Informed Consent to Participate in a Research Project
Investigator(s): / Leigh Ridings, B.S. and Catherine Zois, Ph.D. (faculty sponsor)
Description of Study: / This study requires that I complete questionnaires that assess personality and behavioral and emotional characteristics. Some questions pertain to general behavioral tendencies such as how I engage in conversations with others, while others pertain to the experience of negative emotional states such as depression and anxiety. Further, some questions regard hurtful behaviors that I have committed against others or to myself. Finally, I will be answering some demographic information about myself, such as my age, ethnicity, and gross family income.
Adverse Effects and Risks: / It is possible that I might experience minor emotional discomfort while answering some of these questions. Some of the questions asked might pertain to the negative things that I have done to others and may cause some feelings of guilt or remorse. Other questions focus on suicidal thoughts or negative emotions such as depression, which may cause some discomfort. In the event that I do experience distress as a function of completing these questionnaires, I am aware that I can contact the Counseling Center at (937) 229-3141. I am also aware that services provided at the Counseling Center are free of charge to all undergraduate University of Dayton students. If you find yourself experiencing distress after the Counseling Center is closed for the day, you may call the number and will be connected to an answering service, and a counselor will return your call.
Duration of Study: / The study will take approximately 45 minutes to complete.
Confidentiality of Data: / My name will be kept separate from the data. Both my name and the data will be kept in a locked filing cabinet. Only the investigators named above will have access to the locked filing cabinet. My name will not be revealed in any document resulting from this study. As this study is being conducted anonymously, I understand that there is no way for the researchers to contact the participants if any of the participants’ responses on the questionnaires indicate any potential psychological problems for which they could benefit from counseling.
Contact Person: / Participants may contact Leigh Ridings, St. Joseph Hall 313, (937) 229-2175, , or Dr. Catherine Zois, St. Joseph Hall 308, (937) 229-2164,. If I have questions about your rights as a research participant I may also contact the chair of the Research Review and Ethics Committee, Dr. Greg Elvers, in SJ 312, (937) 229-2171, .
Consent to Participate: / I have voluntarily decided to participate in this study. The investigator named above has adequately answered any and all questions I have about this study, the procedures involved, and my participation. I understand that the experimenter will be available to answer any questions about research procedures throughout this study. I also understand that I may voluntarily terminate my participation in this study at any time and still receive full credit. I also understand that the investigator named above may terminate my participation in this study if s/he feels this to be in my best interest. In addition, I certify that I am 18 (eighteen) years of age or older.
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Signature of Student Student’s Name (printed) Date
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Signature of Witness Date