4 = OTHER
7 = REFUSED
9 = DK

MARITAL STATUS
1 = MARRIED W/SP
2 = MARRIED W/O SP
3 = WIDOWED
4 = SEPARATED
5 = DIVORCED
7 = REFUSED
8 = NA
9 = DK

HOW OFTEN UPSET B/C OF AN UNEXPECTED OCCURENCE
0 = NEVER
1 = ALMOST NEVER
2 = SOMETIMES
3 = FAIRLY OFTEN
4 = VERY OFTEN
9 = DK/REFUSED

NEVER HESITATE TO GO OUT OF WAY TO HELP SOMEONE IN TROUBLE
0 = FALSE
1 = DK
2 = TRUE
7 = REFUSED
9 = MISSING

OCCUPATION (SEE OCC CODES)
0 = NO OCCUPATION - NEVER WORKED
997 = REFUSED
999 = OCCUPATION NOT REPORTED

WHAT KINDS OF JOBS HAVE YOU HAD (IF NO OCC LITSED) (SEE OCC CODES)
0 = NO OCCUPATION - NEVER WORKED
997 = REFUSED
998 = NA
999 = OCCUPATION NOT REPORTED

HAVE YOU WORKED IN THE PAST 2 MONTHS
0 = NO
1 = YES - FULL-TIME
2 = YES - PART-TIME
7 = REFUSED
8 = NA
9 = DK

WERE YOU RETIRED
0 = NO - NOT CHECKED
1 = YES - CHECKED
8 = NA
9 = DK

FULL OR PART-TIME STUDENT
1 = FULL-TIME
2 = PART-TIME
8 = NA
9 = DK

WHAT WAS YOUR PRIMARY STATUS
1 = RETIRED
2 = HOMEMAKER
3 = STUDENT
4 = LAID OFF
5 = HOSPITALIZED
6 = DISABLED
7 = INCARCERATED
8 = EMPLOYED - ON VACA/LEAVE
9 = UNEMPL - SEEKING
10 = UNEMPL - NOT SEEKING
11 = OTHER
98 = NA
99 = REFUSED

SUBJECTS EDUCATION LEVEL
12 = HS GRAD
13 = 1 YR OF COLLEGE
14 = 2 YRS OF COLLEGE
15 = 3 YRS OF COLLEGE
16 = COLLEGE GRAD
17 = SOME GRAD SCHOOL
18 = GRAD DEGREE
19 = POST GRAD STUDY
20 = POST GRAD STUDY
97 = REFUSED
98 = NA
99 = DK

AGE OF SEPARATION FROM BIOLOGICAL MOTHER
0 = LESS THAN 1 YEAR
97 = REFUSED
98 = NA
99 = DK

PARENTAL FIGURE 2 - GENDER
1 = MALE
2 = FEMALE
7 = REFUSED
8 = NA
9 = DK

BEAT AS CHILD (12 & UNDER)
0 = NEVER
1 = ONCE
2 = TWICE
3 = SOMETIMES
4 = FREQUENTLY
5 = MOST OF TIME
7 = REFUSED
8 = NA
9 = DK

MOST SEVERE PUNISHMENT EVER RECEIVED
0 = NONE
1 = VERBAL
2 = MATERIAL
3 = NEGLECT
4 = SPANKING
5 = PHYSICAL
6 = WEAPON USE
7 = SEXUAL ABUSE
96 = OTHER
97 = REFUSED
98 = NA
99 = DK

MOTHER (BIOLOGICAL) EVER ADMITTED TO PSYCH HOSP
0 = NEVER
1 = ONCE
2 = TWICE
3 = SEVERAL TIMES
4 = VERY OFTEN
6 = YES - UNK FREQ
7 = REFUSED
8 = NA
9 = DK

SUBJECTS AGE AT TIME OF MOTHERS (BIOLOGICAL) FIRST ADMIT
0 = NOT YET BORN
1 = UP TO 1 YR
97 = REFUSED
98 = NA
99 = DK

DID MOTHER (BIOLOGICAL) EVER DRINK EXCESSIVELY
0 = NEVER
1 = DAILY
2 = TWICE A WEEK
3 = ONCE A WEEK
4 = ONCE A MONTH
5 = LESS OFTEN
6 = YES, UNK
7 = REFUSED
8 = NA
9 = DK

