Senior Thesis Project by Clara Gruen & Karen Hooker Doug Davis, Faculty Advisor
Thank you for participating in this study. This is the preliminary survey, which consists of questions regarding background information and alcohol use, as well as questions concerning how accurately certain statements describe you. The second part of this study is a weekly questionnaire, in which you will be asked to log your choices of social activities, including use of alcohol, for approximately ten weeks. Please be aware that this is a very important part of the study, and while it will not take a significant amount of time, it is necessary that you complete all questionnaires. (**Note that this also means that you need to be on campus next semester. Students going abroad second semester are not eligible to participate.) At the completion of the study, there will be a lottery for numerous prizes to thank you for your participation. You will be eligible for the lottery when you have completed all parts of the study.
Confidentiality: All responses will be completely confidential. The researchers will not know the names of the people in the study. All identifying information will be coordinated through a secretary who is not involved in the study. There is no way for the researchers to trace the submission of the forms to you as an individual. We take these precautions because we want your complete and honest responses. Please direct any questions or concerns to Merleen MacDonald (mmacdona@haverford.edu),who will be coordinating e-mail with participants.
Survey ID Number:
Class: First-year Sophomore Junior Senior
Sex: Male Female
Age:
What kind of computer operating system are you completing the questionnaires on? Apple Macintosh OS Microsoft Windows Other
What type of computer are you using?
Laptop/Notebook Desktop
Do you participate in any of the following activities this school year? Check all that apply.
Intercollegiate athletics Intramural club sports Religious group Student Government (SC, HC, JSAAPP) Music or performing arts groups Customs (Customs person, HCO, UCA) Other College Organization
How often have you consumed alcoholic beverages during this academic year?
Never Less than once a month Once a month Two-three times a month Once a week Two-three times a week Four-five times a week Daily
What is your usual quantity of alcoholic beverages consumed at any one drinking occasion?
**Note: 1 drink=one 12 oz beer or 4 oz glass of wine or one oz shot or one oz alcohol in a mixed drink
None One drink Two drinks Three -four drinks Five-six drinks Seven-eight drinks Nine or more
How many times, this academic year, did you drink five or more drinks (see note above for equivalencies) on a single occasion?
To what extent has your amount of alcohol use changed since starting your first year of college?
I have not used alcohol since coming to college decreased greatly decreased somewhat stayed the same increased somewhat increased greatly
Have you ever done anything out of character (i.e. done something you wouldn't normally do) as a result of drinking alcohol?
Yes No optional: what did you do?
Have you ever had a bad experience as a result of drinking, or while under the influence of alcohol?
Yes No optional: what happened?
How many times have you used marijuana this academic year?
How many times have you used other drugs during this academic year?
If you do drink, even occasionally, to what extent do the following reasons explain why you choose to drink? (If you always abstain from drinking, please click here to skip to the next question.)
**Please rate each reason on a scale of 1 to 5 where 1 means it is not at all a reason why you choose to drink, 3 means it is somewhat a reason why you choose to drink and 5 means that it is very much a reason why you choose to drink.
Because I want to relax. Not at all 1 2 3 4 5 Very much
Because I want to change my personality (i.e. act differently). Not at all 1 2 3 4 5 Very much
Because I want to have fun. Not at all 1 2 3 4 5 Very much
Because I want to increase chances for sexual opportunities. Not at all 1 2 3 4 5 Very much
Because the people I am with are drinking. Not at all 1 2 3 4 5 Very much
Because I like the physical effects. Not at all 1 2 3 4 5 Very much
Because I want to be more sociable. Not at all 1 2 3 4 5 Very much
Because I am stressed about schoolwork. Not at all 1 2 3 4 5 Very much
Because I am stressed about my personal life. Not at all 1 2 3 4 5 Very much
Because I feel shy or uncomfortable. Not at all 1 2 3 4 5 Very much
Because I am angry or irritable. Not at all 1 2 3 4 5 Very much
Because I am sad or lonely. Not at all 1 2 3 4 5 Very much
Because I am bored. Not at all 1 2 3 4 5 Very much
Because I want to escape or forget. Not at all 1 2 3 4 5 Very much
Other: Not at all 1 2 3 4 5 Very much
If you abstain from drinking alcohol, to what extent do the following reasons explain why you choose not to drink? (If you do drink alcohol, please click here to skip to the next question.)
