Three Clinical Experiences with SNP Array Results Consistent with Parental Incest: A Narrative with Lessons Learned

Single nucleotide polymorphism microarrays have the ability to reveal parental consanguinity which may or may not be known to healthcare providers. Consanguinity can have significant implications for the health of patients and for individual and family psychosocial well-being. These results often present ethical and legal dilemmas that can have important ramifications. Unexpected consanguinity can be confounding to healthcare professionals who may be unprepared to handle these results or to communicate them to families or other appropriate representatives. There are few published accounts of experiences with consanguinity and SNP arrays. In this paper we discuss three cases where molecular evidence of parental incest was identified by SNP microarray. We hope to further highlight consanguinity as a potential incidental finding, how the cases were handled by the clinical team, and what resources were found to be most helpful. This paper aims to contribute further to professional discourse on incidental findings with genomic technology and how they were addressed clinically. These experiences may provide some guidance on how others can prepare for these findings and help improve practice. As genetic and genomic testing is utilized more by non-genetics providers, we also hope to inform about the importance of engaging with geneticists and genetic counselors when addressing these findings.     

An exploratory study of the effects of emotionally toned incidental stimuli1

The present study examined the effects of emotionally toned (angry or pleasant) incidental stimuli upon fantasy production Subjects told more aggressive TAT stories when highly aggressive passages from a play were audible from the next room (at a volume and fidelity which made it difficult to follow the verbal message) than they did when no such stimulus was playing No increase in aggression was noted in the presence of a pleasantly toned stimulus Individual differences in responsiveness to the incidental stimulus were related to other measures of influence by incidental stimuli, and little individual consistency was evident It was suggested that the concept of a general trait of responsiveness to incidental stimulation may be too global, and that consistencies may be limited to particular response modes, types of stimuli, and orientations to the situation.     

A branch-and-bound algorithm for fitting anti-robinson structures to symmetric dissimilarity matrices

The seriation of proximity matrices is an important problem in combinatorial data analysis and can be conducted using a variety of objective criteria. Some of the most popular criteria for evaluating an ordering of objects are based on (anti-) Robinson forms, which reflect the pattern of elements within each row and/or column of the reordered matrix when moving away from the main diagonal. This paper presents a branch-and-bound algorithm that can be used to seriate a symmetric dissimilarity matrix by identifying a reordering of rows and columns of the matrix optimizing an anti-Robinson criterion. Computational results are provided for several proximity matrices from the literature using four different anti-Robinson criteria. The results suggest that with respect to computational efficiency, the branch-and-bound algorithm is generally competitive with dynamic programming. Further, because it requires much less storage than dynamic programming, the branch-and-bound algorithm can provide guaranteed optimal solutions for matrices that are too large for dynamic programming implementations.     

Incidental learning of real-world regularities

The large literature on incidental learning relies almost exclusively on laboratory experiments. Whenever researchers have attempted to demonstrate incidental learning of real-world regularities, they have typically failed to show learning. For example, it is well established that people do not learn regularities in everyday objects, such as the left-right orientation of faces on coins, despite a very large exposure to them. In this report, we examine this apparent contradiction. We argue that most studies exploring real-life incidental learning use tests that are not as sensitive to low-confidence information as those traditionally used in laboratory tasks. Using more sensitive measures, we show that it is possible to learn regularities from British and Japanese cultural life as a direct result of exposure to these regularities. Further, confidence measures suggest that although the information may be acquired incidentally, it can be expressed with and without concomitant awareness of that knowledge.     

颅内脂肪瘤的诊断与治疗

为了分析和讨论颅内脂肪瘤的诊断和治疗,我们回顾性分析23例颅内脂肪瘤患者的临床特点、影像学资料,对17例有症状的患者行手术治疗,6例无相关症状患者行CT或MRI随访。结果显示,17例手术患者中,除1例较术前症状加重外,余16例症状缓解或明显改善。6例无症状患者随访1年～6年,CT或MRI显示脂肪瘤无明显增大。因此,无相关症状患者可行CT或MRI随访;有明显的神经表现者可行手术治疗,手术目的是充分的神经结构减压,部分切除及减压术可实现长期的症状缓解。     

Data-driven sequence learning or search: What are the prerequisites for the generation of explicit sequence knowledge?

