Questback Survey Questionnaire
Health and Resilience Following Stress and Adversity
Thank you for your interest in our study. Before we can begin, we would like to ask you to complete the following four questions. These questions will be used to assess your eligibility to participate in the study. Thank you for taking the time to complete this form. If you have any questions or require any assistance, please feel free to contact us.
University College Dublin (UCD)
School of Psychology
(00353) 87 0988869
(0041) 44 635 7308
(please tick the relevant box)
1. Is English your native language (are you fluent in English)?
2. How old are you?
50 years or older
Younger than 50 years
3. Have you been
with or are you in
for any of the following health problems?
Yes (please specify):
Dementia (e.g., Alzheimer’s Disease, Parkinson’s, etc.)
Pronounced sleep disorders
Other (please specify):
4. Were you ever in an institution in Ireland (i.e., children’s home, reformatory or industrial school) during your childhood and/or adolescence?
Institutional care includes:
Orphanage; reformatory; industrial school; children’s home; non-private, state-run boarding schools; psychiatric hospital.