Consent Form for Participation in a Research Study
Researcher(s): Dr. Eli Somer, Hildy Wen
Study Title: The Effects of Daily Feelings on the Affective Valence of Daydreams Among Maladaptive Daydreamers
WHAT IS THIS FORM?
This form is called a Consent Form. It will give you information about the study so you can make an informed decision about participation in this research. This form will describe the procedures, inclusion criteria, and risks that are associated with participation. We encourage you to take some time to think this over and ask questions now and at any other time. If you decide to participate, you will be asked to sign this form and you will be given a copy for your records.
WHAT ARE SOME OF THE IMPORTANT ASPECTS OF THIS RESEARCH STUDY THAT I SHOULD BE AWARE OF?
The purpose of this research study is to further develop our knowledge of maladaptive daydreaming (MD) by examining the relationship between daily depressive feelings and the emotional tone of daydreams among MDers. The goal of our research is to identify the relationship between depressive symptoms and the emotional tone of daydreams. We also strive to better understand maladaptive daydreaming as a coping mechanism. If you agree to participate in this study, you will be asked to complete an online survey that assesses emotions, psychological symptoms, and daydreaming characteristics. There is no monetary compensation for participation in this study and all participation is completely voluntary.
WHO CAN PARTICIPATE IN THIS RESEARCH STUDY?
To consent to this research study, you must be 18 years of age or older. Participants must also self-identify as a maladaptive daydreamer. By consenting to this research study, you are agreeing that you are both at least 18 years of age and a maladaptive daydreamer.
WHAT WILL I BE ASKED TO DO AND HOW MUCH TIME WILL IT TAKE?
If you agree to take part in this study, you will be asked to complete a daily survey that includes questions about your emotions, psychological symptoms and daydreaming characteristics. This survey will take approximately 20 minutes to finish each day for a total of 14 days (2 weeks).
WILL BEING IN THIS RESEARCH STUDY HELP ME IN ANY WAY?
Although there are no direct benefits for participating in this study, you may learn more about your experiences with MD and your emotions surrounding daydreaming. We hope that this work will help in providing a better understanding and awareness of MD among mental health professionals.
WHAT ARE MY RISKS OF BEING IN THIS RESEARCH STUDY?
You may find answering some questionnaire items to be upsetting as they may remind you of things you do not want to think about. Mental health resources and mood-enhancing links will be offered at the end of the questionnaire. You may skip any questions that make you uncomfortable or that you do not wish to answer. Additionally, completing this survey may be dull or inconvenient at times.
As researchers, we do not provide mental health services and we will not be following up with you after this study. However, if you believe that you need to discuss issues that arise as a result of your participation in this study, we encourage you to seek counseling at your locality. For further questions, we will provide you with our contact information below.
We believe there are minimal risks associated with this research study; however, a risk of breach of confidentiality always exists.
HOW WILL MY PERSONAL INFORMATION BE PROTECTED?
As with any online related activity, a breach of privacy is always possible. To the best of our ability, your answers in this study will remain confidential.
We will not collect information associated with your name to further protect your privacy. All electronic files containing identifiable information will be password protected. Any computer hosting such files will also have password protection to prevent access by unauthorized users. Only the members of the research staff will have access to the passwords. At the conclusion of this study, the researchers may publish their findings. Information will be presented in summary format and you will not be identified in any publications or presentations.
If at any point you indicate to the principal investigator that you are at imminent risk to harm yourself or another person, or a child or elderly individual is at risk for abuse, your confidentiality cannot be guaranteed, and steps may be taken to ensure the public safety as required by law (for instance, by contacting the authorities). Please note that we will not ask any questions related to this risk.
WHO CAN I TALK TO IF I HAVE QUESTIONS?
Take as long as you like before you decide. We will be happy to answer any question you have about this study. If you have further questions about this project or if you have a research-related problem, you may contact the researchers:
Eli Somer, Ph.D.
somer@resewarch.haifa.ac.il or Hildy Wen,
hildyjwen@gmail.com WHAT HAPPENS IF I SAY YES, BUT I CHANGE MY MIND LATER?
You do not have to be in this study if you do not want to. If you agree to be in the study, but later change your mind, you may drop out at any time. There are no penalties or consequences of any kind if you decide that you do not want to participate.
