1. Did a parent or other adult in your household often or very often swear at you, insult you, put you down, humiliate you, or act in a way that made you afraid that you might be physically hurt?
2. Did a parent or other adult in your household often or very often push, grab, slap, or throw something at you, or ever hit you so hard that you had marks or were injured?
3. Did a parent or other adult in your household often or very often touch you inappropriately or sexually abuse you?
4. Did you often or very often feel that no one in your family loved you or thought you were important or special, or your family didn't look out for each other, feel close to each other, or support each other?
5. Did you often or very often feel that you didn't have enough to eat, had to wear dirty clothes, and had no one to protect you, or your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
6. Were your parents separated or divorced during your childhood?
7. Did you ever live with anyone who was a problem drinker or alcoholic, or who used street drugs?
8. Was a household member depressed or mentally ill, or did a household member attempt suicide?
9. Did a household member go to prison?
10. Were you ever in foster care, or did you live in a household where there was someone with a substance abuse problem, mental illness, or who was abusive?
11. Did you ever experience a traumatic event such as a serious accident, injury, or natural disaster during your childhood?
12. Did you ever witness domestic violence in your household?
