BACKGROUND INFORMATION
1) Which sex are you?
Male
Female
2) Where do you live? U. S.
---Select One---
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
or other country?
---Select One---
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antartica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaidjan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
Former USSR
France
France (European Territory)
French Guyana
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe (French)
Guam
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique (French)
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldavia
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Neutral Zone
New Caledonia (French)
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Polynesia (French)
Portugal
Qatar
Reunion (French)
Romania
Russian Federation
Rwanda
S Georgia & S Sandwich Islands
Saint Helena
Saint Kitts & Nevis Anguilla
Saint Lucia
Saint Pierre and Miquelon
Saint Tome and Principe
Saint Vincent & Grenadines
Samoa
San Marino
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovak Republic
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syria
Tadjikistan
Taiwan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
UK
Ukraine
United Arab Emirates
Uruguay
USA Minor Outlying Islands
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (USA)
Wallis and Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
3) How old are you?
4) How much school did you complete?
Some high school
High school graduate
Some college
College graduate
Some graduate school
Graduate school degree
5) What is your occupation?
6) How did you learn about this survey?
LEARNING FROM EXPERIENCE QUESTIONS
The following questions will ask you to describe what you have learned from your own experiences. You will be asked to select
TWO
topics from a list. For
EACH
topic, you will be asked to write a one-sentence summary of something you feel you have learned about this topic through your own life experience. Then, tell the story of how you learned this life lesson.
1)
TOPIC ONE
(Choose one from he list below):
Self (The Kind of Person I Am)
Work
Friendship
Love, Marriage, Relationships
Children & Parents
Hard Times
Turning Points, Transitions, Transformations
Illness or Death
Happiness & Fulfillment
Other (Please Specify):
2) GIVE A ONE-SENTENCE SUMMARY of what you have learned about this topic through your own life experience.
"I learned that...
3) TELL THE STORY OF HOW YOU LEARNED THIS.
Describe the experiences that helped you gain this understanding, using as many words as you want. What event(s) or circumstances helped you learn this? Was it a sudden insight or a gradual realization?
Your story should have a BEGINNING, MIDDLE, and END.
4)
TOPIC TWO
(Choose one from the list below):
Self (The Kind of Person I Am)
Work
Friendship
Love, Marriage, Relationships
Children & Parents
Hard Times
Turning Points, Transitions, Transformations
Illness or Death
Happiness & Fulfillment
Other (Please Specify):
5) GIVE A ONE-SENTENCE SUMMARY of what you have learned about this topic through your own life experience.
"I learned that...
6) TELL THE STORY OF HOW YOU LEARNED THIS. Describe the experiences that helped you gain this understanding, using as many words as you want. What event(s) or circumstances helped you learn this? Was it a sudden insight or a gradual realization?
Your story should have a BEGINNING, MIDDLE, and END.
WELL-BEING QUESTIONS
The final section of this survey contains 27 brief questions about your general well-being.
Below are five statements with which you may agree or disagree. Indicate your agreement with each item by clicking on the circle by the appropriate number on the 7-point scale following each item. Please be open and honest in your responding.
S1) In most ways my life is close to my ideal.
1 = strongly disagree
2 = disagree
3 = slightly disagree
4 = neither agree or disagree
5 = slightly agree
6 = agree
7 = strongly agree
S2) The conditions of my life are excellent.
1 = strongly disagree
2 = disagree
3 = slightly disagree
4 = neither agree or disagree
5 = slightly agree
6 = agree
7 = strongly agree
S3) I am satisfied with my life.
1 = strongly disagree
2 = disagree
3 = slightly disagree
4 = neither agree or disagree
5 = slightly agree
6 = agree
7 = strongly agree
S4) So far I have gotten the important things I want in life.
1 = strongly disagree
2 = disagree
3 = slightly disagree
4 = neither agree or disagree
5 = slightly agree
6 = agree
7 = strongly agree
S5) If I could live my life over, I would change almost nothing.
1 = strongly disagree
2 = disagree
3 = slightly disagree
4 = neither agree or disagree
5 = slightly agree
6 = agree
7 = strongly agree
For each of the following four statements and/or questions, please click on the point on the scale that you feel is most appropriate in describing you.
H1) In general, I consider myself:
1 = not a very happy person
2
3
4
5
6
7 = a very happy person
H2) Compared to most of my peers, I consider myself:
1 = less happy
2
3
4
5
6
7 = more happy
H3) Some people are generally very happy. They enjoy life regardless of what is going on, getting the most out of everything. To what extent does this characterization describe you?
1 = not at all
2
3
4
5
6
7 = a great deal
>H4) Some people are generally not very happy. Although they are not depressed, they never seem as happy as they might be. To what extent does this characterization describe you?
1 = not at all
2
3
4
5
6
7 = a great deal
The following set of 18 questions deals with how you feel about yourself and your life. Please remember that there are no right or wrong answers. Click on the circle by the appropriate number that best describes your present agreement or disagreement with each statement
WB1) I tend to be influenced by people with strong opinions.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB2) In general, I feel I am in charge of the situation in which I live.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB3) I think it is important to have new experiences that challenge how you think about yourself and the world.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB4) Maintaining close relationships has been difficult and frustrating for me.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB5) I live life one day at a time and don't really think about the future.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB6) When I look at the story of my life, I am pleased with how things have turned out.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB7) I have confidence in my opinions, even if they are contrary to the general consensus.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB8) The demands of everyday life often get me down.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB9) For me, life has been a continuous process of learning, changing, and growth.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB10) People would describe me as a giving person, willing to share my time with others.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB11) Some people wander aimlessly through life, but I am not one of them.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB12) I like most aspects of my personality.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB13) I judge myself by what I think is important, not by the values of what others think is important.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB14) I am quite good at managing the many responsibilities of my daily life.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB15) I gave up trying to make big improvements or changes in my life a long time ago.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB16) I have not experienced many warm and trusting relationships with others.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB17) I sometimes feel as if I've done all there is to do in life.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
WB18) In many ways, I feel disappointed about my achievements in life.
1 = strongly disagree
2 = disagree somewhat
3 = disagree slightly
4 = agree slightly
5 = agree somewhat
6 = strongly agree
OPTIONAL: Do you have any other comments or observations about your experiences or about this survey?
OPTIONAL: Would you be willing to be interviewed further BY EMAIL about the experiences you described? If so, please write your email address in the box below. (Not everyone who volunteers will be contacted. Email address will be kept confidential and will only be used in the context of this study.)
EMAIL ADDRESS:
OPTIONAL: Would you like to receive a summary of the findings of this study? If so, please write your email address in the box below. (Your email address will be kept confidential and will be used only to send the summary of findings.)
EMAIL ADDRESS:
Thank you for participating in this study. We sincerely appreciate your willingness to share your thoughts and experiences.