DRUGS USED BY MOTHER (BIOLOGICAL) - DRUG 1
1 = MARIJUANA
2 = STIMULANTS
3 = SEDATIVES
4 = OTHER RX DRUGS
5 = COCAINE
6 = HEROIN
7 = COCAINE/HEROIN COMBO
8 = OPIATES
9 = PCP
10 = PSYCHEDELICS
11 = INHALANTS/OTHER
13 = PCP AND OTHR DRUG
14 = MULTIPLE - COCAINE/CRACK AND OTHER DRUG
97 = REFUSED
98 = NA
99 = DK

WAS MOTHER (BIOLOGICAL) EVER ARRESTED
0 = NEVER
1 = 1 TIME
2 = 2 TIMES
3 = 3 TIMES
4 = 4 TIMES
5 = 5-10 TIMES
6 = 10+ TIMES
7 = YES, UNSPECIFIED # OF TIMES
8 = NA
9 = DK

CRIME CLASSIFICATION FOR MOST SERIOUS CHARGE (BIOLOGICAL MOTHER)
0 = NO CRIME
1 = MURDER
2 = RAPE
3 = ASSAULT
4 = ROBBERY
5 = KIDNAPPING/ARSON
6 = OTHER CRIMES AGAINST PERSON
7 = SEX CRIME
8 = PROP CRIMES
9 = DRUG CRIMES
10 = MINOR CRIMES
97 = REFUSED
98 = NA
99 = DK

SUBJECTS AGE AT TIME OF FATHERS (NOT BIOLOGICAL) FIRST ADMIT
0 = NOT YET BORN
97 = REFUSED
98 = NA
99 = DK

HOW OFTEN THOUGHT OF HURTING SELF
1 = RARELY
2 = SOMETIMES
3 = OFTEN
4 = ALMOST ALWAYS
7 = REFUSED
8 = NA
9 = DK

HOW TRY TO HURT SELF
0 = NO VALID ATTEMPT
1 = GUN
2 = KNIFE/SHARP EDGE
3 = PILLS/DRUGS ALCOHOL
4 = HANGING
5 = SUFFOCATED
6 = JUMP FROM HIGH PL
7 = THROW SELF IN FRONT OF MOVING VEHICLE
8 = STARVATION
9 = FIRE/BURNING
10 = DROWNING
11 = VEHICULAR SUICIDE
12 = OTHER
13 = GUN AND DRUGS
14 = KNIFE AND DRUGS
15 = GUN AND OTHER
16 = KNIFE AND OTHER
17 = DRUGS AND OTHER
18 = OTHER, MULT
97 = REFUSED
98 = NA
99 = DK

DEGREE OF SELF-HARM SOUGHT
0 = NONE
1 = INJURY
2 = DEATH
7 = REFUSED
8 = NA
9 = DK

ACTS IN ANTICIPATION OF DEATH
0 = NONE
1 = THOUGHT ABOUT
2 = MADE DEFINITE PLANS
7 = REFUSED
8 = NA
9 = DK

ALTERATION/MANIPULATION OF ENVIRONMENT AS GOAL
0 = NONE
1 = UNCLEAR/SECOND GOAL
2 = PRIMARY GOAL
7 = REFUSED
8 = NA
9 = DK

DEGREE OF PREMEDITATION
0 = NONE
1 = SELF HARM CONTEMPLATED <3 HRS BEFORE ATTEMPT
2 = SELF HARM CONTEMPLATED >3 HRS BEFORE ATTEMPT
7 = REFUSED
8 = NA
9 = DK

ACTIVE PREPARATION
0 = NONE
1 = MINIMAL TO MODERATE
2 = EXTENSIVE
7 = REFUSED
8 = NA
9 = DK

SELF-HARM NOTE
0 = ABSENCE OF NOTE
1 = NOTE THOUGHT ABOUT
2 = PRESENCE OF NOTE
7 = REFUSED
8 = NA
9 = DK

PROBABILITY OF INTERVENTION
0 = INTERVENTION PROBABLE
1 = INTERVENTION NOT LIKELY
2 = INTERVENTION HIGHLY UNLIKELY
7 = REFUSED
8 = NA
9 = DK

ISOLATION
0 = SOMEBODY PRESENT
1 = SOMEBODY NEARBY OR IN VISUAL OR VOCAL CONTACT
2 = NO ONE NEARBY OR IN VISUAL OR VOCAL CONTACT
7 = REFUSED
8 = NA
9 = DK

PRECAUTIONS AGAINST DISCOVERY
0 = NO PRECAUTIONS
1 = PASSIVE PRECAUTIONS
2 = ACTIVE PRECAUTIONS
7 = REFUSED
8 = NA
9 = DK

