Detailed Case History Questionnaire for the Plaintiff1

Detailed Case History Questionnaire for the Plaintiff1

Detailed case history questionnaire for the Plaintiff1

Please note: All information gathered in the course of this investigation is considered confidential. This information is not made available except as may be authorized by Church law or State law regarding mandated reporting.

DIOCESE OF LAFAYETTE-IN-INDIANA

OFFICE OF THE TRIBUNAL

2300 South 9th Street

Lafayette, IN 47909-2400

765-474-0506

CASE HISTORY QUESTIONNAIRE

Instructions:

  1. The case history must be typed.
  2. Please paginate (include page numbers).
  3. Please avoid short answers, giving examples and details whenever possible.
  4. ** If you did not include a current address for your former spouse on the application, please submit it on the last page (signature page).

The completed case history questionnaire must beprinted out and signedin order to submit it by mail to the Tribunal. In order to protect your privacy, electronic submission of documents is not available at this time.

YOUR CHILDHOOD AND ADOLESCENCE:

1)What kind of family background, upbringing and discipline did you have as you were growing up?

2)Who took over most of the disciplining? Was it reasonable? Was it consistent?

3)Was either parent abusive or overprotective to you or to the other parent or to your brothers and sisters? If so, who and how?

4)What kind of personality did your father have, and what kind of relationship did you have with him as you were growing up? Were you his favorite?

5)Did your father spend much time with you? If so, what kinds of things did you do together? If not, why not?

6)What kind of personality did your mother have, and what kind of relationship did you have with her as you were growing up? Were you her favorite?

7)Did your mother spend much time with you? If so, what kinds of things did you do together? If not, why not?

8)Was there anything unusual in your relationship with either parent?

9)What kind of relationship did your parents have with each other? Who was the dominant one?

10)Did your parents show affection to each other? If so, how? If not, why not?

11)How did they work out disagreements and problems? Did they disagree in front of you or did they argue only when alone?

12)Did you have any brothers and sisters? If so, how many of each and where were you in the birth order? Were you treated any differently from your brothers and sisters by either parent?

13)What kind of relationship did your brothers and sisters have with each other as you were growing up?

14)What kind of relationship did you have with your brothers and sisters as you were growing up?

15)Have your brothers and sisters had any significant personal or marital problems as adults? If so, what? Is there a common thread among these problems? If so, what is the common thread?

16)Were they any notable family problems in your family as you were growing up? If so, what and how did they affect you?

17)Did you suffer any unusually upsetting experiences while growing up? If so, what and how did they affect you?

18)During your pre-school and grade school years, how did you relate with adults other than your parents, especially teachers and school administrators?

19)During your pre-school and grade school years, how did you relate with children other than your siblings? Did you find it easy to make and keep friends? If not, why not?

20)What kind of grades did you receive when you were in grade school? Did you have problems of any kind in grade school? If so, what problems did you have?

21)During your pre-school and grade school years, did you have any unusual fears? If so, what and how did you deal with them?

22)What kind of personality characteristics did you have in high school? In other words, were you outgoing or shy, responsible or irresponsible, concerned about others or self-centered, self-directed or a follower? Please evaluate the strong and weak areas of your own personality – inferiority complex, sensitive to the needs of others, nervous, quick tempered, moody, jealous, selfish, ungrateful, lie habitually, cheat habitually, conduct erratic or unpredictable, often outlandish or fantastic, lacking good judgment in everyday situations. Please explain in as much detail as possible, using examples where possible.

23)During adolescence, did you have any notable characteristics of mood or emotion or any patterns of emotional outbursts?

24)What kind of lifestyle and social life did you lead during high school? In other words, besides school, how did you spend leisure time?

25)During adolescence, what kinds of responsibilities were you expected to take at home? At school? How well were these responsibilities handled? If the responsibilities were not carried out, how did your parents and/or teachers handle it?

26)During high school, did you have any close friends?

  1. If so, what sort of people were the close friends and what kind of influence did they have on you? Were they considered good or delinquent?
  2. If you did not have close friends, please explain.

27)During high school, did you date?

  1. If so, how many persons did you date and how seriously?
  2. If you did not date in high school, why not?

28)In high school, were the values of you held the same as most people or were they different?

