The Bantu Clerk: A Study of Role Expectations

Summary

In an earlier work an hypothesis of consistency between a number of independent beliefs and attitude, and between a number of independent behaviors and attitude, was developed and tested by survey research. The present study extended the earlier work by investigating the joint relationship of belief and behavior to attitude. Both belief and behavior indices were found to correlate significantly with attitude. Further, the multiple correlation, with attitude as the dependent variable, was significantly stronger than either first-order relationship. This research has implications for specific attitude-belief and attitude-behavior consistencies and for attempts to understand unimpressive relations between behavior and attitude.     

Therapy Expectations of Adolescents with Depression Entering Psychodynamic Psychotherapy: A Qualitative Study

Patient expectations about therapy have been regarded as a common factor affecting the course and outcome of psychotherapy. However, little is known about the expectations of adolescents. We aimed to explore the therapy expectations of young people (YP) with depression prior to psychotherapy. We conducted semi-structured interviews with six YP (5 female, 15–19 years old) entering psychodynamic outpatient treatment. Interviews were transcribed verbatim and analyzed using Interpretative Phenomenological Analysis. The careful analysis of the YPs’ accounts yielded the following four key themes: not knowing but being cautiously hopeful; therapy as a long and difficult process; therapy as a place to understand oneself and to develop; and the importance of the professional and interpersonal skills of the therapist. The findings suggest to foster realistic treatment and outcome expectations while at the same time individual therapists should pay careful attention to the specific expectations that YP bring into therapy.     

Genetic Testing and Post-Testing Decision Making among <Emphasis Type="Italic">BRCA</Emphasis>-Positive Mutation Women: A Psychosocial Approach

Through an analysis of an online survey of women who tested positive for the BRCA genetic mutation for breast cancer, this research uses a social constructionist and feminist standpoint lens to understand the decision-making process that leads BRCA-positive women to choose genetic testing. Additionally, this research examines how they socially construct and understand their risk for developing breast cancer, as well as which treatment options they undergo post-testing. BRCA-positive women re-frame their statistical medical risk for developing cancer and their post-testing treatment choices through a broad psychosocial context of engagement that also includes their social networks. Important psychosocial factors drive women’s medical decisions, such as individual feelings of guilt and vulnerability, and the degree of perceived social support. Women who felt guilty and fearful that they might pass the BRCA gene to their children were more likely to undergo risk reducing surgery. Women with at least one daughter and women without children were more inclined toward the risk reducing surgery compared to those with only sons. These psychosocial factors and social network engagements serve as a “nexus of decision making” that does not, for the most part, mirror the medical assessments of statistical odds for hereditary cancer development, nor the specific treatment protocols outlined by the medical establishment.     

The Role of Emotion in Decision Making: A Cognitive Neuroscience Perspective

ABSTRACT— Decision making often occurs in the face of uncertainty about whether one's choices will lead to benefit or harm. The somatic-marker hypothesis is a neurobiological theory of how decisions are made in the face of uncertain outcome. This theory holds that such decisions are aided by emotions, in the form of bodily states, that are elicited during the deliberation of future consequences and that mark different options for behavior as being advantageous or disadvantageous. This process involves an interplay between neural systems that elicit emotional/bodily states and neural systems that map these emotional/bodily states.     

Feminism and Psychological Autonomy: A Study in Decision Making

Women seeking to realize the feminist goal of autonomy, defined as self-interested decision making, encounter conflict and anxiety. This study reports a group experience that used life-space drawings and force-field analyses to reduce anxiety and foster autonomous decision making. The 15 women participants in the yearlong study reported at least one action in the area originally designated for decision making. Among the components in the process, participants cited identification with, and support and information from, other group members. The results suggest that for the women in this study, group participation enhanced individual autonomy. Autonomy for me is believing in my own ability to do what I want to do, … then taking productive, creative steps toward fulfilling my own goals. … Autonomy for me is a personal thing, an internal thing, feeling that I have power.*     

Knowledge and Expectations of Women Undergoing Cancer Genetic Risk Assessment: A Qualitative Analysis of Free-Text Questionnaire Comments

