Subjective and Objective Risks of Carrying a BRCA1/2 Mutation in Individuals of Ashkenazi Jewish Descent

This repeated measures study examines (1) the change in subjective risk of mutations pre- to postcounseling, (2) the accuracy of BRCAPRO estimates of mutations, and (3) the discrepancy between subjective risk and BRCAPRO estimates of mutations before and after genetic counseling. Ninety-nine Ashkenazi Jewish individuals pursued testing for BRCA1/2 mutations. Most had a personal cancer history (N = 51; family only: N = 48); and received uninformative negative results (N = 66; positives: N = 23; informative negative: N = 10). The coping strategy of defensive pessimism predicts that individuals will believe the worst case scenario to better cope with a potential negative outcome. Consistent with this, most felt they would have a mutation, if not mutations in both genes. The BRCAPRO model appeared to overestimate risk of having a mutation in this sample (p < .001). BRCAPRO overestimates notwithstanding, genetic counseling increased accuracy of subjective risk (p < .01). Individuals with a family-only cancer history had the least accurate estimates of risk (p < .05) and may need further intervention to either manage anxiety or improve knowledge.     

Online Module for Carrier Screening in Ashkenazi Jewish Individuals Compared with In-Person Genetics Education: A Randomized Controlled Trial

To increase accessibility to genetics services for low-urgency patients seeking Ashkenazi Jewish (AJ) carrier screening, we designed an interactive computer (IC) module that provides pre-test genetics education and allows genetics professionals to order the test without meeting the patients beforehand. We compared this module with in-person genetic counseling (GC) using a randomized trial. AJ individuals were randomized to undergo genetics education via the IC module (n = 26) or GC (n = 28). We compared post-interventional genetics knowledge, perceived genetic risk, and anxiety between the two groups, after accounting for pre-interventional scores, using ANCOVA. Wilcoxon Rank-Sum test was used to compare post-interventional satisfaction. Post-interventional genetics knowledge, risk perception, or anxiety were not significantly different between the two groups after accounting for baseline scores (p = 0.50–0.54), although the data are inconclusive regarding the module’s non-inferiority at a 5% margin. Post-intervention satisfaction scores were generally higher in the GC group than the IC module group. Our IC module has the potential to improve access to clinical genetics services for patients and staff, but it is not suitable for all AJ patients and cannot completely replace the benefits of in-person consultations.     

Knowledge About Genetics Among African Americans

Although knowledge about genetic concepts is important for individuals to be active participants in medical technologies that use genetic science, limited information is available on knowledge about basic genetic concepts and terminology in African Americans. The purpose of this study was to evaluate knowledge about general genetic concepts and medical genetics terminology among African Americans and to identify factors having independent associations with knowledge. Participants were 109 adult African Americans enrolled in a study on attitudes about race, genetics, and smoking. The majority of respondents were knowledgeable about general genetic concepts, but were less knowledgeable about medical genetics terminology. Education was the only factor independently associated with knowledge about sporadic disorders in multivariate logistic regression analysis. Respondents with at least some college education were most likely to be knowledgeable about sporadic disorders (OR=2.70, 95% CI=1.10, 6.67, p=.03). The results of this study suggest that genetics education targeted to African Americans may need to focus on increasing understanding about technical concepts related to genetics.     

Knowledge and Concern about STIs/HIV and Sociodemographic Variables Associated with Getting Tested for HIV Among the General Population in Spain

HIV testing is important in terms of prevention and treatment. However, HIV testing rates in the Spanish general population remains low. Therefore, HIV testing promotion constitutes a key issue. A high level of knowledge about HIV/AIDS is associated with having been tested for HIV. The general aim of this study was to determine the prevalence of people who had ever been tested for HIV in Spain. The sample consisted of 1,106 participants from the general population — 60.0% females and 40.0% males — aged between 17 and 55 years old. The assessment instruments were a questionnaire on sociodemographic data and HIV testing, a scale of knowledge about STIs and HIV/AIDS, and a scale of concern about STIs/HIV. Results showed that greater knowledge about STIs and HIV was associated with a greater likelihood of being tested for HIV (OR = .77; 95.0% CI = .73–.82; p < .05). In addition, higher concern about HIV/AIDS decreased the likelihood of not having been tested for HIV (OR = .87; 95.0% CI = .83–.92; p < .05). In fact, the higher participants concern about STIs was, the lower their likelihood of not having been tested for HIV was (OR = .87; 95.0% CI = .83–.91; p < .05). It is necessary to promote HIV testing in the general population as well as to consider their socio-demographic and psychological characteristics.     

