Genetic counseling for pregnant adolescents

The genetic counseling literature has a paucity of information on how to provide genetic counseling services to adolescents, especially those who are pregnant. The adolescent population should be viewed as a separate culture, complete with their own beliefs and viewpoints, which are dependent upon the developmental growth tasks of puberty. The completion of these tasks is complicated by pregnancy, which has its own set of developmental goals. The adolescent struggle with developmental goals interferes with the ability to identify consequences, predict future outcomes, and communicate self-revealing statements or decisions effectively. Instead, the adolescent has an egocentric frame of reference and seeks peer approval. The genetic counseling dilemmas presented by pregnant adolescents are illustrated through two case reports. A model based on our own experience and a literature review for successful counseling of adolescents is presented, and utilizes the foundation of trust, patience, and nonjudgmental behavior. Techniques that address the adolescent's concern for autonomy and peer approval are important, and can be achieved through nonthreatening, open-ended questions that promote self-expression. Incorporation of these techniques in genetic counseling and in graduate training will enhance genetic counseling services to the adolescent population.     

Loneliness: counseling adolescents

This paper discusses the related concepts of loneliness and the guidance counseling of adolescents. Part One argues that the fear of loneliness and the accompanying need to avoid it constitutes a universal motivational principle in all human beings, and that it is especially acute during adolescence. Part Two shows how loneliness may serve the counselor as a basis for understanding and interpreting much of adolescent behavior. Part Three proposes some therapeutic principles and procedures designed to alleviate the sense of loneliness and isolation so prevalent among contemporary adolescents.     

Why theories about developmental dyslexia require developmental designs

This article examines the importance of developmental designs in dyslexia research using a neuroconstructivist framework. According to neuroconstructivism, the lowest level of impairment should be identified as early as possible, and developmental effects on higher-level cognition examined longitudinally. A number of recent studies proposing candidate low-level impairments have not used such developmental designs. The role of normal variation in postulated causal factors on development is ignored, inadequate control groups are used, and the nature and timing of environmental inputs are not measured, even though reading is taught systematically and both reading acquisition and dyslexia vary with orthography. It is suggested here that only a phonological deficit arising from low-level auditory processing problems meets the criteria for a neuroconstructivist approach.     

Implications of goal theories for the theories of reasoned action and planned behaviour

This paper argues that the predictive validity of the theories of reasoned action and planned behaviour could be enhanced by considering key ideas from goal theories. In particular, goal theories highlight the importance of: (a) construing action as a process of behavioural selection designed to achieve actors’ goals, (b) assessing the extent to which people have planned how to perform action sequences implied by their goals (c) investigating goal conflict in order to understand intention-behaviour discrepancies (d) examining contextual variations in goal salience to account for the dynamics of choice, (e) using intention stability to index the prioritization of goals, and (f) analyzing the content of the goals underlying attitudes and intentions. Suggestions are made about self-report measures and computations that would permit greater use of these ideas in future research.     

Implications of goal theories for the theories of reasoned action and planned behaviour

This paper argues that the predictive validity of the theories of reasoned action and planned behaviour could be enhanced by considering key ideas from goal theories. In particular, goal theories highlight the importance of: (a) construing action as a process of behavioural selection designed to achieve actors’ goals, (b) assessing the extent to which people have planned how to perform action sequences implied by their goals (c) investigating goal conflict in order to understand intention-behaviour discrepancies (d) examining contextual variations in goal salience to account for the dynamics of choice, (e) using intention stability to index the prioritization of goals, and (f) analyzing the content of the goals underlying attitudes and intentions. Suggestions are made about self-report measures and computations that would permit greater use of these ideas in future research.     

The visual search analogue of latent inhibition: Implications for theories of irrelevant stimulus processing in normal and schizophrenic groups

Latent inhibition (LI) is a robust phenomenon that is demonstrated when a previously inconsequential stimulus is less effective in a new learning situation than a novel stimulus. Despite LI’s simplicity, there is considerable disagreement as to its theoretical basis. Attentional theories claim that unattended stimulus preexposures reduce stimulus associability. Alternatively, it has been asserted that associability is unaffected and that LI is a result of competition/retrieval processes. The present article reviews a series of visual search studies, some with normal subjects, both undifferentiated and divided into low and high schizotypals, and others with pathologies that entail dysfunctional attention, such as schizophrenia, Parkinson’s disease, and anxiety. The visual search conditions were designed to model those of traditional LI experiments, while tapping attentional processes independently of the learning scores that index LI. A variety of evidence from these and other studies is used to support the involvement of attentionaland retrieval processes in LI. A model of the mechanism of action of these processes in LI is presented, together with its application to schizophrenia.     