Individuals undergoing cancer genetic risk assessment have been found to have a poor understanding of the process, which may affect how well they cope with learning their risk. This paper reports free-text data from questionnaires completed by women undergoing a randomised controlled trial of a psychological intervention. Of the 268 women undergoing genetic assessment for familial breast/ovarian cancer risk who were invited to take part in the trial, 157 women returned research questionnaires. Of these, 97 women provided free-text comments upon referral to a cancer genetics clinic, 62 provided comments whilst waiting for risk information (average, moderate or high), and 36 women provided comments following notification of risk. This paper reports a thematic analysis of the free-text data. Themes reflected individuals’ poor knowledge and uncertainty about genetic risk assessment. How well individuals responded to learning their risk depended upon whether expectations had been met. Regardless of risk, individuals undergoing cancer genetic risk assessment are likely to benefit from increased information about its process and timescales, and access to increased psychological support. Free-text comments can provide valuable data about individuals’ expectations and knowledge of genetics services.     

Nutrition and Decision Making in the Elderly People: A Preliminary Study

This study aimed to identify what influences food acceptance and decision making in the elderly following the work of Sulmont Rossé (Gérontologie et Société 3: 134 2010). Sixty participants, divided between an elderly and an older elderly group, were presented with a number of specific scenarios depicting an item of food, and they were asked to indicate how willing they would be to consume this food. The scenarios were created by varying three factors likely to impact on people’s acceptance of a specific food item: (a) The visual appearance of the food, (b) the taste of the food and (c) the texture of the food. The results mean that all participants agreed that a visual aspect and texture were the most important factors in decision making. The elderly people consider the visual aspect and texture of the food are more important than people aged between 60 and 74 years old. In view of the clarity and the diversity of these findings, this technique involving specific scenarios appears suitable for use in a larger sample.     

Predictors of Diabetes Fatalism Among Arabs: A Cross-Sectional Study of Lebanese Adults with Type 2 Diabetes

Fatalism is a grounded cultural belief that is common among Arabs and is known to hinder self-care in chronic diseases including diabetes (Nabolsi and Carson in Scand J Caring Sci 25(4):716–724, 2011). The purpose of this study is to identify predictors of diabetes fatalism in this population. Data on 280 Lebanese patients with type 2 diabetes (mean age 58.24 ± 13.48 years; mean HbA1c 7.90 ± 1.90%; 53.76% females) recruited from one hospital in greater Beirut, Lebanon, and from the community using snowballing technique were examined. Multiple linear regression was used to assess the independent association between diabetes fatalism and demographic and patient characteristics. Age (β = ?.14, 95% CI ?.27, ?.002), BMI (β = .35, 95% CI .15; .54), level of education (β = ?3.98, 95% CI ?7.64; ?.32) and number of diabetes problems (β = ?5.03, 95% CI ?9.89; ?.18) were significantly associated with diabetes fatalism in the regression model. The combination of demographic and patient characteristics accounted for 14.5% of the variance in diabetes fatalism scores’ change. Patients with type 2 diabetes who exhibited more fatalistic attitudes were younger, of lower education levels, had higher BMI and had fewer diabetes comorbidities. Such findings are crucial for healthcare practitioners to identify fatalistic patients and to tailor culturally appropriate strategies in diabetes management. Further studies are warranted to explore other potential determinants of diabetes fatalism with larger sample and non-Lebanese Arabic population.     

Genetic Counseling as a Tool for Type 2 Diabetes Prevention: A Genetic Counseling Framework for Common Polygenetic Disorders

Advances in genetic epidemiology have increased understanding of common, polygenic preventable diseases such as type 2 diabetes. As genetic risk testing based on this knowledge moves into clinical practice, we propose that genetic counselors will need to expand their roles and adapt traditional counseling techniques for this new patient set. In this paper, we present a genetic counseling intervention developed for a clinical trial [Genetic Counseling/Lifestyle Change for Diabetes Prevention, ClinicalTrials.gov identifier: NCT01034319] designed to motivate behavioral changes for diabetes prevention. Seventy-two phenotypically high-risk participants received counseling that included their diabetes genetic risk score, general education about diabetes risk factors, and encouragement to participate in a diabetes prevention program. Using two validated genetic counseling scales, participants reported favorable perceived control and satisfaction with the counseling session. Our intervention represents one model for applying traditional genetic counseling principles to risk testing for polygenetic, preventable diseases, such as type 2 diabetes.     

