Boundary Issues and Multiple Relationships in Genetic Counseling Supervision: Supervisor,Non-supervisor,and Student Perspectives

Boundary issues and multiple relationships potentially affect all supervision interactions. Boundary crossings are departures from the strictest professional role and may or may not benefit supervisees. Boundary violations are outside common practice and may place supervisees at significant risk. Multiple relationships occur when supervisors concurrently or consecutively hold two or more roles with supervisees. Studies in other fields indicate supervisors and supervisees may be uncertain about professional conduct regarding these issues. In this study, genetic counselor supervisors (n?=?126), non-supervisors (n?=?72), and genetic counseling students (n?=?129) completed an anonymous survey investigating four major questions: 1) Are various boundary issues and multiple relationships perceived as differentially appropriate? 2) Do supervisor, non-supervisor, and student perceptions differ? 3) What challenging situations have respondents experienced? and 4) What management strategies did they use? There was general agreement among groups in their appropriateness ratings of 56 hypothetical supervisor behaviors, although supervisor ratings tended to reflect stricter boundaries regarding the appropriateness of interactions than student ratings. A majority rated unavoidable boundary crossings and supervisor multiple relationships involving an academic relationship as most appropriate, and romantic/sexual multiple relationships and/or boundary violations as least appropriate. Analysis of respondents’ actual challenging situations revealed many involved boundary violations, placed students at risk of harm, and often resulted in student compliance.     

Exploration of Male Attitudes on Partnerships and Sexuality with Female <Emphasis Type="Italic">BRCA1/2</Emphasis> Mutation Carriers

Women with BRCA mutations are inundated with decisions about managing cancer risks and childbearing considerations. Decisions become more complicated when women face disclosing their mutation and risk-reduction options to a romantic partner. This study identifies the concerns and perspectives of male romantic partners regarding these unique decisions. Twenty-five male participants completed an online survey posted to cancer support group message boards. Participants reported relationship changes regarding intimacy levels (n?=?9), attraction (n?=?2), and communication (n?=?22) after mutation disclosure. Participants whose partners had not undergone prophylactic mastectomy (n?=?14) reported concerns regarding sexual relations (n?=?5), post-surgical appearance (n?=?2), post-surgical attraction (n?=?5), and health/lifespan (n?=?9). Participants did not express attitude changes toward childbearing. While mutation disclosure conversations and surgical options are concerns for many BRCA mutation carriers in relationships, male partners share these concerns. Aspects of the relationship may change, but male study participants continued to support their partners. This information can benefit female BRCA mutation carriers, their current or future partners, and genetic counselors working with this particular population.     

EFL Teachers’ Verbal and Nonverbal Immediacy: A Study of its Impact on Students’ Emotional States,Cognitive Learning,and Burnout

Effective teacher–student interaction is an essential element of an ideal classroom which promotes the opportunity for expanded learning and stimulates the connections between students and teacher. The focus of the present study is on an instructional communication element that is teacher immediacy. It is defined as the mutual sensory and psychological stimulation between teacher and students. It can be verbal or nonverbal. Verbal immediacy is characterized as stylistic differences in expression from which like–dislike is inferred and includes using humor or personal examples, getting feedback, or even calling students by name. Nonverbal immediacy encompasses behaviors such as appropriate eye contact, the use of gestures, movement about the classroom, smiling, and vocal variety. In particular, the present study sought to explore the impact of English as a foreign language (EFL) teachers’ perceived verbal/nonverbal immediacy on students’ self-actualization, stress-control, and self-esteem. Moreover, it examined the role of EFL teachers’ immediacy behaviors in students’ cognitive learning and emotional exhaustion, which is a burnout subscale. To this end, 206 EFL students participated from selected universities of Mashhad, a city in northeast of Iran. The respondents were asked to complete five inventories about themselves and the previous EFL teacher they had had classes with. The results of structural equation modeling demonstrated that teacher immediacy behavior had a positive significant impact on all student-related variables: stress tolerance (β?=?.65, t?=?7.59), self-actualization (β?=?.69, t?=?8.02), self-esteem (β?=?.63, t?=?7.71), burnout (β?=?.31, t?=?4.05), and cognitive learning (β?=?.45, t?=?6.08). The highest impact was exerted on self-actualization and self-esteem.     

