ACES, CODEPENDENCY, AND MALE EXPERIENCES OF INTIMATE PARTNER VIOLENCE

INFORMED CONSENT FORM FOR RESEARCH - Exploring the Effect of Adverse Childhood Experiences in Male Survivors of Psychological Intimate Partner Violence as Mediated by Codependency Traits

Key Information
Your voluntary consent is being sought out to participate in an unpaid research study exploring the effects of adverse childhood experiences and codependency traits on the experiences of psychological intimate partner violence. The target of this survey are heterosexual, cisgender males between the ages of 18-65 who identify as having experienced intimate partner violence in a past or current relationship. This voluntary survey is expected to take 20-30 minutes to complete. Please note that this survey may evoke an emotional response or may bring up negative memories from the past. If you feel that you need mental health support or resources, please contact SAMHSA's National Helpline at 1-800-662-HELP (4357). You may also visit: https://www.apa.org/topics/crisis-hotlines, for additional support and resources.

About This Research Study
You are asked to participate in a research study. Scientists do research to answer important questions which might help change or improve the way we do things in the future. This consent form will give you information about the study to help you decide if you want to participate. We ask that you read this form and ask any questions you may have before agreeing to be in the study.
This study is being conducted by: Kaitlyn Briar, MS, PsyM, LPC, Wright State University, School of Professional Psychology; under the direction of Jeremiah Schumm, PhD, ABPP, Wright State University, School of Professional Psychology.

Why is This Study Being Done?
The purpose of this study is to explore adverse childhood experiences and codependency traits on the experiences of psychological intimate partner violence in male survivors. You were selected as a possible participant because you have self-identified as a heterosexual, cisgender male between the ages of 18-65 who has experienced psychological intimate partner violence. If you agree to participate, you will be one of 55 participants taking part in this study.

Taking Part in this Study is Voluntary
You may choose not to take part in this study or choose to leave the study at any time. Deciding to not participate, or deciding to leave the study later, will not result in any penalty or loss of benefits to which you are entitled. You can skip any questions that make you uncomfortable and can stop the interview/survey at any time.

What Will Happen During the Study?
If you agree to be in this study, we would ask you to do the following things: Complete a single-session survey, which will include the following measures: the Composite Codependency Scale (CCS), the Revised Conflict Tactics Scale (CTS-2), and the Adverse Childhood Experiences-Questionnaire (ACE-Q). Some basic demographic information will be gathered on the first page of the survey prior to administration of the measures. Participation in the study involves the following time commitment: The survey is expected to be completed in one session and is expected to take 20-30 minutes to complete.

What are the Risks of Taking Part in the Study?
The study involves the following foreseeable risks or discomforts: This survey may evoke an emotional response or may bring up negative memories from the past due to the content of questions being asked. In order to assist with the offset of these risks, mental health resources are offered on the final page of the survey. No funds have been set aside by Wright State University to compensate you in the event you wish to seek out mental health treatment.

What are the Potential Benefits of Taking Part in the Study?
The benefits to participation are: There are no direct benefits to you. More broadly, this study may help the researchers learn more about male experiences of intimate partner violence and may help provide context for future intervention with this population.

Will I Receive my research results?
We may learn things about you from the study activities which could be important to your health or well-being; however, we do not plan to share any of these results with you.

Will I be Paid to Participate in the Research?
You will receive no payment for participating in this study.

How Will my Information Be Protected?
The information you give in the study will be anonymous. This means that your name will not be collected or linked to the data in any way. The researchers will not be able to remove your data from the dataset once your participation is complete.

Your data will be stored via a secure OneDrive through a secure Wright State University Microsoft account which uses two-factor authentication to access.

The research team works to ensure confidentiality to the degree permitted by technology. It is possible, although unlikely, that unauthorized individuals could gain access to your responses because you are responding online. However, your participation in this online survey involves risks similar to a person’s everyday use of the internet. Survey Monkey will save IP addresses associated with your responses for 13 months. They will not report these addresses to the researcher, and the research team will not personally access, use, or store your IP address. If you have concerns, you should consult the survey provider privacy policy at https://www.surveymonkey.com/mp/legal/privacy/

It is unlikely, but possible, that others responsible for research oversight may require us to share the information you give us from the study to ensure that the research was conducted safely and appropriately. Wright State Institutional Review Board (IRB) and research investigators may inspect your research records.

Will My Information Be Used for Research in the Future?
Information collected from you may be used for future research studies or shared with other researchers for future research. If this happens, information which could identify you will be removed before any information is shared.

Who Should I Call with Questions?
If you have questions about the research study itself, please contact the Principal Investigator at 520-539-2683 or briar.3@wright.edu. If you have questions about your rights as a research volunteer or would simply like to speak with someone other than the research team about concerns regarding this study, please contact the IRB at 937-775-5171 or irb-rsp@wright.edu. All reports or correspondence will be kept confidential.

You will be given a copy of this information to keep for your records.