Appendix F
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Questionnaire:
Identifying Alcohol Problems
Parents can provide this questionnaire to their children to complete on their own.
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Do you miss class because of drinking or hangovers?
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Do you drink to overcome shyness and to build confidence?
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Do you drink to escape from study or home worries?
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Does it bother you or anger you if someone says you drink too much?
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Do you need to have a drink before you go out on a date?
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Do you ever have money problems due to alcohol consumption?
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Do your friends drink less than you?
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Do you ever have a memory loss due to drinking?
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Do you get into trouble with residential life staff due to drinking?
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Do you ever think you have a drinking problem?
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Does drinking affect your reputation?
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Do you always drink until the bottle is empty, all the beer cans are dead, or until the party is over?
Assessment
A YES answer to one question is a warning.
A YES answer to as few as three questions indicates that alcohol has become or is becoming a problem.
Reflections
After completing the survey, ask yourself the following:
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How do you feel about the results of this survey?
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What role does alcohol play in your life?
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Is alcohol having a negative impact on your college career?
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Do you know what campus resources are available to assist people with alcohol or other drug problems?