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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, 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 telephone screening, you will be asked to do the following:


Complete at-home tasks over the internet on your personal computer. Complete some questionnaires related to the study on your personal computer. 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-$1.00) 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 data is never directly linked to individual identity. The master list linking code names with subject names, telephone numbers (and addresses, if applicable) 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 the end of the study, you will receive pro-rated payment for the duration of your participation according to the approved hourly rate.


The investigator has explained this study to you and answered your questions.  If you have a concern about any aspect of this study, you should ask to speak to the Principal Investigator 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 sponsoring faculty 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.