Informed Consent Form I

 

Study Title: Social Mood and Recall Study

Investigators: Jonathan Waldron, M.S.

                        Angela Scarpa, Ph.D.

 

I.               Purpose of this research

 

As the first part of a two-part study, the purpose of this study is to examine the effects of mood recall in social settings in college students. Results will be used in the researcher's dissertation, with the potential for publication and/or use in presentations.

 

II.             Procedures

 

You will be asked to complete a questionnaire about your background, mood, and health. If you decide to participate, you will be asked to respond to an online questionnaire expected to last between 30 to 45 minutes. Based on your responses to the measures, you may or may not be contacted for participation in the second portion of the study, where you would be in a lab with another participant of the same gender. In the event that you are eligible for the second part of the study, you will be contacted by email and will be eligible for additional extra credit. If any stressful or difficult issues arise at any time during the completion of the questionnaires, emergency contact phone numbers will be listed on the main webpage.

 

III.           Risks

 

There will be minimal discomfort associated with the completion of the questionnaires.

 

IV.           Benefits

 

Your participation in this study will help advance the understanding of the effects of mood recall in social settings in college students.

 

V.             Confidentiality

 

Any information you provide will be confidential. You will be asked to provide your name, phone number, and e-mail address solely for the purpose of obtaining extra credit and being contacted for the second study. A participant number will be assigned to your responses and only this number will be associated with your information for purposes of data analyses and writing of results. Please note that although the responses to the questionnaire require a password for entry and completion for the questionnaire, this does not guarantee complete confidentiality in the event the responses are intercepted inappropriately from the Internet.

 

At no time will the researchers release identifying information from this study to anyone other than those working on the study and the one additional participant (should you be eligible and participate in the second part) without your written consent. However, confidentiality may be broken if you express intent to harm yourself or someone else, in which case the researchers are legally obligated to inform the appropriate authorities. In such a case, you will be informed of the need to do so, and are encouraged to contact the Cook Counseling Center (231-6557) or the Psychological Services Center (231-6914). Research findings may be published or presented for scientific purposes, but your identity will not be revealed in the description or publication of this research.

 

VI.           Compensation

 

You may receive 0.5 extra credit points for the psychology class you are currently enrolled in. If you are not currently enrolled in a psychology class, please speak with your professor about alternative methods of receiving extra credit.

 

VII.         Freedom to Withdraw

 

You are free to withdraw from this study at any time.

 

VIII.       Participant Responsibilities

 

I voluntarily agree to participate in this study and complete the questionnaires associated with this phase of the current research study.

 

IX.           Participant Permission

 

I have read and understand the informed consent and conditions of this project. I have had my questions answered. I hereby acknowledge the above and give my voluntary consent for participation in this project. If I participate, I may withdraw at any time. I agree to abide by the rules of this project.

 

 

By entering your personal information and completing the online questionnaire, you are giving consent to participate in this study. If you do not wish to participate, simply exit the survey now.

 

 

Should I have any further questions about this research or its conduct, I will contact:

 

________________________

Jonathan Waldron

jwaldron22@vt.edu

540-231-2594

________________________

Angela Scarpa, Ph.D.

ascarpa@vt.edu

540-231-2615

________________________

David Moore, Ph.D.

IRB Chair

mooredv@vt.edu

540-231-4991

________________________

David Harrison, Ph.D.

Psychology Human Subjects Committee Chair

dwh@vt.edu

540-231-4422