title: Worth the risk? Relationship of incentives to risk and benefit perceptions and willingness to participate in schizophrenia research.
abstract: OBJECTIVE
  Providing incentives for research participation is widely practiced but minimally studied. In schizophrenia research, questions about capacity to consent and potential vulnerability may raise concerns when offering incentives for participation. Despite empirical attention focused on consent and decision-making capacity in schizophrenia, the issue of incentives has been essentially ignored. We examined willingness to participate in research, in relation to perceived risks and benefits, among people with schizophrenia and schizoaffective disorder.
  
  
  METHODS
  Forty-six people with schizophrenia or schizoaffective disorder rated perceived risks and benefits of 5 hypothetical research vignettes. They also indicated whether they would be willing to participate at each of 5 incentive levels (including no compensation). Cognition was assessed with Mattis Dementia Rating Scale.
  
  
  RESULTS
  Ratings of risk and potential personal benefit were inversely correlated. For all scenarios, significant correlations were found between perceived risk and willingness to participate for greater compensation. Conversely, lower perceived likelihood of benefit was associated with a higher compensation threshold for participation in each scenario. Even at the highest proffered payment level for each scenario, however, a substantial proportion of respondents were not willing to participate. Risk assessment and willingness to participate (at all levels of compensation) were not associated with demographic variables or cognitive status.
  
  
  CONCLUSIONS
  Determining whether incentives impede voluntarism remains an important task for empirical ethics research. Assessing potential research participants' understanding and perceptions of risks, benefits, and alternatives to participation will help ensure that informed consent fulfills its mission--embodying the ethical principle of respect for persons.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, Box GPP-0984, San Francisco, CA 94143, USA. Laura.Dunn@ucsf.edu
authors.forename: Laura B
authors.initials: LB
authors.lastname: Dunn
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kim
authors.forename: Ian E
authors.initials: IE
authors.lastname: Fellows
authors.forename: Barton W
authors.initials: BW
authors.lastname: Palmer
mesh_terms: D002986:Clinical Trials as Topic / Q000523:psychology; D003657:Decision Making; D032984:Ethics, Research; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D009042:Motivation; D010358:Patient Participation / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D035842:Research Subjects / Q000523:psychology; D018570:Risk Assessment; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology