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New York University 

A private university in the public service

Faculty of Arts and Science
Department of Psychology
The Graduate Program in Cognition and Perception
 6 Washington Place, 8th Floor
New York, NY 10003-6634
 

Consent Form

 

You have been invited to take part in a research study to learn more about mental health disorders.  This study will be conducted by Dr. Claire Gillan under the supervision of Dr. Elizabeth Phelps, Department of Psychology, New York University, or by a designated member of the research team. You must be 18 years or older to participate.

 

If you agree to participate in this study, and are deemed eligible to take part after a screening interview, you will be asked to do the following:

Complete at-home tasks over the internet on your personal computer, which involve being shown an image of a 1 cent coin when a correct answer is made Complete some questionnaires related to a medical perspective of psychiatric disorders on your personal computer Complete an IQ test Provide some general demographic information about yourself. This information may include name, date of birth, address, phone number, gender, race, education, etc. 

 

You will receive $20, plus a small bonus ($0.00-$3.00) that will be linked to your performance on one of the online tasks. Please note that you will only receive payment if we determine that you are eligible to take part and you complete the study.

 

By providing your consent, you agree for us to store your name and contact information so that we can contact you about a future (voluntary) follow-up study.

 

There are no known risks associated with your participation in this research. Although you will receive no direct benefits, this research may help the investigator understand more about mental health disorders. Although every effort will be made to prevent it, you may find the sensitive nature of some of the questions upsetting. In that event, please contact the investigator, who will provide you with useful information for how to best address these feelings.

 

At the start of the interview, you may be required to provide your full name and current location. In the event that you provide any information that indicates that you may be at risk of hurting yourself or someone else, we may need to disclose this information to protect your safety or the safety of others. This information will be destroyed at the conclusion of the interview.

 

Confidentiality of your research records will be strictly maintained. We assign code numbers to each participant so that sensitive data is never directly linked to your identity, such as name or phone number. We do however collect your email address along with some pre-screening information that is sensitive in nature. Within 14-days of signing up, we expunge your email address from this file and replace it with a code number. The master list linking code names with email addresses will be securely stored in a password protected computer file on a computer stored in a locked room at the psychology department of New York University. All of the other data that you supply will be associated only with a code number, never your name. We are interested in group results rather than the responses of particular individuals. Data are kept in our laboratory and are only viewed by the investigators and collaborators.

 

Participation in this study is voluntary. You may refuse to participate or withdraw at any time without penalty. Should you withdraw before completing all of the computerized tests and questionnaires, you will receive pro-rated payment for those portions of the experiment that you have completed. Sometimes research studies allow subjects to skip questions that they do not wish to answer, however, as this study seeks to examine the inter-relationship between all self-report items, skipping questions is not allowed. Please note that this does not affect your right to withdraw from the study at any time and receive a pro-rated payment for work completed.

 

If you have a concern about any aspect of this study, you should ask to speak to the study manager Dr. Claire Gillan, who will do her best to answer your questions (Dr. Claire Gillan, +1 212-998-8317, dimensionalpsychiatry@gmail.com). If you remain unhappy, you can contact the Principal Investigator for this project (Dr. Elizabeth A. Phelps, 212-998-8337, liz.phelps@nyu.edu).

 

For questions about your rights as a research participant, you may contact the University Committee on Activities Involving Human Subjects (UCAIHS), 665 Broadway, Suite 804, New York University, (212) 998-4808 or ask.humansubjects@nyu.edu.

 

Any specific information gathered in the study will be disclosed only to the investigator or collaborators.  If the results are published, the information remains anonymous and disguised so that no identification can be made.

 

Please save a copy of this consent document to keep.


Do you agree to participate given the terms laid out above?

[Optional] Are you interested in completing an additional screening phone interview to help us assess the quality and reliability of our screening methods? If you are randomly selected to take part in this test, you will receive an additional $10 for taking part.