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Description

DEPARTMENT OF COMMUNITY MEDICINE MGM MEDICAL COLLEGE,

INDORE CME WORKSHOP 2010-11

Study of Effects of Caffeine Addiction on BPO Employees

Submitted tobyDr

Sanjay Dixit Professor and Head Department of Community Medicine,

MGM Medical College,

Submitted Brijmohan Sahu Harshit Gehlot Harshul Patidar Humaeel Abbas Ali

DEPARTMENT OF COMMUNITY MEDICINE MGM MEDICAL COLLEGE INDORE

CERTIFICATE This is to certify that the research project entitled “Study of Effects of Caffeine Addiction on BPO Employees” has been successfully carried out under the Department of Community Medicine as a project under Orientation Workshop on Research Designing in Community Medicine

The project was carried out by Brijmohan Sahu Harshit Gehlot Harshul Patidar Humaeel Abbas Ali

The work has been executed with due care and precision and my entire satisfaction

Sanjay Dixit Professor and Head Department of Community Medicine,

MGM Medical College,

DEPARTMENT OF COMMUNITY MEDICINE MGM MEDICAL COLLEGE INDORE

CERTIFICATE This is to certify that the research project entitled “Study of Effects of Caffeine Addiction on BPO Employees” has been successfully carried out under the Department of Community Medicine as a project under Orientation Workshop on Research Designing in Community Medicine

The project was carried out by Brijmohan Sahu Harshit Gehlot Harshul Patidar Humaeel Abbas Ali

The work has been executed with due care and precision and my entire satisfaction

Bhagwan Waskel Facilitator [CME Workshop] Assistant Professor Department of Community Medicine,

MGM Medical College,

DEPARTMENT OF COMMUNITY MEDICINE MGM MEDICAL COLLEGE INDORE

CERTIFICATE This is to certify that the research project entitled “Study of Effects of Caffeine Addiction on BPO Employees” has been successfully carried out under the Department of Community Medicine as a project under Orientation Workshop on Research Designing in Community Medicine

The project was carried out by Brijmohan Sahu Harshit Gehlot Harshul Patidar Humaeel Abbas Ali

The work has been executed with due care and precision and my entire satisfaction

Harish Shukla Facilitator [CME Workshop] Department of Community Medicine,

MGM Medical College,

DEPARTMENT OF COMMUNITY MEDICINE MGM MEDICAL COLLEGE INDORE

CERTIFICATE This is to certify that the research project entitled “Study of Effects of Caffeine Addiction on BPO Employees” has been successfully carried out under the Department of Community Medicine as a project under Orientation Workshop on Research Designing in Community Medicine

The project was carried out by Brijmohan Sahu Harshit Gehlot Harshul Patidar Humaeel Abbas Ali

The work has been executed with due care and precision and my entire satisfaction

Satish Saroshe Facilitator [CME Workshop] Department of Community Medicine,

MGM Medical College,

ACKNOWLEDGEMENT Expressing gratitude is a difficult task,

and words often fall short of reflecting one’s feeling

It is our proud privilege,

however to do so and we undertake this task with utmost sincerity

We are grateful to Dr

Sanjay Dixit sir,

Professor and Head of the Department of Community Medicine,

MGM Medical College,

Indore for assigning this project under the Continued Medical Education Workshop [CME Workshop] for his invaluable guidance,

significant suggestion and help accomplishing the project work

We express our heartfelt thanks to Dr

Bhagwan Waskel Sir,

for providing us with an opportunity to do this project and giving invaluable encouragement in our endeavors

We also thank Dr

Deepa Raghunath Ma’am for her expert guidance

We acknowledge with sincerity and deep sense of gratitude,

the invaluable guidance given to us by Dr

Harish Shukla and Dr

Satish Saroshe Sir

Their suggestions and discussions were enlightening and constant source of inspiration during our project work

We are indebted to him for sparing valuable time for helping us in acquiring knowledge of current approaches

Finally we thank the BPO employees of Teleperformance and First Source for cooperating with us

Without the help of all of them,

this project could not have materialized

THANK YOU

Brijmohan Sahu Harshit Gehlot Harshul Patidar Humaeel Abbas Ali

CONTENTS •

Introduction

Review of Literature 14 Research Question 15 Objectives 16 Method and Materials 17 Implementation 18 Scoring Criteria 19-20 Observations and Interpretation 2133

