Emotional Reaction to Fragile X Premutation Carrier Tests Among Infertile Women

Female fragile X premutation carriers are at ∼10-fold increased risk of premature ovarian failure (follicle stimulating hormone >40 mIU/mL, amenorrhea, age <40). A milder degree of premature ovarian aging (diminished ovarian reserve, where follicle stimulating hormone levels are typically 10–20 mIU/mL) results in infertility. Approximately 10% of fertility clinic patients have this diagnosis. A cohort of 20 women diagnosed with diminished ovarian reserve provided a blood specimen (confidential results), and completed structured questionnaires that assessed emotional reactions to potentially being a premutation carrier (pretest questionnaire, n = 20) and the posttest known carrier status (3 month follow-up questionnaire, n = 18 non-carriers). Responses were measured using 9-point scales, and analyzed with Fisher exact and Wilcoxon exact tests. While most participants did not view fragile X premutations as a serious medical condition, perceptions of seriousness were positively correlated with anger and regret about not knowing sooner of the potential association of these premutations with infertility. Overall, when women (pretest) imagined themselves as carriers, their self-esteem and Health Orientation Scale responses were unchanged with the exception of feeling more afraid (p = 0.004). Despite strongly wishing for negative test results, they were glad to know there might be a medical explanation for their infertility. Financial Support: This work was financially supported by a University of Virginia School of Medicine Research & Development Award.     

Psychological Profiles of Individuals Seeking Ordination in the Episcopal or Presbyterian (PCUSA) Churches: Comparisons and Contrasts

The present study examined the psychological profiles of 138 candidates for ordained ministry from the Episcopal (n = 90) and Presbyterian Church (USA) (n = 48). Employing scales scores from the MMPI-2, MCMI-III, and 16PF-5, we used a series of one-way ANOVAs to test for differences between genders, denominations, and (for Episcopalians) ordination type and completion versus non-completion of the ordination process. Our results suggest that, consistent with the literature, these future clergy were generally well-adjusted and socially skilled. Denominational differences in our sample were virtually non-existent. While similar on most dimensions, female candidates may appraise their circumstances and relationships with a greater emphasis on emotional considerations than their male counterparts. Differences between Episcopal candidates for the Priesthood and the Deaconate were consistent with differences in their respective leadership and support roles. Finally, discriminant function analysis indicated that candidates who completed their ordination appeared to have a more realistic and positive attitude toward the process as well as a more deferential and less independent orientation than those who did not.     

Self-objectification and Well-being: The Impact of Self-objectification on Women’s Overall Sense of Self-worth and Life Satisfaction

Research on objectification theory (Fredrickson and Roberts in Psychology of Women Quarterly 21:173–206, 1997) has demonstrated relations among self-objectification, body shame, and negative health outcomes. Less research has focused on the relation of self-objectification to indicators of well-being. We examined associations among self-objectification, body shame, and two indicators of well-being (i.e., self-esteem and satisfaction with life) in a path analytic model. We also tested explicitly whether body shame mediated the relation between self-objectification and self-esteem and whether self-esteem mediated the relation between body shame and life satisfaction. Female undergraduates (N = 227) from the United States completed questionnaires assessing the constructs of interest. Results indicated that the proposed model fit the data and that body shame and self-esteem mediated as predicted. Implications of these findings are discussed.     

The UCLA Body Project II: Breast and Body Dissatisfaction among African, Asian, European, and Hispanic American College Women

Breast and global body dissatisfaction were examined in Asian (n = 237), European (n = 196), Hispanic (n = 109), and African (n = 58) American college women. Asian American women reported the lowest body satisfaction on the Appearance Evaluation Scale (Cash, T. F. The multidimensional body-self relations questionnaire users’ manual: 3rd revision, 2000) and greatest breast dissatisfaction on one of two breast dissatisfaction measures. Ethnic differences in breast dissatisfaction, but not in body dissatisfaction, disappeared when body size (BMI) was statistically controlled. Results were consistent with research showing that (1) ethnic differences in body dissatisfaction are small, (2) studies of ethnic differences must include appropriate controls for total or specific body size, and (3) Asian college women report lower global body satisfaction than women of African, European, or Hispanic heritage. For additional papers and information, please contact David Frederick at enderflies1@aol.com, visit his website at or contact Gordon B. Forbes at gforbes@millikin.edu.     

