Development and Evaluation of a Telephone Communication Protocol for the Delivery of Personalized Melanoma Genomic Risk to the General Population

Communicating personalized genomic risk results for common diseases to the general population as a form of tailored prevention is novel and may require alternative genetic counseling service delivery models. We describe the development and evaluation of a communication protocol for disclosing melanoma genomic risk information to the asymptomatic general population and assess participants’ satisfaction and acceptability. Participants (n?=?117) were aged 22–69 years, living in New South Wales, Australia and unselected for family history. They provided a saliva sample and had genomic testing for melanoma for low to moderate penetrant melanoma susceptibility variants in 21 genes. Participants could choose to receive their results from a genetic counselor via telephone, followed by a mailed booklet or to receive their risk result via mailed booklet only with a follow-up call for those at high risk. A follow-up questionnaire was completed by 85% of participants 3-months later. Most participants (80%) elected to receive their result via telephone. Participants were highly satisfied with the delivery of results (mean 3.4 out of 4, standard deviation 0.5), and this did not differ by delivery mode, risk category, age or sex. On follow-up, 75% accurately recalled their risk category, 6% indicated a preference for a different delivery mode, either electronic or face-to-face. The process of disclosing genomic risk results to the general population over the telephone with accompanying written material was feasible and acceptable, and may be useful for communicating polygenic risk for common diseases in the context of increasing demands for genomic testing.     

Individual differences in physiological flexibility predict spontaneous avoidance

People often regulate their emotions by resorting to avoidance, a putatively maladaptive strategy. Prior work suggests that increased psychopathology symptoms predict greater spontaneous utilisation of this strategy. Extending this work, we examined whether heightened resting cardiac vagal tone (which reflects a general ability to regulate emotions in line with contextual demands) predicts decreased spontaneous avoidance. In Study 1, greater resting vagal tone was associated with reduced spontaneous avoidance in response to disgust-eliciting pictures, beyond anxiety and depression symptoms and emotional reactivity. In Study 2, resting vagal tone interacted with anxiety and depression symptoms to predict spontaneous avoidance in response to disgust-eliciting film clips. The positive association between symptoms and spontaneous avoidance was more pronounced among participants with reduced resting vagal tone. Thus, increased resting vagal tone might protect against the use of avoidance. Our findings highlight the importance of assessing both subjective and biological processes when studying individual differences in emotion regulation.     

Sarcasm and emoticons: Comprehension and emotional impact

Most theorists agree that sarcasm serves some communicative function that would not be achieved by speaking directly, such as eliciting a particular emotional response in the recipient. One debate concerns whether this kind of language serves to enhance or mute the positive or negative nature of a message. The role of textual devices commonly used to accompany written sarcastic remarks is also unclear. The current research uses a rating task to investigate the influence of textual devices (emoticons and punctuation marks) on the comprehension of, and emotional responses to, sarcastic versus literal criticism and praise, for both unambiguous (Experiment 1) and ambiguous (Experiment 2) materials. Results showed that sarcastic criticism was rated as less negative than literal criticism, and sarcastic praise was rated as less positive than literal praise, suggesting that sarcasm serves to mute the positive or negative nature of the message. In terms of textual devices, results showed that emoticons had a larger influence on both comprehension and emotional impact than punctuation marks.     

Genetic Counselors’ Religiosity & Spirituality: Are Genetic Counselors Different from the General Population?

Although there is evidence that the religious beliefs of genetic counselors (GCs) can induce internal conflict in at least some genetic counseling scenarios, empirical research on the religiosity of GCs is limited. This study compares genetic counselors to a representative sample of the adult U.S. population on multiple religiosity measures. After controlling for several sociodemographic factors the percentage of GCs who report having a religious affiliation is similar to the general U.S., but GCs are less likely to affiliate with conservative Christian religions and are more likely to be Jewish. GCs are significantly less likely than the general U.S. population to: believe in god, attend religious services, pray, and believe in an afterlife even after controlling for relevant sociodemographic factors. Despite the lower levels of religiosity, a majority of GCs do report themselves to be moderately to highly spiritual. We explore potential reasons for religiosity differences as well as possible implications in the context of the GC scope of practice.     

Using motivational interviewing as a supplement to obesity treatment: a stepped-care approach.

OBJECTIVE: This investigation was designed to improve behavioral weight loss program (BWLP) treatment outcomes by providing stepped care (SC) to individuals experiencing difficulties with weight loss during treatment. SC entails transition to more intensive treatments when less intensive treatments fail to meet treatment goals. In a BWLP, motivational interviewing (MI) may increase participants' motivation toward behavioral change and thus complement the acquisition of behavioral change skills. It was hypothesized that BWLP+SC (MI) participants (i.e., participants who failed to meet weight loss goals and received MI) would demonstrate superior treatment outcomes when compared with BWLP (SC matched) participants (i.e., participants who failed to meet weight loss goals but did not receive MI). DESIGN: Fifty-five obese, sedentary adults were randomly assigned to a BWLP+SC or a BWLP. MAIN OUTCOME MEASURES: Changes in weight, cardiorespiratory fitness, self-reported physical activity, and diet (i.e., calories, percentage daily intake of fat, protein, and carbohydrates) in response to treatment were assessed. RESULTS: Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps<.05). BWLP+SC (MI) participants lost more weight and engaged in greater weekly exercise than BWLP (SC matched) participants who did not receive MI (ps<.05). CONCLUSION: For individuals experiencing weight loss difficulties during a BWLP, MI may have considerable promise.     