Evaluation and Analysis Conclusion Discussion Recommendations Bibliography Appendix I

Time Line Chart II

Questionnaire III

Master Table

INTRODUCTION Caffeine is a natural component of chocolate,

and is used as an added energy boost in most colas and energy drinks

It’s also found in diet pills and some over-thecounter pain relievers and medicines

Caffeine is the most commonly consumed psychoactive drug in the entire world

Medically,

caffeine is useful as a cardiac stimulant and also as a mild diuretic

Recreationally,

it is used to provide a "boost of energy" or a feeling of heightened alertness

College students often use it to stay awake while cramming for finals and drivers use it to push through to their destination

Many people feel as though they "cannot function" in the morning without a cup of coffee to provide caffeine and the boost it gives them

In doses of 100-200 mg

caffeine can increase alertness,

relieve drowsiness and improve thinking

At doses of 250-700 mg/day,

It can curiously enough make it more difficult to lose weight because it stimulates insulin secretion,

It's important to know that caffeine is an addictive drug

Among its many actions,

it operates using the same mechanisms that amphetamines,

and heroin use to stimulate the brain

Relatively speaking,

caffeine's effects are milder than amphetamines,

but it is manipulating the same channels in the brain,

and that is one of the things that give caffeine its addictive qualities

If you feel like you cannot function without it and must consume it every day,

then you may be addicted to caffeine

Caffeine and Adenosine Adenosine is found in every part of the body,

but it has special functions in the brain

As adenosine is created in the brain,

it binds to adenosine receptors

The binding of adenosine causes drowsiness by slowing down nerve cell activity

In the brain,

adenosine binding also causes blood vessels to dilate,

most likely to let more oxygen in during sleep

Caffeine readily crosses the blood–brain barrier that separates the bloodstream from the interior of the brain

Once in the brain,

the principal mode of action is as a nonselective antagonist of adenosine receptors

The caffeine molecule is structurally similar to adenosine,

and binds to adenosine receptors on the surface of cells without activating them (an "antagonist" mechanism of action)

Therefore,

caffeine acts as a competitive inhibitor

Instead of slowing down because of the adenosine's effect,

Caffeine also causes the brain's blood vessels to constrict,

because it blocks adenosine's ability to open them up

This effect is why some headache medicines like Anacin contain caffeine

the caffeine will close down the blood vessels and relieve it

now you have increased neuron firing in the brain

The pituitary gland sees all of this activity and thinks some sort of emergency must be occurring,

so it releases hormones that tell the adrenal glands to produce adrenaline (epinephrine)

Adrenaline is the "fight or flight" hormone,

and it has a number of effects on your body: • Your pupils dilate

• Your breathing tubes open up (this is why people suffering from severe asthma attacks are sometimes injected with epinephrine)

• Blood vessels on the surface constrict to slow blood flow from cuts and also to increase blood flow to muscles

• Blood flow to the stomach slows

• The liver releases sugar into the bloodstream for extra energy

This explains why,

after consuming a big cup of coffee,

you feel excited and you can feel your heart beat increasing

Caffeine and Dopamine Caffeine also increases dopamine levels in the same way that amphetamines do

Dopamine is a neurotransmitter that activates pleasure centres in certain parts of the brain

Heroin and cocaine also manipulate dopamine levels by slowing down the rate of dopamine reabsorption

Obviously,

caffeine's effect is much lower than heroin's,

It is suspected that the dopamine connection contributes to caffeine addiction

You can see why your body might like caffeine in the short term,

especially if you are low on sleep and need to remain active

Caffeine blocks adenosine reception so you feel alert

It injects

adrenaline into the system to give you a boost

And it manipulates dopamine production to make you feel good

The problem with caffeine is the longer-term effects,

For example,

once the adrenaline wears off,

you face fatigue and depression

So what are you going to do

? You consume more caffeine to get the adrenaline going again

As you might imagine,

having your body in a state of emergency all day long isn't very healthy,

and it also makes you jumpy and irritable

The most important long-term problem is the effect that caffeine has on sleep

Adenosine reception is important to sleep,

The half-life of caffeine in your body is about six hours

That means that if you consume a big cup of coffee with 200 mg of caffeine in it at 3:00 p

about 100 mg of that caffeine is still in your system

You may be able to fall asleep,

but your body will probably miss out on the benefits of deep sleep

That deficit adds up fast

The next day you feel worse,

so you need caffeine as soon as you get out of bed

The cycle continues day after day

Once you get in the cycle,

you have to keep consuming the drug

Even worse,

if you try to stop consuming caffeine,

splitting headache as blood vessels in the brain dilate

These negative effects force you to run back to caffeine even if you want to stop

