Why Is Cancer Genetic Counseling Underutilized by Women Identified as at Risk for Hereditary Breast Cancer? Patient Perceptions of Barriers Following a Referral Letter

Family history information comprises an important tool in identifying and referring patients at risk for hereditary breast and ovarian cancer (HBOC) to cancer genetic counseling. Despite recommendations and support provided by numerous professional organizations, cancer genetic counseling services are underutilized by atrisk patients. This study aimed to: (1) determine the rate of genetic counseling utilization following a referral letter, (2) characterize factors (barriers and supports) which influenced uptake of services, and (3) identify potential strategies for increasing utilization. This study evaluated the uptake of cancer genetic counseling among 603 screening mammography patients identified as having an increased risk for HBOC based on National Comprehensive Cancer Network (NCCN) guidelines. At risk individuals and their primary care providers were mailed a referral letter recommending genetic counseling. Three focus groups (N = 24) were conducted to identify responses to receiving a letter recommending genetic counseling, barriers to seeking genetic counseling, and facilitating factors to utilizing these services. Participant responses were qualitatively analyzed using thematic and cross case analysis. Within one year, 50/603 (8 %) of the identified at-risk women completed a genetic counseling appointment. Participant-perceived barriers which influenced their decision not to seek genetic counseling included lack of relevance and utility, limited knowledge about genetic counseling, concerns about the genetic counseling process, and concerns about cost and insurance coverage. Participant-perceived facilitating factors which would support a decision to seek genetic counseling included greater awareness and education about genetic counseling services when receiving a referral, and improved follow up and guidance from their provider. Findings from this study support the need for patient and primary care provider education, and improved provider-patient communication to increase uptake of genetic counseling services.     

Using Visual Journaling in Individual Counseling: A Case Example

The purpose of this article is to describe and illustrate through a hypothetical case example how visual journaling, a form of expressive arts counseling, can be adapted for use in individual counseling. Counselors may consider using visual journaling as a counseling intervention when working with clients who may not have words for what they are feeling or experiencing, and for clients who tend to be very analytical. Visual journaling can be a way to bypass the intellect and give clients another way to access their experience.     

Expanding Perspectives on Evangelicalism: How Non-evangelical Students Appreciate Evangelical Christianity

Evangelical students pose a distinctive set of challenges to higher education professionals. These students, though advantaged to some degree because of their Christian identity, commonly report feeling marginalized and silenced on college campuses. In light of these tensions, the purpose of this study was to examine how non-evangelical students come to an appreciative understanding of evangelical Christianity. Specifically, the research focused on the specific campus conditions and experiences that influence non-evangelical students’ appreciative attitudes toward evangelicals. Findings reveal distinct demographic, institution type, and academic major differences in those students’ perspectives toward their evangelical peers. Additionally, the results suggest that appreciative attitudes toward evangelicals are associated with non-evangelical students’ interfaith experiences, albeit to differing degrees based on self-identified worldview. Recognizing that the work of helping non-evangelical students develop an appreciative understanding of evangelicals is as complicated as it is challenging, especially in the collegiate context, the authors conclude with a discussion of implications for research and practice.     

Group prevention of depression and anxiety symptoms

To prevent depression and anxiety, we delivered a brief, classroom-based cognitive-behavioral workshop along with ongoing Web-based materials and e-mail coaching to college students at risk for depression. At risk was defined as having mild to moderate depressive symptoms on a self-report measure of depression. Two hundred forty students were randomized into either an eight-week workshop that met in groups of 10, once per week for 2 h or into an assessment-only control group. We plan to track participants for 3 years after the workshop and here we report the 6 month preventive effects on depression and anxiety. The workshop group had significantly fewer depressive symptoms and anxiety symptoms than the control group, but there was no significant difference between the conditions on depression or anxiety episodes at 6 month follow up. The workshop group had significantly better well being than the control group, and the workshop group had significantly greater improvement in optimistic explanatory style than the control group. Improved explanatory style was a significant mediator of the prevention effects from pre- to post-workshop for depressive and anxiety symptoms, as well as for improved well being.     

Four‐year‐olds incorporate speaker knowledge into pragmatic inferences

Human communication relies on the ability to take into account the speaker's mental state to infer the intended meaning of an utterance in context. For example, a sentence such as ‘Some of the animals are safe to pet’ can be interpreted as giving rise to the inference ‘Some and not all animals are safe to pet’ when uttered by an expert. The same inference, known as a scalar implicature, does not arise when the sentence is spoken by someone with partial knowledge. Adults have been shown to derive scalar implicatures in accordance with the speaker's knowledge state, but in young children this ability is debated. Here, we revisit this question using a simple visual world paradigm. We find that both 4‐ and 5‐year‐olds successfully incorporate speaker knowledge into the derivation of scalar inferences. However, this ability does not generalize immediately to non‐linguistic communicative contexts. These findings have important implications for the development of pragmatic abilities.     

