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Surveys
2014
February
P
PTSD, Depression, and Alcohol
PTSD, Depression, and Alcohol
Effects of PTSD symptoms on Depression and Alcohol use.
0%
Exit Survey
INFORMED CONSENT FORM
I agree to participate in the research project “Veterans and Depression” being conducted by Rob Jackson—a student in Dr. Lisa Paul’s PSYC 413 course at Northern Illinois University (NIU). I understand that the purpose of this study is to learn more about how PTSD relates to alcoholism and depression.
I understand that completion of this study includes completing measures related to PTSD, alcohol use, and depression. I also understand that my participation will take approximately 10-15 minutes.
I understand that my participation is voluntary and that I may stop my participation at any time without experiencing any penalty or negative consequences. If I have any additional questions, I will contact Dr. Lisa Paul (815-753-0778). I understand that data collection is solely for the purpose of a PSYC 413 class project, and thus, is not a formal research project and was not submitted to the Institutional Review Board (IRB) at NIU for approval.
I understand that I may not receive direct benefit from participating in this research. However, my participation in this project is intended to increase knowledge about how to improve the lives of soldiers after returning from a war; thus, I am helping to contribute to the development of knowledge in this area.
I understand that potential risks and discomfort involved in this study may include answering questions about sensitive information. I understand that I may choose to not respond to any questions that I do not wish to answer. Further, should I find myself upset following my participation; I will contact Dr. Paul or another resource, including the Psychology Services Center (815-753-0591) or the Counseling and Student Development Center (815-753-1206). I understand that my study responses are anonymous, and that neither my name nor any identifying information will be included on any study measures. I understand that any presentation of this data will be at the group, and not individual, level.
I understand that my consent to participate in this project does not constitute a waiver of any legal rights or redress I might have as a result of my participation, and I acknowledge that I will receive a copy of this consent form should I request one.
By checking the Acceptance CheckBox, I agree to participate in this study
I Agree
Demographics Questionnaire
What is your gender?
Male
Female
What is your age?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
What is the highest level of school that you have completed?
Some high school, but no diploma
High school diploma (or GED)
Some college, but no degree
2-year college degree
4-year college degree
Graduate-level degree
None of the above
Which of the following categories best describes your employment status?
Employed, working 40 or more hours per week
Employed, working 1-39 hours per week
Not employed, looking for work
Not employed, NOT looking for work
Retired
Disabled, not able to work
Which of the following best describes your current relationship status?
Married
Widowed
Divorced
Separated
In a domestic partnership or civil union
Single, but cohabiting with a significant other
Single, never married
What is your ethnicity? (Please select all that apply.)
Hispanic or Latino
Not Hispanic or Latino
Unknown
What is your racial background? (Please select all that apply)
White
Black or African-American
American Indian or Alaskan Native
Asian
Native Hawaiian or other Pacific Islander
From multiple races
What is your approximate average household income?
$0-$24,999
$25,000-$49,999
$50,000-$74,999
$75,000-$99,999
$100,000-$124,999
$125,000-$149,999
$150,000-$174,999
$175,000-$199,999
$200,000 and up
*
Do you have combat exposure?
Yes
No
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