Tolerance and withdrawal Because caffeine is primarily an antagonist of the central nervous system's receptors for the neurotransmitter adenosine,

the bodies of individuals that regularly consume caffeine adapt to the continuous presence of the drug by substantially increasing the number of adenosine receptors in the central nervous system

the stimulatory effects of caffeine are substantially reduced,

a phenomenon known as a tolerance adaptation

Second,

because these adaptive responses to caffeine make individuals much more sensitive to adenosine,

a reduction in caffeine intake will effectively increase the normal physiological effects of adenosine,

resulting in unwelcome withdrawal symptoms in tolerant users

Caffeine tolerance develops very quickly,

especially among heavy coffee and energy drink consumers

A reduction in serotonin levels when caffeine use is stopped can cause anxiety,

and diminished motivation to initiate or to complete daily tasks

in extreme cases it may cause mild depression

Together,

these effects have come to be known as a "crash"

Careful research conducted by the department of psychiatry and behavioural sciences at Johns Hopkins University School of Medicine shows that low to moderate caffeine intake (as little as one 14-ounce mug per day) can quickly produce withdrawal symptoms

Withdrawal symptoms — possibly including headache,

insomnia and pain in the stomach,

and joints may appear within 12 hours after discontinuation of caffeine intake,

and usually last from one to five days,

representing the time required for the number of adenosine receptors in the brain

Caffeine Intoxication and Overdose An acute overdose of caffeine usually in excess of about 250 mg,

dependent on body weight and level of caffeine tolerance,

can result in a state of central nervous system overstimulation called caffeine intoxication (DSMIV 305

or colloquially the "caffeine jitters"

It may include restlessness,

a rambling flow of thought and speech,

irregular or rapid heart beat,

In cases of much larger overdoses,

and rhabdomyolysis (breakdown of skeletal muscle tissue) can be provoked

These symptoms can cause significant social and occupational disturbances

Caffeine intoxication is rarely fatal,

although 5,000-10,000 mg of caffeine can actually kill you

Fortunately,

most people won’t ever ingest this much caffeine accidentally it would take between 30 and 60 cups of coffee in one morning

Overuse In large amounts,

and especially over extended periods of time,

caffeine can lead to a condition known as Caffeinism

Caffeinism usually combines caffeine dependency with a wide range of unpleasant physical and mental conditions including nervousness,

muscle twitching (hyper-reflexia),

Furthermore,

because caffeine increases the production of stomach acid,

high usage over time can lead to peptic ulcers,

and gastroesophageal reflux disease

Caffeine may also increase the toxicity of certain other drugs,

There are four caffeine-induced psychiatric disorders recognized by the Diagnostic and Statistical Manual of Mental Disorders,

Fourth Edition: caffeine intoxication,

caffeine-induced anxiety disorder,

caffeine-induced sleep disorder,

and caffeine-related disorder not otherwise specified (NOS)

Caffeine-induced sleep disorder Caffeine-induced sleep disorder is a psychiatric disorder that results from overconsumption of the stimulant caffeine

The specific criteria for this disorder in the fourth axis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) include that there must be a significant inability to sleep which is caused entirely by the physiological effects of caffeine as proven by an examination

if sleeping issues can be accounted for due to a breathing-related sleep disorder,

then caffeine-induced sleep disorder is not the cause

This condition causes a notable impairment in functioning in sufferers Although the number of symptoms due to caffeine consumption are many,

however on the basis of importance,

relation to working habits of the BPO employees we have selected- Sleep Disturbances,

