Genetic Counseling in the Era of Genomics: What’s all the Fuss about?

As genomic sequencing becomes more widely available in clinical settings for diagnostic purposes, a number of genetic counseling issues are gaining precedence. The ability to manage these issues will be paramount as genetic and non-genetic healthcare professionals navigate the complexities of using genomic technologies to facilitate diagnosis and inform patient management. Counseling issues arising when counseling for diagnostic genomic sequencing were identified by four genetic counselors with 10 years of collective experience providing genetic counseling in this setting. These issues were discussed and refined at a meeting of genetic counselors working in clinical genomics settings in Melbourne, Australia. Emerging counseling issues, or variations of established counseling issues, were identified from the issues raised. Illustrative cases were selected where pre- and post-test genetic counseling was provided in clinical settings to individuals who received singleton or trio WES with targeted analysis. Counseling issues discussed in this paper include a reappraisal of how genetic counselors manage hope in the genomic era, informed consent for secondary use of genomic data, clinical reanalysis of genomic data, unexpected or unsolicited secondary findings, and trio sequencing. The authors seek to contribute to the evolving understanding of genetic counseling for diagnostic genomic sequencing through considering the applicability of existing genetic counseling competencies to managing emerging counseling issues and discussing genetic counseling practice implications.     

Adjustment Profiles of Low-Income Caregivers from the United States and South Africa: Contrasts and Commonalities

Although low-income parents living in under-resourced communities in the United States and around the world face challenges, many do well while others struggle in one or more areas of functioning. The present study examined patterns of adjustment among maternal caregivers living in the United States (US) (N?=?320) and South Africa (SA) (N?=?324). Cluster analyses across four domains of functioning representing both positive and negative adjustment and conducted within country revealed similar patterns of adjustment, with a majority of caregivers (37.8% in the US; 47.5% in SA) landing in a “holding steady” pattern, exhibiting good but not exceptional adjustment. Other patterns of adjustment (three additional in the US sample; two additional in the SA sample) showed elevated impairment in somatic complaints, problems with alcohol, or life satisfaction. In both the US and SA, support from family, friends, and neighbors differentiated the adjustment profiles. Further, both current stressors within and outside of the family and previous stressors including direct and indirect exposure to violence discriminated caregivers who were “holding steady” from those who were struggling in one or more domains. Additionally, across both countries, caregivers who were “holding steady” evidenced less avoidant coping. Implications of this work for fostering resilience among caregivers and their children are discussed.     

Influence of Siblings on Child Health Behaviors and Obesity: A Systematic Review

Family structure plays an important role in childhood obesity but the association between having siblings and childhood obesity is not well established. The purpose of this systematic review was to examine the relationship between sibling factors and child health behaviors and child obesity. CINAHL, Cochrane Reviews, PsycINFO and PubMed were searched to identify relevant publications between 2000 and 2016. Of 141 identified studies, 22 peer-reviewed, primary research reports satisfied inclusion criteria and were included in the review. Findings indicated that children without siblings are more likely to be overweight or obese. Having fewer siblings was associated with decreased physical activity, inadequate sleep, and unhealthy dietary habits. The relationship between the number of siblings and childhood obesity persisted over time. All but two studies reported an association between birth order and childhood obesity. Youngest siblings were at a higher risk of becoming overweight or obese than their older siblings. Overall, the findings emphasize the importance of sibling factors in the development of childhood obesity. Further studies are needed to understand the dynamics underlying the effect of siblings on child’s health-related behaviors in order to develop effective childhood obesity prevention programs. Healthcare professionals should focus on family structure and at-risk children when intervening to prevent childhood obesity.     

Agents of Prosociality: Agency Affirmation Promotes Mutual Prosocial Tendencies and Behavior Among Conflicting Groups

Members of conflicting groups are motivated to restore their ingroup's agency, leading to antisocial tendencies against the outgroup. The present research tested the hypothesis that affirming conflicting groups' agency would increase their members' mutual prosociality. The effectiveness of agency affirmation was demonstrated in three contexts of conflict between groups: Switzerland and the EU following the 2014 referendum (Study 1), Israelis and Palestinians (Study 2), and Israeli rightists and leftists (Study 3). Study 1 found that in a nonconflictual context Swiss participants prioritized their moral (prosocial) over agentic goals, yet in the context of conflict with the EU, they prioritized their agentic over moral goals. This “primacy‐of‐agency” effect, however, was eliminated once their ingroup's agency was affirmed. Studies 2 and 3 demonstrated the positive effect of agency affirmation on prosociality among Israelis referring to Palestinians and Israeli rightists and leftists referring to the adversarial political camp. This effect was mediated by group members' readiness to relinquish some power for the sake of morality. Pointing to the importance of the affirmation's specific content, Studies 2 and 3 demonstrated that morality affirmation failed to increase prosociality. As such, the present research puts forward a promising strategy to reduce hostility and promote prosociality between conflicting groups.     