Deliberation Versus Intuition: Decomposing the Role of Expertise in Judgment and Decision Making

What produces better judgments: deliberating or relying on intuition? Past research is inconclusive. We focus on the role of expertise to increase understanding of the effects of judgment mode. We propose a framework in which expertise depends on a person's experience with and knowledge about a domain. Individuals who are relatively experienced but have modest knowledge about the subject matter (“intermediates”) are expected to suffer from deliberation and to benefit from a more intuitive approach, because they lack the formal knowledge to understand the reasons underlying their preferences. Individuals who are high (“experts”) or low (“novices”) on both experience and knowledge are expected to do well or poorly, respectively, regardless of decision mode. We tested these predictions in the domain of art. Experiments 1 and 2 showed that intermediates performed better when relying on intuition than after deliberation. Judgments of experts and novices were unaffected. In line with previous research relating processing style to judgment mode, Experiment 3 showed that the effect of processing style (global versus local) on judgment quality is similarly moderated by expertise. Copyright © 2012 John Wiley & Sons, Ltd.     

A Heuristic Framework for Understanding the Role of Participatory Decision Making in Community-Based Non-Profits

This paper explores the role of member participation in decision-making (PDM) from an organizational learning (OL) perspective. Community-based organizations (CBOs) serve as mediators between the individual and the local community, often providing the means for community member participation and benefiting organizationally from members' input. Community psychologists have recognized these benefits; however, the field has paid less attention to the role participation plays in increasing CBOs' capacity to meet community needs. We present a framework for exploring how CBO contextual factors influence the use of participatory decision-making structures and practices, and how these affect OL. We then use the framework to examine PDM in qualitative case study analysis of four CBOs: a youth development organization, a faith-based social action coalition, a low-income neighborhood organization, and a large human service agency. We found that organizational form, energy, and culture each had a differential impact on participation in decision making within CBOs. We highlight how OL is constrained in CBOs and document how civic aims and voluntary membership enhanced participation and learning.     

The Meaning and Role of Spirituality for Older Adults: A Qualitative Study

Journal of Religion and Health - This study is designed to identify the meaning and effects perceived by a person concerning religion and spirituality as that person grows old. A total of nineteen...     

Knowledge and Attitudes Towards Genetic Testing: A Two Year Follow-Up Study in Patients with Asthma,Diabetes Mellitus and Cardiovascular Disease

Adequate knowledge and personal attitudes towards DNA-testing are major determinants of optimal utilization of genetic testing. This study aims to (1) assess the genetic knowledge and attitude towards genetic testing of patients with asthma, diabetes mellitus type II and cardiovascular diseases, (2) determine whether their knowledge or attitude changed since 2002, and (3) investigate the predictive role of knowledge on attitude. Data were collected within the Panel of Patients with Chronic Diseases in 2002 and 2004, resulting in 398 data-pairs. Results show that factual knowledge mainly relates to associations between genes and diseases, less is known on associations between genes, chromosomes, cells and body. The perceived knowledge on DNA-testing has not increased since 2002. The attitude towards genetic testing also appeared to be rather consistent. Less perceived medical genetic knowledge and more perceived social genetic knowledge were found predictive for a more reserved attitude towards genetic testing. In conclusion, advanced developments in the field of genetics are not accompanied by increased knowledge of patients with common multi-factorial diseases. The finding that more perceived social genetic knowledge results in more reluctance can be considered an indicator for the necessity of social debates on genetic testing.     

The Effect of Genetic Counseling for Adult Offspring of Patients with Type 2 Diabetes on Attitudes Toward Diabetes and its Heredity: A Randomized Controlled Trial

The aim of this study is to investigate the effect of diabetes genetic counseling on attitudes toward diabetes and its heredity in relatives of type 2 diabetes patients. This study was an unmasked, randomized controlled trial at a medical check-up center in Japan. Subjects in this study are healthy adults between 30 and 60 years of age who have a family history of type 2 diabetes in their first degree relatives. Participants in the intervention group received a brief genetic counseling session for approximately 10 min. Genetic counseling was structured based on the Health Belief Model. Both intervention and control groups received a booklet for general diabetes prevention. Risk perception and recognition of diabetes, and attitude towards its prevention were measured at baseline, 1 week and 1 year after genetic counseling. Participants who received genetic counseling showed significantly higher recognition about their sense of control over diabetes onset than control group both at 1 week and 1 year after the session. On the other hand, anxiety about diabetes did not change significantly. The findings show that genetic counseling for diabetes at a medical check center helped adults with diabetes family history understand they are able to exert control over the onset of their disease through lifestyle modification.     

