17 Appendices

Mental Health in relation to Quality of Life and Coping Strategies of adolescents

APPENDIX

Appendix I: Personal Data Sheet

NAME

(OPTIONAL)

Tick Wherever

Applicable

AGE

1 11yrs to 14 yrs

Early Adolescence

2 15yrs to 18 yrs

Middle Adolescence

3 18yrs to 20 yrs

Late Adolescence

GENDER 1 MALE

2 FEMALE

FATHERS EDUCATION

1 ILLITERATE

2 UNDERGRADUATE

3 GRADUATE

4 POST GRADUATE

5 DOCTORATE

6 ANY OTHER (SPECIFY)

FATHERS OCCUPATION

1 PRIVATE

2 GOVERNMENT

3 SELF EMPLOYED

4 UNEMPLOYED

5 ANY OTHER, SPECIFY

MOTHERS EDUCATION

1 ILLITERATE

2 UNDERGRADUATE

3 GRADUATE

4 POST GRADUATE

5 DOCTORATE

6 ANY OTHER (SPECIFY)


MOTHERS

WORKING

STATUS

1 EMPLOYED

2 HOUSEWIFE

RELIGION

1 HINDU

2 CATHOLICS

3 MUSLIM

4 ANY OTHER, SPECIFY

FAMILY TYPE 1 JOINT FAMILY

2 NUCLEAR FAMILY

BIRTH ORDER 1 ONLY CHILD

2 ELDER SIBLING

3 MIDDLE SIBLING

4 YOUNGEST SIBLING

Annual Family

Income

1 2 Lac and Above

2 1,50,000 2,00,000

3 1,00,000 1,50,000

4 50,000 1,00,000

5 Below 50,000


Appendix II: Mental Health Battery

Arun Kumar Singh and Alpana Sen Gupta (2000)

Part 1

Instructions

Read the following questions carefully. In front of each question there are two options

Yes or No. You have to tick () in any one of them whichever you think is suitable

and correct. Do not leave any question. Your answers will be kept confidential.

S.N. STATEMENTS YES NO

1 When a person criticizes you, do you get angry?

2 If a teacher asks you some question in the class and you are not able to

answer, do you feel bad?

3 If you fail in an examination, do you feel like committing suicide?

4 Do you get afraid if your parents slightly rebuke or chide you?

5 Are you very afraid to see a snake, lizard, spider or any such reptiles?

6 Do you feel guilty if you go without completing your homework?

7 Do you silently sit after stealing anything belonging to your friend?

8 Do you feel good to criticize your friends?

9 Do you feel very happy for one moment and very sad in another?

10 If you lose in a game do you think your friend is to be blamed and

criticize him?

11 Do you feel very happy if your parents gave you a favourite thing?

12 Do you get upset if a close friend criticizes you?

13 Do you maintain your balance even in adverse situations?

14 Do you get angry if someone criticizes you even slightly?

15 Do you get more upset if a teacher scolds you on being indisciplined?

Part II

Instructions

Like Part I, each question have have two answers, Yes or No. out of these answers,

you have to select appropriate answer and tick the correct () mark either Yes or

No i.e. any one in the box given below. Do not leave any question.

S.N. STATEMENTS YES NO

16 Is your relation with your parents comparatively better than other

members of your family?

17 If you do not go to school any day, do you feel uneasy at home?

18 Do you feel more self conscious while expressing your views before

others?

19 Are you always ready to take responsibilities in any social work?

20 Are you often unable to sleep at night?


21 Do you often indulge into hot discussions with your siblings due to one

reason or the other?

22 Do you like mixing with people very much?

23 Do you often complain of constipation?

24 Do useless topics often come into your thinking?

25 Do you feel suffocation in school or college environment?

26 Is your home environment peaceful?

27 Do you easily make friends with strangers?

28 Do you have complaints related to digestion?

29 Do you lose your balance if someone slightly criticizes you?

30 Do you like going to school or college everyday?

31 Dont you do a work without taking permission of your parents?

32 Do you take help from others without any hesitation?

33 Do you wear glasses with power?

34 Do you get upset if someone insults you?

35 Do you like sharing a work along with your friends?

36 Do you feel that your family members like you lesser?

37 Do you want to be the key person in any social work?

38 Do you have less blood in your body?

39 Do you often feel helpless?

40 If your friend doesnt have a book do you help him by offering your own book?

41 Do you get worried, if your parents fall ill?

42 If you travel by train, do you easily make friends with your fellow

passengers?

