Balancing Genetics (Science) and Counseling (Art) in Prenatal Chromosomal Microarray Testing

Genetic counselors frequently are called upon to assist patients in understanding the implications of prenatal testing information for their pregnancies and their family’s lives. The introduction of highly sensitive testing such as chromosomal microarray has generated additional kinds of uncertainty into the prenatal period. Counselors may feel uncomfortable or inadequately prepared to engage in discussions with prospective parents who are faced with making critical, and timely, decisions about a pregnancy based on uncertain information. As highly sensitive prenatal testing becomes routine in prenatal care, counselors may be in search of approaches to prenatal counseling, as well as specific skills to approach, engage with, and help families find resolution in such challenging circumstances. To assist genetic counselors, we describe practice skills and provide language for approaching conversations with prospective parents. When clinicians regularly provide care to patients and families making life-altering decisions under conditions of significant uncertainty, discomfort is common and compassion fatigue is likely. We make recommendations directly to the genetic counselor working in reproductive and perinatal settings to enhance training and self-care and to decrease discomfort in balancing the scientific- and art- demands of genetic counseling.     

Pet Peeves and Happiness: How Do Happy People Complain?

The present study was designed to investigate the relationships among mindfulness, happiness, and the expression of pet peeves. Previous research has established a positive correlation between happiness and mindfulness, but, to date, no research has examined how each of these variables is related to complaining in the form of pet peeves. Four hundred ten male and female college students listed the pet peeves they had with a current or former relationship partner. They also completed measures of happiness, positive and negative affect, depression, mindfulness, relationship satisfaction, and satisfaction with life. Pet peeves were negatively correlated with relationship satisfaction, well-being, and mindfulness. Consistent with hypotheses, support was found for the mediating role of mindfulness in the relationship between happiness and pet peeves.     

Spirituality and Optimism: A Holistic Approach to Component-Based,Self-management Treatment for HIV

For people living with HIV (PLWH), spirituality and optimism have a positive influence on their health, can slow HIV disease progression, and can improve quality of life. Our aim was to describe longitudinal changes in spirituality and optimism after participation in the SystemCHANGE?-HIV intervention. Upon completion of the intervention, participants experienced an 11.5 point increase in overall spiritual well-being (p = 0.036), a 6.3 point increase in religious well-being (p = 0.030), a 4.8 point increase in existential well-being (p = 0.125), and a 0.8 point increase in total optimism (p = 0.268) relative to controls. Our data suggest a group-based self-management intervention increases spiritual well-being in PLWH.     

A Dose-Ranging Study of Behavioral and Pharmacological Treatment in Social Settings for Children with ADHD

Placebo and three doses of methylphenidate (MPH) were crossed with 3 levels of behavioral modification (no behavioral modification, NBM; low-intensity behavioral modification, LBM; and high-intensity behavior modification, HBM) in the context of a summer treatment program (STP). Participants were 48 children with ADHD, aged 5–12. Behavior was examined in a variety of social settings (sports activities, art class, lunch) that are typical of elementary school, neighborhood, and after-school settings. Children received each behavioral condition for 3 weeks, order counterbalanced across groups. Children concurrently received in random order placebo, 0.15 mg/kg/dose, 0.3 mg/kg/dose, or 0.6 mg/kg/dose MPH, 3 times daily with dose manipulated on a daily basis in random order for each child. Both behavioral and medication treatments produced highly significant and positive effects on children’s behavior. The treatment modalities also interacted significantly. Whereas there was a linear dose–response curve for medication in NBM, the dose–response curves flattened considerably in LBM and HBM. Behavior modification produced effects as large as moderate doses, and on some measures, high doses of medication. These results replicate and extend to social-recreational settings previously reported results in a classroom setting from the same sample (Fabiano et al., School Psychology Review, 36, 195–216, 2007). Results illustrate the importance of taking dosage/intensity into account when evaluating combined treatments; there were no benefits of combined treatments when the dosage of either treatment was high but combination of the low-dose treatments produced substantial incremental improvement over unimodal treatment.     

