Appendix A.

Assessment of verbal and physical abuse.

In the past year how many times did you experience the following?

Someone yelled at or insulted you?

For each positive response ask: By whom?

Someone threatened to withhold assistance or equipment?

For each positive response ask: By whom?

Someone actually withheld assistance or equipment?

For each positive response ask: By whom?

Someone threatened to hit you?

For each positive response ask: By whom?

Someone actually hit you?

For each positive response ask: By whom?

Someone actually raped or sexually assaulted you?

For each positive response ask: By whom?

Someone took something from you by force or threat of force?

For each positive response ask: By whom?

Someone took something from you by force or threat of force using a weapon?

For each positive response ask: By whom?