In incidental sequence learning situations, there is often a number of participants who can report the task-inherent sequential regularity after training. Two kinds of mechanisms for the generation of this explicit knowledge have been proposed in the literature. First, a sequence representation may become explicit when its strength reaches a certain level (Cleeremans, 2006), and secondly, explicit knowledge may emerge as the result of a search process that is triggered by unexpected events that occur during task processing and require an explanation (the unexpected-event hypothesis; Haider & Frensch, 2009). Our study aimed at systematically exploring the contribution of both mechanisms to the generation of explicit sequence knowledge in an incidental learning situation. We varied the amount of specific sequence training and inserted unexpected events into a 6-choice serial reaction time task. Results support the unexpected-event view, as the generation of explicit sequence knowledge could not be predicted by the representation strength acquired through implicit sequence learning. Rather sequence detection turned out to be more likely when participants were shifted to the fixed repeating sequence after training than when practicing one and the same fixed sequence without interruption. The behavioral effects of representation strength appear to be related to the effectiveness of unexpected changes in performance as triggers of a controlled search.     

A Qualitative Study of Healthcare Providers’ Perspectives on the Implications of Genome-Wide Testing in Pediatric Clinical Practice

The utilization of genome-wide chromosomal microarray analysis (CMA) in pediatric clinical practice provides an opportunity to consider how genetic diagnostics is evolving, and to prepare for the clinical integration of genome-wide sequencing technologies. We conducted semi-structured interviews with 15 healthcare providers (7 genetic counselors, 4 medical geneticists, and 4 non-genetics providers) to investigate the impact of CMA on clinical practice, and implications for providers, patients and families. Interviews were analyzed qualitatively using content analysis. Most providers reported that genomic testing enhanced their professional experience and was beneficial to patients, primarily due to the improved diagnostic rate compared with earlier chromosomal studies. Other effects on practice included moving towards genotype-first diagnosis and broadening indications for chromosomal testing. Opinions varied concerning informed consent and disclosure of results. The duty to disclose incidental findings (IFs) was noted; however concerns were raised about potential psychosocial harms of disclosing pre-symptomatic findings. Tensions were revealed between the need for comprehensive informed consent for all families and the challenges of communicating time-consuming and potentially anxiety-provoking information regarding uncertain and incidental findings that may be relevant only in rare cases. Genetic counselors can play an important role in liaising with families, health professionals and testing laboratories, providing education and guidance to non-genetics providers, and enabling families to receive adequate pre-and post-test information and follow-up care.     

记忆加工策略对ECM的影响

该研究采用ECM实验范式,操纵记忆加工策略验证联想网络模型或情绪渗透模型。电影片段诱发被试高兴或悲伤的情绪状态后,被试在有意识记和无意识记加工策略下学习情绪词,然后进行自由回忆。结果：情绪电影片段成功诱发被试高兴或悲伤情绪;被试在采用无意识记和有意识记加工策略学习情绪词时均出现ECM,无意识记加工策略下效应量的大小显著高于有意识记加工策略下效应量的大小,实验结果支持情绪渗透模型。     

Directed forgetting in incidental learning and recognition testing: support for a two-factor account

Instructing people to forget a list of items often leads to better recall of subsequently studied lists (known as the benefits of directed forgetting). The authors have proposed that changes in study strategy are a central cause of the benefits (L. Sahakyan & P. F. Delaney, 2003). The authors address 2 results from the literature that are inconsistent with their strategy-based explanation: (a) the presence of benefits under incidental learning conditions and (b) the absence of benefits in recognition testing. Experiment 1 showed that incidental learning attenuated the benefits compared with intentional learning, as expected if a change of study strategy causes the benefits. Experiment 2 demonstrated benefits using recognition testing, albeit only when longer lists were used. Memory for source in directed forgetting was also explored using multinomial modeling. Results are discussed in terms of a 2-factor account of directed forgetting.     

Reducing the saliency of intentional stimuli results in greater contextual-dependent performance

Wright and Shea (1991) described intentional stimuli as explicitly identified information necessary to successfully perform a task, whereas incidental stimuli are not explicitly identified as crucial to task performance but have the potential to become associated with particular responses because of their selective presence in the training environment. Shea and Wright (1995), using a speeded-choice RT task, indicated that manipulating the strength of association between incidental information and the responses, by changing the discriminability of incidental stimuli while fixing the strength of the association between the intentional stimuli and each response, had a significant impact on task performance. The present experiment further examined the role played by incidental stimuli when the strength of association between the intentional stimuli and the associated responses was reduced, by minimising stimulus-response compatibility. It was assumed that this latter manipulation would have a similar impact as increasing the strength of incidental stimuli-response relationships. That is, the relative contribution of the incidental stimuli would increase, resulting in an increase in context-dependent behaviour during tests in which the intentional and incidental stimuli activated different responses. The results were in agreement with this prediction and consistent with a model for contextual-dependent performance proposed by Shea and Wright (1995) as well as with the outshining hypothesis forwarded by Smith (1988, 1994).     