Ethical Decision Making in the Conduct of Research: Role of Individual, Contextual and Organizational Factors

Despite the importance of scientific integrity to the well-being of society, recent findings suggest that training and mentoring in the responsible conduct of research are not very reliable or effective inhibitors of research misbehavior. Understanding how and why individual scientists decide to behave in ways that conform to or violate norms and standards of research is essential to the development of more effective training programs and the creation of more supportive environments. Scholars in business management, psychology, and other disciplines have identified many important factors that affect ethical behavior, including individual, contextual, and organizational factors. Surprisingly little research has been conducted to examine the role of these factors in either the development of ethical decision-making skills, or their applicability to ethical issues commonly encountered in research and other scholarly and professional activities. Interdisciplinary approaches combined with research and discipline relevant paradigms should greatly enhance understanding of the individual contextual and organizational factors involved in ethical and unethical research conduct. Such studies will inform and facilitate the development of more effective ethics education programs in the sciences and engineering professions.     

Preparing the Way: A Qualitative Study of High-Achieving African American Males and the Role of the Family

Employed qualitative methods to examine the role of the family in the academic success of very high-achieving African American males. Findings revealed a complex tapestry of family processes and contexts involved in each youth's journey to outstanding academic achievement. Specifically, the combined importance of parental-determined academic engagement, strict discipline, nurturance, and community connectedness appeared to counteract potentially negative contextual influences of neighborhood, peers, schools, and society. The qualitative findings tell a multifaceted, rich, and compelling story of the pathways to academic success for Black males, and highlight the need for culture-specific and ecologically based conceptualization, research, and intervention approaches.     

Dimensions of Moral Intensity and Ethical Decision Making: An Empirical Study

Moral intensity is a construct that relates to issues in terms of their perceived moral significance. Individuals' perceptions of moral intensity should impact their recognition of issues as posing moral dilemmas and should also affect ethical judgments and behavioral intentions regarding issues. This study examined the relationship between 4 dimensions of moral intensity and the ethical decision-making process. Two work-related actions were presented to respondents, who then completed measures of the 4 dimensions of moral intensity, whether the actions posed an ethical issue, ethical judgments regarding the actions, and the likelihood that they would engage in the actions. Results indicate that moral intensity dimensions were associated with individuals' ethical decisions. Social consensus and seriousness of consequences were particularly important influences on the ethical decision-making process.     

Teaching About Genetic Testing Issues in the Undergraduate Classroom: A Case Study

Educating undergraduates about current genetic testing and genomics can involve novel and creative teaching practices. The higher education literature describes numerous pedagogical approaches in the laboratory designed to engage science and liberal arts students. Often these experiences involve students analyzing their own genes for various polymorphisms, some of which are associated with disease states such as an increased risk for developing cancer. While the literature acknowledges possible ethical ramifications of such laboratory exercises, authors do not present recommendations or rubrics for evaluating whether or not the testing is, in fact, ethical. In response, we developed a laboratory investigation and discussion which allowed undergraduate science students to explore current DNA manipulation techniques to isolate their p53 gene, followed by a dialogue probing the ethical implications of examining their sample for various polymorphisms. Students never conducted genotyping on their samples because of ethical concerns, so the discussion served to replace actual genetic testing in the class. A basic scientist led the laboratory portion of the assignment. A genetic counselor facilitated the discussion, which centered around existing ethical guidelines for clinical genetic testing and possible challenges of human genotyping outside the medical setting. In their final papers, students demonstrated an understanding of the practice guidelines established by the genetics community and acknowledged the ethical considerations inherent in p53 genotyping. Given the burgeoning market for personalized medicine, teaching undergraduates about the psychosocial and ethical dimensions of human gene testing seems important and timely, and introduces an additional role genetic counselors can play in educating consumers about genomics.