Perceptual Alternation in Binocular Rivalry:
Heritability and Correlation with Brain Disorders

INFORMED CONSENT

This form explains the purpose, procedure, risks and benefits of research taking place in the laboratory of Associate Professor David G. King, Ph. D., at Southern Illinois University School of Medicine. Total time required for your participation in this research should be less than one hour. Please read this form carefully and sign in the space provided if you are willing to participate.   

    Purpose.  We are studying how different people respond to a visual stimulus.  Data about close relatives will be used to study genetic variation in such responses.  Information from this research may help understand how the brain works and possibly offer insight into abnormal brain function.  Specifically, results will test whether certain responses are associated with mental conditions such as bipolar disorder (manic depression).  A more detailed explanation is available upon request.

    Description of activity.  Your participation will begin with an interview, during which you will be asked for basic information such as date of birth, gender, family background, and also asked about your personal and family medical history of psychiatric diagnosis.  You may decline to answer any questions about your medical history.  Although information concerning your medical history may contribute substantially to our research, your participation will be valuable even if you do not provide this information.  Should you choose answer these questions, the information will be kept confidential and used solely for statistical analysis.  If you do voluntarily reveal information about your personal medical history, AND if you give written permission for us to contact your health care provider (such as your psychiatrist or family doctor), then confirmation of information relevant to this study will be requested from your provider.
    The visual measurement itself will take about thirty minutes.  You will be seated in front of a computer display screen while the procedure is explained.  The room lights will then be turned down. Special glasses, which look and feel rather like sunglasses and which fit over regular eyeglasses, will let your two eyes see two different images at the same time.  You will respond by pressing buttons on a computer mouse to indicate what you see on the screen.  Your responses will be recorded in a computer file for later analysis.  At the end of the study, you will be given a few moments for your eyes to readjust to normal vision and room light.  (A more detailed explanation of the apparatus and procedure is available upon request.)     You may wish to spend additional time to discuss the study or ask questions.  Throughout this time, your continuing participation is entirely voluntary.  You may quit at any time.

    Follow-up study.  At the end of the session, you will be asked whether we may contact you in the future to repeat the procedure.  Even if you agree, you might not be contacted.

    Confidentiality.   Confidentiality of individual records will be maintained within legal limits, but cannot be absolutely guaranteed.  All data collected during this study (including both written information and computer files) is identified only by code number.  The list matching subject names with code numbers is kept in a separate locked file cabinet.  Only the principal investigator and his assistant will normally have access to both data and code list.  The computer which records your responses is not connected to any network.

    Potential risks.  Apart from the hazards and minor discomforts listed below, potential risk to participants in this research project should be minimal. This study does not involve the application or testing of any medical treatment or therapy. No invasive procedure will be used.
    (1)  In today's society, revealing a personal or family history of psychiatric treatment could jeopardize one's job or social position.  Although individual records will be kept confidential, as noted above, such confidentiality cannot be absolutely guaranteed.  Therefore, participants who are concerned about this risk are advised not to answer these questions.
    (2)  Flickering visual displays can be disturbing to some individuals, and in rare cases may induce seizures.  YOU SHOULD NOT PARTICIPATE in this study if you have had any past history of seizure associated with flickering lights or other stimuli.
    (3)  For a few participants, the visual task may result in some minor eyestrain, which should dissipate quickly once the procedure is terminated.  If you experience more severe discomfort, you should discontinue participation.  The researcher will also terminate any session if significant discomfort becomes evident.  You are advised by NuVision, the supplier of the stereoscopic glasses, to "Wait a few moments after removing the glasses for eyesight to return to normal before resuming regular activities."
    You are free to quit at any time if you begin to experience any discomfort, such as eyestrain, headache, or motion sickness.  

    Potential benefit.
    Volunteers should expect no direct personal benefit from participation in this research, apart from contribution to scientific knowledge.  Although your own measurements will not be shared with you, a summary of research results will be sent to you when the study is completed.
    Volunteers who satisfactorily complete the measurement procedure may be offered $10.00 as compensation for the time and expense incurred by participation.

    Medical treatment.  The Department of Health and Human Services requires that you be advised as to the availability of medical treatment if a physical injury should result from research procedures.  No special medical arrangements have been made regarding your participation in this project.  If you are a registered student at SIU-C, you are eligible to receive medical treatment at the University Health Service.  If you are not a registered student at this University, immediate medical treatment is available at usual and customary fees at the Carbondale Memorial Hospital.  

This research has been reviewed and approved by the SIUC Human Subjects Committee.  

    Questions concerning the research.  For answers to questions about this research, contact
        Dr. David G. King, Ph.D.
        Department of Anatomy, School of Medicine
        Southern Illinois University, Carbondale IL 62901-6523
        Telephone:  618-453-1509;  e-mail:  dgking@siu.edu

    Questions concerning research-related injury.  In the event you believe that you have suffered any injury as a result of your participation in this research program, please contact the Chairperson of the Human Subjects Committee who will review the matter with you and identify other resources that may be available to you.
        Human Subjects Committee Chairperson
        Office of Research Development and Administration
        Southern Illinois University, Carbondale, IL 62901-4709
        Telephone 618-453-4533.  

    Questions concerning your rights as a research subject.  Questions concerning your rights as a research subject may be addressed to:
        Human Subjects Committee Chairperson
        Office of Research Development and Administration
        Southern Illinois University, Carbondale, IL 62901-4709
        Telephone 618-453-4533.  

INFORMED CONSENT:  I have read the material above, and any questions I have asked have been answered to my satisfaction.  A copy of this form has been given to me for the relevant information and phone numbers.  I agree to participate in the activity described and I know that my responses will be recorded.  I realize that I may withdraw without prejudice at any time.

Project Web Page

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