Informed Consent

IRB Protocol Title:
Cross-Cultural Study on Establishment of Self-Esteem: Differences between American Students and Japanese Female Students.

Principal Investigator: Ayako Nakashita

Research Purpose:
Educational institutions and social norms in different cultures may have an effect on the construction of self-esteem in young adults. In order to elucidate the factors that determine cultural differences in self-esteem, correlations between the big five personality traits, parental relationships, and degree of self-esteem will be studied in American and Japanese college students.

Description of the Research: 
The study should take about 30 to 40 minutes. In addition to a brief demographics form you will be asked to complete a 10 item questionnaire, a 60 item questionnaire, and a 50 item questionnaire.

Potential Risks: 
The risks associated with participating in this study are minimal; previous participants in studies similar to this one have reported no ill effects.  You may feel some discomfort sharing your thoughts and feelings, but all answers remain anonymous, and, you will have a chance to discuss any feelings that arise at the conclusion of the study today.  Psychological upset is not expected; however, should you wish to seek additional support following participation, please contact the Adelphi University Student Counseling Center (516-877-3646) or the Long Island Crisis Center (516-679-1111).  Please contact Ayako Nakashita (949-610-4328; if there are other issues or concerns.

Potential Benefits:
By assessing the cultural influence on the degree of self-esteem, the study may allow us to learn more about the construction of self-esteem, and eventually contribute to the improvement of education on self-esteem for younger generations.

You will not receive compensation for taking part in this study; participation is entirely voluntary.

Contact Persons: 
If you have any questions, at any time, about this research, or want to discuss any possible study-related injuries, please contact

Ayako Nakashita:                   949-610-4328               
Dr. Robert Bornstein:             516-877-4736               

Your identity as a participant in this research study will be kept confidential in any publication of the results of this study. The information obtained during this research (research records) will be kept confidential to the extent permitted by law.  
By completing the survey you are agreeing to participate in the research; For Web-based surveys, add a click-through button.
There is a limit to the confidentiality that can be guaranteed due to the technology itself. Specifically, although the risk is small, no guarantees can be made regarding the interception of data sent via the Internet by any third parties.

Voluntary Participation: 
Participation in this study is voluntary. If you decide not to participate, this will not affect your ability to participate in future studies.  If, for any reason, you decide you do not want to participate in this study, you may leave at any time without penalty, even after the study has begun. 
Any new information that develops during this study which might affect your decision to participate will be given to you immediately.  A signed copy of this consent form will be given to you.

Institutional Review Board Approval: 
This research has been reviewed and approved by   the Adelphi University Institutional Review Board (IRB). If you have any questions or comments, you may contact Dr. David Prottas, Chair of the Adelphi University IRB, at  (516) 877-3615;<

Question Title

1. Do you agree with the terms?