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.     

An Evaluation of the NAMI Basics Program

This brief report describes results from an evaluation of NAMI Basics, a peer-delivered family education program for family caregivers of children and adolescents with mental illness. Over six classes, family members are given information (e.g. education about mental illness and treatments), skills training (e.g. family communication skills) and advocacy support. We report data from 36 caregivers who completed pre and posttest instruments measuring self-care, empowerment, and family problem-solving and communication skills. Results showed significant improvements in self-care, empowerment, and “incendiary” family communication after participation in the program. Results suggest that NAMI Basics may improve both parental functioning and familial processes. Implications and future directions 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.     

Motor proficiency and emotional/behavioural disturbance in autism and Asperger's disorder: another piece of the neurological puzzle?

The relationship of motor proficiency with emotional/behavioural disturbance, autistic symptoms and communication disturbance was investigated in children diagnosed with autism and Asperger's disorder (AD). The Movement Assessment Battery for Children was used as a measure of motor impairment, and the Developmental Behavioural Checklist was used as a measure of emotional/behavioural disturbance in the following groups: AD (n?=?22), high functioning autism (HFA) (n?=?23), LFA (n?=?8) and typically developing children (n?=?20). The HFA group had more difficulty with motor items, such as ball skills and balance, than did the AD group. There were significant positive correlations between impairments in motor proficiency (in particular ball skills and balance) and emotional/behavioural disturbance, autistic symptoms and communication disturbance. These findings are consistent with the hypothesis that there are qualitative and quantitative differences in the motor profile between autism and AD. In addition, the association between motor proficiency impairment and emotional/behavioural disturbance in autism and AD emphasizes the importance for screening of co-occurring emotional/behavioural symptoms in individuals with motor difficulties. These findings have implications for the potential use of adjunct motor measures in the diagnosis and definition of autism spectrum disorders.     

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.     

When up-words meet down-sentences: evidence for word- or sentence-based compatibility effects?

Participants were presented with sentences mentioning an entity with a typical location in the upper or lower vertical space (e.g., roof vs. root). Sentences supported or reversed the typical location of the target entity. Sensibility judgments requiring upwards or downwards responses were faster when the response matched rather than mismatched the target entity's typical location. This compatibility effect was independent of whether the sentence context supported or reversed the target entity's typical location. The results, therefore, provide clear evidence for word-based but no evidence for sentence-based simulation processes.