Interference Control in Children with Attention Deficit/Hyperactivity Disorder

The view that Attention Deficit/Hyperactivity Disorder (ADHD) is associated with a diminished ability to control interfference is controversial and based exclusively on results of (verbal)-visual interference tasks, primarily the Stroop Color Word task. The present study compares medication-naïve children with ADHD (n?=?35 and n?=?51 in Experiments 1 and 2, respectively) with normal controls (n?=?26 and n?=?32, respectively) on two interference tasks to assess interference control in both the auditory and the visual modality: an Auditory Stroop task and a Simon task. Both groups showed reliable but equal degrees of interference on both tasks, suggesting that children with ADHD do not differ from normal controls in their ability to control interference in either modality.     

Developing a Revised Cross-Cultural Academic Integrity Questionnaire (CCAIQ-2)

Understanding and measuring levels of academic integrity within higher education institutions across the world is an important area of study in the era of educational internationalization. Developing a cross-cultural measure will undoubtedly assist in creating standardization processes and add to the discourse on cross-cultural understanding on what constitutes honest and dishonest action in the higher education context. This study has used a combination of exploratory and confirmatory factor analytical procedures to validate a previously published questionnaire, namely the cross-cultural academic integrity questionnaire (CCAIQ). Inspection of response distributions was also undertaken. Primary participants in this study were from Iran (n?=?216), and secondary reference participants were from New Zealand (n?=?366) and Nigeria (n?=?330). The findings indicate that a revised questionnaire (CCAIQ-2) better represents the data obtained from all three regions. Three CCAIQ-2 domains are proposed: cheating, collusion and complying. However, the response distributions (skewness and kurtosis) indicated differences among the three groups, further suggesting that the theoretical constructs developed through factors analysis may not represent equivalence in terms of cross-cultural understanding. This research will inevitably create international debate on the measurement of integrity and how this measurement process can be used to establish internationally recognized and accountable educational regulations.     

Pilot Mindfulness Intervention for Children Born with Esophageal Atresia and Their Parents

A pilot mindfulness home intervention was conducted for 6 weeks among 8–12-year-old children born with esophageal atresia and their parents. Participants were randomly assigned to a waiting list control (WLC) group (n?=?8) and an experimental group (n?=?12). When all participants had completed the mindfulness-based program, data were pooled and treated for the entire sample (n?=?19). Self-assessment measures included the Mindful Attention Awareness Scale for Adolescents (MAAS-A), the Child and Adolescent Mindfulness Measure (CAMM), the modified Spielberger State-Trait Anxiety Inventory—Child (STAI-C), the Children’s Depression Inventory (CDI), and the Cognitive Emotion Regulation Questionnaire Kids version (CERQ-k). Parental assessment measures included the modified STAI-C. The results underlined the program’s feasibility and acceptability. Clinical effects of the mindfulness-based program were observed. Self-assessed data for children who had practiced mindfulness compared to the WLC group showed increased mindfulness and decreased depression. Reduced anxiety was found in all groups. Positive affect tended to improve from pre-test to post-test in children who had practiced mindfulness compared to the WLC group. Parental assessments showed significant improvement in positive affect and decreases in anxiety and negative affect in the intervention group compared to the WLC group. Cognitive emotion regulation strategies were also affected by the mindfulness-based program. Rumination scores significantly decreased from pre-test to post-test in the intervention group. This preliminary study suggests that regular mindfulness practice presents a promising approach to reducing the burden of this neonatal malformation.     