Life Matters: Exploring the Influence of Games and Mental Skills on Relatedness and Social Anxiety Levels in Disengaged Adolescent Students

LifeMatters is a 10-session life skills program implemented with youth that uses mental skills training and games to meet the three basic psychological needs of relatedness, autonomy, and competence. Forty disengaged students (20 experimental, 20 control) 16–17?years of age from a YMCA vocational school completed self-report measures before and after the intervention period. The school focuses on services for adolescents who find it difficult to gain an education through mainstream education due to behavioral and developmental issues. Mixed between-within subjects analyses of variance showed that there was a significant decrease in social anxiety, Wilks’s λ?=?.84, F(1, 26)?=?5.07, p?=?.03, partial?η²?= .16, and a significant increase in relatedness Wilks’s λ = .87, F(1, 26) = 4.2, p = .05, partial η² = .14, over time for the experimental group compared to the control group. Analyses of covariance showed no significant difference between the two groups in change on social anxiety levels, F(1, 25)?=?1.34, p?=?.26, partial η²?=?.05, when controlling for relatedness, and no significant difference between the two groups in change in relatedness levels, F(1, 25) = 1.34, p = .26, partial η² = .05, when controlling for social anxiety. This study provides insight into the potential effectiveness of using games and mental skills training to increase relatedness and decrease levels of social anxiety in disengaged students.

Lay Summary: LifeMatters is a life skills program combining mental skills training and physically active games. Disengaged students who took part in the program reported lower levels of social anxiety and higher levels of relatedness compared to students who did not take part.     

Jewish Identity and the Secular Achievements of American Jewish Men and Women

Three questions are addressed concerning the relationship of Jewish identity to secular achievements. Are the secular achievements of American Jews related at all to the strength of their Jewish identity? Which has a stronger relationship to secular achievement, a religious or an ethnic Jewish identity? Do communal aspects or private, personal aspects of Jewish identity have the stronger relationship to secular achievements? Using the 2000–2001 National Jewish Population Survey, we find that educational attainment, labor force participation, and occupational achievements are related to several expressions of Jewish identity, even after controlling for the traditional sources of variation (age, gender, education, family status). Jewish identity, as expressed in terms of religion, ethnicity, communal commitment, and private attitudes and practices, is related to contemporary Jewish secular achievement, albeit differently for men and women.     

High School Coaches’ Coaching Efficacy: Relationship with Sport Psychology Exposure and Gender Factors

Coaching efficacy (CE) is largely influenced by mastery experiences such as formal education and coaching experience. However, specific education has not previously been considered in relation to CE. Therefore, examining specific educational experiences, such as those related to sport psychology, which have previously been reported to increase self-efficacy, may prove helpful in advancing CE. Also, previously reported gender differences in CE and perceptions of sport psychology advocate for gender consideration. The purpose of this study was to explore high school coaches’ coaching experience to determine whether sport psychology exposure and gender factors relate to CE. Participants (N?=?2,018) completed the Coaching Efficacy Scale II–High School Teams. An analysis of covariance revealed that more sport psychology education and more frequent contact with sport psychology practitioners resulted in statistically higher CE (p < .05). Analysis of covariance indicated that female coaches reported significantly lower CE than males (p < .05), and coaches of only female athletes reported significantly lower motivation efficacy and physical conditioning efficacy than their peer groups (p < .05). Sport psychology consultants and coach educators should consider these differences when consulting and when developing educational materials and workshops.     

Disclosure of Genetic Research Results to Members of a Founder Population

There is currently extensive discussion and debate in the literature on how, when, and to whom genetic research results should be returned (see Genetics in Medicine, April 2012 issue). Here, we describe our experience in disclosing genetic information on Mendelian disorders discovered during the course of our research in the Hutterites. We first assessed attitudes toward the disclosure of carrier results, which revealed that many individuals wanted carrier information and that many intended to use the information in family planning. Based on this information, we developed a pilot study to test and disclose cystic fibrosis (CF) carrier status. Next, a larger scale project was developed in order to disclose genetic research results for 14 diseases to those interested in receiving the information. We developed brochures, offered a live interactive educational program, conducted a consent process, and disclosed results in letters mailed to the consented individuals. Overall, ~80 % of individuals who participated in the educational program signed consent forms for the release of their results for 14 diseases. We describe our experience with returning individual genetic research results to participants in a population-based research study.     

