Predictors of Genetic Testing Decisions: A Systematic Review and Critique of the Literature

Genetic testing is increasingly available in medical settings and direct-to-consumer. However, the large and growing literature on genetic testing decisions is rife with conflicting findings, inconsistent methodology, and uneven attention across test types and across predictors of genetic testing decisions. Existing reviews of the literature draw broad conclusions but sacrifice nuanced analysis that with a closer look reveals far more inconsistency than homogeny across studies. The goals of this paper are to provide a systematic review of the empirical work on predictors of genetic testing decisions, highlight areas of consistency and inconsistency, and suggest productive directions for future research. We included all studies that provided quantitative analysis of subjective (e.g., perceived risk, perceived benefits of testing) and/or objective (e.g., family history, sociodemographic variables) predictors of genetic testing interest, intentions, or uptake, which produced a sample of 115 studies. From this review, we conclude that self-reported and test-related (as opposed to disorder-related or objective) predictors are relatively consistent across studies but that theoretically-driven efforts to examine testing interest across test types are sorely needed.     

Relational processing following stroke

The research examined relational processing following stroke. Stroke patients (14 with frontal, 30 with non-frontal lesions) and 41 matched controls completed four relational processing tasks: sentence comprehension, Latin square matrix completion, modified Dimensional Change Card Sorting, and n-back. Each task included items at two or three levels of relational complexity. Relational processing was impaired in the stroke groups. This was due mainly to items at the intermediate ternary-relational level of complexity. Less complex binary-relational items and more complex quaternary-relational items (the latter are difficult for adults generally) were less sensitive to stroke status. Impairment was greater in frontal than non-frontal stroke patients. Positive inter-correlations among measures supported the domain-general nature of relational processing. Implications for assessment and intervention are discussed.     

The relative importance of patients’ decisional control preferences and experiences

Objective: Patients’ role in treatment decision-making can influence psychosocial and health-related outcomes (i.e. satisfaction, felt respect, adherence). We examined decisional control in a surgical context, identifying correlates of patients’ preferences and experiences.

Design: 380 patients and 7 surgeons were surveyed during initial surgical consultation visits in a low-income outpatient clinic.

Measures: Patients reported preferences for (pre-consultation) and experiences of (post-consultation) decisional control, demographics, satisfaction with care, and adherence to treatment recommendations. Surgeons rated patients’ health status.

Results: Preferences for and experiences of decisional control were unrelated, suggesting significant preference–experience misalignment. However, this misalignment did not appear to be consequential for patient outcomes. Rather, more decisional control, regardless of patients’ preferences, predicted greater satisfaction with care and greater self-reported adherence as assessed at a post-surgical appointment.

Conclusions: Decisional control predicts better outcomes for patients, regardless of their preferences for control over treatment decisions. These findings suggest that interventions should aim to increase patients’ degree of decisional control when feasible and appropriate.     

Using the Implicit Association Test to Assess Children's Implicit Attitudes toward Smoking

The development and psychometric properties of an Implicit Association Test (IAT) measuring implicit attitude toward smoking among fifth grade children were described. The IAT with "sweets" as the contrast category resulted in higher correlations with explicit attitudes than did the IAT with "healthy foods" as the contrast category. Children with family members who smoked (versus non-smoking) and children who were high in sensation seeking (versus low) had a significantly more favorable implicit attitude toward smoking. Further, implicit attitudes became less favorable after engaging in tobacco prevention activities targeting risk perceptions of addiction. Results support the reliability and validity of this version of the IAT and illustrate its usefulness in assessing young children's implicit attitude toward smoking.     

Eye movements and morphological segmentation of compound words: There is a mouse in mousetrap

In two experiments, readers' eye movements were monitored as they read sentences containing compound words. In Experiment 1, the frequency of the first and second morpheme was manipulated in compound words of low whole word frequency. Experiment 2 compared pairs of low frequency compounds with high and low frequency first morphemes but identical second morphemes that were embedded in the same sentence frames. The results showed significant effects of the frequency of both morphemes on gaze duration and total fixation time on the compound words. Regression analyses revealed an influence of whole word frequency on the same measures. The results suggest that morphemic constituents of compound words are activated in the course of retrieving the representation of the whole compound word. The fact that the frequency effects were not confined to fixations on the morphemic constituents themselves implies that saccadic eye movements are implemented before morphemic retrieval has been completed. The results highlight the importance of developing more precise models of the perceptual processes underlying reading and how they interact with the processes involved in lexical retrieval and comprehension.     

