Action‐semantic and syntactic deficits in subjects at risk for Huntington's disease

Frontostriatal networks play critical roles in grounding action semantics and syntactic skills. Indeed, their atrophy distinctively disrupts both domains, as observed in patients with Huntington's disease (HD) and Parkinson's disease, even during early disease stages. However, frontostriatal degeneration in these conditions may begin up to 15 years before the onset of clinical symptoms, opening avenues for pre‐clinical detection via sensitive tasks. Such a mission is particularly critical in HD, given that patients’ children have 50% chances of inheriting the disease. Against this background, we assessed whether deficits in the above‐mentioned domains emerge in subjects at risk to develop HD. We administered tasks tapping action semantics, object semantics, and two forms of syntactic processing to 18 patients with HD, 19 asymptomatic first‐degree relatives, and sociodemographically matched controls for each group. The patients evinced significant deficits in all tasks, but only those in the two target domains were independent of overall cognitive state. More crucially, relative to controls, the asymptomatic relatives were selectively impaired in action semantics and in the more complex syntactic task, with both patterns emerging irrespective of the subjects’ overall cognitive state. Our findings highlight the relevance of these dysfunctions as potential prodromal biomarkers of HD. Moreover, they offer theoretical insights into the differential contributions of frontostriatal hubs to both domains while paving the way for innovations in diagnostic procedures.     

Offering predictive testing for Huntington disease in a medical genetics clinic: Practical applications

Predictive testing for Huntington disease is presently offered in a select few medical genetics centers in the United States. This is in part due to the labor intensive counseling and psychological testing suggested by the research protocols. We discuss some specific suggestions for establishing programs for Huntington disease predictive testing within pre-existing medical genetics clinics to encourage more centers to offer presymptomatic testing. This will allow more at risk individuals the opportunity to consider predictive testing and cut down the expenses of traveling to the few predictive testing centers that currently exist. The counseling principals will remain similar to those discussed here, even following the identification of the Huntington disease mutation.     

Autonomous buses: Intentions to use,passenger experiences,and suggestions for improvement

Research on the use of autonomous vehicles as a mode of public transport in a city context is lacking. This paper focuses on the use of recently established autonomous buses (self-driving electric shuttle buses) running along a regular public transport line in a residential area of Oslo, Norway. We use a mixed-methods approach based on survey and interview data from two independent studies. The paper examines intentions to use autonomous buses before and after these were introduced in the case area as well as how passengers experience traveling by autonomous bus. Results show that the intention to use the autonomous buses was mostly positive both before and after using them. Most users felt safe while traveling by autonomous bus. Two suggestions for improvement made by the users were to: increase the speed and reduce the abrupt breaking of the autonomous buses. Overall, outcomes from this paper suggest that residents would be willing to use autonomous buses if these offer more frequent bus departures than the existing ones. However, as full automation has not been achieved yet and there is a host on board who can control the vehicle if necessary, passenger experiences and intentions to use should be reassessed with fully automated buses in future studies.     

Nonlinear judgment analysis: Comparing policy use by those who draft and those who coach

ObjectivesIn the NBA draft, talent potential is assessed by a group of evaluators (e.g., coaches, personnel directors, general managers) who determine the order in which players are drafted, and talent actualization is assessed by a second group of evaluators (coaches) who determine how much time players spend on the court. This study examines the cue use by these two groups and considers the utility of a nonlinear assessment technique.MethodThe implicit policies used by talent evaluators were examined using both linear regression and nonlinear backpropagation.ResultsAlthough both groups heavily value scoring, discrepancies were observed among the other characteristics. The use of a nonlinear technique produced better cross-validated fits than linear regression, but the rank ordering of cue importance produced by both models was generally similar.ConclusionsPlayers favored by draft personnel primarily become scorers whereas coaches value a wider range of skills. The nonlinear approach better captured the policies of groups of evaluators and should be used to assess potential incongruities among judges of talent.     

