Screening Questionnaire

What is your age?

What is your gender?

Do you consider yourself Hispanic or Latino?

Which best describes your ethnic background (check all that apply)?

Are you a current U.S. resident?

How did you hear about this study?

Do you currently have a diagnosis of a neurological disorder? (e.g. Alzheimer's or other
dementia, Parkinson's)

Do you have any physical disability that affects your ability to respond to pictures and words on
your computer screen?

Have you suffered any accident or head injury in the last year that resulted in a loss of
consciousness lasting more than one minute?

In the past three months, how often have you used the following substances?

Cocaine (coke, crack, etc.)
Amphetamine-type stimulants (speed, diet pills, ecstasy, etc.)
Inhalants (nitrous, glue, petrol, paint thinner, etc.)
Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.)
Other

If you used a substance in the last three months that was not listed in the previous question, please specify.

Over the last 2 weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself?

Do you have regular or daily access to a smartphone over the next three weeks?

Does the smartphone have reliable internet access?

Was the smartphone purchased in the last 5 years?

Are you awake by 9am (or soon after) most days?

Do you go to sleep before 9pm most days?

Will you be able to complete 5-10 minute assessments, three times a day for the next three weeks?
(between 9am and 9pm)

What is your email address?

What time zone do you live in?

Do you live in a place that observes daylight savings time?

In the past 7 days including today, how much were you distressed by faintness or dizziness?

In the past 7 days including today, how much were you distressed by feeling no interest in things?

In the past 7 days including today, how much were you distressed by nervousness or shakiness inside?

In the past 7 days including today, how much were you distressed by pains in heart or chest?

In the past 7 days including today, how much were you distressed by feeling lonley?

In the past 7 days including today, how much were you distressed by feeling tense or keyed up?

In the past 7 days including today, how much were you distressed by nausea or upset stomach?

In the past 7 days including today, how much were you distressed by feeling blue?

In the past 7 days including today, how much were you distressed by suddenly feeling scared for no reason?

In the past 7 days including today, how much were you distressed by trouble getting your breath?

In the past 7 days including today, how much were you distressed by the feeling of worthlessness?

In the past 7 days including today, how much were you distressed by spells of terror or panic?

In the past 7 days including today, how much were you distressed by numbness or tingling in parts of your body?

In the past 7 days including today, how much were you distressed by feeling hopeless about the future?

In the past 7 days including today, how much were you distressed by feeling so restless you couldn't sit still?

In the past 7 days including today, how much were you distressed by feeling weak in parts of your body?

In the past 7 days including today, how much were you distressed by thoughts of ending your life?

In the past 7 days including today, how much were you distressed by feeling fearful?