Modelling decisions to undergo genetic testing for susceptibility to common health conditions: an ancillary study of the Multiplex Initiative

New genetic tests reveal risks for multiple conditions simultaneously, although little is understood about the psychological factors that affect testing uptake. We assessed a conceptual model called the multiplex genetic testing model (MGTM) using structural equation modelling. The MGTM delineates worry, perceived severity, perceived risk, response efficacy and attitudes towards testing as predictors of intentions and behaviour. Participants were 270 healthy insured adults aged 25-40 from the Multiplex Initiative conducted within a health care system in Detroit, MI, USA. Participants were offered a genetic test that assessed risk for eight common health conditions. Confirmatory factor analysis revealed that worry, perceived risk and severity clustered into two disease domains: cancer or metabolic conditions. Only perceived severity of metabolic conditions was correlated with general response efficacy (β?=?0.13, p<0.05), which predicted general attitudes towards testing (β?=?0.24, p<0.01). Consistent with our hypothesised model, attitudes towards testing were the strongest predictors of intentions to undergo testing (β?=?0.49, p<0.01), which in turn predicted testing uptake (OR 17.7, β?=?0.97, p<0.01). The MGTM explained a striking 48% of the variance in intentions and 94% of the variation in uptake. These findings support use of the MGTM to explain psychological predictors of testing for multiple health conditions.     

Genetic Counseling as a Tool for Type 2 Diabetes Prevention: A Genetic Counseling Framework for Common Polygenetic Disorders

Advances in genetic epidemiology have increased understanding of common, polygenic preventable diseases such as type 2 diabetes. As genetic risk testing based on this knowledge moves into clinical practice, we propose that genetic counselors will need to expand their roles and adapt traditional counseling techniques for this new patient set. In this paper, we present a genetic counseling intervention developed for a clinical trial [Genetic Counseling/Lifestyle Change for Diabetes Prevention, ClinicalTrials.gov identifier: NCT01034319] designed to motivate behavioral changes for diabetes prevention. Seventy-two phenotypically high-risk participants received counseling that included their diabetes genetic risk score, general education about diabetes risk factors, and encouragement to participate in a diabetes prevention program. Using two validated genetic counseling scales, participants reported favorable perceived control and satisfaction with the counseling session. Our intervention represents one model for applying traditional genetic counseling principles to risk testing for polygenetic, preventable diseases, such as type 2 diabetes.     

Prior Trauma Exposure for Youth in Treatment Foster Care

Very little research has focused on rates of trauma exposure for youth in treatment foster care (TFC). Available research has utilized record review for assessing exposure, which presents limitations for the range of trauma types examined, as records are predominantly focused on abuse and neglect. The current study examines exposure rates and association with emotional and behavioral outcomes for 229 youth in 46 TFC agencies. The youth in this study had exceptionally high rates of trauma exposure by foster parent report, similar to youth in traditional foster care, with nearly half of the sample exposed to four or more types of traumatic events. A composite child abuse and neglect exposure variable was associated with child and adolescent emotional and behavioral outcomes. Implications for services provided as part of TFC are discussed.     

The impact of self-reported pubertal status and pubertal timing on disordered eating in irish adolescents

This paper considers the impact of pubertal status and pubertal timing on disordered eating in Irish adolescents. 1190 boys and 1841 girls completed the Eating Attitudes Test-26, the Eating Disorder Inventory-III and self-report measures of pubertal status and pubertal timing. Regarding pubertal status, greater maturity in girls was associated with increased overall eating concerns, higher drive for thinness and higher levels of body dissatisfaction. In boys, greater maturity was associated with lower drive for thinness and lower body dissatisfaction. Regarding pubertal timing, early-maturing girls showed the most eating concerns, the highest drive for thinness, scored highest on bulimic symptoms and were the most dissatisfied with their bodies. In contrast, late-maturing boys had more bulimic symptoms and more dissatisfaction with their bodies than on-time peers. The findings suggest that puberty itself is a risk factor for disordered eating for girls rather than boys; however, pubertal timing is a risk factor for both. Copyright ? 2012 John Wiley & Sons, Ltd and Eating Disorders Association.     

