Direct-to-Consumer Personal Genomic Testing: A Case Study and Practical Recommendations for “Genomic Counseling”

Technological advances and information-seeking consumers have pushed forward the movement of direct-to-consumer (DTC) genetic testing. Just like with other types of testing, there are potential risks, benefits and limitations. A major limitation of DTC testing is the incomplete view it provides regarding lifetime risk for common, complex diseases, since most tests only analyze 1–2 single nucleotide polymorphisms (SNPs) and do not include evaluation of medical or family histories, which is necessary to risk assessment. Further, it is not currently well-established whether personal genomic testing results will lead toward improved health behaviors, adverse psychological effects or potential overuse of the health care system. To display these and other issues, we present an in-depth case study of an individual who ordered DTC genetic testing and subsequently sought genetic counseling. This case presents a unique learning experience for the field of genomic counseling, as the patient did not fit the typical assumptions regarding ‘early adopters’ of DTC testing. It also allowed the genetics health care providers involved in the case to identify gaps in current genetic counseling practice that need to be filled and approaches to employ for successful delivery of genomic counseling. Based on our experience, we developed practical recommendations for genomic counseling, which include novel approaches to case preparation, use of electronic tools during the counseling session, and focusing on education as the major component of the genomic counseling session, in order to provide patients with the knowledge necessary to independently interpret and understand large amounts of genomic testing information provided to them.     

Parent and Family Impact of Autism Spectrum Disorders: A Review and Proposed Model for Intervention Evaluation

Raising a child with an autism spectrum disorder (ASD) can be an overwhelming experience for parents and families. The pervasive and severe deficits often present in children with ASD are associated with a plethora of difficulties in caregivers, including decreased parenting efficacy, increased parenting stress, and an increase in mental and physical health problems compared with parents of both typically developing children and children with other developmental disorders. In addition to significant financial strain and time pressures, high rates of divorce and lower overall family well-being highlight the burden that having a child with an ASD can place on families. These parent and family effects reciprocally and negatively impact the diagnosed child and can even serve to diminish the positive effects of intervention. However, most interventions for ASD are evaluated only in terms of child outcomes, ignoring parent and family factors that may have an influence on both the immediate and long-term effects of therapy. It cannot be assumed that even significant improvements in the diagnosed child will ameliorate the parent and family distress already present, especially as the time and expense of intervention can add further family disruption. Thus, a new model of intervention evaluation is proposed, which incorporates these factors and better captures the transactional nature of these relationships.     

The Effect of Praise, Positive Nonverbal Response, Reprimand, and Negative Nonverbal Response on Child Compliance: A Systematic Review

Lack of compliance has both short- and long-term costs and is a leading reason why parents seek mental health services for children. What parents do to help children comply with directives or rules is an important part of child socialization. The current review examines the relationship between a variety of parenting discipline behaviors (i.e., praise, positive nonverbal response, reprimand, negative nonverbal response) and child compliance. Forty-one studies of children ranging in age from 1? to 11?years were reviewed. Reprimand and negative nonverbal responses consistently resulted in greater compliance. Praise and positive nonverbal responses resulted in mixed child outcomes. The findings are discussed based on theory and populations studied. The authors propose a mechanism that may increase children’s sensitivity to both positive and negative behavioral contingencies.     

Sociocultural antecedents of academic motivation and achievement: Role of values and achievement motives in achievement goals and academic performance

With a view to understand the influence of culture on achievement motivation, the study aimed to test the hypothesized mediating role of individual‐oriented and social‐oriented achievement motives in linking value orientations (e.g. achievement, security, conformity, hedonism) to achievement goals (i.e. mastery‐approach, mastery‐avoidance, performance‐approach, and performance‐avoidance goals) as predictors of English and mathematics achievements. These hypothesized relationships were tested in the one‐path analytic model with a sample of Indonesian high‐school students (n = 356; 46% girls, M age = 16.20 years). The findings showed that security and conformity values positively predicted social‐oriented achievement motive; self‐direction values positively predicted individual‐oriented achievement motive; and hedonism values negatively predicted both achievement motive orientations. Both individual‐oriented and social‐oriented achievement motives positively predicted mastery‐approach and performance‐approach goals. Interestingly, social‐oriented achievement motive also positively predicted mastery‐avoidance and performance‐avoidance goals, which in turn, negatively predicted English and mathematic achievement. There was also some evidence for the direct effects of values on performance‐approach goals and achievement. Taken together, the findings evinced the relevance of achievement goal constructs to Indonesian students and the psychometric properties of the Indonesian version of the Achievement Goals Questionnaire for further use in Indonesia. The study concludes that the meanings of academic motivation and achievement should be seen from a sociocultural perspective relevant to the context in which they are being studied.     

Worms under cover: relationships between performance in learning tasks and personality in great tits (Parus major)

In animals, individual differences in learning ability are common and are in part explained by genetic differences, developmental conditions and by general experience. Yet, not all variations in learning are well understood. Individual differences in learning may be associated with elementary individual characteristics that are consistent across situations and over time, commonly referred to as personality or temperament. Here, we tested whether or not male great tits (Parus major) from two selection lines for fast or slow exploratory behaviour, an operational measure for avian personality, vary in their learning performance in two related consecutive tasks. In the first task, birds had to associate a colour with a reward whereas in the second task, they had to associate a new colour with a reward ignoring the previously rewarded colour. Slow explorers had shorter latencies to approach the experimental device compared with fast explorers in both tasks, but birds from the two selection lines did not differ in accomplishing the first task, that is, to associate a colour with a reward. However, in the second task, fast explorers had longer latencies to solve the trials than slow explorers. Moreover, relative to the number of trials needed to reach the learning criteria in the first task, birds from the slow selection line took more trials to associate a new colour with a reward while ignoring the previously learned association compared with birds from the fast selection line. Overall, the experiments suggest that personality in great tits is not strongly related to learning per se in such an association task, but that birds from different selection lines might express different learning strategies as birds from the different selection lines were differently affected by their previous learning performance.     

A telehealth intervention for veterans on antiviral treatment for the hepatitis C virus

The standard treatment for chronic hepatitis C (pegylated interferon and ribavirin) causes challenging physical and psychological side effects. The current pilot study evaluated the efficacy of a brief, telephone-based, cognitive-behavioral self-management intervention designed to address mood and quality of life within a sample of veterans on antiviral treatment for hepatitis C. Results from this pilot study support the feasibility of this telehealth intervention, showing that veterans were highly satisfied with the content of the intervention and compliant with the telephone calls. Findings further indicate that symptoms of depression and anxiety and mental health quality of life either remained stable or improved in those participants who received the brief telephone intervention, while those receiving usual care showed significant declines in mood and mental health quality of life. The findings from this study provide evidence that a brief, clinician-administered phone intervention may help individuals on antiviral therapy for hepatitis C to cope more effectively with the negative treatment side effects.     

Unemployed Adults’ Career Thoughts,Career Self‐Efficacy,and Interest: Any Similarity to College Students?

Little empirical knowledge about unemployed adults exists during a time when this group needs substantial career assistance. Because there is greater empirical understanding of college student career development compared with what is known about unemployed adults, a chi square and analyses of covariance were used to compare the career thinking, self‐efficacy, and interests of 169 unemployed adults seeking public job center assistance with that of 200 college students. Additionally, a diverse sample of 2,444 unemployed adults is demographically reviewed. Unemployed adults reported a higher level of Realistic interests and similar levels of negative career thinking and career decision‐making self‐efficacy compared with college students.