Statistical inference and spatial patterns in correlates of IQ

Cross-national comparisons of IQ have become common since the release of a large dataset of international IQ scores. However, these studies have consistently failed to consider the potential lack of independence of these scores based on spatial proximity. To demonstrate the importance of this omission, we present a re-evaluation of several hypotheses put forward to explain variation in mean IQ among nations namely: (i) distance from central Africa, (ii) temperature, (iii) parasites, (iv) nutrition, (v) education, and (vi) GDP. We quantify the strength of spatial autocorrelation (SAC) in the predictors, response variables and the residuals of multiple regression models explaining national mean IQ. We outline a procedure for the control of SAC in such analyses and highlight the differences in the results before and after control for SAC. We find that incorporating additional terms to control for spatial interdependence increases the fit of models with no loss of parsimony. Support is provided for the finding that a national index of parasite burden and national IQ are strongly linked and temperature also features strongly in the models. However, we tentatively recommend a physiological - via impacts on host-parasite interactions - rather than evolutionary explanation for the effect of temperature. We present this study primarily to highlight the danger of ignoring autocorrelation in spatially extended data, and outline an appropriate approach should a spatially explicit analysis be considered necessary.     

Defining the Nature and Impact of Goals in Children and Adolescents with a Chronic Health Condition: A Review of Research and a Theoretical Framework

This paper presents a review of research related to goals in youth with a chronic health condition (CHC) and a related framework to inform theory and research. Performed literature review using PsychINFO and Medline with a combination of many key words related to health, goals, and youth. Sixteen studies related to goals in youth with a CHC were identified. An integrative framework to inform research on goals in pediatric CHCs was presented based on studies reviewed. The impact of a CHC on goals and related behaviors, impact of goal conflict and collaboration, interventions with goal-setting components, and impact of developmental, disease, socioeconomic, and cultural factors were described. Recommendations for future research were discussed. The application of theory related to the nature and impact of goals in youth with a CHC will advance the field from a research and clinical standpoint.     

BIOFEEDBACK,AUTOGENIC TRAINING,AND PROGRESSIVE RELAXATION IN THE TREATMENT OF RAYNAUD'S DISEASE: A COMPARATIVE STUDY

Twenty-one female patients suffering from diagnosed idiopathic Raynaud's Disease were trained to raise digital skin temperature using either autogenic training, progressive muscle relaxation, or a combination of autogenic training and skin temperature feedback. Patients were instructed in the treatment procedures in three one-hour group sessions spaced one week apart. All patients were instructed to practice what they had learned twice a day at home. Patients kept records of the frequency of vasospastic attacks occurring over a four-week baseline period, and during the first four weeks and the ninth week of training. In addition, patients underwent four laboratory cold stress tests during which they were instructed to maintain digital temperature as the ambient temperature was slowly dropped from 26° to 17°C. Cold stress tests were given during week 1 of baseline and during weeks 1, 3, and 5 of training. Results indicated that all patients improved during the first four weeks of training. No significant differences between the three behavioral treatment procedures were obtained. In addition, the ability of patients to maintain digital temperature during the cold stress challenge showed significant improvement from the first to the last tests. Symptomatic improvement was maintained by all patients nine weeks after the start of the training. The implications of these findings for the behavioral treatment of Raynaud's Disease are discussed.     

Consenting to uncertainty: challenges for informed consent to disease screening—a case study

This paper uses chronic beryllium disease as a case study to explore some of the challenges for decision-making and some of the problems for obtaining meaningful informed consent when the interpretation of screening results is complicated by their probabilistic nature and is clouded by empirical uncertainty. Although avoidance of further beryllium exposure might seem prudent for any individual whose test results suggest heightened disease risk, we will argue that such a clinical precautionary approach is likely to be a mistake. Instead, advice on the interpretation of screening results must focus not on risk per se, but on avoidable risk, and must be carefully tailored to the individual. These points are of importance for individual decision-making, for informed consent, and for occupational health.

Can I Be Ill and Happy?

