Read the life events listed below and if any of these have occurred in the last two years check the box. |
Marriage and Relationship |
Divorce | | 1. |
Gaining a new family member (birth, adoption, older adult moving in, etc.) | | 2. |
Major change in the number of arguments with spouse (either a lot more or a lot less than usual regarding child rearing, personal habits, etc.) | | 3. |
Marital reconciliation with mate | | 4. |
Marital Separation from mate | | 5. |
Marriage | | 6. |
Pregnancy | | 7. |
Sexual Difficulties | | 8. |
Son or daughter leaving home (marriage, attending college, joined military) | | 9. |
Trouble with in-laws | | 10. |
Finance |
Foreclosure on a mortgage or loan | | 11. |
Taking on a loan (for car, tv, freezer, etc.) | | 12. |
Taking on a mortgage (for home, business, etc.) | | 13. |
Work Related |
Being fired at work | | 14. |
Changing to a different line of work | | 15. |
Major business readjustment | | 16. |
Major change in financial state (a lot worse or better off than usual) | | 17. |
Major change in responsibilities at work (promotion, demotion, etc.) | | 18. |
Major changes in working hours or conditions | | 19. |
Retirement from work | | 20. |
Spouse beginning or ceasing work outside the home | | 21. |
Trouble with the boss | | 22. |
Change in Lifestyle |
Beginning or ceasing formal schooling | | 23. |
Changes in residence | | 24. |
Changing to a new school | | 25. |
Major change in church or temple activity (a lot more or less than usual) | | 26. |
Major change in eating habits (a lot more or less food intake, or very different meal hours or surroundings) | | 27. |
Major change in living condition (new home, remodelling, deterioration of neighbourhood or home etc.) | | 28. |
Major change in number of family get-togethers | | 29. |
Major change in sleeping habits (a lot more or a lot less than usual) | | 30. |
Major change in social activities (clubs,movies,visiting,etc.) | | 31. |
Major change in usual type and/or amount of recreation | | 32. |
Major holidays | | 33. |
Major�Change�in�the�health/behavior�of�a�family�member | | 34. |
Outstanding personal achievement | | 35. |
Revision of personal habits (dress manners, associations, quitting smoking) | | 36. |
Vacation | | 37. |
Violations and Law |
Detention in jail or other institution | | 38. |
Minor violations of the law (traffic tickets, jaywalking, disturbing the peace, etc.) | | 39. |
Death & Injury |
Death of a close family member | | 40. |
Death of a close friend | | 41. |
Death of spouse | | 42. |
Major personal injury or illness | | 43. |
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