Headache & Irritability

REVIEW OF LITERATURE Although a number of studies on caffeine addiction have been conducted in the past,

the following two appeared to be significant with respect to our study

The first study done by the University of the Philippines (UP) Population Institute is about prevalence of caffeine consumption among BPO workers

The study,

entitled Lifestyle and Reproductive Health Issues of Young Professionals in Metro Manila and Metro Cebu (),

focused on the profile and lifestyle of young workers in the call center and non-call center industries in Metro Manila and Metro Cebu

The results obtained were: ○ Highly-caffeinated drinks like coffee and tea are a staple of BPO workers diets,

which are provided by management through establishment of Vendor machines,

but call center workers drink more coffee that their non-call center counterparts (2

○ More call center workers also consume tea (1/4 of respondents),

compared to non-call center workers (only 1/5)

○ The study also revealed that half of young workers drink soda daily,

energy drinks are not as popular: only 15% of young workers drink energy drinks daily,

The second was a study conducted by American Academy of Pediatrics (Charles P

Pollak,

A total of 191 students participated

Caffeine intake ranged between 0 and 800 mg/d

Mean use over 2 weeks ranged up to 379

According to the study,

higher caffeine intake in general was associated with shorter nocturnal sleep duration,

increased wake time after sleep onset,

Regardless of whether caffeine use disturbed sleep or was consumed to counteract the daytime

caffeinated detectable pharmacologic effects

RESEARCH QUESTION “Will a cross-sectional study on 100 BPO workers of age group 20-50 yrs to detect the effects of caffeine addiction show any relationship between altered working habits and excess caffeine consumption as assessed by questionnaire method

OBJECTIVES •

To find the prevalence of caffeine consumption among BPO employees

To assess the proportion of BPO employees experiencing headache,

irritability and sleep related symptoms

• To explore the relationship between the above mentioned symptoms and excess caffeine consumption

To give recommendations to BPO employees based on the observations of the study

MATERIALS & METHODS Design of study

Cross-sectional study

Subjects

Randomly selected Sample of 100 BPO Employees 20 to 50 years old and working at BPO firms-Telecommunication and First Source

Inclusion Criteria

All BPO workers in the age group 20-50 yrs

Exclusion Criteria

BPO employees older than 50 yrs BPO employees working at BPO firms other than Telecommunication and First Source

Sampling Technique

Simple Random Sampling

Study Tool

Pre-determined Semi-structured Questionnaire

Study Area

Manpower

Volunteers

Material

Questionnai re

Require d

Availabl e

Incidental Charges

IMPLEMENTATION The entire research study was done on 2 BPO firms in IndoreTelecommunications and First Source

A Qualitative protocol was used which involved data collection through a detailed objective-questionnaire

The questionnaire was distributed in random manner through the HR manager of the firms to BPO workers

Due to the concerns of the HR about compromise of their office time,

they were given 2 days to fill the questionnaires

The Instrument for data collection,

in the form of a ‘Structured Questionnaire’,

consisted of the following sections: 1

Demographic aspects included name,

working hours and Alcoholic & Smoking nature

Caffeine Consumption was assessed by objective questions about choice of beverage,

size of cup and interval between drinks

(Q1-5) Sleep disturbance suspected to be caused due to caffeine was assessed mainly by subject’s perception of his quality of sleep along with the duration of sleep

(Q6-10) Headache problems were asked directly

(Q11) Irritability as a part of the mood disorders suspected to be caused by Caffeine was assessed by 8 part questionnaire modified and adopted from The Irritability Questionnaire by K

Craig et al

A copy of Questionnaire is given in the Appendix

The responses thus obtained were then compiled,

processed and analysed to arrive at the opinions on various issues

SCORING CRITERIA As already mentioned the questions were divided in four sections

Most questions had three responses

Maximum points were allotted to exaggerated responses and associations,

whereas minimum points were allotted to responses depicting least degree of association

The score of each section was then added to attain the total score

RESPONSE

Which beverage you take often

Energy Drinks

De-Caffeinated Beverages

How often do you drink

How many cups you drink/day

Which cup do you prefer

Disposable Tea Cup

Regular Coffee Mug

Usual interval between 2 beverages

½-2 hr

4-6 hrs

>12 hrs

How much do you usually sleep in a day

4-6 hrs

6-8 hrs

8-10 hrs

Do you have trouble sleeping at night

Do you feel sleepy all the day

The amount of time that you usually take to fall asleep is: a

C > 1 hr

Refreshed

Once every 3-4 days

Total score for Caffeine Consumption (Q1-5) 1-6

Mild intake

Moderate intake

Heavy intake

OBSERVATIONS & INTERPRETATION

INITIAL RESEARCH FINDINGS ○ Out of the total 100 respondents 71% were male and 29% were