The effects of 'non-directive' questioning on an anticipated decision whether to undergo predictive testing for heart disease: an experimental study

This study investigates how individuals can be helped to make decisions about predictive genetic testing. Participants (n = 120) rated how likely they would be to opt for predictive testing for heart disease if it were available, and other variables such as anxiety about heart disease. They received information on predictive testing for heart disease and ratings were repeated. Participants were then randomly allocated to one of three groups and focused on the personal relevance of positive issues or negative issues which had been mentioned as part of the standardised information previously given. The third group focused on issues irrelevant to testing for heart disease. The form of questioning used in this focusing manipulation was intended to model the processes involved in non-directive questioning. Results showed a significant increase in likelihood of testing in the positive group, and a significant decrease in the negative group. There was also a significant decrease in rated anxiety about heart disease and perceived severity of an increased susceptibility to heart disease of the negative group relative to the positive and control groups. The results may have implications for the ways in which pre-test counselling is carried out.     

Understanding responses to predictive genetic testing: A grounded theory approach

Abstract

In view of the absence of data concerning the understanding and experience of families in which one or more members have undergone predictive genetic testing, a pilot study using a qualitative methodology was conducted with members of families at risk for the late-onset genetic disease, familial adenomatous polyposis (FAP). Semistructured interviews were conducted to elicit illness representations, with responses tape-recorded and analysed using a grounded theory approach. Several themes emerged. The most striking was that when genetic testing indicated an extremely low risk of developing the disease, there was a desire to continue regular bowel screening, even though it was experienced as extremely aversive. Possible explanations draw upon both other themes of the interviews, and psychological models. The role of “functional pessimism” and “uncertain wellness” in maintaining a high threat from the disease, and the role of reinforcement and the nature of tests in providing bowel screening with a high value are discussed.     

How the Powerful Decide: Access to Research Participation by those at the Margins

How do those in power decide to include and exclude those at the margins from community life? We used simulated review of research vignettes to examine how researchers and members of Institutional Review Boards make decisions concerning the research participation of adults with and without intellectual disabilities. Results indicate that decision‐makers are influenced by the disability status of the sample, characteristics of the research in which they are engaged, and their attitudes toward the research participation of adults with intellectual disabilities as well as their own relationship to the research process. For example, decision‐makers may create situations that limit the self‐determination of adults with intellectual disabilities and adults without disabilities within the research context, particularly when the research poses some risk of harm to participants. Implications for theory, action and research are explored.     

Perspective-taking differences between high- and low-adjustment marriages: Implications for those in intervention

Abstract

Perspective-taking is defined as the cognitive ability to understand the point of view of another. Recent studies have demonstrated that perspective-taking is an important component of a satisfying marriage, and therapists have spoken of the need for perspective-taking training. The present study examined perspective-taking differences among a sample of 259 individuals in high- and 43 individuals in low-adjustment marriages. Four hypotheses were tested that demonstrated that females in high- and low-adjustment marriages did not differ in their perspective-taking ability with others in general. However, males and females in high- and low-adjustment groups did differ in their perspective-taking with their spouses (dyadic perspective-taking). Males and females in high-adjustment relationships perceived their spouses to be better at dyadic perspective-taking than individuals in low-adjustment marriages. Implications for family therapists include the need not merely to teach perspective-taking skills but to focus upon characteristics of the relationship and motivational factors that may either increase or decrease perspective-taking with a spouse.     

Adverse effects of predictive testing for Huntington disease underestimated: long-term effects 7-10 years after the test.

The 7-10-year psychological effects of presymptomatic testing for Huntington disease are described in 142 individuals and 104 partners. Questionnaires included the Beck Hopelessness Scale (A. T. Beck, A. Weissman, D. Lester, & L. Trexler, 1974), the Impact of Event Scale (M. J. Horowitz, N. Wilner. & W. Alvarez. 1979). and the General Health Questionnaire (D. P. Goldberg. 1972). Carriers and their partners were more distressed immediately after the test result, although their outlooks improved somewhat in the 2-3-year posttest period. However, they became more pessimistic thereafter, when approaching the age of onset. Carriers, who were lost to follow-up after disclosure of test results, reported more distress pretest than did retained carriers. This demonstrates that studies that report few harmful effects may have underestimated the real impact. Moreover, follow-up studies need to investigate time effects for longer than a few years.     