Can one be ill and happy? I use a phenomenological approach to provide an answer to this question, using Merleau-Ponty’s distinction between the biological and the lived body. I begin by discussing the rift between the biological body and the ill person’s lived experience, which occurs in illness. The transparent and taken for granted biological body is problematised by illness, which exposes it as different from the lived experience of this body. I argue that because of this rift, the experience of illness cannot be captured within a naturalistic view and propose to supplant this view with a phenomenological approach. The latter approach accounts for changes in the ill person’s relationship to her social and physical world. These changes, I argue, cannot be captured by a naturalistic perspective. I then propose the notion of health within illness as a useful concept for capturing the experience of well-being reported by some ill people. I present empirical evidence for this phenomenon and assess its philosophical significance. Finally, I suggest that adaptability and creativity are two common positive responses to illness, demonstrating that health within illness is possible. The three elements combined – the transformed body, health within illness and adaptability and creativity – serve as the basis for a positive answer to the question posed above.     

Church-based health behavior programs: Using social cognitive theory to formulate interventions for at-risk populations

Epidemiological analyses conclude that the major contributors to all-cause premature mortality and morbidity are smoking, alcohol abuse, inappropriate diet, and a sedentary lifestyle. Efforts to modify these health behaviors in populations with community and worksite interventions, although initially promising, have had difficulty in sustaining health-behavior changes. More intensive, theoretically based interventions targeted to at-risk groups and delivered in smaller social units, such as churches and other religious organizations, have been recommended. An intervention based on social cognitive theory that entails integrating self-regulatory procedures with social and environmental supports in rural churches serving people from lower socioeconomic groups is described in detail.     

Illness perception patterns in patients with Coronary Artery Disease

The purpose of this study is to identify patterns of illness perception in patients with angiografically verified Coronary Artery Disease. A total of 166 patients (age: 64.4 ± 12.1, 80.7% male) were recruited after angiography. Cluster analysis on the items of the Brief Illness Perception Questionnaire was used to identify patterns of illness perception. The resulting groups were characterized with regard to Quality of Life (MacNew), anxiety and depression (GAD-7 and PHQ-9) and resilience (RS-13). The analysis revealed 4 distinct groups differing with regard to the items covering the perception of the physical and emotional impact of disease. Stronger perceptions in these domains were associated with lower Health Related Quality of Life and higher levels of emotional distress. Group 1 (33.1%) reported the strongest perceptions of the physical and emotional impact of disease and expressed low treatment control, high chronic timeline and significantly higher levels of depression than the other groups. Group 2 (27.7%) was characterized by more moderate perceptions of the emotional and physical impact of disease together with low scores on illness coherence and chronic timeline. Groups 3 (25.3%) and 4 (13.9%) reported smaller physical and emotional impact of illness but differed in chronic timeline. Our results correspond largely to recent findings in patients with other chronic diseases. Further research is needed to explore if stratification of patients according patterns of illness perception can help to inform patient–physician communication strategies.     

What Do We Tell the Children? Contrasting the Disclosure Choices of Two HD Families Regarding Risk Statusand Predictive Genetic Testing

Above all else, predictive genetic testing provides information. Gaining insight into the psychosocial effects of this information is a primary goal of genetic counseling. For individuals utilizing predictive genetic testing, the acquisition of genetic information requires choices regarding disclosure within the family. This study uses a phenomenological methodology to explore the contrasting choices of two sets of HD parents regarding the disclosure of genetic risk status to their children. Additionally, the children (now adults) discuss their lived experience growing up with contrasting disclosure dynamics, and their current views regarding the use of predictive genetic testing for themselves. The primary finding of this study is that all of the adult children now express preference for early disclosure of genetic risk and an open/supportive communication style regarding HD. This finding has value for clinicians working with HD families who must make decisions regarding disclosure issues related to predictive genetic testing.     

Psychodynamic Theory and Counseling in Predictive Testing for Huntington’s Disease

This paper revisits psychodynamic theory, which can be applied in predictive testing counseling for Huntington’s Disease (HD). Psychodynamic theory has developed from the work of Freud and places importance on early parent–child experiences. The nature of these relationships, or attachments are reflected in adult expectations and relationships. Two significant concepts, identification and fear of abandonment, have been developed and expounded by the psychodynamic theorist, Melanie Klein. The processes of identification and fear of abandonment can become evident in predictive testing counseling and are colored by the client’s experience of growing up with a parent affected by Huntington’s Disease. In reflecting on family-of-origin experiences, clients can also express implied expectations of the future, and future relationships. Case examples are given to illustrate the dynamic processes of identification and fear of abandonment which may present in the clinical setting. Counselor recognition of these processes can illuminate and inform counseling practice.