4-3 Qualtrics Survey Tool

4-3 Qualtrics Survey Tool This survey is designed to explore adolescents and adults on their decisionmaking abilities and their individual thought process. Anyone who ranges from the age of 10 through 49 and above are welcomed to participate in this survey. During this survey the only personal information that will be asked of you be demographic information, and broad information, such as you age, education, etc. This survey is purely for feedback purposes only. Participants should be reminded that this survey is based on individuals who were willing and able to volunteer their time. As a participant may stop this survey at any time that you wish. Within each question, please circle or click on the letter that best answers the question suited to you. 1. What does your gender identify? a. b. c. d. e. Male Female Transgender Other Non-binary 2. How old are you? a. b. c. d. e. 10-18 18-24 24-30 36-42 42 or older 4-3 Qualtrics Survey Tool 3. Do you believe that education serves a purpose? a. Yes b. No 4. What is your highest level or education? a. b. c. d. e. High school or GED Associates Bachelors Masters Ph.D. 5. Was attending college purely your decision? a. Yes b. No 6. What part of the country are you originally from? a. Northeast b. South c. Midwest d. Southeast e. North 7. Have you ever used medications as a way to help with your concentration? a. b. Yes No 8. What is your racial ethnicity? a. American Indian or Alaska Native b. Black or African American c. Hispanic or Latino 4-3 Qualtrics Survey Tool 4 d. Native Hawaiian or Other Pacific Islander e. Asian 9. Do you make important decisions independently or with a parent or guardian? a. Independently b. With a parent or guardian 10. Do you make decisions based on the short term or long term? a. Short term b. Long term 11. Do you drink alcohol? a. Yes b. No 12. Are you motivated by fear or proving others wrong? a. Fear b. Proving others wrong 13. Do you ever find yourself procrastinating a lot? a. Yes b. No c. Sometimes 14. Which phrase best describes you? a. Get a move on b. Slow and steady wins the race 4-3 Qualtrics Survey Tool 15. Have you ever misused a medication before? a. Yes b. No 16. Do you believe the decisions you make today affect your future? a. b. Yes No 17. Do you know of anyone who suffers from depression under the age of 25? a. Yes b. No 18. What is your employment status? a. Full-time employed b. Part-time employed c. Unemployed 19. What is your current relationship status? a. b. c. d. e. Single Married Divorced Separated Widow 20. Are you someone who experiences a lot of self-doubt or are you confident in each decision you make? a. Yes b. Sometimes c. No 21. How many hours of sleep do you get at night? 4-3 Qualtrics Survey Tool a. Less than 5 hours b. 5-6 hours c. 6-8 hours 22. Would you say that it’s easy to follow any given task? a. b. c. d. Yes No Sometimes It all depends on the task at hand 23. Are you a caffeine drinker? a. Yes b. No c. Sometimes 24. Do you make a lot of time for social activities? a. Yes b. No 25. Do you find yourself saying yes to an obligation if there is an award in it for you? a. Yes b. No c. It depends on the reward 26. Do you get anxious around a lot people to the point where you have to leave? a. Yes b. No c. Sometimes 27. What motivates you each day? 4-3 Qualtrics Survey Tool 7 a. Your family b. Career/Job c. Friends/social life 28. Do you believe that too much binge watching can be addictive? a. Yes b. No c. Sometimes 29. Do you believe a person’s economic status represents a lot about who they are as an individual? a. Yes b. No c. Sometimes 30. Have you ever been diagnosed with a mental illness? a. Yes b. No c. Unsure 31. Does religion play a role in how you make important decisions a. Yes b. No c. Sometimes 32. Do you believe in taking a mental health day for yourself? (Taking the day off, listening to music, working out, etc.) a. Yes b. No c. Sometimes