Technology-Assisted Psychotherapy (TAP): Adapting Computerized Treatments into Traditional Psychotherapy for Depression

Technology may be changing the process of psychotherapy. Unfortunately, some therapists lack the computer skills or financial resources needed for the newest technology. The literature is reviewed for journal articles on the treatment of depression published during the past 7 years in which treatments have been guided by technology. Six findings are summarized that may be helpful when therapists lack skills or resources for advanced technology. (1) The assessment of depression can be facilitated by technology, whether using standardized questionnaires or simple ratings of mood submitted each day. (2) Technology tools can be used to send daily reminders to help clients develop more adaptive habits in thoughts or actions. (3) Clients can confront their problems through therapeutic dialogue, whether conducted in person, over the telephone, or via videoconference. (4) Depressed clients can confront their negative attitudes, often triggered by some form of loss, failure, or rejection, whether real, imagined, or anticipated. (5) Clients can use writing assignments to identify, label, explore and express their thoughts and feelings. These writing assignments can be conducted via email, or internet forms. (6) Clients value rapport with a therapist, and this bond seems important to ensure participation and adherence with treatment. Therapists can strengthen the treatment of depression using basic technology tools to extend, or supplement traditional sessions. However, it is important to protect the rapport needed for sustained participation in psychotherapy sessions.     

Neuropsychological Findings in Congenital and Acquired Childhood Hydrocephalus

Hydrocephalus is an increase in cerebrospinal fluid volume that can be caused by a variety of etiologies. The most common connatal and acquired causes of hydrocephalus are spina bifida, aqueduct stenosis, and preterm low birthweight infants with ventricular hemorrhage. In general, the literature suggests mild neuropsychological deficits associated with hydrocephalus, which are predominant in visuospatial and motor functions, and other nonlanguage skills. Although the precise nature of the neuropsychological deficits in hydrocephalus are not completely known, several factors such as etiology, raised intracranial pressure, ventricular size, and changes in gray and white matter tissue composition as well as shunt treatment complications have been shown to influence cognition. In fact, the presence of complications and other brain abnormalities in addition to hydrocephalus such as infections, trauma, intraventricular hemorrhage, low birthweight, and asphyxia are important determinants of the ultimate cognitive status, placing the child at a high risk of cognitive impairment.     

The effects of ordinal load on incidental temporal learning

How can we grasp the temporal structure of events? A few studies have indicated that representations of temporal structure are acquired when there is an intention to learn, but not when learning is incidental. Response-to-stimulus intervals, uncorrelated temporal structures, unpredictable ordinal information, and lack of metrical organization have been pointed out as key obstacles to incidental temporal learning, but the literature includes piecemeal demonstrations of learning under all these circumstances. We suggest that the unacknowledged effects of ordinal load may help reconcile these conflicting findings, ordinal load referring to the cost of identifying the sequence of events (e.g., tones, locations) where a temporal pattern is embedded. In a first experiment, we manipulated ordinal load into simple and complex levels. Participants learned ordinal-simple sequences, despite their uncorrelated temporal structure and lack of metrical organization. They did not learn ordinal-complex sequences, even though there were no response-to-stimulus intervals nor unpredictable ordinal information. In a second experiment, we probed learning of ordinal-complex sequences with strong metrical organization, and again there was no learning. We conclude that ordinal load is a key obstacle to incidental temporal learning. Further analyses showed that the effect of ordinal load is to mask the expression of temporal knowledge, rather than to prevent learning.     

Chronisches Ersch?pfungssyndrom

The treatment of chronic fatigue syndrome (CFS) may pose a challenge as controversial concepts of its aetiology are discussed. Psychotherapy and graded exercise therapy have been suggested for the treatment of CFS. The aim of the present literature review is to summarize the evidence for these treatments based on two meta-analyses and more recently published randomized controlled trials. There is robust evidence for the efficacy of cognitive-behavioural therapy for CFS, showing moderate effects especially on fatigue severity and physical functioning at post-treatment and at short to medium term follow-up. Other psychological treatments have mainly been tested as control conditions and not as bona fide psychotherapy; however, single trials suggest benefits of non-directive counselling and psycho-education. To further improve treatment results and their maintenance, relapse prevention strategies are important and a stronger empirical foundation of long-term effects is needed.     

Cognitive Behavioral Therapy for Chronic Pain: Strategies for the Successful Use of Homework Assignments

Presents an overview of the research findings to date, and practical guidelines for the use of homework in psychosocial treatments for patients with chronic pain. Generally, psychosocial treatments incorporating homework assignments help patients to improve more than when treatment is comprised entirely of in-session work. The article outlines common obstacles experienced when using homework with pain patients and strategies to combat these obstacles. The types of homework assignments that may be most helpful, as well as interventions that can be used to promote homework compliance and successful treatment outcome are discussed.     

