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PARCS Screening Survey

The Proximal Affect Regulation and Cognition Study (PARCS) is currently recruiting young adults ages 18-30. The study is conducted at the UIC Psychiatric Institute Building and involves 3 trips into the lab, a week of data collection in daily life, a follow-up phone call and follow-up surveys that are completed online. The study involves Psychiatric interviews, Questionnaires on a computer, a week of completing surveys on your cell phone a few times each day, wear an athletic shirt under your clothing to measure your heart rate and breathing, and wear a watch on your wrist to measure your sleep. It also involves watching videos and answering questions while your heart rate and breathing are measured, and an interview by phone 3 months after starting the study, along with some online surveys.

In order to see if you qualify for the study, we need you to provide us with some preliminary information. The easiest way to do this is to complete our confidential online prescreen questionnaire. You will not be compensated for completing this questionnaire.

Once you have filled out the questionnaire, we will review your responses and reach out to you via phone. Please note that this review may take up to two weeks. If you have already filled out a questionnaire, please DO NOT fill out another questionnaire. Instead, please email us to see where you are in the recruitment process.

All of the information you disclose on the questionnaire is confidential. In the event that the study does not match your qualifications, it is not our policy to disclose why, but we will give you the option of removing your information from our files.

If you meet the basic criteria, you will be contacted over the phone for some additional questions. You may decline to answer a question or decline continued participation at any point. Risks associated with the screening process involve a potential loss of confidentiality. Potential benefits of the screening process include discovery of a previously undiagnosed psychiatric condition.

It is important to know that your responses will not be immediately transmitted to the study coordinators. If you are in danger of harming yourself or others, it is essential that you call 911 in an emergency, go to the nearest emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). We also recommend that you contact your mental health care provider.

Please email us at PARCStudy@uic.edu if you have any questions.

Principal Investigator: Jonathan Stange, PhD
IRB# 2019-XXXX

Cognition and Affect Regulation Lab
Department of Psychiatry
University of Illinois at Chicago
Psychiatric Institute
1601 West Taylor Street
Chicago, IL 60612

First name:

* must provide value

Last name:

* must provide value

Date of birth:

* must provide value

M-D-Y

Age

* must provide value

Gender:

* must provide value

Height (in inches)

Remember:
1 ft = 12 inches
2 ft = 24 inches
3 ft = 36 inches
4 ft = 48 inches
5 ft = 60 inches
6 ft = 72 inches

* must provide value

Weight (in pounds)

* must provide value

Are you right or left handed?

* must provide value

Phone number:

* must provide value

Best day and time to call:

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Email Address:

* must provide value

How did you hear about our study?

* must provide value

Do you have a smart phone (cell phone that can use the internet, such as an Android or iPhone) that you would be willing to use to complete surveys for one week as part of the study?

* must provide value

Yes

PARCS Screening Survey

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