Institutional care and iron deficiency increase ADHD symptomology and lower IQ 2.5–5 years post‐adoption

Increased ADHD symptomology and lower IQ have been reported in internationally adopted (IA) children compared to non‐adopted peers (Hostinar, Stellern, Schaefer, Carlson & Gunnar, 2012; Kreppner, O'Connor & Rutter, 2001). However, it is unclear whether these outcomes are due to institutional deprivation specifically or to co‐occurring micronutrient deficiencies that disrupt brain development (Fuglestad, Rao & Georgieff, 2008b). In this study, IA children were compared to children raised in their biological families to examine differences in ADHD symptomology and IQ 2.5–5 years post‐adoption and to assess the contributions of iron deficiency (ID) and duration of deprivation to these cognitive outcomes. ADHD symptoms (parent‐ and experimenter‐reported) and IQ were evaluated in 88 IA (M = 62.1 months, SD = 2.4) and 35 non‐adopted children (M = 61.4 months, SD = 1.6). IA children were assessed 29–64 months post‐adoption (M = 41.9 months, SD = 10.2). ID was assessed during the initial post‐adoption medical visit in 69 children, and children were classified into four groups by iron status, ranging from normal to ID anemia (most severe). IA children had greater ADHD symptomology, p < .01, and lower IQ, p = .001, than non‐adopted children. Within the IA group, children with more severe ID at adoption had greater ADHD symptomology, r(69) = 0.40, p = .001, and lower IQ, r(68) = −0.28, p < .05. Duration of institutional care was positively correlated with ADHD symptoms, r(86) = .28, p < .01, but not IQ, r(85) = −.08, p = .52. Longitudinal results indicate improvement in IQ from 12 months post‐adoption to age 5 for children with greater ID severity at adoption and longer duration of institutional care but no improvement in ADHD symptoms. These results signify continuing effects of early deprivation and ID on ADHD symptoms and IQ years after adoption. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=vUFDAS3DD1c     

Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial

Disorder-specific cognitive behavioural therapy programs delivered over the internet (iCBT) with clinician guidance are effective at treating specific anxiety disorders and depression. The present study examined the efficacy of a transdiagnostic iCBT protocol to treat three anxiety disorders and/or depression within the same program (the Wellbeing Program). Seventy-seven individuals with a principal diagnosis of major depression, generalised anxiety disorder, panic disorder, and/or social phobia were randomly assigned to a Treatment or Waitlist Control group. Treatment consisted of CBT-based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. Eighty one percent of Treatment group participants completed all 8 lessons within the 10 week program. Post-treatment data were collected from 34/37 Treatment group and 35/37 Control group participants, and 3-month follow-up data were collected from 32/37 Treatment group participants. Relative to Controls, Treatment group participants reported significantly reduced symptoms of anxiety and depression as measured by the Depression Anxiety and Stress Scales-21 item, Patient Health Questionnaire-9 item, and Generalised Anxiety Disorder-7 item scales, with corresponding between-groups effect sizes (Cohen’s d) at post treatment of.56,.58, and.52, respectively. The clinician spent a mean time of 84.76 min (SD = 50.37) per person over the program. Participants rated the procedure as highly acceptable, and gains were sustained at follow-up. These results provide preliminary support for the efficacy of transdiagnostic iCBT in the treatment of anxiety and depressive disorders.     

TO MAKE SPANISH A SACRED LANGUAGE: WRITING AND THE CRYPTO‐JEWISH ALLEGORY IN SABINA BERMAN’S LA BOBE

The prominent Jewish‐Mexican author Sabina Berman explores her relationship to Judaism in the semi‐autobiographical novel La Bobe (1990; Bubbeh, 1998) via a loving portrait her grandmother. Undeterred by her Ashkenazi background, Berman employs a Crypto‐Jewish allegory in her portrayal of the grandmother. Through this allegory, Berman is able to restructure Jewish identity as female centered and mouldable. The allegory also opens up a tradition of women’s religious knowledge and prayer that becomes the foundation of the narrator’s future as a Jewish‐Mexican writer. In her narrative, Berman argues for a spiritual identity based not on strict observance of ritual form but on the devotion with which the rituals are undertaken, be they the transmission of a sacred text, the performance of domestic chores, or the writing of stories and plays.     

