Informed Consent
Informed Consent Form
Please read this information carefully before deciding to participate.
Important Disclaimers:
- This is a research study, NOT medical treatment or psychological therapy. Participation does not constitute or replace professional medical or psychological advice, diagnosis, or treatment.
- We are researchers, NOT medical doctors or licensed therapists. We cannot provide medical advice or therapeutic support. This study is not designed to diagnose any condition.
- This study is NOT intended to teach you about altered states or replicate their effects. It solely aims to gather perceptual data about visual simulations based on your past experiences.
- Participation does not establish a doctor-patient or therapist-client relationship.
1. Purpose of the Study
We are conducting research to understand how individuals with previous experience of altered states of consciousness perceive specific computer-generated visual simulations. The goal is to explore potential similarities and differences between these simulations and the visual phenomena associated with various types of non-ordinary states (which may include, but are not limited to, experiences induced by substances, meditation, breathwork, sensory deprivation, etc.). This research aims solely to contribute to the scientific understanding of subjective experiences during altered states.
2. Procedures
If you choose to participate, you will first be asked to complete brief screening questionnaires. These include:
- A brief psychological screening.
- A short questionnaire about your demographics and history with altered states or significant subjective experiences. This initial screening helps determine eligibility.
If you meet the eligibility criteria based on the screening, you will proceed to the main part of the study. This involves:
- Viewing a series of brief (approximately 10–20 seconds each) visual stimuli presented on your computer screen.
- After viewing each stimulus, you will be asked to rate it based on its similarity to visual effects you may have experienced during past altered states of consciousness.
- You will also rate each stimulus on affective dimensions, such as how pleasant or unpleasant you found it, and its perceived intensity. The total estimated time commitment for the entire process is approximately 20-60 minutes.
3. Potential Risks, Discomforts, and Safety Precautions
- Emotional Discomfort: Recalling past altered states or intense subjective experiences, whether positive or negative, may evoke emotions or memories that could cause temporary discomfort.
- Visual Stimuli Effects: The visual stimuli involve changing patterns, colors, and movements.
- Photosensitive Epilepsy/Seizures: Individuals with a history of seizures, epilepsy, or photosensitivity must not participate. The stimuli could potentially trigger a seizure.
- HPPD (Hallucinogen Persisting Perception Disorder): While this study includes experiences beyond hallucinogen use, HPPD is a known risk associated with some types of altered states (primarily hallucinogenic ones). Individuals with a known history or current experience of HPPD must not participate. Viewing the visual stimuli could potentially exacerbate persistent perceptual disturbances.
- General Discomfort: Even without a history of the above conditions, some individuals might find the visual stimuli intense, disorienting, or unpleasant. They might potentially trigger unwanted feelings or temporary visual after-effects related to past experiences.
- Recent Difficult Experiences: If you have had a significantly difficult or distressing experience during or related to an altered state of consciousness within the last 3 months that continues to negatively affect you, participation is strongly discouraged as the stimuli or recollection could potentially be triggering.
- Recommendation Regarding Activities Post-Participation: Due to the nature of the visual stimuli, some participants might experience temporary disorientation or visual artifacts immediately following the study. As a precaution, we strongly recommend that you DO NOT drive, operate heavy machinery, or engage in activities requiring sharp focus and attention for at least one hour after completing the study, or until you feel fully alert and visually returned to your normal baseline. Your safety is paramount.
4. Potential Benefits & Compensation
There is no direct therapeutic or diagnostic benefit anticipated from participating in this study. The primary potential benefit is contributing to scientific knowledge regarding the phenomenology of altered states of consciousness and visual perception.
As a token of appreciation for your time and effort, upon verified completion of the full survey, you will be eligible to receive a complimentary Qualia Research Institute t-shirt (limited to the first 100 participants). Instructions on how to provide necessary information (e.g., size and shipping address) for the t-shirt will be provided after you have fully completed the survey, typically through a separate, optional form unlinked to your survey responses to protect your anonymity.
5. Voluntary Participation and Withdrawal
Your decision to participate in this research is entirely voluntary. You are free to decline participation, skip any question you prefer not to answer (unless required for study progression), or withdraw from the study at any point without penalty or loss of benefits to which you are otherwise entitled. You can withdraw by simply closing the survey window.
Please note that the t-shirt incentive is only provided to participants who complete the entire survey. If you choose to withdraw before completion, you will not be eligible for the t-shirt. This condition does not penalize withdrawal itself, which remains your right at any time. If you withdraw, any data collected up to that point may still be used in the analysis unless you explicitly request its deletion by contacting us.
6. Confidentiality and Data Security
We are committed to protecting your privacy. We collect minimal personally identifiable information directly within the survey. Your survey responses will be assigned a random identification code, not linked to your name. Research data will be stored on secure, password-protected servers.
Any optional contact or shipping information you provide separately for the purpose of receiving the complimentary t-shirt will be stored securely, encrypted where possible, and kept separate from your survey data to maintain the anonymity of your responses. This separate information will only be used for fulfilling the t-shirt shipment and will not be linked to your research answers. While we employ robust security measures, absolute confidentiality cannot be guaranteed over the internet. Aggregated, anonymized results may be shared in scientific publications or presentations.
7. Contacts for Questions or Problems
If you have any questions about the research, your rights as a participant, or experience any unexpected discomfort or problems related to your participation, please contact the research team at hello@qri.org.
Eligibility and Safety Confirmation (Exclusion Criteria)
For your safety and the integrity of the study, you cannot participate if ANY of the following statements are true for you:
Please carefully consider these criteria before proceeding. If you've checked any of the boxes above, we recommend not participating in this study for your own wellbeing.
8. Statement of Consent
By checking the boxes below and clicking "Begin Survey", you are indicating your informed consent:
Your participation is highly valued. You may exit the survey at any time by closing your browser window.