Implementing a program in developmental guidance and counseling

This is a “how to” article. Too often in the past 10 years we have heard the term “change agent” applied to the counselor without the necessary filing in of how one goes about making major changes in a school or other social system. Tuma describes her early frustrations, her exposure to a “theory” of change, and the step-by-step application of the same—including how her plans had to change to meet the changing reality. And with a successful ending!     

Implications of termination for the pastoral counseling “contract”

Pastoral Psychology -     

Revisiting rapprochement in the light of contemporary developmental theories

Margaret Mahler's thinking, revolutionary for its time, led to the observational study of mother-infant pairs, followed almost day by day as the preverbal infant developed into a toddler whose increasing cognitive capacities made new demands on the mother's presence and emotional availability. The rapprochement crisis, as formulated based on these observations, is reexamined in the light of contemporary theory, and the concept of co-construction is used to show how mother and toddler repair misunderstandings and inevitable conflicts. With the growth of new verbal capacities during rapprochement, the toddler moves from early, sensorimotor interactions to interactions governed by language, in the process gaining new understanding of his or her emotional life.     

Phenotypic and genotypic heterogeneity in gaucher disease: Implications for genetic counseling

Genetic counseling for Gaucher disease is complicated by the vast degree of clinical heterogeneity encountered in the disorder. Recent advances in our understanding of the molecular genetics of Gaucher disease are particularly relevant to genetic counseling. Although the identification of mutations in the glucocerebrosidase gene has enabled genotypic screening of Gaucher patients, the ability to reliably predict patient outcome on the basis of DNA studies is often limited. An appreciation of both the spectrum of clinical manifestations in Gaucher patients and the limitations of the available genotypic information is necessary when counseling patients, families and at-risk individuals.     

Developments in cognitive neuroscience: II. Implications for theories of transference

An integration of psychoanalytic theory with contemporary developments in cognitive neuroscience offers a useful perspective on long-standing controversies about the nature of transference, and a better understanding of the precise mechanisms by which transferential processes occur. Contemporary psychoanalytic views of transference are reviewed, and the many processes that constitute transference are described. Two issues that have emerged in different guises for several decades-the role of the analyst in eliciting transference, and the nature of "real" and "transferential" components of the therapeutic relationship-are reconsidered in the light of concepts such as connectionist networks. Although a useful analytic stance is one that allows the patient's enduring dynamics to dominate the analytic field, it is suggested, anonymity is neither a cognitive possibility nor the driving force behind most transference reactions, and the distinction between "real" and "transferential" perceptions is one of therapeutic interest, not of mechanism. Certain features of the analytic situation make some dynamics more likely than others to enter the treatment relationship, notably those related to authority, intimacy and attachment, and sexuality. Transference reactions are best understood as constructed from a combination of the patient's enduring dispositions to react in particular ways under particular conditions; features of the analytic situation and of the analyst; and interactions between patient and analyst. These reactions do not unfold ineluctably from the patient's mind in the consulting room, nor are they cognitive constructions of the patient-analyst dyad or co-constructions of relatively equal partners exerting their influence on the analytic field.     

Reproductive issues in adults with cystic fibrosis: Implications for genetic counseling

This article reviews reproductive issues faced by the growing number of individuals with cystic fibrosis (CF) who reach adulthood. Approximately 97–98% of males with CF are infertile and they may have an increased risk for genitourinary anomalies. Females with CF may experience delayed puberty, irregular menstrual cycles, and decreased fertility. Women with CF who have good clinical scores, good nutritional status, and normal lung volumes with mild to moderate airway obstruction, have a better chance for successful pregnancies. The role of the genetic counselor in counseling adults with CF is discussed and resources for CF adults are provided.     