The influence of context on the implementation of adaptive emotion regulation strategies

Putatively adaptive emotion regulation strategies (e.g., acceptance, problem solving, reappraisal) show weaker associations with psychopathology than putatively maladaptive strategies (e.g., avoidance, self-criticism, hiding expression, suppression of experience, worry, rumination). This is puzzling, given the central role that adaptive strategies play in a wide range of psychotherapeutic approaches. We explored this asymmetry by examining the effects of context (i.e., emotion intensity, type of emotion, social vs. academic circumstances) on the implementation of adaptive and maladaptive strategies. We asked 111 participants to describe 8 emotion-eliciting situations and identify which strategies they used in order to regulate their affect. We found support for a contextual model of emotion regulation, in which adaptive strategies were implemented with more cross-situational variability than maladaptive strategies. In addition, the variability in implementation of two adaptive strategies (acceptance, problem solving) predicted lower levels of psychopathology, suggesting that flexible implementation of such strategies in line with contextual demands is associated with better mental health. We discuss these findings by underscoring the importance of adopting a functional approach to the delineation of contextual factors that influence the implementation of emotion regulation strategies.     

When are adaptive strategies most predictive of psychopathology?

In recent work, we showed that putatively adaptive emotion regulation strategies, such as reappraisal and acceptance, have a weaker association with psychopathology than putatively maladaptive strategies, such as rumination, suppression, and avoidance (e.g., Aldao & Nolen-Hoeksema, 2010; Aldao, Nolen-Hoeksema, & Schweizer, 2010). In this investigation, we examined the interaction between adaptive and maladaptive emotion regulation strategies in the prediction of psychopathology symptoms (depression, anxiety, and alcohol problems) concurrently and prospectively. We assessed trait emotion regulation and psychopathology symptoms in a sample of community residents at Time 1 (N = 1,317) and then reassessed psychopathology at Time 2 (N = 1,132). Cross-sectionally, we found that the relationship between adaptive strategies and psychopathology symptoms was moderated by levels of maladaptive strategies: adaptive strategies had a negative association with psychopathology symptoms only at high levels of maladaptive strategies. In contrast, adaptive strategies showed no prospective relationship to psychopathology symptoms either alone or in interaction with maladaptive strategies. We discuss the implications of this investigation for future work on the contextual factors surrounding the deployment of emotion regulation strategies.     

The need of young adults to text now: Using delay discounting to assess informational choice

This study examined the value of responding immediately to a text or call and the ability to wait. The willingness to delay texting or calling for a larger monetary reward was compared with delay tolerance for monetary rewards alone. The results of two experiments showed no differences in the qualitative shape of the delay discounting functions, indicating a similar decision-making process for informational (texting or calling) and monetary decisions. Data in the second experiment showed that the degree of delay tolerance varied as a function of the social distance of the texting partner, indicating a strategic decision-making process in informational decisions. However, the time course of loss of value for informational versus monetary rewards revealed substantial quantitative differences. While money loses value on the time span of weeks, information loses value within minutes, which may explain why behaviors like texting often occur in inappropriate situations and may seem like addictions.     

Pathways Between Concealable Stigmatized Identities and Substance Misuse

Individuals with concealable stigmatized identities often possess no obviously devalued attributes, yet are at greater risk for problematic substance use compared to their privileged counterparts. We present a conceptual model, which proposes that identity‐relevant content and characteristics have important implications for cognitive, affective, and behavioral consequences of stigma‐related stress. In doing so, we synthesize stigma‐related models from the extant literature and attempt to integrate these concepts with previous work detailing potential contributors to substance use behaviors specifically. Finally, we ask readers to consider the various ways in which the content and characteristics of an individual's stigmatized identity might combine with situational and additional individual difference factors to influence the likelihood of substance misuse.     

Traits and Roles in Gender Stereotypes: A Comparison between Moroccan and Spanish Native Samples

This study examines gender role attitudes and attitudes toward “man” and “woman” in two native samples from Spain and Morocco. The samples were made up of 400 participants, 200 in each country, containing the same number of men and women and selected with a similar procedure. We expected differences based on the independent variables of nationality, gender and educational level. The Spanish sample, female and student participants were predicted to present more egalitarian gender role attitudes and more positive attitudes toward “woman” than participants in the Moroccan sample, male and non-student participants. Overall MANOVAs were used to show the differences in gender role attitudes and attitudes toward “man” and “woman”. Results confirmed the role of the nationality variable in the expected way. The Spanish sample showed a more egalitarian view and more favorable attitudes toward “woman” than the Moroccan one. Educational level and gender showed significant effects on the Moroccan sample but only partially. Moroccan student females and non-student males presented a more egalitarian view than non-student females and student males respectively.