Haverford College
Department of Psychology

Senior Thesis Project by Clara Gruen & Karen Hooker
Doug Davis, Faculty Advisor

Weekly Logging Questionnaire for 1/17-1/23

ID Number: **
** This is the ID Number that you received in an email from Merleen MacDonald.

Please answer all of the following for each day of the week from last Monday through Sunday. Please be as honest and accurate in your responses as possible.
**If you always abstain from drinking alcohol (meaning you have not drunk for at least this entire academic year) click here.

How many drinks did you consume on each day of the week?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

On each night that you drank, what type of alcohol did you drink? Check all that apply.
**For the days that you didn't drink, you do not need to check any boxes.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Beer

Wine or Wine Coolers

Hard Alcohol/Shots

Mixed Drinks

Which of the following were significant factors in choosing to drink on each day that you drank? Check all that apply.
**For the days that you didn't drink, you do not need to check any boxes.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Because I wanted to relax

Because I wanted to change my personality

Because I wanted to have fun

Because I wanted to increase chances for sexual opportunities

Because the people I was with were drinking

Because I was in a drinking game

Because I was pressured to drink

Because I wanted to be more sociable

Because I was celebrating an event (i.e. birthday or accomplishment)

Because I finished my schoolwork

Because I wanted the physical effects

Because I was stressed about schoolwork

Because I was stressed about my personal life

Because I felt shy or uncomfortable

Because I was angry

Because I was sad or lonely

Because I was bored

Because I wanted to escape or forget

Because I wanted to get drunk

Other

Which of the following were significant factors in choosing not to drink on each day that you did not drink? Check all that apply.
**For the days that you did drink, you do not need to check any boxes.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Because I was not in a social situation where alcohol was present

Because I had to study

Because I had to get up early for class the next day

Because I wasn't in the mood

Because I wasn't feeling well

Because I was on medication that shouldn't be mixed with alcohol

Because none of the people I was with were drinking

Because I was having fun without drinking

Because I drank the night before

Because I didn't like the drink options (i.e. only beer)

Because I was tired

Other

 

On each day, which of the following situations were you in where alcohol was present or part of the social activity, whether or not you drank? Check all that apply.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Restaurant

Bar or Club

My room alone

My room with friends

Small party (3-11 people)

Pre-party before large party or event

Campus party

With my athletic team

With my social organization (club/activity)

With my family

Drinking game

Other

For each day that you drank, in which situation did you consume the most alcohol?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

On each day, which of the following situations were you in where alcohol was not present or part of the social activity? Check all that apply?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

On-campus movie

Campus dance

Hanging out with friends

Doing homework

Getting off campus (i.e. going to Philadelphia, movies, restaurants, plays, museums, etc.)

Please rate your personal stress level for this past week, where 5 is your average personal stress level, 1 is your least stressed ever, and 10 is the most stressed you ever are.

1 2 3 4 5 6 7 8 9 10

**BE SURE YOU ENTERED YOUR ID# AT THE TOP OF THE FORM BEFORE CLICKING THE SUBMIT BUTTON**

Please click the submit button below ONCE to send your responses.