Ethnocultural Differences in Prevalence of Adolescent Suicidal Behaviors

Data from an ethnically diverse sample of middle school students (grades 6–8; n = 5,423) are analyzed for ethnic differences in suicidal ideation, thoughts about suicide in the past 2 weeks, suicide plans, and suicide attempts. Ideation was examined using a four-item scale and a single item on suicidal thoughts. Ideation was higher among females, older youths, and lower status youths. The same general pattern held for recent suicidal plans and attempts, with the exception of gender, where the trend was for males to report more attempts. Lifetime plans and attempts were higher for females, older youths, and lower status youths. Data were sufficient to compare nine ethnic groups. Multivariate logistic regression analyses, adjusting for the effects of age, gender, and socioeconomic status, yielded significant odds ratios using the Anglo group as the reference, for suicidal ideation for the Mexican (OR = 1.76, p < .001), Pakistani (OR = 2.0, p < .01), and Vietnamese (OR = 1.48, p < .05) American groups. For thoughts about suicide in the past 2 weeks, only Pakistani and Mixed Ancestry youths had elevated risk. For suicidal plans in the past 2 weeks, Mixed Ancestry youths (OR = 2.02, p < .05) and Pakistani youths (OR = 3.20, p < .01) had elevated risk. For recent attempts, only the Pakistani American youths had elevated risk (OR = 3.19, p < .01). Future research needs to address whether these results hold in other ethnically diverse communities and, if so, what factors contribute to increased risk among some minority youth and not others.     

Human rights and ethnic attitudes in Spain: The role of cognitive, social status, and individual difference factors

Cognitive, individual differences, and intergroup contact factors were examined in the formation of attitudes about human rights and ethnic bias in two studies conducted in Spain. A 7‐item scale measuring knowledge about human rights laws in Spain and the European Union was used in both studies. Participants were university students enrolled at the Universidad Autónoma de Madrid. In study one, participant (n = 127) knowledge about human rights laws, intergroup contact, Right Wing Authoritarianism (RWA), and Gough's Prejudice/Tolerance (Pr/To) scale were examined in relationship to bias towards Gitanos. Findings revealed that knowledge about human rights and social status variables (gender and age) were not significant predictors of Gitano bias, whereas Pr/To, RWA, and contact were all (R² = .28) significant predictors of bias against Gitanos. Findings provided cross‐cultural replication (Dunbar & Simonova, in press) of the relationship of Pr/To and RWA to Gitano bias. In study two, participant (n = 100) knowledge and feelings (measured on a three‐item semantic differential scale) about human rights laws, Pr/To, and RWA were examined in relation to strategies influencing peer attitudes about human rights on the Raven Social Influence Inventory (RSII) scale. Findings indicated that knowledge about human rights laws were correlated (r = .47, p < .001) with positive feelings about these laws. Results of a hierarchical regression analysis, controlling for knowledge about human rights laws and participants' social status, found that the Prejudice/Tolerance scale and feelings about human rights were related with both hard (R² = .11) and soft (R² = .08) social influence strategies influencing peer human rights attitudes on the RSII. Men and higher‐scoring participants on Pr/To both employed more hard social influence strategies. Findings indicate that while knowledge of human rights laws is unrelated to ethnic bias, more accurate knowledge is correlated to more positive feelings about laws meant to protect the rights of ethnic minorities.     

Organ donation intentions and behaviors: application and extension of the theory of planned behavior

Organ donation intentions and behaviors were investigated using a traditional and extended theory of planned behavior (TPB). In study 1, attitudes, subjective norms, and perceived behavioral control were associated with intentions to engage in donation behaviors in a student sample (all p ≤ .02), and intentions significantly predicted behavior 2 months later (p < .001). Study 2 utilized a community sample of Catholic, Jewish, and Muslim individuals. Measures of affect and religious attitudes were added to the traditional TPB, increasing the variance in intentions accounted for by the model, F(7, 181) = 6.94, p < .001. The studies support the use of an extended TPB in predicting donation‐related intentions and behaviors and suggest potential targets of interventions to promote donation.     

The Effects of Adapted Tango on Spatial Cognition and Disease Severity in Parkinson's Disease

The authors determined effects of community-based adapted tango on spatial cognition and disease severity in Parkinson's disease (PD) while controlling for the effects of social interaction. Thirty-three individuals with mild-to-moderate PD (stage I–III) were assigned to twenty 90-min tango (n = 24) or education (n = 9) lessons over 12 weeks. Disease severity, spatial cognition, balance, and fall incidence were evaluated pre-, post-, and 10–12 weeks postintervention. The authors evaluated differences using t tests and analyses of variance. Twenty-three tango and 8 education participants finished. Tango participants improved on disease severity (p = .008), and spatial cognition (p = .021) compared with education participants. Tango participants also improved in balance (p = .038), and executive function (p = .012). Gains were maintained 10–12 weeks postintervention. Multimodal exercise with structured syllabi may improve disease severity and spatial cognition in PD.     