LAST TIME HAD A DAYDREAM
1 = TODAY
2 = IN THE PAST TWO DAYS
3 = IN THE PAST 3-7 DAYS
4 = IN THE PAST MONTH
5 = 1-2 MONTHS AGO
6 = 2+ MONTHS AGO
7 = REFUSED
8 = NA (NO FANTASY)
9 = DK

HOW OFTEN HAVE DAYDREAMS
1 = SEVERAL TIMES A DAY
2 = ONCE A DAY
3 = SEVERAL TIMES A WEEK
4 = ONCE A WEEK
5 = FEW TIMES A MONTH
6 = 2-3 TIMES IN THE PAST MONTH
7 = ONCE IN THE PAST 2 MONTHS
8 = NA
9 = DK

WHEN DID DAYDREAMS START
1 = DURING THE PAST MONTH
2 = DURING THE PAST 1-3 MONTHS
3 = DURING THE PAST 3-6 MONTHS
4 = DURING THE PAST 6-12 MONTHS
5 = BEFORE THE PAST YEAR
8 = NA
9 = DK

DAYDREAMS - SAME OR DIFFERENT EACH TIME
1 = SAME
2 = DIFFERENT
8 = NA
9 = DK

INJURIES SAME OR WORSE OVER TIME
1 = LESS SERIOUS
2 = SAME
3 = MORE SERIOUS
8 = NA
9 = DK

# OF TIMES YOU HAVE THROWN
91 = 1-2
92 = 3-5
93 = 6-10
94 = 11-20
95 = 20+
97 = REFUSED
98 = NA
99 = DK

WHAT ELSE VIOLENT
1 = HIT W/CAR
2 = ARSON/FIRE
3 = SCRATCH
4 = THREW LIQUID
5 = MACED
7 = OTHER
8 = NA
9 = DK

INCIDENT TYPE - INCIDENT 1
1 = THREW SOMETHING
2 = PUSHED/GRABBED/ SHOVED
3 = SLAPPED
4 = KICKED/BITTEN/ CHOKED
5 = HIT w FIST/OBJECT
6 = FORCED SEX
7 = THREAT w KNIFE/GUN
8 = USED KNIFE/GUN
9 = OTHR VIOL

# TIMES - INCIDENT 1
95 = MORE THAN 20
96 = 96 OR MORE
98 = NA
99 = DK

# TIMES - INCIDENT 3
94 = 11-20 TIMES
95 = MORE THAN 20
96 = 96 OR MORE
98 = NA
99 = DK

# TIMES - INCIDENT 6
94 = 11-20 TIMES
96 = 96 OR MORE
98 = NA
99 = DK

LOCATION - INCIDENT 1
1 = SUBJECTS HOME
2 = OTHER RESIDENCE
3 = STORE/BANK
4 = FAST FOOD REST
5 = BAR/TAVERN
6 = OTHER COMMERCIAL
7 = WORK
8 = SCHOOL
9 = OUTDOORS
10 = OUTPATIENT TX
95 = INSTITUTION
96 = OTHER
97 = OTHER
99 = DK

FIRST VICTIM - INCIDENT 1
0 = NO VICTIMS
1 = SPOUSE/COHAB/EX
2 = GIRL/BOYFRIEND/EX
3 = CHILD - NONSPANK
4 = CHILD - SPANK
5 = PARENTAL FIGURE
6 = OTHER FAMILY
7 = OTHER KNOWN
8 = STRANGER
9 = DK

INJURY TO VICTIM - INCIDENT 1
0 = NO INJURY
1 = BRUISES, CUTS
2 = UNCON, INTERNAL INJ, BROKEN BONES/TEETH
3 = STAB/SHOT
4 = DEATH
7 = OTHER
8 = NA
9 = DK

WEAPON TYPE - INCIDENT 1
1 = GUN
2 = KNIFE
3 = OTHER
7 = REFUSED
8 = NA
9 = DK

WEAPON THREAT - INCIDENT 1
0 = NO WEAP
1 = IN HAND
2 = IN ROOM
3 = IN BUILDING
4 = ELSEWHERE
5 = WILL OBTAIN
7 = REFUSED
8 = NA
9 = DK

LEVEL 1 INCIDENT #1
0 = BOX NOT CHECKED - CONTINUE
1 = BOX CHECKED - NO INCIDENT
9 = DK

LEVEL 1 INCIDENT #1 - INCIDENT NUMBER
99 = DK INC#

PROBLEM THAT LED TO INCIDENT - INCIDENT 1
0 = CLEARLY UNPROVOKED
1 = TX OF CHILDREN
2 = INFIDELITY
3 = PERS REJECTION
4 = FAMILY MATTERS
5 = MONEY
6 = POSS OF GOODS
7 = DESTR/VIOLATION OF PROP
8 = STEAL GOODS
9 = ALC OR DRUGS
10 = EMBARRASSING
11 = PERS/BUS OBLIG
12 = WHAT TO DO
13 = PHYS VIOLATION
14 = PHYS ASSAULT
15 = MEDS
16 = VERBAL ASSAULT
17 = SOMEONES DEFENSE
96 = OTHER
97 = REFUSED
98 = DELUSIONAL AT TIME
99 = DK