The Dialectics of Stigma,Silence, and Misunderstanding in Suicidality Survival Narratives

Modern suicidologists have noted a dearth of qualitative research on suicide. The first author conducted 20 in-depth interviews with formerly suicidal adults to understand how they accounted for their experiences contemplating or attempting suicide. According to participants, stigma necessitated impression management, which contributed to the production of silence and misunderstanding. Silence and misunderstanding reinforced stigma. This complex, dialectical, belief system about stigma yields insight into the interpretive culture of surviving suicidal ideation or a suicide attempt. These beliefs about suicide may serve as a barrier to individuals seeking help, recovering from suicidality, and larger social change regarding attitudes toward suicide.     

Influential Factors of Poverty Dynamics among Korean Households that Include the Aged with Disability

The purpose of this longitudinal study was to examine closely the economic status of households that include the aged with disabilities in South Korea, as well as the factors contributing to their poverty dynamics. This study analyzed the poverty dynamics of households that include the aged with disabilities by using data from the Panel Survey of Employment for the Disabled for the years 2008 to 2012. This Survey is conducted by the Korea Employment Agency for the Disabled. Poverty dynamics were classified by the changes in poverty status in 2008 and 2012, including sustained poverty, sustained non-poverty, poverty exit, and poverty entry. We carried out a multinomial logistic regression for poverty dynamics based on demographics and analyzed the differences of income composition and consumption patterns according to poverty dynamics. Gender, education, degree of disability, economic activity, and change in the number of employed family members were identified as significant factors that determine poverty dynamics.     

Connecting the dots from a distance: Does mentally traveling through space and time increase searching for life’s meaning?

As humans, we have the ability to travel beyond the present moment by considering past and future times as well as locations that are distant from oneself. An interesting possibility is that such mental travel to far-away times and places (vs. focusing on times and places closer to the present) may increase people’s desire to search for their lives’ meaning. Since searching for meaning involves the integration of separate life events into a coherent life story, mentally traveling farther away from the present may make people aware that their life stories include more than what is happening at this very minute. Such awareness, then, may increase their desire to ‘connect the dots’ between their life events by searching for some underlying meaning. Three experiments (N = 838) tested this prediction and found that greater (vs. lower) mental travel through space or time increased the search for life’s meaning.     

Sexting as a predictor of sexual behavior in a sample of Czech adolescents

The purpose of this longitudinal study is to examine the relationship between teen sexting and offline sexual behavior. Using a sample of 1134 Czech adolescents aged 10–18 (M_age = 13.84, SD = 1.94, girls = 58.8%) from 55 schools, the latent growth model of offline sexual behavior with sexting as a time-varying covariate was employed. Participants differed at baseline for offline sexual behavior at both individual and school levels, and they varied in the growth rate of offline sexual behavior at the individual level. Only age and sensation seeking explained the variability at baseline of offline sexual behavior. The positive association between sexting and offline sexual behavior was not constant across time. However, sexting at baseline predicted offline sexual behavior a half year and one year later. Sexting may be treated as a precursor of offline sexual behavior.     

The roles of order,distance, and interstitial items in temporal visual statistical learning

Humans are adept at learning regularities in a visual environment, even without explicit cues to structure and in the absence of instruction—this has been termed “visual statistical learning” (VSL). The nature of the representations resulting from VSL are still poorly understood. In five experiments, we examined the specificity of temporal VSL representations. In Experiments 1A, 1B, and 2, we compared recognition rates of triplets and all embedded pairs to chance. Robust learning of all structures was evident, and even pairs of non-adjacent items in a sequentially presented triplet (AC extracted from a triplet composed of ABC) were recognized at above-chance levels. In Experiment 3, we asked whether people could recognize rearranged pairs to examine the flexibility of learned representations. Recognition of all possible orders of target triplets and pairs was significantly higher than chance, and there were no differences between canonical orderings and their corresponding randomized orderings, suggesting that learners were not dependent upon originally experienced stimulus orderings to recognize co-occurrence. Experiment 4 demonstrates the essential role of an interstitial item in VSL representations. By comparing the learning of quadruplet sets (e.g., ABCD) and triplet sets (e.g., ABC), we found learning of AC and BD in ABCD (quadruplet) sets were better than the learning of AC in ABC (triplet) sets. This pattern of results might result from the critical role of interstitial items in statistical learning. In short, our work supports the idea of generalized representation in VSL and provides evidence about how this representation is structured.