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  2. 2015
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  5. College Student Survey
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Exit Survey
 
 
This survey is for college students only.  If you are not a college student I ask you kindly to not take the survey, but I thank for your interest. In this survey you will be asked to read different statements and rate how well they do or don't describe and also be asked some miscellaneous background questions.  Your participation in this study is completely voluntary. If you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Stephen Randazzo at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
 
Please verify by entering captcha text so the results aren't screwed up by robots!
   
 
 
How accurate are the following statements in describing yourself:
Not at all Characteristic of Me Not very Characteristic of Me Neutral Somewhat Characteristic of Me Extremely Characteristic of Me
I rarely worry about seeming foolish to others.
I worry about what people will think of me even when I know it doesn't make any difference.
I become tense and jittery if I know someone is sizing me up.
I am unconcerned even if I know people are forming an unfavorable impression of me.
I feel very upset when I commit some social error
The opinions that important people have of me cause me little concern
I am often afraid that I may look ridiculous or make a fool out of myself
I react very little when other people disapprove of me
I am frequently afraid of other people noting my shortcomings
The disapproval of others would have little effect on me
Not at all Characteristic of Me Not very Characteristic of Me Neutral Somewhat Characteristic of Me Extremely Characteristic of Me
If someone is evaluating me, I tend to expect the worst
I rarely worry about what kind of impression I am making on someone
I am afraid that others will not approve of me
I am afraid the people will find fault with me
Other people’s opinions of me do not bother me
I am not necessarily upset if I don’t please someone
When I am talking to someone, I worry about what they may be thinking about me
I feel that you can’t help making social errors, so why worry about it
I am usually worried about what kind of impression I make
I worry a lot about what my superiors think of me
Not at all Characteristic of Me Not very Characteristic of Me Neutral Somewhat Characteristic of Me Extremely Characteristic of Me
If I know someone is judging me, it has little effect on me
I worry that others will think I am not worthwhile
I worry very little about what others may think of me
Sometimes I think I am too concerned with what other people think of me
I often worry that I will say or do the wrong things
I am often indifferent to the opinions others have of me
I am usually confident others will have a favorable impression of me
I often worry that people who are important to me won’t think very much of me
I brood about the opinions my friends have about me
I become tense and jittery if I know I am being judged by my superiors.
 
 
 
Thank you for your participation.  Please answer a few demographic questions.
 
 
 
What is your Gender?
 
Male
 
Female
 
Other
 
Prefer not to answer
 
 
Have you ever drank alcohol?
 
Yes
 
No
 
 
During the last 12 months, how often did you usually have any kind of drink containing alcohol? A drink being half an ounce of absolute alcohol (e.g. a 12 ounce can or glass of beer or cooler, a 5 ounce glass of wine, or a drink containing 1 shot of liquor).
 
Every day
 
5 to 6 times a week
 
3 to 4 times a week
 
Twice a week
 
Once a week
 
2 to 3 times a month
 
Once a month
 
3 to 11 times in the past year
 
1 or 2 times in the past year
 
N/A
 
 
During the last 12 months, how many alcoholic drinks did you have on a
typical day when you drank alcohol?
 
25 or more drinks
 
19 to 24 drinks
 
16 to 18 drinks
 
12 to 15 drinks
 
9 to 11 drinks
 
7 to 8 drinks
 
5 to 6 drinks
 
3 to 4 drinks
 
2 drinks
 
1 drink
 
N/A
 
 
What were the circumstances of the first time you drank? (How old, with who, where, etc.)? Consumed at least half an ounce of absolute alcohol (e.g. a 12 ounce can or glass of beer or cooler, a 5 ounce glass of wine, or a drink containing 1 shot of liquor).
   
 
 
When you drink what is the usual reason? (Select all that apply)
 
Beverage of Choice/Like the taste
 
To Socialize
 
To Relax
 
N/A
 
Other