Behavioral Survey

Consent to participate
Kean University Psychology Department ____________________________________________________________________ Consent Form to Participate in Student Research Project: Behavioral Disorders and Drug Abuse
Principle Investigator: Jessica Bonafide, School of Psychology
Email: [email protected]
Faculty Advisor: Jane O’Brien, School of Psychology
Location: East Campus, Room 226F
Telephone: 908-737-5892Email: [email protected]
Invitation to Participate: You are invited to participate in a study investigating behavioral disorders and drug abuse. This study is being conducted to assess the correlation between behavioral disorders and drug abuse. The lack of mental health care for behavioral disorders contributes to drug abuse. Procedures: If you decide to participate in this study, you will be asked to complete a questionnaire, about behavior and drug habits. It is expected that participation in this study will take no more than 20 minutes to complete. Risks and Benefits of Being in the Study: There are no more than minimal risks (i.e., those risks encountered in everyday life) involved in this study. For example, there is a possibility that you may feel some discomfort when answering an item. If this occurs you may leave the item blank. You may also stop your participation at any time without penalty. If you feel upset by any of the questions and would like to speak with someone, you will be referred to the Kean University Counseling Center (908-737-4850). There are no direct benefits to you for participation in this research study. There is no compensation or cost to you for participating in this study. However, there are indirect benefits to you for participating in this research study. You will be provided with the results of this study if you wish. You will also have the satisfaction of helping improve the understanding of the role of behavioral disorders in drug use. Confidentiality: Participant’s names will not be recorded on any of the materials used in this study. Every effort will be made to ensure that all information regarding this study remains confidential. In particular, do not include any identifying information on any survey material. Research records will be stored securely in a locked cabinet in a locked office located in the School of Psychology (EC Room 226F) at Kean University, and only the researcher and faculty advisor will have access to the records. At the end of the semester all study material will be destroyed. Only summary or group data will be reported in the study; no individual data will be shared. Voluntary Nature of the Study: Participation in this study is completely voluntary. Your decision whether or not to participate will not affect your current or future relations with Kean University. If you decide to participate, you are free to not answer any question or to withdraw your participation at any time without penalty and your data will not be recorded. Contacts and Questions: If any questions arise related to this study, you can contact the researcher, Jessica Bonafide, at [email protected], or the faculty advisor, Dr. Jane O’Brien at [email protected]. Consent Statement: By signing this form, I have agreed to participate as a participant in a research study entitled Attractiveness, Self-esteem, Body Image, and Relationships, to be carried out by Your Name, School of Psychology, under the direction of Dr. Jane O’Brien (East Campus, Room 226F) at Kean University. I have read and understand the above information. I have asked questions and have satisfactorily received answers. I have been told that my participation in this study is voluntary and that I may withdraw form the study at any time without penalty. I consent to participate in this study. A copy of this consent form will be given to me for my records.