○ All of the subjects worked in Day Shifts

○ Most of the subjects fall in the range of age 20-25 yrs

Which beverage you take often…

Table 1 – Choice of Beverage

Choice of Beverage

Percentage (%)

Energy Drinks

De-Caffeinated Beverages

Grand Total

Most of the respondents selected Tea as their drink of choice,

whereas none opted for De-Caffeinated Beverages

This indicates a need to create awareness amongst the BPO employees about the benefits of switching to DeCaffeinated Beverages (like Decaf Coffee)

Tea- 61%,

Coffee- 34%,

Energy Drink- 5%,

De-Caffeinated- 0%

How often do you drink…

Table 2 – Frequency of Beverage Consumption

Frequency of Beverage Consumption

Percentage (%)

Grand Total

As the above table shows,

Never- 10%,

Often- 29%,

Daily- 61%

How much cups you drink/day…

Table 3 – Number of cups consumed per day

Cups consumed per day

Percentage (%)

Grand Total

The responses show that only about a fourth of the subjects drink more than 5 cups a day,

or in other word are dependent on caffeine

While half of the subjects have only an ordinary intake of upto 2 cups per day

Which cup do you prefer…

Table 4 – Type of Cup preferred

Preference of Cup

Percentage (%)

Disposable Tea Cup

Regular Coffee Mug

Other Grand Total

Since majority of the respondents have selected Tea as their choice of beverage,

so it’s understandable that 58% chose Disposable Tea Cup as their option

Disposable Tea Cup- 58%,

Regular Coffee Mug- 34%,

Other- 8%

Usual interval between 2 beverages…

Table 5 – Interval between consumption of Beverages

Interval between 2 beverages

Percentage (%)

- 2 hrs

- 6 hrs

Grand Total

More than 50% of the subjects consume the beverage at an avg

However,

½-2hrs- 27%,

How much do you usually sleep in a day…

Table 6 – Duration of Sleep

Duration of Sleep

Percentage (%)

- 6 hrs

- 8 hrs

- 10 hrs

Grand Total

Only 14% were found to have reduced amount of sleep

Do you have trouble sleeping at night…

Table 7 – Percentage of people having trouble sleeping at night

Trouble sleeping at night

Percentage (%)

Grand Total

More than half of the BPO employees have reported they have trouble sleeping at night,

which may be due their caffeine consumption in addition to other factors

Yes- 52%,

No- 48%

Do you feel sleepy all the day…

Table 8 – Percentage of people feeling sleepy all day

Sleepy all Day

Percentage (%)

Grand Total

Despite the fact all of the BPO employees were day-shift workers and majority having an adequate sleep,

more than half of them feel sleepy all day

Yes- 55%,

No- 45%

The amount of time that you usually take to fall asleep is…

Table 9 – Time taken to fall asleep

Time taken to fall asleep

Percentage (%)

Maximum of the respondents require a considerable time of upto 1 hr to fall asleep

Only 4 respondents out of 100 take even longer than 1 hr to fall asleep

After taking a nap you usually feel…

Table 10 – Proportion of people who

Percentage (%) Refreshed

Grand Total

Around 1/3rd of the subjects feel sleepy upon waking up

Refreshed- 63%,

Sleepy-37%

How often do you have a headache…

Table 11 – Frequency of Headache

Frequency of Headache

Percentage (%)