Providers’ Perceptions and Practices Regarding <Emphasis Type="BoldItalic">BRCA1/2</Emphasis> Genetic Counseling and Testing in African American Women

We examined healthcare providers’ perceptions of genetic counseling and testing in African American women at moderate to high-risk of carrying a BRCA1/2 mutation. We conducted 20 in-depth interviews with genetic counselors (n = 5), medical oncologists (n = 8), obstetrician/gynecologists (n = 2) and surgeons (n = 5). Interviews were audiotaped, transcribed and independently coded by two individuals using a content analysis approach. Seven themes emerged relevant to providers’ perceptions of African American women’s use of BRCA1/2 genetic services: access factors, cultural beliefs and preferences, effects of testing, patient motivators for genetic counseling and testing, patient-provider communication, reasons for provider referral, and reasons for patient refusal. Providers identified individual- and system-level barriers to African American women’s use of genetic services, including lack of follow-up after referrals to genetic specialists and challenges to obtaining financial coverage for under- and uninsured high-risk women. Results have implications for physician and patient education regarding appropriate referrals to and uptake of genetic services in at-risk African American women.     

Genetic Testing Likelihood: The Impact of Abortion Views and Quality of Life Information on Women’s Decisions

Little is known about factors predicting the likelihood of choosing genetic testing in college aged women versus older women, including knowledge of quality of life (QOL) associated with a disorder. Using vignettes with female college students (Experiment 1: n = 257, mean age = 19.70 yrs) and female faculty/staff/alumni (Experiment 2: n _nulliparous = 83, mean age = 30.20 yrs; n _mothers = 53, mean age = 33.77 yrs), we examined the contribution of multiple factors to predicting genetic testing likelihood for cystic fibrosis. We investigated malleable situational factors (style of genetic risk presentation and providing QOL information including physical and social aspects) and stable dispositional factors (abortion views). Parity (i.e., prior births) was more influential in women’s genetic testing likelihood than was age. Greater acceptability of abortion for oneself and self-assessed knowledge following QOL information were predictors of higher testing likelihood for college students. Greater acceptability of abortion for another person was a predictor for nulliparous women. Abortion views moderated the effect of predictors for nulliparous women and mothers. Findings encourage genetic counselors to utilize QOL information to promote informed decision making through genetic testing.     

An Evaluation of the Relation Between Distress Tolerance and Posttraumatic Stress within a Trauma-Exposed Sample

The present investigation examined the incremental associations between distress tolerance, or the perceived capacity to tolerate emotional distress, and global posttraumatic stress symptom severity as well as symptom cluster severity, beyond the variance accounted for by number of trauma exposure types and negative affectivity. The sample consisted of 140 adults (72 women; M _age = 25.9, SD = 11.1) who endorsed exposure to traumatic life events, as defined by posttraumatic stress disorder diagnostic criterion A (American Psychiatric Association 2000). Participants did not meet diagnostic criteria for current axis I psychopathology. Distress tolerance demonstrated significant incremental associations with global posttraumatic stress symptom severity (p < .01) as well as re-experiencing (p < .05), avoidance (p = .05), and hyperarousal (p < .001) symptom cluster severity. Given the cross-sectional study design, causation cannot be inferred. Theoretical implications and future directions for better understanding associations between distress tolerance and posttraumatic stress are discussed.     

Sociocultural Predictors of Physical Appearance Concerns among Adolescent Girls and Young Women from China

This research assessed the extent to which sociocultural predictors of body dissatisfaction implicated in Western studies extend to the prediction of physical appearance concerns among young women and adolescent girls in Southwest China. In Study 1, 408 Chinese university-age women completed measures of fatness concern (FC), facial appearance concerns (FAC), sociocultural influence (i.e., appearance pressure, comparison, teasing), and demographics. In hierarchical regression analyses, appearance pressure and comparison predicted both FC and FAC, independent of other factors. In Study 2, effects of appearance pressure and comparison were replicated among middle school (n = 346) and high school (n = 563) girls. Together, findings suggest that appearance pressure and social comparison correspond with specific body image concerns of young females in China.     

