Decision-Making About Inherited Cancer Risk: Exploring Dimensions of Genetic Responsibility

Since genetic information has implications for family members, some choices about genetic risk may be influenced by perceptions of responsibility to relatives. Drawing upon 25 semi-structured interviews with test recipients in Canada, this study explored decisions about inherited breast-ovarian and colon cancer. Qualitative data analysis revealed the pervasive significance of genetic responsibility in test decisions. We highlight three dimensions of genetic responsibility: 1) to know about the self for self; 2) to know about the self for others; 3) to know about the self to oblige others to know. It is argued that these dimensions of genetic responsibility have implications for test decisions, family relationships and other family members’ desire to know (or not know) and to act (or not act) with respect to their own genetic risk. In particular, genetic responsibility may play out as a framing of a relative’s moral obligation to know their risk that could obviate any interest they might have in not knowing. We conclude that perceptions of responsibility to—and of−other family members be thoroughly explored in genetic counseling sessions.     

Health Beliefs and Behaviors of Women Who Have Received Genetic Counseling For Breast Cancer

There are both genetic and behavioral risk factors for breast cancer, but the interaction between these factors is not clear. Little is known about the impact of receiving genetic risk information for breast cancer on behaviors such as diet and physical activity. Seven focus groups were conducted with 23 women who had recently received genetic counseling for breast cancer, in order to explore health beliefs and behaviors following genetic counseling. Findings revealed that there was much confusion and uncertainty about the associations between health behaviors and breast cancer risk, and participants reported that receiving genetic counseling had little impact on health protective behaviors. Further research is required to understand variation in response to genetic risk information, and to assess the impact of providing additional information regarding lifestyle factors.     

What Patients and Their Relatives Think About Testing for BMPR2

Clinical genetic testing is available for mutations in BMPR2 associated with pulmonary arterial hypertension (PAH). The aim of this study is to assess attitudes of individuals affected by or at risk for PAH regarding genetic testing. Structured telephone interviews were conducted with 119 individuals affected by or at risk for PAH recruited from pulmonary hypertension clinic at Vanderbilt, Vanderbilt familial PAH registry, attendees at 2006 PHA meeting, and a local PAH support group. Sixty-four percent reported knowing little or nothing about BMPR2 testing. Predictors of greater self-assessed knowledge included having an affected family member and learning about BMPR2 testing through the internet. Most respondents reported that while they spent some time thinking about being tested for BMPR2, they had little trouble deciding. The most frequently cited reason for testing was to provide information for their children. About 20% said they had been tested, even though <5% have actually received clinical testing. Although patients with PAH and their at-risk relatives typically feel relatively uninformed about testing for mutations in BMPR2 and at times are confused about their testing status, they nonetheless report that it is easy to decide about testing.     

The genetic and environmental architecture to the stability of IQ: Results from two independent samples of kinship pairs

Existing research has revealed that IQ remains relatively stable over the life course, though questions remain about how stable IQ is and whether the stability of IQ varies across different developmental periods of the life course. Despite this stability, there are also questions surrounding the factors that might explain the stability of IQ. Against this backdrop, we conduct bivariate genetic models to estimate genetic, shared environmental, and nonshared environmental influences on the stability of IQ. To do so, we analyze kinship pairs drawn from two separate longitudinal samples: The National Collaborative Perinatal Project (CPP) and the National Longitudinal Study of Adolescent Health (Add Health). Across both samples, IQ was found to be relatively stable. Moreover, the genetic analyses revealed that between 66% and 83% of the stability in IQ was due to genetic factors and between 43% and 69% of the change in IQ was due to genetic factors. The remainder of the stability and change in IQ was the result of a combination of shared and nonshared environmental influences. Importantly, some substantive race differences emerged in respect to genetic and environmental influences on the stability of IQ. We conclude with a discussion of the limitations of the study and avenues for future research.     

Preventing Vascular Effects on Brain Injury and Cognition Late in Life: Knowns and Unknowns

For some researchers, the relationship between prevalent cardiovascular risk factors and late-life cognitive decline is not worthy of further study. It is already known that effective treatment of vascular risk factors lowers risk of such major outcomes as stroke and heart attack, the argument goes; thus, any new information about the relationship between vascular risk factors and another major outcome - late-life cognitive decline-- is unlikely to have an impact on clinical practice. The purpose of this review is to probe the logic of this argument by focusing on what is known, and what is not known, about the relationship between vascular risk factors and late-life cognitive decline. The unknowns are substantial: in particular, there is relatively little evidence that current vascular risk factor treatment protocols are adequate to prevent late-life cognitive decline or the clinically silent brain injury that precedes it. In addition, there is relatively little understanding of which factors lead to differential vulnerability or resilience to the effects of vascular risk factors on silent brain injury. Differential effects of different classes of treatments are similarly unclear. Finally, there is limited understanding of the impact of clinically-silent neurodegenerative disease processes on cerebrovascular processes. Further study of the relationships among vascular risk factors, brain injury, and late-life cognitive decline could have a major impact on development of new vascular therapies and on clinical management of vascular risk factors, and there are promising avenues for future research in this direction.     