Rewards decrease risky decisions for adolescent drivers: Implications for crash prevention

Motor vehicle crashes (MVCs) are a major contributor to adolescent mortality. Adolescent drivers are more likely to make risky decisions in the presence of peers. However, rewards have also been shown to improve decision making in adolescence. Our goal was to determine if peer observation and reward effects on decision-making were dependent upon adolescent driving styles.Twenty-four healthy adolescents played a driving game in a 2 (no peer; peer) × 2 (no rewards; rewards) within-subjects experiment. Driving styles were measured by self-report.Rewards favoring safe choices reduced risky decision making, but this effect was especially robust for adolescents with driving styles that increase risk of MVCs (i.e., dangerous, fast, angry, or distracted styles). Findings suggest that rewards for safe driving can be an effective mechanism for reducing MVCs, especially for the most at-risk drivers, if they can be made appetizing to adolescents.     

Non-addictive psychoactive drug use: Implications for behavioral addiction

The newly proposed framework for non-addictive psychoactive substances postulated by Müller & Schumann (M&S) provides an interesting and plausible explanation for non-addictive drug use. However, with specific reference to the relevant behavioral addiction literature, this commentary argues that the model may unexpectedly hold utility not only for non-addictive use of drugs, but also for non-addictive use of other potentially addictive behaviors.     

Huntington disease: A case study describing the complexities and nuances of predictive testing of monozygotic twins

When a candidate for predictive testing for the Huntington disease gene is a monozygotic twin, confidentiality of the co-twin's diagnosis and autonomy of participation are among the critical genetic counseling issues. Predictive testing can proceed when twins voluntarily and simultaneously request counseling and evaluation in an HD testing program. This case describes a young man referred for predictive testing to an HD testing site on the East Coast of the United States. Family history revealed a twin brother of unknown zygosity who resided on the West Coast of the United States. The genetic counselors on opposite coasts collaborated to provide genetic counseling and evaluation for voluntary, informed predictive testing of the twins, protecting their rights while observing national protocol guidelines.     

Research on familial Creutzfeldt-Jakob disease (FCJD) resulting in presymptomatic testing: Implications for the human genome project

A research study to identify the priori gene mutation in a family with familial Creutzfeldt-Jakob disease (FCJD) evolved into presymptomatic diagnostic testing. Our experience with one case raises concerns regarding similar studies that will ensue as a result of the Human Genome Project. Technological advances in human molecular genetics make it difficult for Institutional Review Boards (IRB) to adequately evaluate proposed studies. Additionally, changes in the implications of the study may occur after initial IRB approval, due to technological progress. While FCJD, like Huntington's disease (HD), has adult onset and causes progressive dementia and ataxia, protocols established for presymptomatic testing of HD were not included in the FCJD study design. It is thus recommended that IRB committees include a genetics professional and that IRB-approved research studies be reevaluated on a regular basis to monitor the impact that technological advances may have on participating human subjects.     

Intentions to use hormonal male contraception: The role of message framing,attitudes and stress appraisals

Two studies are reported. Study one (N = 104) explored the extent to which male hormonal contraception is perceived as risky compared to other prevention behaviours. Study two examined the effects of message framing on intentions to use hormonal male contraception and investigated whether attitude moderates message framing effects. Three hundred and four participants read either a loss frame or gain frame message and then completed questionnaires assessing their intentions to use hormonal male contraception, stress appraisals and the theory of planned behaviour (TPB) variables. Exposure to a loss frame influenced intention to use the daily male pill in men with a more postive attitude. This suggests that attitude, but not other TPB variables or stress appraisals have the capacity to moderate framing effects. Stress appraisals, in addition to TPB variables, significantly predicted variance in behavioural intentions in men and women. These findings are discussed within the context of Prospect Theory, perceived risk and prevention/detection behaviours.     

The community alcohol use scale: A scale for use in prevention programs

The Community Alcohol Use Scale (CAUS) was developed as a continuous, reliable, valid, and acceptable measure for primary prevention studies. Items were written following a comprehensive review of the literature on alcohol dependence and alcoholism. Based upon the responses of 315 respondents to the 100-item initial version of the scale, the 45-item CAUS was developed. The CAUS was then cross-validated on a local sample (n = 274) and a provincial sample (n = 745). Estimates of internal consistency were .91, .96, and .94, respectively, for the initial and cross-validation samples. Correlations of .48 and .69 were obtained between the CAUS and the Michigan Alcohol Screening Test for the initial and local cross-validation samples. In the provincial cross-validation sample a correlation of .62 was obtained between the CAUS and the Usual Weekly Alcohol Index. Preliminary cutting scores were developed to identify those at risk for alcoholism, and alcoholics. The CAUS has potential use as an evaluative and predictive instrument in a variety of primary prevention programs.