Effects of In-Group Bias on Planned Encounters of Jewish and Arab Youths

Abstract

In a sample of 9th-grade Jewish (n = 118) and Arab (n = 100) students in Israel who participated in planned binational encounters, the author examined in-group biases as a function of (a) their perceptions of the encounter between the groups as interpersonal or as intergroup contact and (b) their views of the status of their respective national groups in Israel as legitimate and stable. In comparisons of the 2 encounter groups (of equals status), both groups showed in-group biases. In comparisons of the national groups at large (of unequals status), the Arab students considered their group similar to the Jewish group, whereas the Jewish students rated their group more favorably than they rated the Arab group. For the Jewish, but not the Arab, students, in-group bias was contingent on simultaneous ratings (legitimate–illegitimate; stable–unstable) of the binational situation in Israel. The data support a 2-dimensional model rather than a 1-dimensional model of intergroup-interpersonal definition of the encounter.     

Does substance abuse contribute to further risk of falls in dementia

This study aimed to predict the risk of falls by focusing on substance abuse in the elderly with dementia. Our national cross-sectional survey included 1210 elderly Malaysian demented subjects. The study identified the effects of age, ethnicity, sex differences, marital status, educational level, and substance abuse on the likelihood of falls in the elderly with dementia. The multivariate logistic regression model was used to analyze data collected from samples. The prevalence of falls was about 17% among subjects and significantly increased with age (p = .006). Furthermore, the results showed that age (OR = 1.03), ethnicity (OR = 1.69), substance abuse (OR = 1.68), and female sex (OR = 1.45) significantly enhanced the risk of falls in respondents (p < .05). Educational level and marital status had no significant effects on the likelihood of falls (p > .05). However, the findings provided evidence of an additional effect of substance abuse on further risk of falls in older adults with dementia.     

Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study

With limited efficacy of medications for symptom relief, non-medication treatments may play an important role in the treatment of irritable bowel syndrome (IBS), the most common functional gastrointestinal (GI) disorder. This study aimed to evaluate the efficacy of two self-regulation strategies for symptom relief and mood management in IBS patients. Thirty-five adult participants meeting ROME III criteria for IBS were enrolled, 27 of the 35 participants (77%) completed treatment and pre- and post-treatment visits (89% women, 11% men; M (SD) age = 36 (13)), and 20 of the 27 (74%) completed a 6-month follow-up. Participants were randomly assigned to 16 biweekly group sessions of Iyengar yoga or a walking program. Results indicated a significant group by time interaction on negative affect with the walking treatment showing improvement from pre- to post-treatment when compared to yoga (p < .05). There was no significant group by time effect on IBS severity. Exploratory analyses of secondary outcomes examined change separately for each treatment condition. From pre- to post-treatment, yoga showed significant decreases in IBS severity measures (p < .05), visceral sensitivity (p < .05), and severity of somatic symptoms (p < .05). Walking showed significant decreases in overall GI symptoms (p < .05), negative affect (p < .05), and state anxiety (p < .05). At 6-month follow-up, overall GI symptoms for walking continued to significantly decline, while for yoga, GI symptoms rebounded toward baseline levels (p < .05). When asked about self-regulated home practice at 6 months, significantly more participants in walking than in yoga practiced at least weekly (p < .05). In sum, results suggest that yoga and walking as movement-based self-regulatory behavioral treatments have some differential effects but are both beneficial for IBS patients, though maintenance of a self-regulated walking program may be more feasible and therefore more effective long term.     

Psychosocial correlates of hiv-related sexual behavior in an inner city std clinic

Little is known about the relationship between smoking and meaning in life, although the association of meaninglessness with other addictive behaviours has been widely investigated. The aim of this study is to examine whether a relationship exists between meaning in life and intensity of smoking as measured by cigarettes smoked per day. The study population was 3506 current smokers from the Hungarostudy 2002 Hungarian representative cross-sectional survey. Age, educational level, marital status, subjective financial status, household income, coffee consumption, hazardous alcohol use, general well-being, anxiety, and depressive symptomatology were included in the analyses as covariates. On the bivariate level, life meaning was associated with smoking intensity in the total sample and among women (p < 0.001), while for males, only a tendency was found (p = 0.069). In the multivariate analyses, life meaning proved to be a significant negative predictor of smoking intensity for females (p = 0.005) even after controlling for the covariates, whereas in men, meaning in life completely lost its significance (p = 0.852). In the total sample, both meaning in life (p = 0.005) and its interaction with gender (p = 0.024) related to the dependent variable. Further research is needed to confirm these explorative findings concerning the protective role of life meaning against more intense smoking among women.