The effect of being reared with an alcoholic half-sibling: a classic study reanalyzed

Data from an early study of alcoholism among half-siblings of alcoholic probands (17) was reanalyzed using log-linear analysis. The original study, which used chi-square analysis, identified genetic factors but found no environmental effects that contributed to the prediction of alcoholism. Log-linear analysis, however, reveals that being reared with a proband is associated with a reduced incidence of alcoholism in half-siblings. The results do not disconfirm the presence of genetic factors, but they do indicate that family dynamics make an independent and statistically significant contribution to the development of alcoholism not heretofore demonstrated. Similarities between these results and the results from studies of identical twins are discussed.     

Right under our noses: Ambient scent and consumer responses

Despite frequent mention, we know relatively little about the effect of ambient environmental factors on consumer behavior. This paper discusses one important aspect of the environment, ambient scent. Based on research from several disciplines, a model describing the effect of ambient scent on consumers is propossed. Ambient scent is portrayed as an environmental cue that is compared with scent preferences to influence affective responses and ultimately approach-avoidance reactions. Moderators of these presumed relationships are also described. Suggestions for empirical research are provided and implications for marketing management are presented.     

The Role of Negative Emotions on Adolescent Evaluation of Clinical Reproductive Healthcare Services

Despite extensive research on adults, we know relatively little about the factors and processes that influence adolescent satisfaction with clinical reproductive healthcare. In this study, survey responses from 135 adolescent clinic users in the western U.S. support a client-satisfaction model that differs from the traditional coping response framework by featuring negative emotions as a primary antecedent of service-quality evaluations, rather than a consequence. Quality evaluations directly impacted satisfaction, which, in turn, affected word of mouth and intentions to return to the clinic. This research represents an initial step toward better understanding of ways that adolescents may differ from adults on factors influencing satisfaction with clinical reproductive healthcare and, hence, holds both theoretical and managerial significance.     

The Centrality of Schools in the Lifecourse: The Case for Focusing on School-Related Influences in Developmental Theory and Research

While the strength of the lifecourse/developmental (LCD) perspective in the examination of antisocial behavior has been clearly demonstrated, this work has given little attention to schools and education as salient influences. By contrast, there is much research using other theoretical frameworks to examine school-related risk factors of deviance. Given what we know about the importance of schooling and education on individual development and subsequent implications for behavior, we contend that academic influences should be more prevalent in LCD theories of deviance and that research using an LCD theoretical perspective should embrace non-LCD work examining school-related risk factors of antisocial behavior.     

Early family context and development of adolescent ruminative style: moderation by temperament

We know very little about the development of rumination, the tendency to passively brood about negative feelings. Because rumination is a risk factor for many forms of psychopathology, especially depression, such knowledge could prove important for preventing negative mental health outcomes in youth. This study examined developmental origins of rumination in a longitudinal sample (N=337; 51% girls) studied in preschool (ages 3? and 4? years) and early adolescence (ages 13 and 15 years). Results indicated that family context and child temperament, assessed during the preschool period, were risk factors for a ruminative style in adolescence. Specifically, early family contexts characterised by over-controlling parenting and a family style of negative-submissive expressivity predicted higher levels of later rumination. These associations were moderated by children's temperamental characteristics of negative affect and effortful control. Further, the interaction of these temperament factors exerted an additional influence on later rumination. Implications for prevention and intervention efforts are discussed.     

Genetic and Environmental Influences on Two Measures of Speed of Information Processing and their Relation to Psychometric Intelligence: Evidence from the German Observational Study of Adult Twins

Speed of information processing, as measured by reaction times (RTs) in elementary cognitive tasks (ECTs), has been found to be an important correlate of human psychometric intelligence. While the heritability of psychometric intelligence is well understood, we know only a little about genetic and environmental influences on ECT performance, particularly about genetic and environmental contributions to ECT–intelligence relation. These questions were studied by employing two widely used ECTs (Sternberg's memory scanning and Posner's letter-matching task) as well as two psychometric intelligence tests (Advanced Progressive Matrices and Leistungs–Prüf System) in a large sample of 169 monozygotic (MZ) and 131 dizygotic (DZ) twin pairs. As expected, RTs correlated negatively with psychometric intelligence. Moreover, heritability estimates were substantial for both psychometric intelligence and RTs in ECTs. Finally, multivariate genetic analyses suggested that most of the phenotypic correlation between mental speed and intelligence is due to genetic factors.     

