Genetic Testing of Children at Risk for Adult Onset Conditions: When is Testing Indicated?

We report a family with an extensive history of colon cancer consistent with hereditary nonpolyposis colorectal cancer (HNPCC). A specific disease causing mutation was identified in affected individuals; p.W714X MLH1 mutation. Given the very young age of onset of cancer in some affected family members, with the youngest affected individual being 19 years of age, genetic counseling was recommended to children as young as 9 years. Ethical issues arose when affected families requested genetic testing for their underage children. Here we describe and debate the value of offering molecular testing for this adult onset disorder to several children in this particular family. We also examine possible molecular causes for the very young age of onset in some family members.     

Adult Male Perpetrators’ Perspectives on What Prevention Approaches Work Best for Young Boys at Risk of Future Intimate Partner Violence Perpetration

As part of a 2-year ethnographic study, 49 adult men who had been convicted of intimate partner violence (IPV) perpetration were interviewed on what they thought would have prevented them from engaging in perpetration behaviors, or rather what they believed prevention with young boys needed to include in order to prevent future IPV perpetration. The authors’ open-ended interviews yielded five main themes: (a) messages about healthy relationship behaviors, (b) the need to promote respect for women, (c) teaching effective skills for communicating and managing anger, (d) programs that provide role models and are school-based, and (e) addressing the impact of experiencing violence as a child. The authors conclude that prevention efforts focused on changing both attitudes regarding IPV and behaviors might be most effective for reducing perpetration, and that greater attention needs to be paid towards prevention among youth most at risk of IPV perpetration, those experiencing violence in their homes.     

The Experience of Sexual Harassment Among Grade-School Students: Early Socialization of Female Subordination?

The purpose of this study was to investigate elementary school children's interpretation of sexual harassment incidents and the relationship of those interpretations to self-esteem and body esteem. Eleven scenarios were read to 73 third- to fifth-grade children. Eight scenarios exemplified peer harassment. The children were asked how they thought the victim felt, what the victim should do, why the perpetrator did this, and whether something similar had ever happened to them. They also completed gender role, self-esteem, and body esteem scales. Results indicated that the majority of the children had experienced peer harassment and that the boys and girls had experienced about equal amounts. However, total harassment was negatively related to self-esteem in girls, but not boys. Furthermore, the children's interpretations of the scenarios as well as the relationship of these interpretations to body and self-esteem indicated that the meaning of sexual harassment was different for the boys and girls. Girls were more likely to think the victim would be frightened and boys more likely to think that the victim would be flattered by the attention. Girls who reported that the victim would be frightened or that they did not know how the victim would react reported lower body esteem. These data are interpreted within the framework of sexual terrorism and sexual objectification theories. These data also underscore the need for additional research in sexual harassment among young children.     

Are Mexican American Adolescents at Greater Risk of Suicidal Behaviors?

A reexamination of ethnicity as a risk factor for adolescent suicidal behavior, focusing on whether Mexican American youths are at increased risk, was undertaken. Data from a sample of 4,175 African, European, and Mexican Americans, aged 11-17, are presented. We examined lifetime attempts and past year attempts, thoughts, and plans. Odds ratios, adjusting for covariates, indicate no differences between European and Mexican Americans on past year thoughts, plans, or attempts or lifetime attempts. Although some studies have reported Mexican American youths are at increased risk, we did not find any differences. Possible explanations for disparate results across studies are discussed, in particular methods effects.     

Parent Training Outcomes Among Young Children with Callous–Unemotional Conduct Problems with or at Risk for Developmental Delay

School-aged children with conduct problems and high levels of callous–unemotional (i.e., lack of empathy, guilt, and lack of caring behaviors) traits (CP + CU) tend to yield less benefit from traditional interventions than do their low-CU counterparts, particularly with respect to conduct problem (CP) outcomes. To date, little is known about treatment response among young children with CP + CU, particularly those with or at risk for developmental delay. Components of parent–child interaction therapy (PCIT), a parent training program effective at reducing CP in young children, have compelling theoretical support for addressing core deficits unique to children with CP + CU and have been used successfully with young children with developmental delay. Our first aim was to test the psychometric properties of a measure of CU traits in preschool children with and without developmental delay. Our second aim was to test whether CU traits predicted post-treatment CP after controlling for initial levels of CP. Participants were 63 families of young children (mean age = 3.87 years), with or at risk for developmental delay, who presented with elevated CP and were treated in a hospital-based outpatient clinic. Results indicated that developmentally delayed children with high levels of CU traits, but not children at risk for delay due to premature birth, showed significantly poorer CP outcomes following treatment with PCIT than did children scoring low on CU traits, even after controlling for initial CP severity. The implications of these findings with regard to treating and preventing severe disruptive behaviors among young children with CP + CU are discussed.     

