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March 22, 2019 11:50
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[1] "3. Age" | |
[2] "4. Gender" | |
[3] "5. Height (cm eg, 168)" | |
[4] "6. Current Weight (kg eg, 66)" | |
[5] "7. The lowest adult weight that you have ever been from age of 18 onwards (kg eg, 50)" | |
[6] "8. Highest adult weight that you have ever been since the age of 18, excluding pregnancy (kg eg, 62)" | |
[7] "9. Ideal Weight (kg, eg 57)" | |
[8] "10.1.a. Am terrified about being overweight." | |
[9] "10.2.a. Avoid eating when I am hungry." | |
[10] "10.3.a. Find myself preoccupied with food." | |
[11] "10.4.a. Have gone on eating binges where I feel that I may not be able to stop." | |
[12] "10.5.a. Cut my food into small pieces." | |
[13] "10.6.a. Aware of the calorie content of foods that I eat." | |
[14] "10.7.a. Particularly avoid food with a high carbohydrate content (i.e. bread, rice, potatoes, etc.)" | |
[15] "10.8.a. Feel that others would prefer if I ate more." | |
[16] "10.9.a. Vomit after I have eaten." | |
[17] "10.10.a. Feel extremely guilty after eating." | |
[18] "10.11.a. Am preoccupied with a desire to be thinner." | |
[19] "10.12.a. Think about burning up calories when I exercise." | |
[20] "10.13.a. Other people think that I am too thin." | |
[21] "10.14.a. Am preoccupied with the thought of having fat on my body." | |
[22] "10.15.a. Take longer than others to eat my meals." | |
[23] "10.16.a. Avoid foods with sugar in them." | |
[24] "10.17.a. Eat diet foods." | |
[25] "10.18.a. Feel that food controls my life." | |
[26] "10.19.a. Display self-control around food." | |
[27] "10.20.a. Feel that others pressure me to eat." | |
[28] "10.21.a. Give too much time and thought to food." | |
[29] "10.22.a. Feel uncomfortable after eating sweets." | |
[30] "10.23.a. Engage in dieting behavior." | |
[31] "10.24.a. Like my stomach to be empty." | |
[32] "10.25.a. Have the impulse to vomit after meals." | |
[33] "10.26.a. Enjoy trying new rich foods." | |
[34] "11. Gone on eating binges where you feel that you may not be able to stop? (Eating much more than most people would eat under the same circumstances)" | |
[35] "11.a. If you answered yes, how often during the worst week?" | |
[36] "12. Ever made yourself sick (vomited) to control your weight or shape?" | |
[37] "12.a. If you answered yes, how often during the worst week?" | |
[38] "13. Ever used laxatives, diet pills or diuretics (water pills) to control your weight or shape?" | |
[39] "13.a. If you answered yes, how often during the worst week?" | |
[40] "14. Ever been treated for an eating disorder?" | |
[41] "14.a. When?" | |
[42] "15. What is the chances that you will sustain an injury on landing? 1 in ........?" | |
[43] "16. What is the chance that you would sustain a serious injury resulting from a collision? 1 in ........?" | |
[44] "17. what do you believe the chance of you being hospitalised due to a bad reaction to the drugs? 1 in ..?" | |
[45] "18. What is the chance you would fall off the horse and sustain minor injuries? 1 in ........?" | |
[46] "19. What are your chances of you still being on the rocks when the tide comes in? 1 in ........?" | |
[47] "20. What is the chance of being pulled over by the police and issued a fine? 1 in ........?" | |
[48] "21. what's the chance of contracting a sexually transmitted infection? 1 in ........?" | |
[49] "22. How do you rate the chance of falling and breaking your leg as a result? 1 in ........?" | |
[50] "23. What are the chances of the saftey equiptment failing and you becoming hospitalised? 1 in ........?" | |
[51] "24. What's the chance that your blood pressure will become high resulting in long term health problems? 1 in ........?" | |
[52] "25. What is the chance you will be involved in a car accident that has a fatality? 1 in ........?" | |
[53] "26. What do you think the chance of you being involved in a road traffic collision is? 1 in ........?" | |
[54] "27. What do you rate the chance of developing lung cancer in later life is, if you continued to smoke 5 cigarettes a day for the next 10 years? 1 in ........?" | |
[55] "28. What do you believe the chances of experiencing complications is? 1 in ........?" | |
[56] "29. How do you rate the chance that the roller coaster will malfunction and you will become stuck for a long period of time? 1 in ........?" | |
[57] "30. What do you feel your chances of developing liver damage are? 1 in ........?" | |
[58] "31. What do you believe the chances of having negative consequences (this does not include pregnancy) such as contracting a sexual transmitted infection are? 1 in ........?" | |
[59] "32. How would you rate the chance of you being mugged before arriving at your destination? 1 in ........?" | |
[60] "33. What are the chances you will fall and break your leg? 1 in ........?" | |
[61] "34. What is the chance that you are going to get hit by a car? 1 in ........?" | |
[62] "35. What are the chances of being seriously injured? 1 in ........?" | |
[63] "36. What are the chances of you becoming injured while crossing? 1 in ........?" | |
[64] "37. How would you rate the chance of you falling and becoming injured? 1 in ........?" | |
[65] "38. What is the chance of you choking to death? 1 in ........?" | |
[66] "39. What are the chances of a fire breaking out? 1 in ........?" | |
[67] "40. What are the chances of you sustaining an injury? 1 in ........?" | |
[68] "41. How do you rate the chance of developing frostbite? 1 in ........?" | |
[69] "42. What is the chances of you causing injury to your teeth? 1 in ........?" | |
[70] "43. How would you rate the chance that you will experience complications? 1 in ........?" | |
[71] "44. What is the chance of you having an allergic reaction? 1 in ........?" | |
[72] "45. Is there any final comments you would like to make about the questionaire?" |
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