Associations of Youth and Adulthood Body-Mass Index and Waist-Hip Ratio with Attachment Styles and Dimensions

The current cross-sectional study examined whether body-mass index (BMI) and waist-hip ratio are associated with adult attachment. Participants were 1,570 men and women participating in Cardiovascular Risk in Young Finns study. BMI was measured in youth and in adulthood and waist-hip ratio in adulthood. A single measure of attachment style was conducted when participants were aged 24–39 years. In age and sex adjusted models, youth BMI (Beta = .066, p = .008), adulthood BMI (Beta = .069, p = .007) and waist-hip ratio (Beta = .082, p = .016) were associated with fearful attachment. The associations remained significant when education and relationship status were adjusted for. Age adjusted association between adulthood waist-hip ratio and preoccupied attachment was found in men (Beta = .132, p = .002). The association was not essentially changed by additionally adjusting for education and relationship status, and including fearful attachment in the model. Furthermore, associations for attachment dimensions were also found. These results suggest that in addition to previously reported negative effects of higher BMI on physical health, higher BMI might have negative associations with psychological functioning as well. Furthermore, our results imply that physical appearance might be associated with attachment style in adulthood.     

Views on Abortion: A Comparison of Female Genetic Counselors and Women from the General Population

While literature characterizing individual genetic counselors’ abortion attitudes is sparse, the National Society of Genetic Counselors takes a clear stance for reproductive autonomy. To determine genetic counselors’ views, this study compared (1) genetic counselors’ abortion attitudes to those of women from the general population and (2) genetic counselors’ professional abortion attitudes to their personal abortion attitudes. Genetic counselors were invited to complete an online survey. Response rate was 44.3% (709/1,601). Compared to women from the general population, female genetic counselors were significantly more likely to agree abortion should be an option in all cases (p < .001). Controlling for other possible confounders, regression analyses revealed that being a genetic counselor, religious service attendance and age were significantly predictive of abortion attitudes. Although the vast majority of genetic counselors agree that abortion should be available, they are significantly less likely to personally consider abortion under all circumstances presented (p < .001), and the percentage of genetic counselors who would consider terminating in the case of a severe birth defect is similar to studies of other women.     

Feminism: What is it Good For? Feminine Norms and Objectification as the Link between Feminist Identity and Clinically Relevant Outcomes

The goal of this study was to explore the relationships between feminism and clinical outcomes, such as eating attitudes, depression, and self-esteem, employing structural equation modeling to look at indirect relationships. This study examined female participants’ (N = 282) responses to an online survey measuring feminist self-identification, conformity to feminine norms, objectified body consciousness, eating attitudes, depression, and self-esteem. Participants were recruited on two college campuses and through online listservs. Feminist self-identification was related to rejecting the feminine norms of thinness, appearance, and the importance of romantic relationships. Endorsing these norms was related to increased body surveillance and shame. Objectification variables were related to negative clinical outcomes. Thus, feminism is a distal, rather than proximal, influence on clinical variables.     

The Impact of Demographic Characteristics on Health-related Quality of Life Profile of Malaysian Epilepsy Population

The possibilities of adverse drug reactions and disease-related psychosocial implications have led to the current emphasis on health-related quality of life (HRQoL) assessment in epilepsy. The main objective of this study was to determine the impact of various demographic characteristics i.e. gender, age, marital status, ethnic origin, religion, and employment status on HRQoL profiles in Malaysian epilepsy patients. Patients with epilepsy were recruited from ten public hospitals in Sabah, Malaysia. Upon written consents, they completed the Malay Quality of Life In Epilepsy-30 (QOLIE-30) instrument which assesses Seizure Worry, Overall QoL, Emotional Well-Being, Energy/Fatigue, Cognitive Functioning, Medication Effects and Social Functioning. An Overall Score was generated to represent a summarised HRQoL score. Univariate and multiple linear regression analyses were both carried out using SPSS 14 for (1) all patients and (2) patients possessing Poor QoL (Overall Score < median) and Good QoL (Overall Score ≥ median). One-hundred-and-thirteen patients participated in the study. The respondents ranged from 18–76 years with a mean age of 31 years. Majority were Kadazandusuns (n = 46; 40.7%) and many were unmarried (n = 68; 60.2%), Muslims (n = 50; 44.2%) and unemployed (n = 54; 47.8%). Age was the most significant factor across all patients (B = −0.372, t = −2.238, p = 0.027), regardless of Poor or Good QoL level. Older patients (>56 years) fared the worst in many HRQoL areas. Those with Poor QoL were mostly affected by marital status (widowed/divorced) and ethnic origin (Kadazandusun/Chinese). Religion (Buddhism/Hinduism) emerged as the most prominent HRQoL predictor for patients experiencing Good QoL and being Chinese too played a role. These outcomes indicate that specific demographic characteristics are influential in determining the HRQoL of epilepsy patients. Consequently, healthcare professionals could utilise such information in planning the best treatment and care by considering both the medical and psychosocial impacts towards patients. This paper was part of a research project and majority of its components had been presented at the 7th Conference On International Society For Quality Of Life Studies (ISQoLS) 2006, Rhodes University, Grahamstown, South Africa, 17–20 July 2006.     