Mindfulness Among Genetic Counselors Is Associated with Increased Empathy and Work Engagement and Decreased Burnout and Compassion Fatigue

Genetic counselors experience high rates of compassion fatigue and an elevated risk for burnout, both of which can negatively impact patient care and retention in the profession. In other healthcare professions, mindfulness training has been successfully used to address similar negative psychological sequelae and to bolster empathy, which is the foundation of our counseling work. We aimed to assess associations between mindfulness and key professional variables, including burnout, compassion fatigue, work engagement, and empathy. Data were collected via an anonymous, online survey that included validated measures of mindfulness and these key professional variables. The survey was completed by 441 genetic counselors involved in direct patient care. Half of the respondents (50.1%) reported engaging in yoga, meditation, and/or breathing exercises. Mindfulness was positively correlated with work engagement (r?=?0.24, p?<?0.001) and empathy (as measured through four subscales: perspective taking (r?=?0.15, p?=?0.002), empathic concern (r?=?0.11, p?=?0.03), fantasy (r?=???0.11, p?=?0.03) and personal distress (r?=???0.15, p?=?0.001)). Mindfulness was negatively correlated with compassion fatigue (r?=???0.48, p?<?0.001) and burnout (r?=???0.50, p?<?0.001). Given these findings, mindfulness training may be a valuable addition to graduate and continuing education for genetic counselors. The integration of mindfulness into the genetic counseling field will likely improve professional morale and well-being, while promoting workforce retention and bolstering the relational and counseling aspects of our clinical work.     

A Psychometric Evaluation of the Behavioral Inhibition Questionnaire in a Non-Clinical Sample of Israeli Children and Adolescents

This study examined the psychometric properties of a Hebrew version of the Behavioral Inhibition Questionnaire (BIQ) in a non-clinical sample of Israeli children and adolescents. We produced a Hebrew translation of the BIQ and collected 227 responses to it from parents of children aged 4–15. Some respondents in the larger sample also completed the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire (n?=?91) and the Conners’ Abbreviated Parent-Teacher (CONNERS) questionnaire (n?=?39), in addition to the BIQ. Lastly, 21 children of BIQ respondents (aged 8–14) completed a self-report version of the questionnaire. Confirmatory factor analysis (CFA) was performed to assess how well the established six correlated factor model of the BIQ applied to the sample data. The Hebrew BIQ demonstrated good internal consistency (Chronbach’s α?=?.94, n?=?227) and 3 month test–retest reliability, (r?=?.95, p?<?.001, n?=?21). It also showed both convergent validity, as scores on the BIQ were correlated with the SCARED (r?=?.66, p?<?.01. n?=?91), and discriminant validity, as BIQ scores were not correlated with the CONNERS (r?=?.24, n?=?39). Finally, mother reports of BI were significantly correlated to child reports of BI via the BIQ (r?=?.60, p?<?.01, n?=?21). Thus, through this preliminary study we demonstrated that the Hebrew version of the BIQ is an effective tool for screening for BI among Israeli children, making it a useful instrument for future research.     

Maltreated and Comparison Adolescents’ Recollections of Lifetime Residences: Relationship to Delinquency and Marijuana Use

This study of child welfare-affiliated maltreated youth (n?=?216) and comparison youth (n?=?128) from the same community (age M?=?18.21, SD?=?1.42) examined: 1. whether child/caregiver characteristics and maltreatment status were associated with lifetime number of residences; and 2. whether child/caregiver characteristics, residences, and maltreatment status were associated with delinquency and marijuana use. Maltreatment status, ever living with a nonparent caregiver, and being older were associated with more residences during childhood. More residences and male sex were associated with person offense delinquency and marijuana use. It is important to help caregivers who live in disadvantaged neighborhoods, especially families with child welfare involvement, understand the behavioral consequences of a high number of residences during childhood and adolescence and provide support for stable long-term housing.     

Do Birds of a Feather Cheat Together? How Personality and Relationships Affect Student Cheating

Academic misconduct is widespread in schools, colleges, and universities and it appears to be an international phenomenon that also spills over into the workplace (Nonis and Swift 2001; Sims 1993; Stone et al. 2011). To this end, while a great deal of research has investigated various individual components such as, demographic, personality and situational factors that contribute to cheating, research has yet to examine why students help others cheat and which students are being asked to help others cheat. In this study, we investigated if the closeness of the relationship to the individual requesting help in cheating to the individual being asked to help cheat, influenced the decision to help cheat. We also investigated if past cheating behavior predicted how an individual would respond to requests to cheat. Additionally, we sought to answer the following questions; whether minor cheating is more prevalent than serious cheating, what personality factors predict helping others cheat, who is helped, and how people rationalize helping others cheat. Results indicate minor cheating to be more prevalent, prudent personalities are less likely to have cheated or to help others cheat, individuals are more likely to help friends cheat than to help strangers, and past cheating behaviors is indicative of helping others to cheat. Implications for research and practice are discussed.     