Once every 3-4 days

Grand Total

which indicates the need to change the working conditions of the BPO employees

Daily- 23%,

Once every 3-4 days- 37%,

Rarely- 40%

Prevalence of Caffeine Consumption Caffeine Consumption I

Percentage (%) 8

Grand Total

EVALUATION & ANALYSIS According to this study about 1/3rd of BPO employees were heavy consumers of Caffeine,

and more than 50% fall in the category of moderate intake

However,

this may not represent the overall trends due to limitation of sample size

Mild intake- 8%,

Moderate intake- 57%,

Heavy intake- 35%

Sleep Disturbance Kruskal-Wallis Test Caffeine Consumption

Mean Rank

Calculated χ2 = 12

Df= 2 Table χ2 = 10

According to Spearman’s rho,

Headache Caffeine Consumption

II Moderate intake

Occasionally

Headache

Pearson’s

GT = 100

P value = 0

According to the above table,

frequency of daily headache increases with increasing intake of Caffeine

From 12

Also total subjects complaining of headache rose significantly from 50% among workers with Moderate intake to 80% among those with Heavy intake

Irritability Kruskal-Wallis Test Caffeine Consumption

Mean Rank

Calculated χ2 = 39

Df= 2 Table χ2 = 10

According to Spearman’s rho,

CONCLUSION • More than 50% of the BPO employees were found to have moderate intake of Caffeine

And as many as 35% were heavy consumers of Caffeine

According to this study 16% of prevalence of Sleep disturbance,

Also Heavy consumers of Caffeine were found to have significantly more complaints (80%) of headache as compared to Mild consumers (50%)

DISCUSSION Caffeine is the most commonly consumed psychoactive drug in the world

It produces tolerance very quickly which is responsible for its various withdrawal symptoms

Out of various side-effects of Caffeine we have selected to study- Sleep disturbances,

The aim of our study was to find out the overall prevalence of caffeine consumption,

and to explore the relationship between excess caffeine consumption and the above mentioned symptoms

It was a cross sectional study done in a randomly selected sample of 100 BPO employees 20 to 50 years old working at Telecommunications & First Source,

Data was collected via a semi-structured questionnaire which was then compiled and analyzed

According to the study 57% of the BPO employees were found to have moderate intake of Caffeine and as many as 35% were heavy consumers

This might be ascribed to free vending machines provided by the management

Also in the study we were able to correlate Sleep Disturbance (16%),

Irritability (50%) with Caffeine consumption

In comparison to a previous study- “Lifestyle and Reproductive Health Issues of Young Professionals in Metro Manila and Metro Cebu” conducted by the University of the Philippines (UP) Population Institute which stated that 2/3rd of BPO employees consumed Caffeine containing beverage on a daily basis,

our results of 61% correlate well,

considering the demographic and geographic limitations

RECOMMENDATIONS • The BPO workers and all who have moderate to heavy intake should be made aware of the ill-effects of long term caffeine consumption

LOTS AND LOTS OF WATER

Get yourself a replacement drink,

Herbal Tea can also be used a good alternative to Caffeine containing beverages

Workers should avoid drinking Caffeine beverage at least 4hrs prior to sleeping,

and get adequate sleep of 6-8 hrs

• They should indulge in relaxation activities such as Meditation,

Exercise

The BPO management should have provisions for De-Caffeinated beverages,

which will improve the working capacity of their employees along with a healthy life style

BIBLIOGRAPHY 1

com/lifestyle/08/05/10/call-centerworkers-diet-fast-food-caffeine-and-alcohol

Charles P

Pollak,

David Bright

Caffeine Consumption and Weekly Sleep Patterns in US Seventh-,

Eighth-,

Pediatrics

Kevin J

Heidi Hietanen,

Ivana S

Markova,

German E

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The Irritability Questionnaire: A new scale for the

Psychiatry Research

367–375

Park's textbook of Preventive and Social Medicine

com/wellness/drugsalcohol/caffeine

APPENDIX

Appendix I

Time Line Chart

Appendix II Department of Community Medicine MGM Medical College & MY Hospital Indore PSBH Questionnaire NameM/F

Age: ___ yrs

Working hours- Day Shift/Night Shift Alcoholic/Non-Alcoholic

Smoking/Non-Smoking

Which beverage you take often

Energy drinks

De-Caffeinated

How often do you drink

How much cups you drink/day

Which cup do you prefer

? Disposable Tea Cup _________________

Regular Coffee Mug

Usual interval between 2 beverages

4-6 hrs

>12 hrs

How much do you usually sleep in a day

6-8 hrs

8-10 hrs

Do you have trouble sleeping at night

Do you feel sleepy all the day

Yes/No Yes/No

The amount of time that you usually take to fall asleep is: ________ 10

After taking a nap you usually feel-

Refreshed

How often do you have a headache

Once every 3-4 days

The following statements are about feelings that everyone experiences from time to time