43 In case of quarrel at home, do you try to pacify it?

44 Do you express your views before others without any hesitation?

45 Do you get nervous to see somebody bleeding?

YES NO

46 If you go to somebodys house do you comment if you dont get your choice food?

47 Are you often ahead of other students in a class competition?

48 Do members of your family do not love you as they should?

49 Do you often keep silent even if you dont like something?

50 Do you take care if your neighbours?

51 Do you like to stay at your friends house instead of staying at home?

52 If you go to any of your relatives, do you easily get adjusted in that

environment?

53 Do your parents criticize you, if you make a mistake?

54 Do you feel unusual nervousness when you see a spider or a lizard?

55 If a person wants to see various rooms of your house do you appreciate

him for this view?


Part III

Instructions

Given below are some situations which a person comes across in his day to day life.

Read these situations carefully and try to answer, if you were in that situation what

would you have done? Your answer should be any form of the two alternatives given

below for each question. So, whichever answer you think to be right, put a correct ()

tick mark in the box in front of it. Do not leave any questions.

S.N. STATEMENTS WITH CHOICES MARK

56

You are going out with a friend in the evening. At that time you find a

money-purse lying on the road. There was some money and that

persons address too. Your friend says, Lets go with this money to a hotel for a good meal and then go to a movie. In such a situation what would you do?

a. Agree with your friend?

b. Disagree with your friends view?

57

Your parents want you to get into a business so you can earn good

money. But you want to become a good doctor so that you can serve

people and treat poor and helpless. What would you do in such a

situation?

a. Agree with your fathers view?

b. Begin preparation for medical examination?

58 If there is a quarrel among your friends in class and it results in

fighting, what would you do in such a situation?

a. Try and pacify the quarrel.

b. Remain neutral and enjoy it.

59 Your examinations are at hand. Your parents ask you to give more time

to your studies but your attention often goes towards movies and games.

What would you do in such a situation?

a. You would not listen to your parents advice?

b. Not take interest in games and entertainment?

60 If while walking on road a person meets with an accident and you reach

there all of a sudden, what would you do in such a situation?

a. You would try to take that person to a doctor or hospital?

b. Watch the person for some time and then walk away?

61

If your brother or your sister brings an eraser or a pencil stolen from school,

you rebuke him and make him understand that stealing is a bad habit. If he

steals someones belongings, people call him a bad person. But one day your friend steals Rs. 500 and comes with the money and says, Let us enjoy with this amount. What would you do in such a situation?

a. You will make your friend understand not to do so?

b. Support your friend?


62

In an examination the questions are very tough and you know the

answers. Your friend asks you to tell him the answer. As a friend, you

think you should help him. But at the same time, it comes to your mind

that cheating in examinations or helping others both are offences in an

examination and if the examiner catches, he will also severely punish

you. What would you do in such a situation?

a. With courage try to make possible help to the friend.

b. Rebuke the friend.

63 At home, if your parents quarrel over some issue, you get worried for

sometime, what would you do in such a situation?

a. You will try to pacify your mother or father or both.

b. You wont go near them because of fear.

64 If a new teacher comes to your class. Some students try to harass him.

What would you do in such a situation?

a. You wont take your friends side.

b. You will tell your friends some new ways to harass the new teacher.

65 If some boys flee from your school to watch a movie, thus committing an act of indiscipline. When you came to know about this, what would you do?

a. You would report to your teacher about those boys.

b. Will remain neutral and do your work.

66 If your friends father falls ill and he doesnt even have money for his treatment, what would you do

a. Will arrange money for the treatment of the friends father.

b. You will sympathize your friend

67 While traveling by bus if a person is caught fleeing with somebodys expensive belongings what would you do?

a. Will sit calmly and watch the drama?

b. Try your best to get the person punished?

68 If you come to know that your friend doesnt have books to read, though he is very interested to study, as his poor parents somehow manage their expenses

of house. In such a situation what would you do?

a. Will give your own books to read for some time?

b. Youll promise to get him a book?