The Factor Structure of the Forms of Self-Criticising/Attacking &amp; Self-Reassuring Scale in Thirteen Distinct Populations

There is considerable evidence that self-criticism plays a major role in the vulnerability to and recovery from psychopathology. Methods to measure this process, and its change over time, are therefore important for research in psychopathology and well-being. This study examined the factor structure of a widely used measure, the Forms of Self-Criticising/Attacking & Self-Reassuring Scale in thirteen nonclinical samples (N?=?7510) from twelve different countries: Australia (N?= 319), Canada (N?= 383), Switzerland (N?= 230), Israel (N?=?476), Italy (N?=?389), Japan (N?=?264), the Netherlands (N?=?360), Portugal (N?=?764), Slovakia (N?=?1326), Taiwan (N?=?417), the United Kingdom 1 (N?=?1570), the United Kingdom 2 (N?=?883), and USA (N?=?331). This study used more advanced analyses than prior reports: a bifactor item-response theory model, a two-tier item-response theory model, and a non-parametric item-response theory (Mokken) scale analysis. Although the original three-factor solution for the FSCRS (distinguishing between Inadequate-Self, Hated-Self, and Reassured-Self) had an acceptable fit, two-tier models, with two general factors (Self-criticism and Self-reassurance) demonstrated the best fit across all samples. This study provides preliminary evidence suggesting that this two-factor structure can be used in a range of nonclinical contexts across countries and cultures. Inadequate-Self and Hated-Self might not by distinct factors in nonclinical samples. Future work may benefit from distinguishing between self-correction versus shame-based self-criticism.     

The Complex Relations Between Wisdom and Significant Life Learning

This study explores the various relations between two important processes in life-span development: wisdom and learning from significant life experience. A diverse sample of 375 individuals from Taiwan, culled from an initial sample of 475, completed a sequence of three questionnaires that asked them to describe their most significant life learning, the wisdom they had displayed, and the relation between the two. The 375 participants specified one of five relations: (a) their most significant life learning led to their display of wisdom (n?=?191, 51%); (b) the two were unrelated (n?=?91, 24%); (c) their display of wisdom led to their most significant life learning (n?=?67, 18%); (d) the wisdom displayed was part of their most significant life learning (n?=?20, 5%); (e) their most significant life learning was part of the wisdom they displayed (n?=?6, 2%). These results suggest that wisdom and significant life learning are seen as related in various ways. The findings shed light on how wisdom and the learning acquired from significant life experiences foster individual development.     

The Treatment of Childhood Disruptive Behavior Disorders in Ambulatory Mental Health Centers

Over the years, evidence-based treatments for children with disruptive behavior disorders (DBDs; e.g., conduct disorder, oppositional defiant disorder) have been developed, however, there is not much information about the treatment children receive in usual mental healthcare settings. This study examined the common treatment provided in US ambulatory mental health clinics to children aged 3 to 9 years who are diagnosed with DBDs. An online survey was filled by appropriate respondents from 145 ambulatory mental health centers across 33 states within the US. The most common treatment provided for childhood DBDs was a combination of child therapy (CT) and parent training (PT) (n?=?81, 56%), followed by family therapy (n?=?42, 29%), CT (n?=?17, 12%), and PT (n?=?5, 3%). Behavioral and cognitive principles were reported as the most common treatment orientations across all types of treatment (n?=?116/145, 80%). The mean number of sessions administered was 31.38?±?22.72, and PT as a standalone treatment required approximately a third of sessions (10.6?±?1.34). In treatments combining CT and PT, the utilization of specific parenting programs was associated with fewer administered sessions. Results suggest that the importance of parental involvement in treating DBDs is acknowledged in routine practice. However, more studies are needed to determine why certain types and orientations of treatments are favored over others.     