DIFFICULTY DOING HOUSEWORK
0 = NONE
1 = SOME
2 = A LOT
3 = UNABLE TO DO IT
7 = REFUSED
8 = NA
9 = DK

DIFFICULTY SHOPPING
0 = NONE
1 = SOME
2 = A LOT
3 = UNABLE TO DO IT
7 = REFUSED
9 = DK

HELPS W/HOUSEHOLD TASKS - PERSON 1 (FROM SNI)
0 = NO ONE
996 = NO ONE IN PART.
997 = REFUSED
999 = DK

HELP GETTING THROUGH HARD TIME - PERSON 1 (FROM SNI)
0 = NO ONE
996 = NO ONE IN PART
997 = REFUSED
999 = DK

TOTAL # OF PEOPLE TO TALK ABOUT IMPORTANT THINGS WITH
0 = NONE
97 = REFUSED
98 = NA
99 = DK

TOTAL # OF PEOPLE WHO VISIT
0 = NO ONE
99 = DK

RESIDENCE-FIRST PERSON
0 = IN HOUSE
1 = LOCALLY
2 = IN STATE
3 = OUT OF STATE
7 = REFUSED
8 = NA
9 = DK

HOW LONG KNOWN FIRST PERSON
0 = ALL HIS/HER LIFE
1 = OVER 10 YEARS
2 = 5 TO 10 YEARS
3 = 1 TO 5 YEARS
4 = 1 MONTH TO 1 YEAR
5 = LESS THAN 1 MONTH
7 = REFUSED
8 = NA
9 = DK

CONTACT WITH FIRST PERSON
1 = DAILY
2 = 1-6 TIMES/WEEK
3 = 1-3 TIMES/MONTH
4 = SEVERAL TIMES A YEAR
5 = LESS THAN ONCE A YEAR
7 = REFUSED
8 = NA
9 = DK

FEELINGS ABOUT FIRST PERSON - INTERVIEWER RATING
1 = POSITIVE
2 = NEGATIVE
3 = AMBIVALENT
4 = NEUTRAL
7 = REFUSED
8 = NA
9 = DK

I PLAN TASKS CAREFULLY (BIS)
0 = RARELY/NEVER
1 = RARELY/NEVER
2 = OCCASIONALLY
3 = OFTEN
4 = ALMOST ALWAYS/ ALWAYS
7 = REFUSED
8 = NA
9 = DK

I NOTICE ANNOYANCES RIGHT AWAY (NAS-A)
1 = NEVER TRUE
2 = SOMETIMES TRUE
3 = ALWAYS TRUE
7 = REFUSED
8 = NA
9 = DK

BEING CRITICIZED IN FRONT OF OTHERS (NAS-B)
1 = NOT AT ALL ANGRY
2 = A LITTLE ANGRY
3 = FAIRLY ANGRY
4 = VERY ANGRY
7 = REFUSED
8 = NA
9 = DK

DID SUBJ SEEM TO UNDERSTAND QUES - INTERVIEWER RATING
0 = NO
1 = SOME
2 = YES
7 = REFUSED
8 = NA
9 = DK

DID SUBJ MISREPORT VIOLENCE - INTERVIEWER RATING
1 = ACCURATE
2 = OVERREPORTED
3 = UNDERREPORTED
7 = REFUSED
8 = NA
9 = DK

Prior Arrest for Crimes Against Property
0 = No
1 = Yes

Mac Dx Categories
1 = MajMen No AlSub
2 = MajMen & AlcSub
3 = Sub/Alc No MajMen
4 = PD Only

Baseline (prior 2Mo) Violence
0 = None
2 = Violence

Prior Arrests - Seriousness
0 = None
1 = ProMinDrg
2 = RapAssRob
3 = Murder

Prior Arrests - Frequency
0 = None
1 = Once
2 = Twice
3 = Three_More

MMDAS - Action
0 = No Actions
1 = Non-Agg Acts
2 = Agg Thoughts
3 = OAA
4 = Violence Unknown Level
5 = Violence

Sex - Male
0 = Female
1 = Male

1 = White
2 = Black
3 = Hispanic