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Department of Psychology

Take Our Social Anxiety & Alcohol Problems Self-Test

 

Information and Consent Form - Combined Alcohol & Social Phobia Web Questionnaire

You are invited to participate in an online study of social anxiety and problem drinking. You will be asked 13 questions about anxiety in social situations, how much alcohol you've drunk and its effects on you. Your answers will be scored by computer and you will receive some feedback about your social anxiety and drinking compared to others who have answered these questions. Then you can chose to

  • discard your answers - there will be no record kept of your answers, OR
  • save your answers anonymously - the researchers will be able to use your answers but they can't be traced to you in any way, OR
  • save your answers and arrange for one of the researchers to contact you to discuss treatment for social anxiety and problem drinking.
If you answer the questions truthfully and accurately your answers can give an indication of problems with social anxiety and drinking. They cannot give a diagnosis. Depending on your answers you may be invited to come to Macquarie University or Royal Prince Alfred Hospital for a thorough assessment of your social anxiety and drinking with one of the researchers. You can also save or print your answers and take them to your local doctor for a diagnosis of your problems.

This research is being carried out by Dr Andrew Baillie (Department of Psychology at Macquarie University, phone 9850 9436, email: casp@psy.mq.edu.au) and his colleagues: Dr Claudia Sannibale and Professor Maree Teesson (both at the University of New South Wales); Professor Ronald Rapee (Psychology at Macquarie), and Professor Paul Haber (Royal Prince Alfred Hospital and the University of Sydney). The study is funded by a Project Grant from the National Health and Medical Research Council. Staff members for the project include Dr Lexine Stapinski, Ms Kristen Tulloch, Ms Mirjana Subotic and Ms Sonia Haggman.

In order to participate you need to be over 18 years of age and be completing this questionnaire in Australia.

If you agree you will be asked questions ask you about your anxiety and drinking which may cause you some distress. If you do feel distressed, you are encouraged to contact your local doctor, Lifeline on 131114, the Salvo Careline on 9331 6000, or the researchers 02 9850 1801.

Any information or personal details gathered in the course of the study are strictly confidential. Only the researchers will have access to the data. No individual will be identified in any publication of the results. Your answers to questions will be transmitted over a secure connection similar to that used for online banking. While it is possible to decode these messages it is highly unlikely.

If you decide to participate, you are free to withdraw from further participation in the research at any time without having to give a reason and without consequence.

The ethical aspects of this study have been approved by the Macquarie University Ethics Review Committee (Human Research). If you have any complaints or reservations about any ethical aspect of your participation in this research, you may contact the Committee through the Research Ethics Officer (Tel: 02 9850 7854, Fax: 02 9850 8799, Email: ethics@mq.edu.au). Any complaint you make will be treated in confidence and investigated, and you will be informed of the outcome.

I give my informed consent to participate in this research, knowing I can choose to withdraw at any time without penalty. The purpose of the study is clear to me and I am aware that I may experiences some distress or discomfort associated with my participation. To ensure the quality of the responses I will only submit my responses once.

By pressing one of the buttons below you agree or decline to participate in this research:

I agree to participate in this survey and confirm that I am over 18 years of age and am currently in Australia

I do not agree to participate in this survey
 

Andrew Baillie Andrew's email address21 May 09 version 1.3