The Delinquency Outcomes of Boys with ADHD with and Without Comorbidity

This study examined the association between childhood ADHD and juvenile delinquency by examining data from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of individuals diagnosed with ADHD in childhood (ages 5–12) and recontacted in adolescence and young adulthood for yearly follow-up (age at first follow-up interview M = 17.26, SD = 3.17). Participants were 288 males with childhood ADHD and 209 demographically similar males without ADHD who were recruited into the follow-up study. Delinquency information gathered yearly during the second through eighth follow-up provided a comprehensive history of juvenile delinquency for all participants. Four childhood diagnostic groups [ADHD-only (N = 47), ADHD + ODD (N = 135), ADHD + CD (N = 106), and comparison (N = 209)] were used to examine group differences on delinquency outcomes. Analyses were conducted across three dimensions of delinquency (i.e., severity, age of initiation, and variety). Individuals with childhood ADHD + CD displayed significantly worse delinquency outcomes than the other three groups, across almost all indices of offending. When compared to comparison participants, boys with ADHD-only and ADHD + ODD in childhood displayed earlier ages of delinquency initiation, a greater variety of offending, and higher prevalence of severe delinquency. These findings suggest that although childhood ADHD + CD creates the greatest risk for delinquency, boys with ADHD-only and ADHD + ODD also appear at a higher risk for later offending. The patterns of offending that emerged from the PALS are discussed in the context of the relationship between ADHD, comorbidity, and delinquency.     

Student Ratings of a Male and Female Professors’ Lecture on Sex Discrimination in the Workforce

Using an experimental design, male (n = 41) and female (n = 46) undergraduate students in the southeastern USA evaluated an identical written lecture by a male and female professor on pay disparities between men and women in the workforce suggesting sex discrimination. Regardless of the students’ sex, the male professor and his lecture was rated more positively and less sexist than the female professor. Moderated multiple regression analysis indicated that more traditional and gender stereotypical attitudes toward women in male students were related to greater sexism ratings of the female professor compared to the male professor whereas; no differences on ratings of sexism between the male and female professor were found for male students with more liberal attitudes.     

Merton’s “True Self”: A Resource for Survivors of Sexual Abuse by Priests

The toxic impact of clergy sexual abuse in childhood and adolescence can be complex and enduring. For some, a particularly painful consequence is noteworthy change in one’s personal identity or sense of self. Survivors frequently experience unrelenting grief over the loss of the “self” that was experienced as “real” prior to the onset of abuse. Memories of days and times when this self was “alive” are often accompanied by strong feelings of affection and joy. Despair over the loss of this identity contrasts sharply with the indifference or hostility felt for the self with which they have been burdened as a consequence of sexual abuse by clergy in childhood. Many struggle with the unbearable conviction that they are fated to live “in the skin” of an identity that is not an authentic expression of the person they were meant to be. This article suggests that the writings of Thomas Merton (1915–1968) may offer a hopeful resource for survivors of clergy sexual abuse and for those working in support of survivors’ recovery. Merton has been described as “the most influential Catholic author of the twentieth century” ). His writings touch the “deeper woundedness of spirit and psyche” (Kilcourse, Cross Curr, 49:87–96, 1999, p. 90) and his elegant examination of the true self lies “at the center of his teaching on the Christian life” (Conn, Pastor Psychol, 46:323–332, 1998, p. 327). For Merton, the true self is indestructible and, because it is “rooted in God” (Merton, The inner experience: Notes on contemplation, Harper Collins, New York, 2003, p. 2), always open to discovery, growth, and transformation. This framework may be especially useful for individuals whose personal identity, as a consequence of sexual abuse in childhood by clergy, is experienced as forever poisoned and beyond redemption.     