Injury characteristics across functional classes of self-injurious behavior

Self-injurious behavior (SIB) is inherently problematic because it can lead to injuries, including those that are quite severe and may result in loss of function or permanent disfigurement. The current study replicated and extended Rooker et al. (2018) by classifying the physical characteristics of injuries across groups of individuals with automatically maintained SIB (ASIB Subtypes 2 and 3) and socially maintained SIB. Individuals with Subtype 2 ASIB had the most frequent and severe injuries. Further, an inverse relation was found between the level of differentiation in the functional analysis and the number of injuries across groups. Studying the response products of SIB (the injuries) documents the risks associated with SIB, justifies the need for research and the intensive intervention, and advances knowledge of SIB. Additional research is needed to replicate these findings, and determine the variables that produce different characteristics of injury secondary to SIB.     

Breadwinner Seeks Bottle Warmer: How Women’s Future Aspirations and Expectations Predict Their Current Mate Preferences

Contemporary women in Western cultures are often trying to juggle careers alongside personal and societal expectations for childrearing in an effort to “have it all.” We examine the effects of this balancing act on heterosexual women’s mate selection motivations. Across three Canadian samples (n?=?360), we tested concurrent hypotheses about the desirability of both similar and complementary characteristics in a potential mate. Specifically, women’s aspirations (to prioritize career over family) and their expectations for the roles they will most likely adopt within their future partnerships (primary breadwinner and/or caregiver) were tested as key predictors of mate preferences. Although specific effects varied across samples, a mega-analysis of the combined sample and an internal meta-analysis of effect sizes from the three studies provided support for both complementary and similarity motives (controlling for gender role attitudes). Women’s aspirations to prioritize career (over family) predicted greater similarity in mate preferences, such that they placed less importance on men’s parenting qualities, more importance on their access to financial resources, and preferred a career-oriented over family-oriented exemplar. However, women’s expectations of actually taking on the breadwinner role predicted greater complementarity in mate preferences (greater desirability of parenting qualities and a family-oriented partner; with financial resources rated as less important). Our work expands current understanding of women’s decision-making processes when selecting a mate and has implications for men’s changing traits and roles.

     

Revised Child Anxiety and Depression Scale: a Psychometric Examination in Chinese Youth

There remains a need for a disorder-specific inventory of children’s depression and anxiety that can reliably screen anxious and depressive disorder symptomatology in Chinese children. The Revised Child and Anxiety Depression Scale (RCADS) is a self-report questionnaire assessing anxiety and depression in children (Chorpita et al., 2000; Piqueras et al., 2017). This study sought to evaluate its psychometric properties in a Mainland Chinese sample. Students from the 4th to 11th grades (N?=?1001) participated in this study. Each of the RCADS subscales, by age and sex, possessed reliability coefficients ranging between .63 and .81. Means and standard deviations for RCADS subscales calculated for the age and sex sub-samples were reported. Participants reported slightly lower levels on five subscales than for Chorpita et al. (2000) normative sample. The scales were significantly and strongly correlated with the Child Behavior Checklist (CBCL) subscales (somatic, withdrawal, anxiety) as well as CBCL internalizing scores. Fit statistics suggested marginal to adequate fit for the six-factor model for the Chinese youth. The present study provides foundational support for the psychometric properties of the RCADS in a large sample of Chinese youth yet indicates that factor structure might be improved through enhanced sampling of culturally relevant symptom expressions.

     

“All I remember is the black eye”: A distinctive facial feature harms eyewitness identification

Many crimes occur in which a perpetrator has a distinctive facial feature, such as a tattoo or black eye, but few eyewitness identification (ID) studies have involved such a feature. We conducted an experiment to determine how eyewitness ID performance is impacted by a distinctive facial feature, and how police could deal with this issue. Participants (N = 4,218) studied a target face with or without a black eye, and later viewed a simultaneous photo lineup either containing the target or not. For those who saw a target with a black eye, this feature was either replicated among all lineup members or was removed. The black eye harmed empirical discriminability regardless of replication or removal, which did not differ. However, participants responded more conservatively when the black eye was removed, compared to replication. Lastly, immediate confidence was consistently indicative of accuracy.