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CIT-Youth TTT Pre-training Survey (SAMHSA)

  • Background

    We would like to know a little about your awareness and experience with mental health conditions in everyday life. (Not required)
  • The following section concerns a hypothetical person named Jenny. The description below outlines her recent feelings and behavior.

    Jenny is a 15 year old who has been feeling unusually sad and miserable for the last few weeks. She is tired all the time and has trouble sleeping at night. Jenny doesn't feel like eating and has lost weight. She can't keep her mind on her studies and her grades have dropped. She puts off making any decisions and even day-to-day tasks seem too much for her. Her parents and friends are very concerned about her. Jenny feels she will never be happy again and believes her family would be better off without her. She has been so desperate, she has been thinking of ways to end her life.
  • Not at allA little bitModeratelyQuite a bitExtremely
  • The next few questions contain statements about Jenny's problem. Please indicate how strongly YOU PERSONALLY agree or disagree with each statement.

  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Now we would like you to tell us what you think MOST OTHER PEOPLE believe. Please indicate how strongly you agree or disagree with the following statements.

  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • The following section concerns a hypothetical person named John. The description below outlines his recent feelings and behavior.

    John is a 15 year old who lives at home with his parents. He has been attending school irregularly over the past year and has recently stopped attending altogether. Over the past six months he has stopped seeing his friends and begun locking himself in his bedroom and refusing to eat with the family or to have a bath. His parents also hear him walking about in his bedroom at night while they are in bed. Even though they know he is alone, they have heard him shouting and arguing as if someone else is there. When they try to encourage him to do more things, he whispers that he won't leave home because he is being spied upon by the neighbor. They realize he is not taking drugs because he never sees anyone or goes anywhere.
  • Not at allA little bitModeratelyQuite a bitExtremely
  • The next few questions contain statements about John's problem. Please indicate how strongly YOU PERSONALLY agree or disagree with each statement.

  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Now we would like you to tell us what you think MOST OTHER PEOPLE believe. Please indicate how strongly you agree or disagree with the following statements.

  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Strongly disagreeDisagreeNeutralAgreeStrongly agree
  • Opinions About Mental Health Conditions

    For each of the statements below please indicate whether you agree or disagree with it, or don't know.
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know
  • AgreeDisagreeDon't know

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