Momentum Potential Participant Contact & Screener

Thank you for contacting us to find out more about our research study. The purpose of our study is to gather information to help understand the brain and behavior processes that underlie mood swings.

The screening takes place over the course of several weeks and it starts with this survey, and involves you participating in clinical interviews with an assessor. The assessor may meet with you up to three or four times for interviews. During the interviews you will be asked questions about changes in your moods and behaviors throughout your life, questions about any mental health treatment you may have had, questions about your cognition, questions about your health and questions about your personality. The purpose of the interviews is to assess whether you qualify for full participation in the study.

In the main part of the study, you will be asked to play mobile games and answer questionnaires on a mobile app while wearing sensors measuring physiological data. You will play mobile games twice a day and each game session can take 25-35 minutes to complete. You will also be asked to answer questionnaires four times a day which can take 5 minutes each to complete. These tasks are expected to take 70-90 minutes per day and you will complete these tasks for 28 days. This study does ask for a decent time commitment.

Does this sound like something you are able to fit into your schedule?

If you are eligible and willing, you will be scheduled for an fMRI during the halfway point of the 28 days of the mobile games protocol. For the procedure, you lie on a table and are slid into a tunnel; it gives us a computer image of your brain. While you are in the scanner, you will be asked to complete some games while looking at a computer screen. This will involve pushing a button to make choices you see on the screen. It will be a 90 minute scan.

Up to 24 hours prior to your scheduled fMRI scan, you receive a phone call assessing your scan eligibility. If you no longer meet eligibility to scan during your scheduled time, your scan appointment will be cancelled. You will have the option of rescheduling and will not be terminated from the study.

Your sobriety is necessary at all research visits to ensure reliable and accurate data collection. If research staff suspect that you may be under the influence of drugs or alcohol, we may perform breathalyzer and/or saliva drug screening. If the results are positive, no testing will be conducted on that day but you will have the option of rescheduling and will not be terminated from the study.

You will be paid for your participation as follows: $100-185 if you complete all diagnostic interviews and self-report assessments, $145-155 if you are eligible and arrive on time to complete the fMRI scan, between $275 and $525 depending on your performance on the 4-week mobile tasks activities. In total, you can earn between $500 and $865 with most people in the upper range if you complete all activities successfully and do well with your mobile game performance.

If you have any questions, please reach out to dependlab@unc.edu.

Do you think you might be interested in participating in this research study?

Before enrolling people in this study, we need to determine if you may be eligible to participate.

The remainder of this survey will ask you a series of questions about your demographics, possible moods and behaviors that may have caused problems for you throughout your life, as well as some general questions about your physical health, and your eligibility to undergo MRI scanning.

There is a possibility that some of these questions may make you uncomfortable or distressed; if so, please let me know. You can skip questions you do not wish to answer. We will keep all the information I receive from you via this survey, including your name and any other identifying information, confidential. The purpose of these questions is to determine whether you may be eligible to participate in the study. Additional screening at a later time may be necessary beyond answering these questions. Remember, your participation is voluntary; you do not have to complete these questions.

If you have any questions or concerns, email dependlab@unc.edu.

Do we have your permission to ask you these questions?

First Name

Last Name

First two letters of first and last name (e.g. Jo Sm)

What is your biological sex assigned at birth?

What gender to you identify with?

Pronouns (e.g. she/her, he/him, they/them, etc)

Age:

Email

Phone Number

What's the highest level of education you've completed?

Are you currently employed either full-time or part-time?

Do you receive social security or disability payments?

If yes to disability payments, is it due to mental health, physical health, or both?

How would you describe your racial identity? (check all that apply)

If "other", please elaborate.

Do you identify as Hispanic?

How did you hear about our study?

Have you ever participated in a research study before?

Do you remember what it was called, where you were seen, or who you saw?

Would you be willing and able to come to UNC for at least 3 in-person visits?

Would you be willing to do any visits over Zoom?

Do you have access to a computer with internet connection?

Do you have access to a smartphone?

What kind of smartphone do you use?

What (operating system) version of Android is your phone running on?

Our 4 week smartphone protocol uses an app downloadable through google drive. Would you be willing to download this app and use your own phone to do the study?

If you do not currently use an Android smartphone, would you be willing to use a lab provided Android for the course of the study?

Have you ever been diagnosed with an Neurological Disorder? (such as Multiple Sclerosis, Tourette's, Parkinson's, Huntington's, etc.)

Please specify:

Have you ever had a seizure?

Please specify:

(When was that? What symptoms did you have? Have you been diagnosed with Seizure Disorder or Epilepsy? How was it diagnosed?)

Have you ever had a stroke?

