MISBEHAVIORS QUESTIONNAIRENo.:
Have you ever done any of the following activities? “Number of times alcohol or drugs were involved, ” means you were on alcohol or drugs at the time or you were doing the activity in order to get alcohol or drugs to take.
Age firstAge lastEver doneNo. of timesNo. of timesNo. of timesNo. of times
did thisdid thiswithouteverever happenedever happenedever happened
alc./drugshappenedwith alcoholwith marijuanawith another
involvedinvolvedinvolveddrug involved
1. Stolen (or tried to steal) a
motor vehicle, such as a car
or motorcycle.______YN______
2. Stolen (or tried to steal)
something worth more than $50.______YN______
3. Knowingly bought, stole, or
held stolen goods (or tried to do
any of these things).______YN______
4. Carried a hidden weapon other
than a plain pocketknife.______YN______
5. Stolen (or tried to steal)
something worth $5 or less.______YN______
6. Attacked someone with the
idea of seriously hurting or
killing him/her.______YN______
7. Been paid for having sexual
relations with someone.______YN______
8. Been involved in gang fights.______YN______
9. Sold marijuana or hashish
(pot, grass, hash).______YN______
10. Hit (or threatened to hit) a
teacher or other adult at school.______YN______
11. Hit (or threatened to hit) your
parents.______YN______
12. Hit (or threatened to hit) other
students.______YN______
13. Been loud, rowdy or unruly in
a public place (disorderly conduct).______YN______
14. Sold cocaine or crack.______YN______
15. Sold hard drugs such as
heroin or LSD.______YN______
16. Taken a vehicle for a ride
(drive) without the owner’s
permission.______YN______
17. Had (or tried to have) sexual
relations with someone against
their will.______YN______
18. Used force (strong-arm
methods) to get money or things
from other students.______YN______
19. Used force (strong-arm
methods) to get money or things
from a teacher or other adult
at school.______YN______
20. Used force (strong-arm
methods) to get money or things
from other people (not
students/teachers).______YN______
21. Stolen (or tried to steal) things
worth between $5 and $50.______YN______
22. Broke into a building or vehicle
(or tried to break in) to steal
something or just look around.______YN______
23. Begged for money or things
from strangers.______YN______
24. Was arrested.______YN______
25. Bullied, threatened or
intimidated others.______YN______
26. Initiated physical fights.______YN______
27. Used a weapon (bat, brick,
broken bottle, knife, gun).______YN______
28. Been physically cruel to
animals.______YN______
29. Been physically cruel to
people.______YN______
30. Set fires with the intention of
causing serious damage.______YN______
31. Destroyed others’ property on
purpose (not by fire setting).______YN______
32. Lied to obtain goods
or favors or to avoid
obligations (cons others).______YN______
33. Stayed out at night despite
house rules not to.______YN______
34. Ran away from home
overnight.______YN______
35. Skipped school.______YN______
36. Could not pay bills (loans,
child support, etc.).______YN______
37. Done something (left school,
a job, etc.) before thinking of what
might happen if you did it (had no
other plans).______YN______
38. Got in trouble at work, was
late for work, or missed work.______YN______
39. Engaging in activities that
could be dangerous to yourself or
others (speeding, etc.).______YN______
40. Of the things we just discussed (theft, damaging others’ property, fighting, etc.), do you feel that you did the right thing and would do the same thing again if you were in the same situations (check one)?
___Not appropriate (rare to check this one!)___Probably do the same (probable lack of remorse)
___No, definitely not (definite remorse)___Definitely the same (definite lack of remorse)
___No, probably not (probable remorse)