69 If a boy does caricature of the teacher in the class, to make his friends

laugh and you see the boy doing so, what you do?

a. You will indication to the boy not to do so?

b. You will complain to the teacher in the middle of the class?

70 While taking bath in a river or lake, you see small child drowning. In that situation, what would you do?

a. You will loudly cry out Help, Help.

b. Try to save him yourself.


Part IV

Instructions

In this, there are some questions related to your behavior. There are no fixed answers

to these questions, so whichever answer you think right, will be the right answer for

you and you have to mark the answer below either Yes or No in the boxes provided

with a correct () mark. Do not leave any question.

Sr.

No.

STATEMENTS YES NO

71 Are you afraid, if your parents are not at home?

72 Do you become disturbed, if while on road the lights suddenly go

off?

73 Does your anxiety / perplexity increases during a quarrel at home?

74 Do you feel more anxious if your family members come late to

receive you at railway station?

75 Do you feel afraid, thinking of going alone at night?

76 Do you feel lonely while in the midst of friends?

77 Do you depend on your friends?

78 Do you feel difficulty in expressing your own feelings?

79 Do you feel that you are well adjusted in your environment?

80 Do you feel that you are deprived of much happiness?

81 Do you feel nervousness while you are introduced to new people?

82 Do you get more praise from people?

83 Do you often remain depressed?

84 Do you feel unhappy due to negligible things?

85 Are you not afraid of any kind of competition?

Part V

Instructions

Read the following statements carefully. In front of each question there are two

answers given, that is Right or Wrong. Out of which you have to select the most

appropriate and correct one and make a () sign on it. Do not leave any question.

Sr.

No.

STATEMENTS RIGHT WRONG

86 I feel that my behavior is mature.

87 My stock of general knowledge is sufficient.

88 I can quickly solve the complicated problems.

89 My aspirations are real or realistic in nature.

90 I have to often face any type of obstacles in way of

progress.


91 I have full expectation that one day I will leave behind

all my competitors.

92 Some persons are very upset due to my success.

93 My expectations are based on my success.

94 I never faced any failure in my life.

95 Each person must try sincerely to be successful in life.

96 My success is always effective.

97 Till now I have not met a person who criticizes my

achievements.

98 My personal habits proved to hinder my achievements.

99 I often feel that a little gain is achieved after several

attempts.

100 My achievements are definitely criticized on certain

grounds.


Appendix III: World Health Organizations Quality Of Life Scale - BREF

(WHOQOL)-BREF

By World Health Organization (WHO)

Very

Poor

Poor Neither

Poor nor

Good

Good Very

Good

1 How would you rate

your quality of life?

1 2 3 4 5

Very

Dissatisfied

Dissatisfied Neither

Satisfied nor

Dissatisfied

Satisfied Very

Satisfied

2 How satisfied are you

with your health?

1 2 3 4 5

The following questions ask you how much you have experienced certain

things in the last weeks.

Not at all A little A

moderate

amount

Very

much

An

extreme

amount

3

To what extent do you

feel that physical pain

prevents you from

doing what you need to

do?

1 2 3 4 5

4

How much do you need

any medical treatment

to function in your

daily life?

1 2 3 4 5

5

How much do you

enjoy life?

1 2 3 4 5

6


feel your life to be

meaningful?

1 2 3 4 5


Not at all A little A moderate

amount

Very

much

Extremely

7

How well are you able

to concentrate?

1 2 3 4 5

8

How safe do you feel

in your daily life?

1 2 3 4 5

9

How healthy is your

physical environment.

1 2 3 4 5

The following questions ask about how completely you experience or were

able to do certain things in the last two weeks.

Not at all A little Moderate Mostly Completely

10

Do you have enough

energy for everyday

life?

1 2 3 4 5

11

Are you able to accept

your bodily

appearance?

1 2 3 4 5

12

Have you enough

money to meet your

needs?

1 2 3 4 5

13

How available to you

is the information that

you need in your day-

today life?

1 2 3 4 5

14


have the opportunity

for leisure activities?

1 2 3 4 5

Very

Poor

Poor Neither

Poor nor

Good

Good Very

Good

15

How well are you able

to get around

1 2 3 4 5

The following questions ask you to say how good or satisfied you felt about

various aspects of your life over the last two weeks

Very

Dissatisfied

Dissatisfied Neither

Satisfied

nor

Dissatisfied

Satisfied Very

Satisfied

16

How satisfied are

you with your sleep?

