Self‐regulation principles underlying risk perception and decision making within the context of genomic testing

Advances in theory and research on self‐regulation and decision‐making processes have yielded important insights into how cognitive, emotional, and social processes shape risk perceptions and risk‐related decisions. We examine how self‐regulation theory can be applied to inform our understanding of decision‐making processes within the context of genomic testing, a clinical arena in which individuals face complex risk information and potentially life‐altering decisions. After presenting key principles of self‐regulation, we present a genomic testing case example to illustrate how principles related to risk representations, approach and avoidance motivations, emotion regulation, defensive responses, temporal construals, and capacities such as numeric abilities can shape decisions and psychological responses during the genomic testing process. We conclude with implications for using self‐regulation theory to advance science within genomic testing and opportunities for how this research can inform further developments in self‐regulation theory.     

Infant responses to adult happy and sad vocal and facial expressions during face-to-face interactions

We examined 5-month-olds’ responses to adult facial versus vocal displays of happy and sad expressions during face-to-face social interactions in three experiments. Infants interacted with adults in either happy-sad-happy or happy-happy-happy sequences. Across experiments, either facial expressions were present while presence/absence of vocal expressions was manipulated or visual access to facial expressions was blocked but vocal expressions were present throughout. Both visual attention and infant affect were recorded. Although infants looked more when vocal expressions were present, they smiled significantly more to happy than to sad facial expressions regardless of presence or absence of the voice. In contrast, infants showed no evidence of differential responding to voices when faces were obscured; their smiling and visual attention simply declined over time. These results extend findings from non-social contexts to social interactions and also indicate that infants may require facial expressions to be present to discriminate among adult vocal expressions of affect.     

Age-related increase in top-down activation of visual features

Previous research suggests that, during visual search and discrimination tasks, older adults place greater emphasis than younger adults on top-down attention. This experiment investigated the relative contribution of target activation and distractor inhibition to this age difference. Younger and older adults performed a singleton discrimination task in which either an E or an R target (colour singleton) was present among distractor letters. Relative to a baseline condition in which the colours of the targets and distractors remained constant, an age-related slowing of performance was evident when either the colour of the target or that of the distractors varied across trials. The age-related slowing was more pronounced in response to target colour variation, suggesting that older adults place relatively greater emphasis on the top-down activation of target features.     

Gendered Self-Concept and the Aggressive Expression of Driving Anger: Positive Femininity Buffers Negative Masculinity

The aggressive expression of driving anger is a risk factor for aggressive and dangerous driving behavior and is associated with a greater risk of accident involvement. The present study related positive and negative facets of a masculine and feminine self-concept to aggressive and adaptive forms of anger expression while driving. A sample of 417 drivers (194 women, 46.5%) in Germany completed the Positive-Negative Sex Role Inventory (PN-SRI) as a measure of positive and negative masculinity and femininity and the Driving Anger Expression Inventory (DAX) as a measure of driving anger expression. Aggressive forms of expressing driving anger were unrelated to gender but differed significantly in relation to gendered self-concept. Negative but not positive masculinity was found to predict higher aggressive and lower adaptive anger expression. No main effects of positive or negative femininity were found. However, the link between negative masculinity and aggressive anger expression was buffered by positive femininity: Negative masculinity was unrelated to aggressive anger expression when accompanied by positive femininity. Adaptive anger expression showed negative links with negative masculinity and positive links with positive masculinity. The findings held for both men and women and support the theoretical distinction between positive and negative facets of the gendered self-concept. The implications for the conceptualization of both gendered self-concept and anger expression on the road are discussed.     

A qualitative analysis of strategies for managing suicide-related events during deployment from the perspective of Army behavioral health providers,chaplains, and leaders

The purpose of this qualitative study was to investigate the use of strategies for managing suicide-related events (SREs; i.e., suicide deaths, suicide attempts, and suicidal ideation with a plan and intent to die) during deployment from the perspective of Army decision makers: behavioral health providers (BHPs), chaplains, and leaders. A total of 76 Army personnel participated in individual interviews or focus groups. Participants identified unit watch, weapon removal, medical evacuations, and debriefings as common strategies used to manage SREs in deployed settings. Many of these strategies were highlighted as short-term solutions only. Participants also underscored the importance of unit cohesion and communication among leaders, BHPs, and chaplains to effectively manage SREs. The need for structured guidelines for successfully managing SREs in deployed settings is discussed.     

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.