Videotapes and interviews

Title: Adult Attachment Models
Researchers: Jane Student and John Faculty, Ph.D.

(Purpose)
The purpose of this research project is twofold, to study (1) connections between childhood experiences and experiences in current relationships, and (2) the development of relationships over time.

(Description of procedures)
Your part in the research project will involve completing a one hour interview, a 15 minute videotaped session of you interacting with your partner, and a number of questionnaires taking about one hour to complete. The interview asks about your present relationship and your feelings since you have been together. The questionnaires ask about your feelings and relationship in positive areas such as feelings of love and commitment, and also in potential problem areas in relationships such as jealousy, arguments, drinking, and life stresses.

(Benefits and Risks)
The total amount of time to complete your participation is approximately two hours. At the end of the session, you will be paid $50.00 (and your partner will also receive $50.00). Some of the questions about past experiences may remind you of sad or upsetting events. The disagreement you are asked to simulate may be upsetting. However, we have interviewed and videotaped many people, and no other risks have been found. There are no known risks to answering the questionnaires.

(Voluntary Participation)
Your participation in this project is completely voluntary. You do not have to participate if you do not want to. Your decision about participation will have no effect on any other treatment to which you are entitled to from the researcher or this institution. You can change your mind and withdraw from the project at any time without penalty. There are no risks to doing so.

(Confidentiality)
Any information obtained about you is confidential according to federal guidelines. To ensure confidentiality: (1) you will be assigned a code number to identify the interviews and questionnaires. Your real name will not be used. (2) The names and code numbers will be kept in a locked drawer. (3) The interview is audiotaped and then transcribed. All personal names and other identifying features of the interview are removed during typing, and the audiotape will be erased after transcription. (4) the videotape of the discussion between you and your partner will be used for research purposes and no one will see them except members of the investigating team. The videotapes are kept in a locked cabinet and accessible to the project coordinator and select staff, will not be erased, and we plan to keep them indefinitely.

(Contacts)
If you have any questions about this study, please contact Dr. John Faculty at 631-447-55**. If you have any questions about your rights as a participant, please contact: Dr. Barbara Ethics, Committee on Research Involving Human Participants, Telephone: (631) 447-44**Any new information that may make you change your mind about being in this study will be given to you.

You will get a copy of this consent to keep.

If you agree to participate in this research project, please sign and print your name below. Your signature indicates that you have read the information provided below, or have had it read to you, and that you have decided to participated.

_____________________________________________________________________________

Signature of participant or authorized representative                                               Date

_____________________________________________________________________________

Name of participant (print)

_____________________________________________________________________________

Signature of investigator or witness Date

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