29)During high school, what were your attitudes toward sex and sexuality, especially premarital sex?

30)During high school:

  1. Did you have any personal, behavioral, or school problems, or any problems with drinking, drugs, gambling, the law or truancy? How old were you when you had these problems? Before age 15?
  2. Were you a person who usually obeyed rules or broke them? If you broke them, please tell what rules and how often you broke them.
  3. Were you ever arrested or threatened by your parents with being sent to juvenile detention? If so, how old were you when you had these problems? Before age 15?

31)What kind of grades did you receive in high school? Did you graduate from high school? If not, why not?

32)During your childhood and adolescence, what were your religious practices and those of your family? Were you and they active churchgoers during this period? If you and/or your family stopped going to church during this period, why was this?

33)During your childhood and adolescence, did you have any serious health problems (physical or emotional)? If so, what problems did you have? How old were you when you had these problems? How long did they last? How did they affect you in your day-to-day life, if at all?

34)During high school, what kind of self-image did you have? Did you feel good about yourself?

35)If you continued your education after high school and before your marriage, please answer the following:

  1. What school did you attend, and what course of studies did you follow?
  2. What kind of grades did you receive?
  3. Did you change courses?
  4. Did you, your lifestyle, or your behavior change during this period? If so, how?
  5. Did you have any problems during this time? If so, what problems did you have?
  6. Did you complete your course of studies? If not, why not?

36)If you worked during or after high school or college and before your marriage, please answer the following:

  1. What kind of work did you do?
  2. Did you change jobs? If so, how often and why?
  3. What kind of work record did you have? Did you always show up for work? Were you always on time for work?
  4. Did you have problems in your work? If so, what problems did you have?

37)After high school or college, and before marriage to your former spouse, did you date others? If so, how many?

38)Prior to when you first began to date your former spouse, had you had any other serious dating relationships? If so, please answer the following questions:

39)How many serious relationships did you have, and over how long a period of time did you have them?

40)How deeply or romantically involved were you with these people?

41)What caused the breakup of each of these relationships and how did it affect you?

42)Were you previously engaged? If so, how many times?

43)What caused the breakup of each engagement, and how did it affect you?

44)How long after the breakup of your last serious relationship or engagement did you meet and begin dating your former spouse?

THE CHILDHOOD AND ADOLESCENCE OF YOUR FORMER SPOUSE:

1)What kind of family background, upbringing and discipline did your former spouse have during childhood?

2)What kind of personality did the father of your former spouse have, and what kind of relationship did they have together during your former spouse’s childhood and adolescence?

3)Did they spend much time together? If so, what kinds of things did they do together? If not, why not?

4)What kind of personality did the mother of your former spouse have, and what kind of relationship did they have together during your former spouse’s childhood and adolescence?

5)Did they spend much time together? If so, what kinds of things did theydo together? If not, why not?

6)Was there anything unusual in your former spouse’s relationship with either parent?

7)What kind of relationship did the parents of your former spouse have with each other? Who was the dominant one?

8)Did the parents of your former spouse show affection to each other? If so, how? If not, why not?

9)How did they work out disagreements and problems? Did they disagree in front of your former spouse or did they argue only when alone?

10)Did your former spouse have any brothers and sisters? If so, how many of each and where was your former spouse in the birth order? Was your former spouse treated any differently from the other siblings by either parent?

11)What kind of relationship did the brothers and sisters of your former spouse have with each other as they were growing up?

12)What kind of relationship did your former spouse have with the siblings as your former spouse was growing up?

13)Have the brothers and sisters of your former spouse had any significant personal or marital problems as adults? If so, what? Is there a common thread among these problems? If so, what is the common thread?

14)Were they any notable family problems in your former spouse’s family during childhood and adolescent years? If so, what and how did they affect your former spouse?

15)Did your former spouse suffer any unusually upsetting experiences while growing up? If so, what and how did they affect your former spouse?

16)During the pre-school and grade school years, how did your former spouse relate with adults other than parents, especially teachers and school administrators?

17)During the pre-school and grade school years, how did your former spouse relate with children other than siblings? Did your former spouse find it easy to make and keep friends? If not, why not?

18)What kind of grades did your former spouse receive in grade school? Did your former spouse have problems of any kind in grade school? If so, what problems occurred?