Please specify:

(When was that? How was it diagnosed? What symptoms did you have?)

Have you ever had a head injury or a concussion?

Please specify:
1. How were you injured?
2. What medical treatment, if any, did you receive (evaluated in the ER, neurology visit, MRI, etc)?
3. Were you diagnosed with with a concussion, skull fracture, hemorrhage, etc?
4. Did you lose consciousness from any head injuries? If so, what's the longest you were unconscious?
5. After any head injuries, did you have problems with headaches, dizziness, memory, seizures, etc?
6. How long did these problems last?

Have you ever been diagnosed with a learning disability or intellectual disability?

Please specify:
What was the name of the disability? In what area do you have difficulties in? How severe are your difficulties?

Have you ever been diagnosed with autism?

If so, could you tell me a little bit about that, for example what types of problems do you experience?

Have you ever struggled with mental or emotional problems? (such as anxiety, depression or substance use issues, even if it was just during a particularly difficult period)

Please specify:

Did you seek treatment? (includes therapy or counseling, PCP, psychiatric hospitalization, couples therapy, religious counseling)

Has your PCP ever prescribed you medication for your mood or anxiety even if it was just temporary?

Please specify:

Have you ever been formally diagnosed with a specific psychiatric disorder (for example: Major Depressive Disorder, Bipolar Disorder, Schizophrenia or Schizoaffective Disorder, Panic Disorder, OCD, Generalized Anxiety Disorder, PTSD, etc.)?

If so, specify any past or present diagnoses & by whom you were diagnosed (e.g. PCP, psychiatrist, therapist, etc).

What medications do you currently take?

Do you take any "as needed" medications? (e.g., Xanax?)

Please specify which medications you take "as needed"

1. My emotions sometimes change for no good reason.

2. I have much stronger emotional reactions than almost everyone else.

3. I am a highly emotional person.

4. I get emotional easily, often for very little reason.

5. I never know where my emotions will go from moment to moment.

6. I get emotional over every little thing.

7. My emotions are unpredictable.

Are you willing to complete the MRI scan if you're eligible?

Height:

Weight:

Have you ever had an MRI before?

Please provide detail on: Prior MRI
Where was your prior MRI done? Was it part of a research study or for medical purposes?

Please provide detail on: Aneurysm Clip

Please provide detail on: Ear Implant/Hearing Aid

Please provide detail on: Heart Valve/Pacemaker/Cardioverter/Defibrillator

Please provide detail on: Shrapnel/Bullets/BB

Please provide detail on: Embolization Coils/Stents

Please provide detail on: Body Piercings/Tattoos

Where is your tattoo located? When did you get the tattoo? Was your tattoo done at a professional studio?

Are your piercings removable? Would you be willing to remove them for the duration of the MRI?

Please provide detail on: Dentures/Braces/Wigs/Hair Extensions

Are they removable? Would you be willing to remove them for the duration of the MRI scan?

Please provide detail on: Electronic Implant or Device

Please provide detail on: Neurostimulation System/Electrodes/Wires

Please provide detail on: Implanted Drug Infusion Device or Pump

Please provide detail on: Vascular Access Port and/or Catheter

Please provide detail on: Medication Patch (Nicotine, Nitroglycerine etc)

Please provide detail on: Tissue Expander or Breast Clip

Please provide detail on: Joint Replacement

Please provide detail on: IUD, Diaphragm, or Pessary

If IUD: is it copper or plastic? Do you know the brand name?

Please provide detail on: History of Medical Procedures
What was implanted or inserted?

Please provide detail on: History of Metal in Eyes /If you were an occupational metal worker

Please provide detail on: Was Metal in Eyes Confirmed by X - Ray?

Please provide detail on: Magnetically - Activated Implant or Device

Please provide detail on: Spinal Cord Stimulator

Please provide detail on: Any Type of Prosthesis (Eye, Penile, etc.)

Please provide detail on: Shunt (Spinal or Intraventricular)

Please provide detail on: Radiation Seeds or Implants

Please provide detail on: Wire Mesh Implants

Please provide detail on: Other Implant or Prosthesis

Please provide detail on: Claustrophobia

Our study involves completing an fMRI, where you will be inside a scanner for up to 90 minutes. Does this sound like something you could do?

Please provide detail on: Surgical History

Please provide detail on: Surgical Staples, Clips, or Metallic Sutures

Please provide detail on: Pin, Screw, Nail, Wire, Plate, etc.

Please provide detail on: recreational substance use (current or past).

Our study asks that you complete an fMRI and for 2 days prior to the fMRI refrain from substance use and for a few hours prior to the fMRI refrain from alcohol. Would this be doable for you?