Mindfulness,Self-Esteem,and Unconditional Self-Acceptance

Ellis (Ellis, A. (1996), Psychotherapy, 22(1), 149–151) has been a longstanding critic of the concept of self-esteem and has offered the notion of unconditional self-acceptance as an alternative. Other researchers have suggested that cultivating mindfulness––attention directed towards one’s immediate experiences with an attitude of non-judgment––also offers a healthier alternative to self-esteem (Ryan, R. M., & Brown, K. W. (2003) Psychological Inquiry, 14(1), 71–76). This study examined the relationship between mindfulness, self-esteem, and unconditional self-acceptance. A sample of 167 university students completed two measures of everyday mindfulness, and measures of self-esteem and unconditional self-acceptance. Positive correlations were found between mindfulness, self-esteem, and unconditional self-acceptance. Mindfulness skills may offer a means to cultivate unconditional self-acceptance and to shift from an emphasis on self-esteem as a measure of worth. This paper was based on data collected for the first author's Master's project.     

Using the ASEBA to Screen for Callous Unemotional Traits in Early Childhood: Factor Structure,Temporal Stability,and Utility

This study evaluated a five-item screening measure of Callous Unemotional (CU) traits using items drawn from the Preschool Form of the Achenbach System of Empirically Based Assessment (ASEBA). Using data from the Durham Child Health and Development study (N = 178), confirmatory factor analyses demonstrated that CU items could be distinguished from Attention Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant (ODD) items. The two-year stability (N = 137) of CU (ϕ = .84) was comparable to that of ADHD (ϕ = .79) and ODD (ϕ = .69). Three groups of children were selected based on parent-rated ODD and CU behaviors at the 36-month assessment (N = 37; ODD+CU, N = 7; ODD-only, N = 12; non-ODD, N = 18). Multiple measures of infant temperament predicted group membership with 84% accuracy. Consistent with Frick and Morris’ (Journal of Clinical Child and Adolescent Psychology 33(1):54–68, 2004) hypotheses, ODD+CU and ODD-only children exhibited temperamental profiles in infancy that were consistent with low fear and emotionally dysregulated pathways into conduct problems, respectively.     

Further Evidence of the Reliability and Validity of the Multidimensional Anxiety

The psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) were examined in adolescent psychiatric inpatient samples. In Study 1 (n = 287), confirmatory factor analyses provided satisfactory fit for the four-factor (comparative fit index; CFI = 0.856) and higher-order (CFI = 0.854) solutions. Using parcels as items, the fit of the four-factor model was improved substantially (CFI = 0.935). Next, in the bifactor analyses, support was attained for a model that included a general factor and four domain specific subfactors. In Study 2 (n = 195 inpatient youths), the MASC showed good scale reliability and concurrent validity. Results of the receiver operating characteristic curve and binary logistic regression analyses provided adequate evidence for discriminative validity. In Study 3 (n = 40), test–retest reliability of scores on the MASC-10 scale over a 3-week period was adequate (r _tt = 0.83, p < 0.001) for children ages 8 to 11 years.     

Patterns of Growth in Adaptive Social Abilities Among Children with Autism Spectrum Disorders

Adaptive social skills were assessed longitudinally at approximately ages 2, 3, 5, 9, and 13 years in a sample of 192 children with a clinical diagnosis of autism (n = 93), PDD-NOS (n = 51), or nonspectrum developmental disabilities (n = 46) at age 2. Growth curve analyses with SAS proc mixed were used to analyze social trajectories over time. Both individual characteristics and environmental resources emerged as key predictors of adaptive social behavior outcome. The gap between children with autism and the other two diagnostic groups widened with time as the social skills of the latter groups improved at a higher rate. However, within diagnostic groups, improvement ranged from minimal to very dramatic. Children with autism most at risk for problems with social adaptive abilities later in life can be identified with considerable accuracy at a very young age so they can be targeted for appropriate early intervention services.