**Please rate each reason on a scale of 1 to 5 where 1 means it is not at all a reason why you choose not to drink, 3 means it is somewhat a reason why you choose not to drink and 5 means that it is very much a reason why you choose not to drink.
Because it is against my religious beliefs. Not at all 1 2 3 4 5 Very much
Because it is against my personal values. Not at all 1 2 3 4 5 Very much
Because I had a bad experience. Not at all 1 2 3 4 5 Very much
Because my friends don't drink. Not at all 1 2 3 4 5 Very much
Because I dislike the taste of alcohol. Not at all 1 2 3 4 5 Very much
Because it is bad for my health. Not at all 1 2 3 4 5 Very much
Because I don't want to lose control. Not at all 1 2 3 4 5 Very much
Because I've seen others drink to excess. Not at all 1 2 3 4 5 Very much
Because I have more fun without drinking. Not at all 1 2 3 4 5 Very much
Because I don't like the effects of alcohol. Not at all 1 2 3 4 5 Very much
Because it is against the law. Not at all 1 2 3 4 5 Very much
Because I have a family member or close friend with a drinking problem. Not at all 1 2 3 4 5 Very much
In what situations do you drink?
Restaurants Never Rarely Sometimes Often
Bars/Clubs Never Rarely Sometimes Often
My room alone Never Rarely Sometimes Often
My room with friends Never Rarely Sometimes Often
Small party (3-10 people) Never Rarely Sometimes Often
As part of a drinking game Never Rarely Sometimes Often
Pre-party before large party/event Never Rarely Sometimes Often
Campus party Never Rarely Sometimes Often
With my athletic team Never Rarely Sometimes Often
With a social organization (clubs, etc.) Never Rarely Sometimes Often
With my family Never Rarely Sometimes Often
Other: Never Rarely Sometimes Often
What social activities have you chosen to do on the weekends which don't involve consuming alcohol? Check all that apply.
On-Campus movies Campus dances Campus concerts Hanging out with friends Going to campus parties but not consuming alcohol Getting off campus (i.e. going to Philadelphia, movies, dinner, play, museum, etc.)
Personal Rating Form
Instructions: On the right side of your screen, there are phrases describing behaviors and attitudes. Please use the rating scale below to describe how accurately each statement describes you. Describe yourself as you generally are now, not as you wish to be. Describe yourself as you honestly see yourself, in relation to other people you know of the same sex as you are, and roughly your same age. So that you can describe yourself in an honest manner, your responses will be kept in absolute confidence. Please read each statement carefully, and then fill in the bubble that corresponds to the number on the scale.
Very Inaccurate Moderately Inaccurate Neither Inaccurate nor Accurate Moderately Accurate Very Accurate
Am the life of the party.
Feel little concern for others.
Am always prepared.
Get stressed out easily.
Have a rich vocabulary.
Don't talk a lot.
Am interested in people.
Leave my belongings around.
Am relaxed most of the time.
Have difficulty understanding abstract ideas.
Feel comfortable around people.
Insult people.
Pay attention to details.
Worry about things.
Have a vivid imagination.
Keep in the background.
Sympathize with others' feelings.
Make a mess of things.
Seldom feel blue.
Am not interested in abstract ideas.
Start conversations.
Am not interested in other people's problems.
Get chores done right away.
Am easily disturbed.
Have excellent ideas.
Have little to say.
Have a soft heart.
Often forget to put things back in their proper place.
Get upset easily.
Do not have a good imagination.
Talk to a lot of different people at parties.
Am not really interested in others.
Like order.
Change my mood a lot.
Am quick to understand things.
Don't like to draw attention to myself.
Take time out for others.
Shirk my duties.
Have frequent mood swings.
Use difficult words.
Don't mind being the center of attention.
Feel others' emotions.
Follow a schedule.
Get irritated easily.
Spend time reflecting on things.
Am quiet around strangers.
Make people feel at ease.
Am exacting in my work.
Often feel blue.
Am full of ideas.