Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.     

Using goal setting, task clarification, and feedback to increase the use of the hands-free technique by hospital operating room staff

We evaluated the effects of a behavioral treatment on the safe passing of sharp instruments using the hands-free technique among hospital operating room personnel during surgical procedures. Treatment consisted of participative goal setting, task clarification, and feedback. The average percentage of sharp instruments passed safely increased from 32% to 64% and 31% to 70% between baseline and treatment phases in the inpatient and outpatient surgery units, respectively. Five-month follow-up data suggested maintenance of treatment effects. These findings suggest the utility of organizational behavior management strategies in reducing risky behavior in hospital settings.     

The catastrophic misinterpretation model of panic disorder.

In the catastrophic misinterpretation model of panic Clark [Behav. Res. Ther. 24(1986)1461] proposes that panic attacks result from the misinterpretation of autonomic arousal stimuli as precursors to a physical or psychological emergency. The model has been widely examined, with many researchers suggesting that this specific cognitive bias is implicated in both the phenomenon of panic, and the aetiology and maintenance of panic disorder. Various research methodologies have provided only partial or inconclusive support for the model as being uniquely associated with panic, and as a cognitive process underpinning the experience of panic. This paper reviews the body of existing evidence and its implications for the model and proposes future research directions. The influence of implicit operational definitions of key terms in the catastrophic misinterpretation literature (e.g. 'catastrophe', 'threat', 'anxiety-related') are examined, and clarifications proposed. Inconsistencies and limitations in the measurement of catastrophic misinterpretation are highlighted, and subsequently developments to measurement instruments are proposed.     

Classroom performance and adaptive skills in children with epilepsy

The relationships of age at onset, seizure syndrome, seizure type, and seizure frequency, respectively, to the classroom performance and adaptive skills of 131 children with epilepsy were studied. The Teacher Report Form of the Child Behavior Checklist was completed by the children's teachers. Hierarchical multiple regression analyses were conducted on ratings of academic subject areas and overall adaptive skills. Significant results were obtained for English/Language, Reading, Mathematics, overall School Performance, Learning, Happy, and Total Adaptive skills. Epilepsy syndrome and frequency of seizures were significantly related to some of these analyses, with amounts of variance accounted for ranging from 11% to 23%. Children with secondary generalized epilepsy performed significantly worse than children with other epilepsy syndromes. The results suggest that a seizure disorder associated with a diffuse or multifocal brain insult can produce problems in achievement and school adaptation as manifested on a day-to-day basis. Suggestions for future research are presented.     

A comparison of on-the-scene coping mechanisms used by two culturally different groups

Five groups of participants from Mississippi (n = 101) completed a questionnaire based on 11 coping mechanisms used most often by Norwegian rescuers (Dyregrov & Mitchell, 1992). Eight significantly different strategies were endorsed by the Mississippians and the Norwegians. Mississippians used more altruistic, cognitive, and social coping mechanisms while the Norwegians tended to endorse emotional distancing and task oriented methods of coping. The strategy judged most important by both Mississippians and Norwegians was maintaining contract with other helpers. It is argued that differences in on-the-scene coping strategies used by rescue workers are based on cultural, social, and individual differences. Researchers concluded that data from one cultural group cannot necessarily be generalized to another group. An examination of differences between the jive groups of Mississippians has been published elsewhere (Holaday, Warren-Miller, Smith & Yost, in press).     

Occupational attainment as a function of abilities and interests: a longitudinal analysis using project TALENT data

Ability, interest, gender, and family socioeconomic status of 13,248 tenth-grade participants in Project TALENT were studied as they relate to occupational attainment by using discriminant analysis. Individuals were classified into 12 broad categories reported 11 years after graduation. Accuracy analyses indicated correct classifications significantly above chance for all except the Technical and Sales categories. Within-category classification percentages were higher for all groups except Construction. Five canonical discriminant functions that jointly accounted for 96.8% of the between-groups variance were interpreted. The first 2 accounted for 81.9% of the variance. Function 1 was a general ability function; Function 2 differentiated the categories on the basis of mathematics ability and gender. Functions 3 through 5 accounted for 14.9% of the between-groups variance. Some implications of these findings are discussed.     

Parent-child conversation of more-liked and less-liked children

Four more-liked boys and four less-liked boys (M age = 58.13 months) were videotaped as they interacted separately in semi-structured activities with their own mother and father, the mother and father of a more-liked boy, and the mother and father of a less-liked boy. Parents of less-liked boys had more intensive interactions that were more controlling, directive, and intrusive than parents of more-liked boys. Parents of more-liked boys had extensive interactive patterns that made them better able to extend praise and encouragement to children not their own. Similarly, more-liked children seemed more sensitive than less-liked children to situational factors that occurred during interactions with parents not their own and were therefore better able to adjust their behavior to the expectations of the situation.     

Analysis of adult-neonate synchrony during speech and nonspeech

Five neonates and two adult female interactants were video-taped and categorized as to their interactionally synchronous movements during speech and nonspeech. Although synchrony occurred during speech as well as nonspeech, it was significantly more likely to occur during periods of speech. Duration of adults' movement were significantly shorter during speech and longer during nonspeech. These findings corroborate previous suggestions that interactional synchrony between adults and infants occurs on a micro-level.     

Factors within the 1969 SVIB for women and relationships to Holland's theory

The Basic Interest Scales (BIS) and the Occupational Scales (O-S) of the revised Strong Vocational Interest Blank for Women (TW 398) were assigned Holland codes, and component scores for the BIS and O-S were separately developed, intercorrelated, and evaluated along with standardized composite scores representing each of the 11 O-S Groups on the profile. The dimensionality of the BIS and O-S was similar, and similar in number to Holland's theory, but the components were only partially congruent. Some profile Groups provided relatively good representations of BIS and/or Occupational scale components, and the grouping of the O-S provided important information not otherwise readily available. Holland's dimensions are not uniformly represented in either the BIS or O-S, and despite some similarities, fundamental problems of compatibility appeared to exist in relating the structure of this instrument to Holland's formulations. Women's interests are in need of independent study.