Understanding the functional properties of tools: chimpanzees (Pan troglodytes) and capuchin monkeys (Cebus apella) attend to tool features differently

We examined whether eight capuchins and eight chimpanzees were able to retrieve a reward placed inside a tube, of varying length, by selecting the correct stick from different sets of three sticks differing in length (functional feature) and handle (non-functional feature). Moreover, to investigate whether seeing the stick inside the tube (visual feedback) improves performance, half of the subjects were tested with a transparent apparatus and the other half with an opaque apparatus. Phase 1 included (a) Training 1 in which each stick had a different handle and (b) Transfer 1 in which the handles were switched among sticks, so that the functional tool had the same length but a different handle than before. The seven chimpanzees and one capuchin that passed Transfer 1 received Transfer 2. The other subjects received (a) Training 2, which used the same sticks from Phase 1 with handles switched in every trial, and (b) Transfer 2 in which the tube was longer, all sticks had the same new handle, and the formerly longest tool became intermediate in length. Eight chimpanzees and three capuchins passed Transfer 2. Results showed that (1) chimpanzees applied relational structures in tool using tasks more quickly than capuchins and (2) capuchins required more varied experience to attend to the functional feature of the tool. Interestingly, visual feedback did not improve performance in either species.     

Do Historical Changes in Parent–Child Relationships Explain Increases in Youth Conduct Problems?

The coincidence of historical trends in youth antisocial behavior and change in family demographics has led to speculation of a causal link, possibly mediated by declining quality of parenting and parent–child relationships. No study to date has directly assessed whether and how parenting and parent–child relationships have changed. Two national samples of English adolescents aged 16–17 years in 1986 (N = 4,524 adolescents, 7,120 parents) and 2006 (N = 716 adolescents, 734 parents) were compared using identical questionnaire assessments. Youth-reported parental monitoring, expectations, and parent–child quality time increased between 1986 and 2006. Ratings of parental interest did not change. Parenting differences between affluent and disadvantaged families narrowed over time. There was thus little evidence of a decline in quality of parenting for the population as a whole or for disadvantaged subgroups. Parent-reported youth conduct problems showed a modest increase between 1986 and 2006. Findings suggested that the increase in youth conduct problems was largely unrelated to observed change in parent–child relationships.     

Lower extremity strength and hopping and jumping ground reaction forces in children with neurofibromatosis type 1

The purpose of this study was to (1) extend the research findings of decreased muscular force production in grip strength to the lower extremity strength of children with NF1 and (2) to determine if there was a relationship between isometric strength and functional activities in children with NF1. Force production was assessed using a hand held dynamometer (HHD) and a functional task (hopping and jumping) on a force plate. Data from twenty-six children with NF1 were compared to data from 48 typically developing children of similar sex, weight and height. Children with NF1 demonstrated statistically significant lower force production with HHD (p<0.01) during hip extension, but similar force production for knee extension and ankle plantar flexion compared to the control group. A relationship existed between the ground reaction forces at take-off from both hopping and jumping and the force generated from knee extensor strength in the NF1 group. The addition of a functional task to hand held dynamometry is useful for determining a relationship between common clinical measures and functional activities.     

The brain's hemispheres and controlled search of the lexicon: evidence from fixated words and pseudowords

Difference between the brain's hemispheres in efficiency of intentional search of the mental lexicon with phonological, orthographic, and semantic strategies was investigated. Letter strings for lexical decision were presented at fixation, with a lateralized distractor to the LVF or RVF. Word results revealed that both hemispheres were capable of using each of the three strategies, but the right hemisphere had better baseline processing of orthography and was better at processing semantics. Pseudoword results supported the right hemisphere advantage for orthography and showed a left hemisphere advantage for phonology and assessment of possible semantic relationships. Taken together, the data support the idea that the right hemisphere uses orthography to make efficient decisions about novelty of an item, while the left engages in grapheme-to-phoneme conversion to test hypotheses about unfamiliar items. The convergence of data with previous research reveals that the procedure, as well as analyses of pseudowords, inform laterality research.