Focusing on Patient Needs and Preferences May Improve Genetic Counseling for Colorectal Cancer

During cancer genetic counseling, different items which counselors consider important are discussed. However, relatively little empirical evidence exists regarding the needs and preferences of counselees. In this study needs and preferences were assessed from counselees with a personal and/or family history of colorectal cancer (CRC), who were referred for genetic counseling regarding CRC. They received a slightly modified version of the QUOTE-GENE^ca questionnaire prior to their first visit to the Hereditary Cancer Clinic. Response rate was 60 % (48/80 participants). Counselees rated the importance of 45 items assessing their needs and preferences regarding the content and process of genetic counseling. Participants rated the items regarding discussion of information about their familial CRC risk (100 %) and preventive options (98 %) as important or very important. Fewer participants rated items concerning general information on genetics as important. Sensitive communication during counseling was considered very important by a large percentage of counselees. Generally, no major differences were seen between participants in relation to individual characteristics. Our data suggest that focusing on familial CRC risk and surveillance options, in combination with sensitive communication may lead to better satisfaction with genetic counseling.     

Breast Cancer Risk Perceptions among Relatives of Women with Uninformative Negative <Emphasis Type="Italic">BRCA1/2</Emphasis> Test Results: The Moderating Effect of the Amount of Shared Information

The most common result of BRCA1/2 mutation testing when performed in a family without a previously identified mutation is an uninformative negative test result. Women in these families may have an increased risk for breast cancer because of mutations in non-BRCA breast cancer predisposition genes, including moderate- or low-risk genes, or shared environmental factors. Genetic counselors often encourage counselees to share information with family members, however it is unclear how much information counselees share and the impact that shared information may have on accuracy of risk perception in family members. We evaluated 85 sisters and daughters of women who received uninformative negative BRCA1/2 results. We measured accuracy of risk perception using a latent variable model where accuracy was represented as the correlation between perceived risk (indicators = verbal and quantitative measures) and calculated risk (indicators = Claus and BRCAPRO). Participants who reported more information was shared with them by their sister or mother about her genetic counseling session had greater accuracy of risk perception (0.707, p?=?0.000) than those who reported little information was shared (0.326, p?=?0.003). However, counselees shared very little information; nearly 20 % of family members reported their sister or mother shared nothing with them about her genetic counseling. Family members were generally not aware of the existence of a genetic counseling summary letter. Our findings underscore the need for effective strategies that facilitate counselees to share information about their genetic counseling sessions. Such communication may help their relatives better understand their cancer risks and enhance risk appropriate cancer prevention.     

Dietary restraint moderates genetic risk for binge eating

Dietary restraint is a prospective risk factor for the development of binge eating and bulimia nervosa. Although many women engage in dietary restraint, relatively few develop binge eating. Dietary restraint may increase susceptibility for binge eating only in individuals who are at genetic risk. Specifically, dietary restraint may be a behavioral exposure factor that activates genetic predispositions for binge eating. We investigated this possibility in 1,678 young adolescent and adult same-sex female twins from the Minnesota Twin Family Study and the Michigan State University Twin Registry. Twin moderation models were used to examine whether levels of dietary restraint moderate genetic and environmental influences on binge eating. Results indicated that genetic and nonshared environmental factors for binge eating increased at higher levels of dietary restraint. These effects were present after controlling for age, body mass index, and genetic and environmental overlap among dietary restraint and binge eating. Results suggest that dietary restraint may be most important for individuals at genetic risk for binge eating and that the combination of these factors could enhance individual differences in risk for binge eating.     

Early family context and development of adolescent ruminative style: Moderation by temperament

We know very little about the development of rumination, the tendency to passively brood about negative feelings. Because rumination is a risk factor for many forms of psychopathology, especially depression, such knowledge could prove important for preventing negative mental health outcomes in youth. This study examined developmental origins of rumination in a longitudinal sample (N=337; 51% girls) studied in preschool (ages 3½ and 4½ years) and early adolescence (ages 13 and 15 years). Results indicated that family context and child temperament, assessed during the preschool period, were risk factors for a ruminative style in adolescence. Specifically, early family contexts characterised by over-controlling parenting and a family style of negative-submissive expressivity predicted higher levels of later rumination. These associations were moderated by children's temperamental characteristics of negative affect and effortful control. Further, the interaction of these temperament factors exerted an additional influence on later rumination. Implications for prevention and intervention efforts are discussed.     

