Consent to Act As a Human Research Subject

KRIST78

CONSENT TO ACT AS A HUMAN RESEARCH SUBJECT

Emotions/Sleep Study

Researcher: Mark Krist

Contact: 906-226-6743

SW 830 Research Methods

Michigan State University (not sanctioned by the University)

Subject: Mark Krist

Purpose of Study: To test the hypothesis that lack of adequate sleep contributes to increased mood fluctuations and lower mental alertness the next day.

[THIS STUDY MAY BE UNETHICAL. IT IS WELL ESTABLISHED THAT SLEEP DEPRIVATION IS ASSOCIATED WITH DIFFICULTY IN MAINTAINING ATTENTION. IT IS A WASTE OF THE SUBJECT'S TIME TO STUDY SOMETHING WHERE NO BENEFIT WILL ACCRUE.]

This study will be a single-subject design of the A-B-A model.

[DESCRIBE AN A-B-A DESIGN. THE SUBJECT IS UNLIKELY TO KNOW WHAT YOU ARE TALKING ABOUT.]

Procedures: Subject will participate in a 3 week study of which the 1st week will set a base line for the intervention in the 2nd week with a withdrawal of intervention in the 3rd week.

[WHAT IS THE INTERVENTION?]

Subject will keep a daily log of sleep over the 3-week trial period.

Subject will keep a journal of emotional fluctuations in 2-hour increments while awake.

[WHAT IS A "MOOD FLUCTUATION"? HOW WILL IT BE MEASURED?]

Subject will record daily a score of mental alertness for the day.

[WHAT IS "MENTAL ALERTNESS"? HOW WILL IT BE MEASURED?]

[DON'T SAY "SUBJECT." SAY "YOU."

Risks: The possible risks and or discomforts associated with a study of this type are minimal; any concerns should be directed to the lead researcher for clarification. [I THINK THAT THERE ARE SOME MEANINGFUL DISCOMFORTS ASSOCIATED WITH SLEEP DEPRIVATION. THERE ARE EVEN HEALTH RISKS.]

Benefits: The possible benefits of this study for the individual would be an increased self-awareness and any health benefits associated with this change. [WHAT HEALTH BENEFITS?] On a larger scale, this study could add weight to the argument that lack of sleep interferes with emotional and mental processes.

Alternate Treatment: Not applicable

Cost/Compensation: Researcher will provide subject with room, board, and a small stipend. Any medical costs incurred related to the study will be paid by the researcher.

Confidentiality: I understand that my research records will be stored with the researcher in hard copy. Only the researcher, supervising faculty, and project staff will have access to my study records to protect my safety and welfare. I understand that any information, which personally identifies me with this research project, will not be voluntarily released or disclosed without my separate consent, except as specified by law.

[THERE SHOULD BE A STATEMENT TO THE EFFECT THAT THE SUBJECT IS FREE TO WITHDRAW FROM THE STUDY AT ANY TIME WITHOUT ANY NEGATIVE CONTINGENCIES.]

______

Subject signature date Witness signature date

______

Researcher signature date