Acceptability of Psychotherapy, Pharmacotherapy, and Self-Directed Therapies in Australians Living with Chronic Hepatitis C

Despite the prevalence of psychiatric co-morbidity in chronic hepatitis C (CHC), treatment is under-researched. Patient preferences are likely to affect treatment uptake, adherence, and success. Thus, the acceptability of psychological supports was explored. A postal survey of Australian CHC outpatients of the Royal Adelaide Hospital and online survey of Australians living with CHC was conducted, assessing demographic and disease-related variables, psychosocial characteristics, past experience with psychological support, and psychological support acceptability. The final sample of 156 patients (58 % male) had significantly worse depression, anxiety, stress, and social support than norms. The most acceptable support type was individual psychotherapy (83 %), followed by bibliotherapy (61 %), pharmacotherapy (56 %), online therapy (45 %), and group psychotherapy (37 %). The most prominent predictor of support acceptability was satisfaction with past use. While individual psychotherapy acceptability was encouragingly high, potentially less costly modalities including group psychotherapy or online therapy may be hampered by low acceptability, the reasons for which need to be further explored.     

It’s in your nature: a pluralistic folk psychology

I suggest a pluralistic account of folk psychology according to which not all predictions or explanations rely on the attribution of mental states, and not all intentional actions are explained by mental states. This view of folk psychology is supported by research in developmental and social psychology. It is well known that people use personality traits to predict behavior. I argue that trait attribution is not shorthand for mental state attributions, since traits are not identical to beliefs or desires, and an understanding of belief or desire is not necessary for using trait attributions. In addition, we sometimes predict and explain behavior through appeal to personality traits that the target wouldn’t endorse, and so could not serve as the target’s reasons. I conclude by suggesting that our folk psychology includes the notion that some behavior is explained by personality traits—who the person is—rather than by beliefs and desires—what the person thinks. Consequences of this view for the debate between simulation theory and theory theory, as well as the debate on chimpanzee theory of mind are discussed.     

On the immunity of perceptual implicit memory to manipulations of attention

In four experiments, we examined the effect of manipulating study phase attention in a Stroop task on the extent of repetition priming in the lexical decision task (LDT). Experiment 1 replicated the immunity of the LDT to division of attention reported by Szymanski and MacLeod (1996), using a standard Stroop configuration. Response times to previously encountered words were identical regardless of whether the participants were required to read the words or name the color in which they were presented. Experiment 2 demonstrated that implementing the Stroop manipulation across separate visual objects reduced but did not eliminate priming of unattended words, provided the words remained in the attended region of the stimulus display. When this constraint was removed in Experiment 3, priming of unattended words disappeared. Experiment 4 demonstrated statistically equivalent priming for attended and unattended words when the Stroop manipulation remained in the same visual object but attention was directed to a single letter of the word. In all four experiments, the Stroop manipulation had a clear effect on recognition. These results qualify claims that the LDT might be immune to manipulations of study phase attention and suggest that the LDT has a lower threshold level of attention at encoding than do other standard implicit tests of memory.     

The development of children's intentions to use alcohol: direct and indirect effects of parent alcohol use and parenting behaviors

The purpose of this study was to explore the effect of parent alcohol use and parenting behavior on the development of children's intentions to use alcohol in Grades 1 through 8. The authors hypothesized that the effect of parent alcohol use on children's intention to use alcohol would be mediated through parenting behavior, specifically monitoring/supervision, positive parenting, and inconsistent discipline. Using cohort-sequential latent growth modeling (LGM), the authors tested 3 models examining the effect of the development of parent alcohol use on the development of children's intentions to use alcohol, as mediated by the development of each of the 3 parenting behaviors. Multiple group analyses were used to explore gender differences. The effect of growth in parent alcohol use on growth in children's intentions was mediated only by parent monitoring/supervision and was significant only for girls. The effect of inconsistent discipline was directly related to growth in intentions for both boys and girls. Although parent alcohol use was related to less positive parenting, positive parenting was unrelated to children's intentions to use alcohol.