Parents’ Communication with Siblings of Children Affected by an Inherited Genetic Condition

The objective of this study was to explore parents’ communication about risk with siblings of children affected by an inherited genetic condition, and to ascertain what level of support, if any, is required from health professionals. Semi-structured interviews were conducted with affected and unaffected children and their parents. Families were affected by one of six genetic conditions representing different patterns of inheritance and variations in age of onset, life expectancy and impact on families. Interviews were analysed using constructivist grounded theory and informed by models which focused on three different aspects of family communication. Interviews with 33 families showed that siblings’ information and support needs go largely unrecognized by health professionals and sometimes by parents. Some siblings were actively informed about the genetic condition by parents, others were left to find out and assimilate information by themselves. Siblings were given information about the current symptoms and management of the genetic condition but were less likely to know about its hereditary nature and their own potential risk. When siblings were fully informed about the condition and included in family discussion, they had a better understanding of their role within their family, and family relationships were reported to be more harmonious. The information and support needs of siblings can be overlooked. Parents with the responsibility for caring for a child affected by a genetic condition may require support from health professionals to understand and respond to their unaffected children’s need for more information about the genetic condition and its implications for the children’s own future health and reproductive decision-making.     

Secular Trends in Depressive Symptoms Among Norwegian Adolescents from 1992 to 2010

Several survey studies among adolescents have shown increasing rates of depressive symptoms over the last two to three decades. We know however little about mechanisms that might explain this increase. The present study uses data from three nationwide representative surveys of 16–17 year-old Norwegian adolescents that were conducted according to identical procedures in 1992, 2002, and 2010 (response rates 97.0, 91.0, 84.3 %, respectively). At each time point, approximately 3,000 adolescents participated (48.8 % girls and 51.2 % boys). Questionnaire data on depressive symptoms and a variety of potential risk and protective factors that might explain time trends in such symptoms were assessed at all time points. The results showed that the prevalence of high scores on depressive symptoms increased significantly between 1992 and 2002 among both boys and girls. No significant changes were observed between 2002 and 2010. The increase from 1992 to 2002 among girls and boys could be partially attributed to increases in eating problems and cannabis use, while reduced satisfaction with own appearance among girls contributed as well. Although the study does not provide information about the causal direction between putative risk factors and depressive symptoms, the results provide some indication that eating problems, cannabis use, and appearance related factors may contribute in explaining secular trends in depressive symptoms.     

Personality and the genetic risk for alcohol dependence

The extent to which the genetic risk for alcohol dependence (AD) and conduct disorder (CD) and their common genetic risk overlap with genetic factors contributing to variation in dimensions of personality was examined in a study of 6,453 individuals from 3,383 adult male and female same-sex and unlike-sex twin pairs from the Australian Twin Registry. The associations between the personality dimensions of positive emotionality, negative emotionality, and AD and CD risk were modest, whereas the associations between behavioral undercontrol and AD and CD risk were substantially higher. Genetic influences contributing to variation in behavioral undercontrol accounted for about 40% of the genetic variation in AD and CD risk and about 90% of the common genetic risk for AD and CD. These results suggest that genetic factors contributing to variation in dimensions of personality, particularly behavioral undercontrol, account for a substantial proportion of the genetic diathesis for AD and most of the common genetic diathesis for AD and CD among both men and women.     

Risk Factors for Alcoholism Among Women Religious: Affect Regulation

Risk factors for addiction have received extensive empirical attention. Specific risk factors for women Religious (nuns), however, are not well known. This report examines risk factors for alcoholism in a retrospective study of 148 chemically dependent women Religious in treatment. Negative emotionality, a personality measure, was the only significant predictor of alcoholism severity in a joint multiple regression with childhood trauma, parental alcoholism, mental health history, ego strength, and self esteem. These findings imply that treatment of this group in chemical-dependency programs needs to include psychological modalities beyond the traditional psychoeducation in order to adequately address difficulties in affect regulation.     

Taiwanese adolescent cognitive autonomy and identity development: the relationship of situational and agential factors

Taiwanese professionals have adopted information about adolescent psychosocial development from Western societies. However, scholars know little about whether they have properly applied the models to both rural and urban youth. The purpose of this study was to examine the development of cognitive autonomy and ego identity in Taiwanese adolescents from Taipei City and surrounding rural counties. We controlled for gender and examined both situational (residential location, family income, and school type) and agential factors (culture value affiliation, attachment, and resiliency) to determine the extent to which each predicted psychosocial developmental outcomes. Among all the factors in this study, resiliency had the most distinctive relationship with adolescent psychosocial development. Each factor successfully predicted specific aspects of psychosocial development for these youth. We conclude with a discussion of the utility of using Western models of development.