Bullying and cyberbullying in adulthood and the workplace

Two studies generated profiles of cyberbullying/cyberincivility and traditional bullying/incivility in adults, particularly within the workplace. In Study 1, 20% of 3,699 participants had the majority of cyberbullying victimization and 7.5% had the majority of traditional bullying victimization occur in adulthood, with 30% saying they were bullied at work. Relationships between bullying and negative outcomes were found. Because of the clear evidence of bullying and cyberbullying in the workplace in Study 1, Study 2 addressed the relationship of these constructs to workplace incivility. Workplace face-to-face incivility and bullying were related among 321 participants, as were workplace cyberbullying and cyberincivility. Face-to-face incivility was more common than online incivility, face-to-face bullying, or online bullying, yet all four behaviors were associated with negative outcomes. Differences in intentionality, acceptability, and severity were observed, with workplace face-to-face bullying perceived as the most severe and having the greatest intentionality to harm. These results emphasize the importance of studying bullying among adults, and highlight the conceptual independence of bullying and incivility. Correlates of workplace aggression are discussed using job demands-resources theory.     

Increasing Behavioral Variability and Social Skill Accuracy in Children with Autism Spectrum Disorder

Although social skills training for children with autism spectrum disorder (ASD) often addresses deficits in social communication, restricted and repetitive social behaviors are less frequently targeted in the literature. The present study evaluated a manualized social skills training program, modified to incorporate lag schedules of reinforcement, to promote appropriate and variable responding in three children in a school setting. Participants attended social skills once weekly, with probes of social skills taking place daily. A multiple baseline design across target skills was used to determine intervention efficacy. Results of the study indicated that the social skills curriculum incorporating lag schedules of reinforcement resulted in substantial increases in the number of appropriate and variable responses demonstrated by participants during each probe session, as well as the number of appropriate and variable responses demonstrated overall.     

Braiding Two Evidence-Based Programs for Families At-Risk: Results of a Cluster Randomized Trial

Child maltreatment is a significant public health problem best addressed through evidence-based parent-support programs. There is a wide range of programs with different strengths offering a variety of options for families. Choosing one single evidence-based program often limits the range of services available to meet the unique needs of families. This paper presents findings from a study to examine the systematic braiding of two evidence-based programs, Parents as Teachers and SafeCare at Home (PATSCH), with the goal to provide a more robust intervention for higher risk families. A cluster randomized effectiveness trial was conducted to examine if PATSCH improved parenting behaviors known to decrease the risk for child maltreatment compared to Parents as Teachers (PAT) Alone. Parents (N?=?159; 92 PAT Alone; 67 PATSCH) were enrolled to complete a baseline, 6-month and 12-month assessment. Results indicate the groups did not differ on number of environmental hazards in the home, parents’ health care decision-making abilities, child abuse potential, and physical assault over time. However, with regard to the potential for child abuse, the PATSCH group showed a decrease in nonviolence discipline and increase in psychological aggression compared to the PAT group. Further research is needed to better examine this concept and its implications for the field.     

The Relationship Between Treatment Acceptability and Youth Outcome in Group CBT for Youth with ASD and Anxiety

Anxiety is one of the most common co-occurring diagnoses in youth with autism spectrum disorder (ASD). Cognitive behavior therapy (CBT) is an evidence-based treatment that has been tailored for youth with ASD and anxiety and has shown good efficacy in reducing youth anxiety immediately after treatment. One area that has not been widely studied is acceptability of CBT for anxiety in this population. Acceptability includes beliefs about the potential helpfulness and satisfaction with a given treatment and may be important in understanding treatment outcomes. This study focuses on parent, youth, and clinician acceptability of a well-researched CBT program, Facing Your Fears, for youth with ASD and anxiety. Data was collected as part of a larger multi-site study that compared three different instructional conditions for clinicians learning the intervention. Results indicated that parents rated acceptability as higher for the overall treatment compared to youth. Further, youth and parents rated exposure related sessions as more acceptable than psychoeducation, and higher exposure acceptability ratings were predictive of lower youth anxiety levels post-treatment. Clinicians who received ongoing consultation rated treatment acceptability lower than clinicians in the other training conditions. While some clinicians may be hesitant to implement exposure techniques with this population, findings suggest that it is the technique that parents and youth rated as the most acceptable. Results are discussed in terms of treatment and research implications for youth with ASD and their families.     

Home-Based Early Head Start plus Attachment and Biobehavioral Catch-up: A Qualitative Study of Implementation Outcomes

Journal of Child and Family Studies - Elucidating factors that promote or hinder successful implementation of evidence-based practices in real-world settings is an essential component of...