1 2 3 4 5


17

How satisfied are

you with your ability

to perform your

daily living

activities?

1 2 3 4 5

18

How satisfied are

you with your

capacity to work?

1 2 3 4 5

19

How satisfied are

you with yourself

1 2 3 4 5

20

How satisfied are

you with your

personal

relationships?

1 2 3 4 5

2

1

How satisfied are

you with your sex

life?

1 2 3 4 5

2

2

How satisfied are

you with the support

you get from your

friends?

1 2 3 4 5

2

3

How satisfied are

you with the

conditions of your

living place?

1 2 3 4 5

2

4

How satisfied are

you with access to

health services?

1 2 3 4 5

25 How satisfied are

you with your

transport?

1 2 3 4 5

The following question refers to how often you have felt or experienced

certain things in the last two weeks

Never Seldom Quite often Very

often

Always

26

How often do you have

negative feelings such

as blue mood, despair,

anxiety, depression?

1 2 3 4 5


Did someone help to fill out this form?

___________________________________

How long did it take to fill this form out?

__________________________________

Do you have any comments about the assessment?

_______________________________________________________________

THANK YOU FOR YOUR HELP


Appendix IV: Adolescent Coping Scale

Erica Frydenberg & Ramon Lewis (1993)

General Scale

Instructions:

Students have a number of concerns or worries about things such as school, work,

family, friends, the world and the like. Below is a list of ways in which people of your

age cope with a variety of concerns and problems. Please indicate by marking the

appropriate box, the things you do to deal with your concerns and worries. Work

down the page and mark 1, 2, 3, 4, or 5 as you come to each statement. There are no

right and wrong answers. Do not spend too much time on any statement but give the

answer which describes how you feel.

1 2 3 4 5

Doesnt apply or dont do it

Used very little Used sometimes Used Often Used a great

deal

Sr.