Gratitude and prosocial behavior: helping when it costs you

The ability of the emotion gratitude to shape costly prosocial behavior was examined in three studies employing interpersonal emotion inductions and requests for assistance. Study 1 demonstrated that gratitude increases efforts to assist a benefactor even when such efforts are costly (i.e., hedonically negative), and that this increase differs from the effects of a general positive affective state. Additionally, mediational analyses revealed that gratitude, as opposed to simple awareness of reciprocity norms, drove helping behavior. Furthering the theory that gratitude mediates prosocial behavior, Study 2 replicated the findings of Study 1 and demonstrated gratitude's ability to function as an incidental emotion by showing it can increase assistance provided to strangers. Study 3 revealed that this incidental effect dissipates if one is made aware of the true cause of the emotional state. Implications of these findings for the role of gratitude in building relationships are discussed.     

Withstanding the test of time: Multisensory cues improve the delayed retention of incidental learning

Multisensory tools are commonly employed within educational settings (e.g. Carter & Stephenson, 2012 ), and there is a growing body of literature advocating the benefits of presenting children with multisensory information over unisensory cues for learning (Baker & Jordan, 2015 ; Jordan & Baker, 2011 ). This is even the case when the informative cues are only arbitrarily related (Broadbent, White, Mareschal, & Kirkham, 2017 ). However, the delayed retention of learning following exposure to multisensory compared to unisensory cues has not been evaluated, and has important implications for the utility of multisensory educational tools. This study examined the retention of incidental categorical learning in 5‐, 7‐ and 9‐year‐olds (N = 181) using either unisensory or multisensory cues. Results found significantly greater retention of learning following multisensory cue exposure than with unisensory information when category knowledge was tested following a 24‐hour period of delay. No age‐related changes were found, suggesting that multisensory information can facilitate the retention of learning across this age range.     

Photo-synthesis: Facilitating Goal Setting in Supervision Using Images and Creativity

ABSTRACT

One of the most important aspects of clinical supervision is goal-setting. In the early stages of supervision, supervisees may find it difficult to connect authentically with their supervisors due to the inherent power differential in supervision. Difficulty connecting may be exacerbated when students are attempting to set goals regarding their areas for growth. Based on literature reviewed on the counselor-client relationship, the authors posit that using images may increase vulnerability between supervisors and supervisees. Additionally, the authors introduce relational-cultural theory as a framework for connecting authentically through creative images. The authors present examples of using images in individual and group supervision, specifically employing The Coaching Game made by Points of You.     

Motivational Interviewing as an Adjunct to Cognitive Behavior Therapy for Anxiety Disorders: A Critical Review of the Literature

Cognitive behavior therapy (CBT) is efficaciously and effectively used in the treatment of anxiety disorders; however, as CBT for anxiety routinely utilizes exposure components, clients often experience ambivalence about treatment and their clinicians often must deal with resistance. Motivational Interviewing (MI) is a therapeutic strategy that addresses ambivalence about change in clinical interventions. MI has been applied as an adjunct for treatments such as CBT in order to increase motivation for and commitment to the intervention, especially when components of the treatment may be challenging (e.g., exposure, cognitive restructuring). Though researchers have commented specifically on the use of MI as a supplement to CBT for anxiety disorders, no comprehensive review has systematically assessed the strengths and limitations of extant literature on the topic, nor across anxiety disorders. Findings are summarized from 6 case studies and uncontrolled trials and 11 randomized controlled trials published through March 2016. An integrated critique of this literature also is offered. Limitations and the preliminary nature of the work in this area notwithstanding, it appears that it is feasible to supplement or integrate CBT with MI and that doing so has the potential to improve treatment initiation and engagement, as well as clinical outcomes. A number of directions for future research are addressed, such as determining which MI approaches to implement, with whom, when, and in what contexts.     

When does feeling of fluency matter?: how abstract and concrete thinking influence fluency effects

It has been widely documented that fluency (ease of information processing) increases positive evaluation. We proposed and demonstrated in three studies that this was not the case when people construed objects abstractly rather than concretely. Specifically, we found that priming people to think abstractly mitigated the effect of fluency on subsequent evaluative judgments (Studies 1 and 2). However, when feelings such as fluency were understood to be signals of value, fluency increased liking in people primed to think abstractly (Study 3). These results suggest that abstract thinking helps distinguish central decision inputs from less important incidental inputs, whereas concrete thinking does not make such a distinction. Thus, abstract thinking can augment or attenuate fluency effects, depending on whether fluency is considered important or incidental information, respectively.