Development and Validation of the Knowledge of Parenting Strategies Scale: Measuring Effective Parenting Strategies

The current study aimed to develop and evaluate a measure of parenting knowledge, the Knowledge of Parenting Strategies Scale (KOPSS); specifically, to establish the scales internal reliability, ensure a clinically appropriate length, provide a community sample for future comparison, demonstrate adequate test–retest reliability and convergent validity, and to compare the scale to dysfunctional discipline styles. A total of n?=?865 parents were involved in the development and evaluation of the scale. In Study 1, data was collected from n?=?229 parents and Rasch analyses revealed seven items did not fit the measurement model. Study 2 involved a further sample of community families (n?=?346) and revealed the scale could be further shortened to 16 items. Study 3 revealed the scale has good test–retest reliability over a one-week period (r?=?.88, p?<?.001). Study 4 demonstrated convergent validity through a comparison to the Knowledge of Effective Parenting Scale (r?=?.583, p?=?.009). Study 5 utilised a sample of community families (n?=?190), revealing the scale was negatively correlated with hostile and lax discipline (r?=??.29, p?<?.001; r?=??.15, p?<?.05). Lastly, Study 6 showed scores on the KOPSS significantly improved following clinic-based and Internet-based Behavioural Parent Training. The KOPSS was found to be a valid and reliable measure of parenting knowledge of effective parenting strategies, which can be used to evaluate knowledge acquisition in parenting programs, and test the role of knowledge in behaviour change.     

Executive Functioning Correlates of <Emphasis Type="Italic">DSM-5</Emphasis> Maladaptive Personality Traits: Initial Evidence from an Italian Sample of Consecutively Admitted Adult Outpatients

In order to evaluate the associations between computer-administered tasks of executive functioning (EF), and maladaptive personality domains and traits listed in DSM-5 Alternative Model of Personality Disorders, 53 consecutively admitted psychotherapy outpatients (female participants: n?=?27, 50.9%; male participants: n?=?26, 49.1%; participants’ mean age?=?37.28 years, SD?=?11.50 years) were administered the Psychology Experiment Building Language (PEBL) EF tasks and the Personality Inventory for DSM-5 (PID-5). According to rank-order correlation analyses, a number of non-negligible and specific associations were observed between selected PID-5 scales and indices of participants’ performance on EF tasks. MM robust regression models showed that participants’ performance on computer-administered EF tasks explained a non-negligible amount of variance in selected PID-5 scale scores (median R² value?=?.17). As a whole, our trait-level analyses of PID-5 dimensions suggest the clinical usefulness of integrating self-reports and EF laboratory tasks in routine clinical assessment.     

Prioritizing Parental Worry Associated with Duchenne Muscular Dystrophy Using Best-Worst Scaling

Duchenne muscular dystrophy (DMD) is a progressive, fatal pediatric disorder with significant burden on parents. Assessing disease impact can inform clinical interventions. Best-worst scaling (BWS) was used to elicit parental priorities among 16 short-term, DMD-related worries identified through community engagement. Respondents viewed 16 subsets of worries, identified using a balanced, incomplete block design, and identified the most and least worrying items. Priorities were assessed using best-worst scores (spanning +1 to ?1) representing the relative number of times items were endorsed as most and least worrying. Independent-sample t-tests compared prioritization of parents with ambulatory and non-ambulatory children. Participants (n?=?119) most prioritized worries about weakness progression (BW score?=?0.64) and getting the right care over time (BW?=?0.25). Compared to parents of non-ambulatory children, parents of ambulatory children more highly prioritized missing treatments (BW?=?0.31 vs. 0.13, p?<?0.001) and being a good enough parent (BW?=?0.06 vs. ?0.08, p?=?0.010), and less prioritized child feeling like a burden (BW?=??0.24 vs. ?0.07, p?<?0.001). Regardless of child’s disease stage, caregiver interventions should address the emotional impact of caring for a child with a progressive, fatal disease. We demonstrate an accessible, clinically-relevant approach to prioritize disease impact using BWS, which offers an alternative to the use of traditional rating/ranking scales.     

Das Absetzen antiandrogener Medikation im ambulanten Setting

In the Forensic Therapeutic Outpatient department in Berlin a total of n?=?20 individually justified, therapeutically accompanied withdrawals from antiandrogenic treatment have been implemented. The sample was compared with n?=?20 patients under antiandrogenic treatment. Patients with withdrawal have been significantly older, than patients without withdrawal. No differences were found regarding their duration of further imprisonment and standardized risk-assessment (HCR-20, LSI-R, Static-99, Stable-2007, PCL-R). Firsts results of the monitoring of the withdrawals indicate, that the symptom-checklist SCL-90-R is not appropriate for that purpose. However, post-hoc both known sexual reoffendings could be identified by the Massachusetts General Hospital Sexual Functioning Questionnaire. By means of practical experience results are getting discussed.     

Development of the Diabetes Self-Care Efficacy Scale

The present study elaborates the conceptualization and process of development of a scale for assessing diabetes self-care efficacy (DSCE) in patients of diabetes, type 1 and type 2. Health maintenance in chronic illness as diabetes is dependent on performing several key self-care behaviours. The present study discusses two parts—Part I elaborates the qualitative exploration of the research construct through semi-structured interview of diabetic patients. It included 25 diabetic patients, Type-I (n?=?5) and Type-II (n?=?20). Part II discusses the quantitative research methods. The sample consisted of 233 diabetic patients, Type-1 (n?=?39) and Type-2 (n?=?194), who were randomly selected from diabetes and endocrine outpatient department (OPD) of a hospital in, Kolkata, India. Following an exploratory approach employing Principal Component Analysis (PCA), three components were yielded that accounted for approximately 60% of explained variance. Cronbach’s alpha was established at 0.89 indicating satisfactory internal reliability. The components were identified as component 1, “Beliefs about physical exercise regimen” (BPE), component 2, “Beliefs about food and insulin administration and medication recommendations” (FMR) and component 3, “Beliefs about learning and following from others” (LFO). To test the obtained factor structure of the proposed DSCE scale, a confirmatory analysis was performed to help validate the 3-factor, 15-item DSCE scale. The scale is first one of its kind to be proposed and developed in an Indian diabetes context and can prove useful in other settings. Study findings have implications for use in hospital setup and for development of intervention programs in dealing with diabetes patient population.     

Risky Business: Risk Perception and the Use of Medical Services among Customers of DTC Personal Genetic Testing

Direct-to-consumer genetic testing has generated speculation about how customers will interpret results and how these interpretations will influence healthcare use and behavior; however, few empirical data on these topics exist. We conducted an online survey of DTC customers of 23andMe, deCODEme, and Navigenics to begin to address these questions. Random samples of U.S. DTC customers were invited to participate. Survey topics included demographics, perceptions of two sample DTC results, and health behaviors following DTC testing. Of 3,167 DTC customers invited, 33% (n?=?1,048) completed the survey. Forty-three percent of respondents had sought additional information about a health condition tested; 28% had discussed their results with a healthcare professional; and 9% had followed up with additional lab tests. Sixteen percent of respondents had changed a medication or supplement regimen, and one-third said they were being more careful about their diet. Many of these health-related behaviors were significantly associated with responses to a question that asked how participants would perceive their colon cancer risk (as low, moderate, or high) if they received a test result showing an 11% lifetime risk, as compared to 5% risk in the general population. Respondents who would consider themselves to be at high risk for colon cancer were significantly more likely to have sought information about a disease (p?=?0.03), discussed results with a physician (p?=?0.05), changed their diet (p?=?0.02), and started exercising more (p?=?0.01). Participants’ personal health contexts—including personal and family history of disease and quality of self-perceived health—were also associated with health-related behaviors after testing. Subjective interpretations of genetic risk data and personal context appear to be related to health behaviors among DTC customers. Sharing DTC test results with healthcare professionals may add perceived utility to the tests.