Adolescents in “Transition”: The Sexual Risk of Self-Channelization

Does labeling teenagers as reckless, impulsive, ruled by hormones, and incapable of considering the consequences of unprotected sex help us understand them better? The present article proposes an interpretation of adolescence as a combination of processes that allow teenagers to undertake experiments, much like (naïve) scientists, with the aim of finding new constructions of self, including in the area of sexuality. After considering some theoretical aspects in construing adolescents’ points of view, examples of adolescents’ stories are presented to suggest an alternative perspective of their risk-taking behavior. It is proposed that this alternative view of adolescents may influence those who work with young people to think differently when drawing up healthcare plans and sex education courses, in which the idea of right and wrong behavior gives way to one of elaborative choice.     

Are UN Peacekeepers at Risk for Suicide?

Media reports connecting UN peacekeeping duties by Canadian soldiers to their subsequent suicide prompted this study of peacekeeping as suicide risk. In a case-control design we retrospectively compared 66 suicides in the Canadian military between 1990 and 1995 with two control groups: (a) 2,601 controls randomly selected from the electronic military database and (b) 66 matched controls with complete personnel and medical data. We found no increased risk of suicide in peacekeepers except among a subgroup of air force personnel. Here confounding individual factors, isolation from supports, and possibly inadequate preparation for deployment elucidated their suicides. Theater of deployment (e.g., Bosnia) did not affect the suicide rate. Military suicides experienced psychosocial stresses and psychiatric illness more often than their matched controls. We conclude that although peacekeeping per se does not increase overall suicide risk, military life-styles may strain interpersonal relationships, encourage alcohol abuse, and contribute to psychiatric illness and suicide in a minority of vulnerable individuals irrespective of peacekeeping assignment. Careful selection, and preparatory military training that encourages intragroup bonding and mutual support, may protect against suicide risk.     

Burnout and psychiatric “cases”: Early evidences of an association

This exploratory study extends the phase model of burnout in a critical direction by assessing whether individuals assigned to eight progressive phases will present escalating mental health symptoms. Despite the small convenience population (N = 161), the present affirmative results encourage early replications for three basic reasons. Thus the associations with mental health reported here are consistent with numerous other tests of the concurrent validity of the phase model. Moreover, substantial proportions of the variance are explained here by data supporting the view that the progressive phases are associated with accelerating proportions of “cases,” here defined as respondents to the General Health Questionnaire (GHQ) who report four or more non-psychotic psychiatric symptoms. The GHQ form used here is modified for U.S. contexts. In addition, this basic conclusion is reinforced in three ways: by factor analysis of GHQ items; by rejecting several variables alternative to the phases as GHQ variants; and by using canonical discriminant functions to compare phase assignments with the actual group memberships of “normals” and “cases” assigned by the GHQ.     

The “Circular” Problems of Calculating Risk: Dealing with Consanguinity

An ongoing problem in the genetics clinic is the calculation of inbreeding coefficients and recurrence risks for complex pedigrees, particularly when multiple loops are present. Although the Human Genome Project promises information about more of our genes in the foreseeable future, the actual assignment of disease status to specific loci will continue at a slower pace, so that accurate risk calculations are needed. In the past few months several families with consanguinity were referred to us to confirm the calculations performed by the genetic counselor, and we became aware of some confusion in the field. We present here both (a) a clarification of definitions and concepts and (b) a review of how to perform the calculations, for several quantities (coefficient of relationship, coefficient of inbreeding, coefficient of kinship, and recurrence risk), in complex pedigrees. We discuss the availability of computer algorithms to assist in these calculations, and we encourage counselors to call on a reliable computer program for any but the simplest cases. At the same time, we reiterate our belief that computer algorithms do not relieve the counselor of the responsibility of knowing what to calculate and when.     

Students’ suggestions for eliminating bullying at a university

Students’ suggestions for how to eliminate bullying at universities were gathered as part of an e-questionnaire sent to each university student (N = 10,551) at a Finnish university. The suggestions (n = 2804) regarding how to address bullying at universities were divided into the following four classes: support (944), punishment (78), support and punishment (65), and no suggestions (1717). Further analysis concerning support revealed the following five categories according to Houses’ (1981) classification: instrumental/material support (n = 265), informational support (n = 263), emotional support (n = 139), and appraisal support (n = 69). In addition, there were 208 inexact suggestions regarding how to stop bullying. Analysis concerning resources for help revealed the following five categories: Finnish Students Health Service/student association/police/university priest (120), university teachers (49), other students/peer support (41) and administration (36). In this classification, there were 698 inexact suggestions. This is a sign of the difficulty in addressing bullying situations.     