No

1 2 3 4 5

1. Talk to others to see what they would do if they had the problem

2. Work at solving whats causing the problem

3. Keep up with work as required

4. Play sport

5. Let God take care of my worries

6. Ask for advice from a qualified person

7. Worry about my future

8. Make a good impression on others who matter to me

9. There is nothing I can do about the problem so I dont do anything

10. I just give up

11. Meet with friends

12. Cry or scream

13. Hope for the best

14. Ring up a close friend

15. Keep my feelings to myself

16. Ignore the problem

17. Talk to others and give each other support

18. Work at solving the problem to the best of my ability

19. Attend school regularly


20. Keep fit an healthy

21. Remember those who are worse off so my troubles dont seem so bad

22. Pray for help and guidance so that everything will be alright

23. Get professional help or counseling

24. Worry about my happiness

25. Work hard

26. Find a way to relax; for example listen to music, read a book, play a musical instrument, watch

television

27. Make myself feel better by taking alcohol, cigarettes or other drugs (Not medication)

28. I get sick

29. Wish a miracle would happen

30. Avoid being with people

31. Seek encouragement from others

32. Consider other points of view and try to take them into account

33. Worry about my relationship with others

34. Go for a workout at the gym

35. Look on the bright side of things and think of all that is good

36. Read a holy book

37. Worry about what is happening

38. Try to fit in with my friends

39. Organize an action petition regarding my concern

40. Get into a steady relationship

41. Hope that the problem will sort out itself

42. Criticize myself

43. Keep others from knowing whats worrying me

44. Think about what I am doing and why

45. Achieve well in what I am doing

46. Go out and have a good time and forget about my troubles

47. Try to have a cheerful outlook on life

48. Pray to God to look after me

49. Organize a group to deal with the concern

50. Improve my relationship with others

51. Realize that I make things difficult for myself

52. Go to meetings which look at the problem

53. Try to make close friends with a guy or girl

54. Daydream about how things will turn out well

55. I have no way of dealing with the situation

56. Blame myself

57. Dont let others know how I am feeling

58. Consciously block out the problem

59. Talk to other people about my concern to help me sort it out


60. Work instead of going out

61. Ask a professional person for help

62. Be happy with the way things are

63. I suffer headaches or stomach aches

64. Worry about what will happen to me

65. Put the problem out of mind

66. Do as my friends want

67. Join with people who have the same concern

68. Take my frustrations out on others

69. Imagine that things will work out

70. See myself as being at fault

71. Get support from others such as parents or friends

72. Discuss the problem with qualified people

73. Worry about the future of the world

74. Make time for leisure activities

75. Change the amount I eat, drink or sleep

76. Shut myself from the problem so that I can avoid it

77. Spend more time with boy/girl friend

78. Think of different ways of dealing with the problrm

79. Find a way to let off steam; for example cry, scream, drink, take drugs

80. List any other things you do to cope with your main concern


Appendix V: Adolescent Coping Scale

Erica Frydenberg & Ramon Lewis (1993)

Specific Scale

Instructions:

Students have a number of concerns or worries about things such as school, work,

family, friends, the world and the like. Which is the main concern for you in terms of

your life? Please describe your main concern, very briefly, in the space below

..

Below is a list of ways in which people of your age cope with a variety of concerns

and problems. Please indicate by marking the appropriate box, the things you do to

deal with your concerns and worries. Work down the page and mark 1, 2, 3, 4, 05 5 as

you come to each statement. There are no right and wrong answers. Do not spend too

much time on any statement but give the answer which describes how you feel.

1 2 3 4 5

Doesnt apply or dont do it

Used very little Used sometimes Used Often Used a great

deal

Sr.

No

1 2 3 4 5

1. Talk to others to see what they would do if they had the problem

2. Work at solving whats causing the problem

3. Keep up with work as required

4. Play sport

5. Let God take care of my worries

6. Ask for advice from a qualified person

7. Worry about my future

8. Make a good impression on others who matter to me

9. There is nothing I can do about the problem so I dont do anything

10. I just give up

11. Meet with friends

12. Cry or scream

13. Hope for the best

14. Ring up a close friend

15. Keep my feelings to myself

16. Ignore the problem

17. Talk to others and give each other support


18. Work at solving the problem to the best of my ability

19. Attend school regularly

20. Keep fit an healthy

21. Remember those who are worse off so my troubles dont seem so bad

22. Pray for help and guidance so that everything will be alright

23. Get professional help or counseling

24. Worry about my happiness

25. Work hard

26. Find a way to relax; for example listen to music, read a book, play a musical instrument, watch

television

27. Make myself feel better by taking alcohol, cigarettes or other drugs (Not medication)

28. I get sick

29. Wish a miracle would happen

30. Avoid being with people

31. Seek encouragement from others

32. Consider other points of view and try to take them into account

33. Worry about my relationship with others

34. Go for a workout at the gym

35. Look on the bright side of things and think of all that is good

36. Read a holy book

37. Worry about what is happening

38. Try to fit in with my friends

39. Organize an action petition regarding my concern

40. Get into a steady relationship

41. Hope that the problem will sort out itself

42. Criticize myself

43. Keep others from knowing whats worrying me

44. Think about what I am doing and why

45. Achieve well in what I am doing

46. Go out and have a good time and forget about my troubles

47. Try to have a cheerful outlook on life

48. Pray to God to look after me

49. Organize a group to deal with the concern

50. Improve my relationship with others

51. Realize that I make things difficult for myself

52. Go to meetings which look at the problem

53. Try to make close friends with a guy or girl

54. Daydream about how things will turn out well

55. I have no way of dealing with the situation

56. Blame myself

57. Dont let others know how I am feeling


58. Consciously block out the problem

59. Talk to other people about my concern to help me sort it out

60. Work instead of going out

61. Ask a professional person for help

62. Be happy with the way things are

63. I suffer headaches or stomach aches

64. Worry about what will happen to me

65. Put the problem out of mind

66. Do as my friends want

67. Join with people who have the same concern

68. Take my frustrations out on others

69. Imagine that things will work out

70. See myself as being at fault

71. Get support from others such as parents or friends

72. Discuss the problem with qualified people

73. Worry about the future of the world

74. Make time for leisure activities

75. Change the amount I eat, drink or sleep

76. Shut myself from the problem so that I can avoid it

77. Spend more time with boy/girl friend

78. Think of different ways of dealing with the problem

79. Find a way to let off steam; for example cry, scream, drink, take drugs

80. List any other things you do to cope with your main concern

17 Appendices

Documents

Transcript of 17 Appendices