19)During pre-school and grade school years, did your former spouse have any unusual fears? If so, what and how did your former spouse deal with them?

20)What kind of personality characteristics did your former spouse have in high school? In other words, was he/she outgoing or shy, responsible or irresponsible, concerned about others or self-centered, self-directed or a follower? Please evaluate the strong and weak areas of his/her personality – inferiority complex, sensitive to the needs of others, nervous, quick tempered, moody, jealous, selfish, ungrateful, lie habitually, cheat habitually, conduct erratic or unpredictable, often outlandish or fantastic, lacking good judgment in everyday situations. Please explain in as much detail as possible, using examples where possible.

21)During adolescence, did your former spouse have any notable characteristics of mood or emotion or any patterns of emotional outbursts?

22)What kind of lifestyle and social life did your former spouse lead during high school? In other words, besides school, how did your former spouse spend leisure time?

23)During adolescence, what kinds of responsibilities was your former spouse expected to take at home? At school? How well were these responsibilities handled? If the responsibilities were not carried out, how did the parents and/or teachers handle it?

24)During high school, did your former spouse have any close friends?

  1. If so, what sort of people were the close friends and what kind of influence did they have on you? Were they considered good or delinquent?
  2. If your former spouse did not have close friends, please explain.

25)During high school, did your former spouse date?

  1. If so, how many persons did your former spouse date and how seriously?
  2. If your former spouse did not date in high school, why not?

26)In high school, were the values that your former spouse held the same as most people or were they different?

27)During high school, what were your former spouse’s attitudes toward sex and sexuality, especially premarital sex?

28)During high school, was your former spouse sexually active with more than light petting? If so, with more than one person? What was the attitude in high school toward sexual activity, and how did this affect your former spouse?

29)What attitudes and values were communicated to your former spouse in the home concerning sexuality and sexual behavior? Who first taught your former spouse about sex?

30)During high school:

  1. Did your former spouse have any personal, behavioral, or school problems, or any problems with drinking, drugs, gambling, the law or truancy? If so, how old was your former spouse when these problems occurred? Before age 15?
  2. Was your former spouse a person who usually obeyed rules or broke them? If the rules were broken, please tell what rules and how often they were broken.
  3. Was your former spouse ever arrested or threatened with being sent to juvenile detention? If so, how old was your former spouse when these problems occurred? Before age 15?

31)What kind of grades did your former spouse receive in high school? Did your former spouse graduate from high school? If not, why not?

32)During childhood and adolescence, what were the religious practices and those of the family? Were your former spouse and family members active churchgoers during this period? If your former spouse and/or the family stopped going to church during this period, why was this?

33)During childhood and adolescence, did your former spouse have any serious health problems (physical or emotional)? If so, what problems? How old was your former spouse when these problems occurred? How long did they last? How did they affect your former spouse’s day-to-day life, if at all?

34)During high school, what kind of self-image did your former spouse have?

35)If your former spouse continued education after high school and before your marriage, please answer the following:

  1. What school did was attended, and what course of studies was followed?
  2. What kindof grades were received?
  3. Was there a change of courses?
  4. Did your former spouse, the lifestyle, or the behavior of your former spouse change during this period? If so, how?
  5. Were there any problems during this time? If so, what problems did you have?
  6. Was the course of studies completed? If not, why not?

36)If your former spouse worked during or after high school or college and before your marriage, please answer the following:

  1. What kind of work did your former spouse do?
  2. Change jobs? If so, how often and why?
  3. What kind of work record? Always show up for work? Always on time for work?
  4. Problems in work? If so, what problems?

37)After high school or college, and before marriage, did your former spouse date others? If so, how many?

38)Prior to when you first began to date your former spouse, did your former spouse have any other serious dating relationships? If so, please answer the following questions:

  1. How many serious relationships, and over how long a period of time?
  2. How deeply or romantically involved was your former spouse with these people?
  3. What caused the breakup of each of these relationships and how did it affect your former spouse?
  4. Was your former spouse previously engaged? If so, how many times?
  5. What caused the breakup of each engagement, and how did it affect your former spouse?
  6. How long after the breakup of the last serious relationship or engagement did the two of you meet and begin dating?

DATING RELATIONSHIP and the TIME BEFORE THE MARRIAGE: