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UNIVERSITY OF WASHINGTON

CONSENT FORM

Brain and Cognition

Researchers: Chantel Prat, Ph.D., Professor, Department of Psychology and the Institute for Learning and Brain Sciences, csprat@uw.edu*

*Confidentiality of information sent by email cannot be assured.

Researchers’ statement

We are asking you to be in a research study. The purpose of this consent form is to give you the information you will need to help you decide whether to be in the study or not. Please read the form carefully. You may ask questions about the purpose of the research, what we would ask you to do, the possible risks and benefits, your rights as a volunteer, and anything else about the research or this form that is not clear. Use the contact information above to contact the researchers involved with this study. When we have answered all your questions, you can decide if you want to be in the study or not. This process is called “informed consent.”

PURPOSE OF THE STUDY

The purpose of this study is to better understand the nature of individual differences by relating performance on cognitive tasks to variability in mental and neural processes, as well as to differences in life experiences.

STUDY PROCEDURES

If you elect to participate in this study, we may ask you to fill out a few initial questions and a series of computerized questionnaires and tests that will measure your cognitive abilities. You will respond to these computerized tasks using a mouse and/or keyboard. We will ask for personal information including gender, age, race, and ethnicity on a demographics form. If you are interested in other research opportunities, we will also collect your name and contact information. We will provide specific instructions for each task and remind you of the instructions before you begin. You can take break between tasks as needed. The total duration of your participation will be 0.5-2.0 hours long.

RISKS, STRESS, OR DISCOMFORT

There are some risks associated with this study. When performing the experimental tasks, you may experience mental fatigue or boredom. There is also a slight risk of headache resulting from eye strain from looking at a computer screen.

BENEFITS OF THE STUDY

You will not directly benefit for taking part in this study. However, we hope that the results of this study will help us develop better, more representative models of the nature of individual differences in the mind and brain.

CONFIDENTIALITY OF RESEARCH INFORMATION

We will keep information about you confidential. We will label all of the study information with a code instead of your name. If you agree to be contacted for future studies, the link between your study data and identifiable information will be maintained and your contact information will be added to a registry. We will use your study data to determine if you qualify for participation in future studies. After this time, you will be contacted and asked about interest in future studies that you qualify for. If you continue to be interested in participating in future studies, we will ask you to update your contact information (if necessary). Although we make every effort to keep your information confidential, no system for protecting your confidentiality can be completely secure. It is possible that unauthorized persons might discover that you are in this study, or might obtain information about you. Government or university staff will sometimes review studies such as this one to make sure they are being done safely and legally. If a review of this study takes place, your records may be examined. The reviewers will protect your privacy. The study records will not be used to put you at legal risk of harm, and any data published from this study will not include any identifying information about you.

OTHER INFORMATION

You may refuse to participate and you are free to withdraw from this study at any time without penalty.

RESEARCH-RELATED INJURY

It is important that you promptly tell the researchers if you believe that you have been harmed because of taking part in this study. If you have questions, complaints or concerns about this study, you can contact the study team at 206-685-8610. This number is monitored during normal business hours.

SUBJECT'S STATEMENT

This study has been explained to me. I volunteer to take part in this research. I have had a chance to ask questions. If I have questions later about the research, or if I have been harmed by participating in this study, I can contact one of the researchers listed on the first page of this consent form. If I have questions about my rights as a research subject, I can call the Human Subjects Division at (206) 543-0098 or call collect at (206) 221-5940.