1. Surveys
  2. 2016
  3. February
  4. A
  5. Anxiety
0%
Exit Survey
 
 
Informed Consent Form Arkansas Tech University Title of Project: Advanced Research Method and Lab for Psychology Student Projects Principal Investigator: Dr. Jennifer E. Samson

Student Researcher: Andrea Canady and Yessenia Jimenez

Dear Arkansas Tech student and community members,
We would like to invite you to take part in a research study at Arkansas Tech University, which is being conducted as part of the Advanced Research Method and Lab for Psychology (PSY 4003) class. You are being asked to participate in this study because you are an Arkansas Tech University student or community member. The purpose of the study is to examine adults’ attitudes and behaviors. If you choose to participate, you will be asked to complete a questionnaire and/or a short task to assess your attitudes and behaviors. The entire process will take no more than 15 minutes.

There are no anticipated risks or direct benefits to you from participating in this study. However, it is hoped that the results will increase our understanding of human attitudes and behaviors.

Reasonable efforts will be made to keep your personal information private, but absolute confidentiality cannot be guaranteed. Your name will never be associated with your answers to any question or task, and this consent form will be kept in a secure location. In the event of any publication or presentation resulting from this research, no personally identifiable information will be shared. However, it is possible that other people may become aware of your participation in this study. For example, the Arkansas Tech University Internal Review Board (a committee that reviews and approves research studies) may inspect and copy records pertaining to this research. Some of these records could contain information that personally identifies you.

You will not receive any compensation for participating in this research study. Taking part in this study is voluntary. You do not have to participate, and you have the right to stop participation at any time with no penalty. For more information about participation in a research study and about the Institutional Review Board (IRB), a group of people who review the research to protect your rights, please visit Arkansas Tech University’s IRB web site at: www.atu.edu/research/human_subjects.php.

By checking the box below, you agree that you have read and understand the information on this page and agree to voluntarily participate in this survey.
 
 
 
 
How old are you?
 
18-20
 
21-23
 
23-25
 
26 and above
 
 
 
Sex
 
Male
 
Female
 
 
 
Did you previously serve in the military?
 
Yes
 
No
 
 
 
If yes to the previous question, how many deployments?
 
0
 
1-2
 
3-4
 
5 or more
 
 
If you were in this situation please check the box to which best describes you.
Not at all A little bit Somewhat Very much Extremely
Social events scared me.
I enjoy talking to people I don't know.
Feeling anxious causes me to avoid doing things or speaking to people.
I enjoy going to parties.
I seek activities in which I am the center of attention.
Talking to strangers bothers me.
I like talking to large groups of people.
I would do anything to avoid being around large groups of people.
My heart rate increases when I'm around big groups of people.
I worry what others will think about me when I don’t make sense.
Forgetting what I'm going to say in front of others is distressing to me.
I feel comfortable in large groups of people.
I find it difficult to mix comfortably with the people I work with.
I find it easy to think of things to talk about.
I like sitting in the front of the room.
 
 
 
Thank you for your participation.