AFFIRM Youth Survey - OhioGuidestone Research Portal

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Access ID: *

Staff Email: *

Date: *

Pre or Post:

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Please read each survey question, then choose the best answer for you.

1. I have the ability to overcome stress. *

2. I know how to decrease my stress in a positive way. *

3. I have what it takes to beat stress. *

4. I have the skills necessary to overcome stress. *

5. I perceive stress as threatening. *

6. I feel anxious. *

7. Stressful events impact me greatly. *

8. The outcome of stressful events is negative. *

9. Stressful events have serious implications for my life. *

10. Stress has a negative impact on me. *

11. There are long-term consequences as the result of stress. *

12. There is someone I can turn to for help. *

13. There is help available to me. *

14. I have the resources available to me to overcome stress. *

Section 2

When stressed, generally, in my DAILY LIFE...

1. I get emotional support from others. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

2. I get comfort and understanding from someone. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

3. I get help and advice from other people. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

4. I try to get advice or help from other people about what to do. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

5. I try to see it in a different light, to make it seem more positive. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

6. I look for something good in what is happening. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

7. I try to come up with a strategy about what to do. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

8. I think hard about what steps to take. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

9. I make jokes about it. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

10. I make fun of the situation. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

11. I criticize myself. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

12. I blame myself for things that happened. *

1-Not at all
2-A little bit
3-A medium amount
4-A lot

Section 3

Please read each survey question, then choose the best answer for you on a scale from 1 to 10 with 1 being poor and 10 being excellent.

1. Overall, my physical health is: *

2. Overall, my mental health is: *

Section 4

Please read each survey question, then choose the best answer for you.

1. I energetically pursue my goals. *

2. My past experiences have prepared me well for my future. *

3. I've been pretty successful in life. *

4. I meet the goals that I set for myself. *

5. I think of many ways to get out of a jam. *

6. There are lots of ways around any problem. *

7. I can think of many ways to get the things in life that are important to me. *

8. Even when others get discouraged, I know I can find a way to solve the problem. *

Section 5

Please read each survey question, then choose the best answer for you.

1. You feel very close to your friends. *

1-Disagree A Lot
2-Somewhat Disagree
3-Somewhat Agree
4-Agree A Lot

2. No matter what happens you know that your friends will always be there for you should you need them. *

1-Disagree A Lot
2-Somewhat Disagree
3-Somewhat Agree
4-Agree A Lot

3. You know your fiends accept your sexual orientation and/or expression/queerness. *

1-Disagree A Lot
2-Somewhat Disagree
3-Somewhat Agree
4-Agree A Lot

4. Your friends help you solve problems in your life. *

1-Disagree A Lot
2-Somewhat Disagree
3-Somewhat Agree
4-Agree A Lot

Section 6

In the past 7 days...

1. I felt too nervous to be with a group of kids my age. *

2. I felt like something awful might happen. *

3. I got scared really easy. *

4. I felt scared. *

5. I worried about what could happen to me. *

6. I was worried I might die. *

7. I woke up at night scared. *

8. I worried when I went to bed at night. *

9. I worried when I was away from home. *

10. I worried when I was at home. *

11. I was afraid of going to school. *

12. I felt worried. *

13. I worried that something might happen to my parents or guardians. *

14. I felt nervous. *

15. It was hard for me to relax. *

16. I didn't care about anything. *

17. I felt sad. *

18. I wanted to be by myself. *

19. It was hard for me to have fun. *

20. I felt alone. *

21. I could not stop feeling sad. *

22. I felt like I couldn't do anything right. *

23. I felt everything in my life went wrong. *

24. I felt stressed. *

25. Being sad made it hard for me to do things with my friends. *

26. I felt sad for no reason. *

27. I felt lonely. *

28. I felt unhappy. *

29. I felt too sad to eat. *

Demographics

1. Age

2. What is your most important gender identity?

I identify as: *

3. What is your most important sexual orientation?

I identify as: *

4. What is your racial/ethnic identity? (You may choose more than one)

Asian (e.g. South Asian, East Asian, etc.)
Black(e.g. Caribbean, African, etc.)
First Nations/Indigenous/Inuit/Metis
Hispanic/Latino/Latinx
Middle Eastern
White (European, etc.)
Mixed/Multi-Ethnic/Racial identity
None of these options describe my ethnicity/racial identity

Please specify *

I identify as: *