Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

The broth in my brother’s brothel: Morpho-orthographic segmentation in visual word recognition

Much research suggests that words comprising more than one morpheme are represented in a “decomposed” manner in the visual word recognition system. In the research presented here, we investigate what information is used to segment a word into its morphemic constituents and, in particular, whether semantic information plays a role in that segmentation. Participants made visual lexical decisions to stem targets preceded by masked primes sharing (1) a semantically transparent morphological relationship with the target (e.g.,cleaner-CLEAN), (2) an apparent morphological relationship but no semantic relationship with the target (e.g.,corner-CORN), and (3) a nonmorphological form relationship with the target (e.g.,brothel-BROTH). Results showed significant and equivalent masked priming effects in cases in which primes and targets appeared to be morphologically related, and priming in these conditions could be distinguished from nonmorphological form priming. We argue that these findings suggest a level of representation at which apparently complex words are decomposed on the basis of their morpho-orthographic properties. Implications of these findings for computational models of reading are discussed.     

Extinction-induced immobility in the water maze and its neurochemical concomitants in aged and adult rats: a possible model for depression?

Extinction of escape behavior in the water maze due to the removal of the platform, was hypothesized to induce a negative state, including the development of immobility, which is held to reflect a state of "despair" when measured in the forced swimming test. 27 aged and 8 adult animals (26 and 3 months old Wistar rats, respectively) were tested in the water maze during nine days with a platform hidden, followed by 7 days of extinction trials with the platform absent. As expected, both age groups developed immobility over the extinction trials, with the aged showing more than the adults. To examine whether the age difference in immobility was related to performance differences during acquisition, the aged were subdivided into superior, intermediate and inferior learners (n = 9 per group) on the basis of overall times to platform during acquisition, and compared with each other and the adults. Results showed that the aged inferior learners displayed the highest levels of immobility among the aged. Immobility scores were then correlated with post-mortem neurotransmitter contents in the hippocampus and ventral striatum. In the ventral striatum, levels of immobility were correlated with levels of acetylcholine, dopamine and the metabolite dihydroxyphenylacetic acid in the aged, and with norepinephrine in the adults. The data support the hypothesis that multiple extinction trials in the water maze result in immobility that may indicate "behavioral despair," and that striatal neurotransmitter systems correlate with the degree of its expression. The concept of extinction-induced despair is held to provide the promise of a conceptual and empirical model of human depression that is the consequence of loss of reinforcers.     

An evaluation of the incremental validity of the MMPI-2 Superlative (S) scale in an inpatient psychiatric sample

The MMPI-2 Superlative (S) scale was developed by Butcher and Han (1995) to assess individuals' tendencies to present themselves in an unrealistically positive light. The current study examined the performance of the L, K, and S scales in accurately distinguishing the MMPI-2 profiles of 379 psychiatric inpatients who produced one or more elevations on the basic scale profiles, from 82 psychiatric inpatients who produced no clinical range elevation on any of the eight basic clinical scales (excluding scales 5 and 0). The findings from the present study indicate that the S scale appears to be effective in the identification of defensiveness among psychiatric inpatients, with mean effect sizes in the moderate to large range. The optimal T-score cutoff for identifying defensive responders was 70 for both men and women. Further, results of hierarchical regression analyses showed that the S scale added incrementally to the prediction levels achieved by the optimal combination of the L and K scales.     

Government initiatives in autism clinical trials

Randomized clinical trials remain the most valid method of testing the efficacy and safety of treatments. While efforts to elucidate the genetic and neurodevelopmental bases of autism are underway, clinicians and families are in need of scientifically valid information on how to best treat patients with autism. The effectiveness of many interventions currently used in communities has not been adequately tested. Given the high public health relevance of autism treatment research and the low interest of the pharmaceutical industry in autism, the role of the National Institutes of Health in supporting this research is paramount. Among recently launched initiatives in autism clinical trials, there are the Research Units on Pediatric Psychopharmacology Autism Network and the network of centers for Studies to Advance Autism Research and Treatment. These and other government activities in the area of autism clinical trials are here briefly reviewed.     

The dilemma of ethics in engineering education

This paper briefly summarizes current thinking in engineering ethics education, argues that much of that ethical instruction runs the risk of being only superficially effective, and explores some of the underlying systemic barriers within academia that contribute to this result. This is not to criticize or discourage efforts to improve ethics instruction. Rather it is to point to some more fundamental problems that still must be addressed in order to realize the full potential of enhanced ethics instruction. Issues discussed will include: intellectual engagement versus emotional engagement; the gravitational pull of curricular structures; the nature of engineering faculty; and the “engineer-ization” of ethics. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

The Gladiator Sparrow: ethical issues in behavioral research on captive populations of wild animals: a case study with commentaries exploring ethical issues and research on wild animal populations

This case involves invasive research on captive wild populations of birds to study aggressive animal behavior. The case and associated commentaries raise and examine fundamental issues, whether and under what conditions, such research is ethically justified when the research has no expected, direct application to the human species; the moral status of animals and how one balances concern for the animal's interests against the value of gains in scientific knowledge. They also emphasize the issue of the importance of a thorough literature search to ensure appropriate research design and experimental design to minimize animal suffering. It raises the issue of circumstances in which such research should be modified or terminated.     

Enhanced occipital and anterior cingulate activation in men but not in women during exposure to angry and fearful male faces

Blood-oxygenation-level-dependent signal was measured with functional magnetic resonance imaging in 24 healthy young subjects (12 men and 12 women) during viewing of angry, fearful, and neutral male and female face pictures. Exposure to angry male as opposed to angry female faces activated the visual cortex and the anterior cingulate gyrus significantly more in men than in women. A similar sex-differential brain activation pattern was present during exposure to fearful but not neutral faces. Previous behavioral studies indicate enhanced physiological arousal in men but not in women during exposure to angry male as opposed to female faces, and brain imaging studies have shown that the occipital cortex and the anterior cingulate gyrus are influenced by activity in the autonomic nervous system as well as by visual attention. Hence, we suggest that the elevated occipital and anterior cingulate activation in men during confrontation with other angry and fearful males may reflect enhanced vigilance in a potentially dangerous situation.     

Does imminent threat capture and hold attention?

According to models of attention and emotion, threat captures and holds attention. In behavioral tasks, robust evidence has been found for attentional holding but not for attentional capture by threat. An important explanation for the absence of attentional capture effects is that the visual stimuli used posed no genuine threat. The present study investigated whether visual cues that signal an aversive white noise can elicit attentional capture and holding effects. Cues presented in an attentional task were simultaneously provided with a threat value through an aversive conditioning procedure. Response latencies showed that threatening cues captured and held attention. These results support recent views on attention to threat, proposing that imminent threat captures attention in everyone.     

Unimodal and crossmodal effects of endogenous attention to visual and auditory motion

Three experiments were conducted examining unimodal and crossmodal effects of attention to motion. Horizontally moving sounds and dot patterns were presented and participants’ task was to discriminate their motion speed or whether they were presented with a brief gap. In Experiments 1 and 2, stimuli of one modality and of one direction were presented with a higher probability ( p = .7) than other stimuli. Sounds and dot patterns moving in the expected direction were discriminated faster than stimuli moving in the unexpected direction. In Experiment 3, participants had to respond only to stimuli moving in one direction within the primary modality, but to all stimuli regardless of their direction within the rarer secondary modality. Stimuli of the secondary modality moving in the attended direction were discriminated faster than were oppositely moving stimuli. Results suggest that attending to the direction of motion affects perception within vision and audition, but also across modalities.