Please circle the number that best shows how you have been feeling over the last 2 weeks

Don't take too long with your answers

Your immediate response is probably the most accurate

• I become impatient easily when I feel under pressure

How often

? 0 – Never 1 – Occasionally 2 – Quite often 3 – Most of the time

How much

? 0 – Not at all 1 – A little 2 – Moderately 3 – Very much so

How often

? 0 – Never 1 – Occasionally 2 – Quite often 3 – Most of the time

How much

? 0 – Not at all 1 – A little 2 – Moderately 3 – Very much so

At times I find everyday noises irksome

At times I can’t bear to be around people

How often

? 0 – Never 1 – Occasionally 2 – Quite often 3 – Most of the time

How much

? 0 – Not at all 1 – A little 2 – Moderately 3 – Very much so

How often

? 0 – Never 1 – Occasionally 2 – Quite often 3 – Most of the time

How much

? 0 – Not at all 1 – A little 2 – Moderately 3 – Very much so

When I get angry,

I use bad language or swear

Things are not going according to the plan at the moment

How often

? 0 – Never 1 – Occasionally 2 – Quite often 3 – Most of the time

How much

? 0 – Not at all 1 – A little 2 – Moderately 3 – Very much so

How often

? 0 – Never 1 – Occasionally 2 – Quite often 3 – Most of the time

How much

? 0 – Not at all 1 – A little 2 – Moderately 3 – Very much so

I am quiet sensitive to others remarks

I feel as if people make my life difficult on purpose

How often

? 0 – Never 1 – Occasionally 2 – Quite often 3 – Most of the time

How much

? 0 – Not at all 1 – A little 2 – Moderately 3 – Very much so

How often

How much

Other people always seem to be getting the breaks

Appendix III

Master Table Names

Age(y rs)

Aashiq Ali Abijeet Singh Abishek Nageshwar Ajay Akansha Dawar Akida Wahi Alka Altaf Khan Anil Bbhosle Anil Maurya Anish Tripathi Ankit Khourke Anshul Kumar Anuj Gupta Anurag Mohan Arjun Verma Arpit Navlikha Ashok Khare Bharat Kumar Bijendra Jaiswal Birbal Singh Brijesh Chaurasia Chagan Lal Chanchal Singh Chandni Likhar Debashish Deepak Bhavsar Devendra Bhayal Dinesh Fatema Collegewala Gaurav Gupta

Q Sex 1

F F F M M M M M M M

M M M M M

Gokul kumar Gopal Rathore Jayshree Jitendra Kamlesh Wadhwani Karan Kumar Karan Trivedi Keerthi Kratika Joshi Laxmi bai Mahesh Rathore Manish Manisha Goyal Mazhar Ali Monica Verma Muffadal Bhojawala Mulayam Singh Munish Nandwani Murtaza Johar Muskan Jain Naman Srrivastava Natasha Shah Naveen Jaiswal Neelam Bajaj Neeraj K Nilesh Nitesh Nishant Rai Palak Dave Parul Shah Pawan Rathore Pawan Sahu Pinky Verma Prashant Choudhary Preeti Preeti Singh Radhe Shyam Rahul Medla

22 20 20

7 17 20

M M M F F F

27 20 22

11 30 44

M F M M M M M F

24 22 21

17 40 31

M F F M M

Rahul Tare Rajendra Verma Rajesh Verma Rakesh Verma Ram Singh Ram Kumar Ram Kumar Gehlot Ranjana Beeghal Rashmi Richya Vyas Rishika Sanju Shagun Sharma Shankar Rathore Shivam Rathore Shraddha Prapanna Sneha Sonal Patil Shubham Surbhi Khatwa Sumit Yadav Swati Sharma Upendra Ranjan Vijay Prakash Vijay Gujral Vikas Soni Vinay Patodia Vinod Gupta Vinod Jaiswal Yash Bhrammabha tt Yogesh Sharma

24 25 32

8 11 26

F F F F M

F F F F

20 21 21

12 19 30

M M M M M M M