“It’s Really No Big Deal”: The Role of Social Supply Networks in Normalizing Use of Cannabis by Students at Canadian Universities

Cannabis (marijuana) has undergone a normalizing process as indicated by high use rates, social tolerance, and broader cultural acceptance of its use in many countries. Users also maintain access through extended friendship networks that facilitate the cultural diffusion of the practice. The social nature of supply is herein theorized in terms of Goffman’s understanding of activities that function to preserve a sense of normalcy as a collective achievement enabling predictable constructions of reality. Based on in-depth interviews with undergraduate students, we explore how social networks of supply—characterized by casual access, reciprocity, and sharing—contribute to shared meanings about using marijuana as an unremarkable or “normal” thing to do.     

Religiosity and HIV Risk Behavior Involvement Among “At Risk” Women

During the past decade, increased attention has been payed to the role that religious and faith-based organizations can play in enhancing health behaviors. Generally, researchers have found that religious and faith-based programs can have a positive impact upon enhancing people's health and helping them to reduce risky health practices. Initial research into the impact that these programs can have on HIV-related knowledge and risk behaviors has also been promising, albeit quite limited. In this study, we examine the role that religiosity plays in women's involvement in HIV risk behaviors. Religiosity was found to be a strong predictor of women's involvement in HIV-related risky behaviors, with the greatest risk reported by women who were the least religious.     

Are Adoptees at Increased Risk for Attempting Suicide?

This study addresses the controversy of whether adopted adolescents are at risk for more mental health problems than the nonadopted and specifically evaluates differences in suicide ideation and depression. Same gender comparisons were made between 346 adopted adolescents and nearly 14,000 others living with biological parents, with nationally representative data from the National Longitudinal Study of Adolescent Health. Results showed few divergences in suicide ideation, attempts, and depression between adopted and nonadopted adolescents and young adults. Future studies employing this same dataset will need to pay closer attention to the high percentages of respondents adopted by blood relatives, which only became known with the collection of the Wave III Add Health data.     

Divine Omniscience: Is God's Foreknowledge at Risk in the Context of Contemporary Science?

Abstract

Does quantum indeterminacy threaten the classical theological doctrine of divine omniscience? Certain popular interpretations of quantum physics have challenged conventional ways of thinking about time and space, being and becoming. Consequently, the traditional doctrine that God knows all things, including future contingent events, has recently come under debate. This paper explores how the way we think about time affects the way we think about God's relation to time. Theologians need to be careful when appropriating scientific theories in their theological reflections because interpretations of those theories often bring along unnecessary metaphysical presuppositions. Using an interpretation of special relativity that focuses on the Lorentz transformation, this paper shows that modern physics does not truly challenge the doctrine of divine foreknowledge. In fact, modern physical theories can actually deepen theological reflection on the classical doctrine of divine omniscience.     

Living at Risk: The Sibling’s Perspective of Early-Onset Alzheimer’s Disease

Early-onset Alzheimer’s disease (EOAD) is an increasingly diagnosed condition and is associated with genetic risk factors. This is one of the first studies exploring the lived experience of siblings of individuals with EOAD. We used structured questionnaires and semi-structured interviews to assess a broad range of siblings’ experiences with and beliefs about EOAD, including knowledge, perceptions of personal risk, level of worry, and effects on life decisions. Participants (n = 24) were predominantly female (62.5%) and middle-aged (mean = 56.8 years; range 37–83). When asked about risk factors, genetics was cited most frequently (62.5%). Several potential means of reducing AD risk were endorsed, with 54% reporting engagement in behaviors for this purpose (e.g., keeping mentally active). Participants ranged widely in their perceived personal risk of AD (range: 0–100; mean = 35.6%), with higher perceived risk associated with worry about AD (p < 0.01). Understanding siblings’ experiences with EOAD can inform how genetic counselors and healthcare professionals work with this population to facilitate risk communication and decision-making about testing and healthcare.     

Suspicious Minds at Risk? The Role of Meaning in Processing War and Peacekeeping Experiences

The purpose of this study was to examine meaning as a mediator between perceived threat and posttraumatic stress responses among a sample of 1,561 veterans who participated in war or peacekeeping operations. Data were collected by questionnaire. Path analysis was performed to assess the expected relationships between the observed variables. Meaning in terms of distrust and personal benefits partially mediated the relation between perceived threat and posttraumatic stress responses. Distrustful beliefs about others and the world were strongly associated with perceived threat, as well as intrusive and avoidant thoughts. Creating meaning in terms of a positive worldview appears to be an important mission after military deployment.