Implicit theories of relationships: Implications for relationship satisfaction and longevity

The role of implicit theories in romantic relationships was investigated in two studies. People holding a soulmate theory, who believed that finding the right person is most important for a satisfying relationship, were compared to people holding a work–it–out theory, who believed that effort is most important for building a successful relationship. In Study 1, college students (N = 527) completed a set of questionnaires, including measures of relationship theories and functioning within romantic relationships. Approximately 8 months later, a subset of these students (N = 176) completed a second set of questionnaires for Study 1. The implicit theories were highly stable over time (r = .74). For soulmate theorists, feelings that one’s specific partner is ideal predicted relationship satisfaction and relationship longevity to a greater extent than for work–it–out theorists. Whereas Study 1 investigated people’s theories of relationships as ends of a bipolar continuum, a separate study explored people’s theories of relationships as two unipolar dimensions. Findings from Study 2 (N = 266) supported a representation of the theories as two negatively correlated factors, and supported findings from Study 1 highlighting the role of the interaction between the relationship theories and partner fit in predicting relationship satisfaction.     

RIASEC interest and confidence cutoff scores: Implications for career counseling

One strategy commonly used to simplify the joint interpretation of interest and confidence inventories is the use of cutoff scores to classify individuals dichotomously as having high or low levels of confidence and interest, respectively. The present study examined the adequacy of cutoff scores currently recommended for the joint interpretation of the Strong Interest Inventory (SII: Donnay, Morris, Schaubhut, & Thompson, 2005) and the Skills Confidence Inventory (SCI: [Betz, Borgen et al., 1996] and [Betz et al., 2005]). Cutoff score criteria were evaluated based on a sample of college students and employed adults (n = 1000), and cross-validated with a second sample of college students (n = 1, 149) who completed an experimental measure of RIASEC interests and confidence. Results were interpreted in the context of social cognitive career theory (Lent, Brown, & Hackett, 1994) by testing predictions regarding the relative frequency of individuals with either matched or mismatched levels of interest and confidence.     

Representation in the mental lexicon: Implications for theories of the generation effect

Three experiments investigated the finding by McElroy and Slamecka (1982) that the “generation effect” (the retention advantage for self-produced over read items) is not obtained when artificial, meaningless nonwords are used as the to-be-remembered items. In Experiment 1, some subjects were asked to generate or read items that they thought were words, but, in fact, were not; no generation effect was found. In Experiment 2, subjects were taught definitions to experimenter-created items. Despite the fact that these subjects could readily retrieve each item’s assigned semantic properties, no generation effect was found. Finally, Experiment 3 examined the read]generate variable as a function of an item’s frequency of use in the language. Whereas medium- and high-frequency words produced large generation effects, no comparable effects were found for low-frequency words or nonwords. These results indicate that representation in the mental lexicon is a necessary, but not a sufficient, condition for the generation effect. Rather, it may be necessary to consider how related the generated item is to other potential retrieval cues in the memory system.     

Action representation deficits in adolescents with developmental dyslexia

Developmental dyslexia (DD), a severe and frequent disorder of reading acquisition, is characterized by a diversity of cognitive and motor deficits whose interactions still remain under debate. Although deficits in the automatization of sensorimotor control have been highlighted, internal action representation allowing prediction has never before been investigated. In this study, we considered action representation of 18 adolescents with pure DD and 18 age-matched typical readers. Participants actually and mentally performed a visually guided pointing task involving strong spatiotemporal constraints (speed/accuracy trade-off paradigm). While actual and mental movement times of typical readers were isochronous and both conformed to Fitts’ law, the movement times of dyslexics differed between conditions, and only the actual movement times conformed to Fitts’ law. Furthermore, the quality of motor imagery correlated with word reading abilities. This suggests that the process of action representation is impaired in pure DD and supports the sensorimotor perspective of DD. Theoretical implications are discussed.     

Implications of the 1992 ethics code for diverse groups

Previous renditions of the American Psychological Association's (APA's) code of ethics have clearly espoused psychologists' commitment to the ideal of having respect for the dignity and worth of the individual human being. The endorsement of the goal to protect fundamental human rights has always been highlighted in the Preambles of each revision of the code. The current code (APA, 1992) appears to have retreated from prioritizing this humanitarian stance. Ethnic minorities, women, gay men, and lesbians have reason to be apprehensive about the apparent downgrading in importance of psychologists' declaration of respect for the dignity and worth of the individual. All previous codes seemed to have been formulated from a perspective of protecting consumers. The new code appears to be driven by a need to protect psychologists. This article examines the possible impact of the shift in traditional priorities on diverse populations.