Genetic Counselors’ Perceived Responsibilities Regarding Reproductive Issues for Patients at Risk for Huntington Disease

Research indicates that health care professionals’ attitudes may affect patients’ decisions regarding prenatal Huntington Disease testing, but few studies have sampled genetic counselors. In this qualitative study, genetic counselors described their experiences counseling individuals at risk for HD regarding reproductive decision-making. Five major research questions were investigated: 1) What are genetic counselor responsibilities? 2) What issues arise for patients and counselors? 3) How do counselors reconcile prenatal testing with presymptomatic testing? 4) To what extent are counselors’ initial expectations of at-risk patients’ beliefs and behaviors met? and 5) What advice would counselors offer to novice practitioners about working with this patient population? Fifteen genetic counselors experienced in counseling individuals at risk for HD participated in a semi-structured phone interview that yielded several themes. For example, participants identified their primary responsibility as information provision; less prevalent were psychosocial support and facilitating decision making. The most common ethical challenge was testing prenatally for HD which also results in presymptomatic testing of minors. Participants were divided about how directive to be in response to this ethical issue and about termination of a gene positive pregnancy.     

An Evaluation of the Psychometric Properties of the Womanist Identity Attitudes Scale

Responses from 101 African American/Black and 100 White women were used to examine the psychometric properties of the Womanist Identity Attitudes Scale (WIAS; Ossana, 1986; Ossana, Helms, & Leonard, 1992). First, internal consistency reliabilities suggested the need for further development of 3 of the 4 WIAS subscales. Second, links between WIAS scores and (a) sexist, (b) hostile sexist attitudes toward women, (c) benevolently sexist attitudes toward women, and (d) egalitarian attitudes toward women's rights and roles provided mixed support for the convergent validity of the WIAS. Third, consistent with theoretical conceptualization, the intercorrelations among WIAS subscales were similar for African American/Black and White women. These intercorrelations, however, were not entirely consistent with the theorized developmental process of the womanist identity model. Finally, the structural validity of the WIAS was examined using confirmatory and exploratory factor-analytic procedures. Both sets of analyses challenged the fit of the theorized womanist identity development model with data produced by the WIAS.     

A Negative Mood Induction Procedure with Efficacy Across Repeated Administrations in Women

Although several experimental techniques are effective in inducing negative mood, none has established efficacy over repeated testing. The lack of mood induction tools validated across repeated administrations impedes study of emotional changes in the same individual over time. A brief, sad mood induction combining music and an autobiographical memory was administered to 17 women on 6 occasions (two 3-day sets over a 2-week period of time). Mood was measured before and after the induction procedure. Repeated measures ANOVAs showed that the induction produced a large increase in POMS depression (d = 1.48) that recurred consistently across all testing days. A brief negative mood induction combining music and autobiographical memory appears suitable for use in studies that involve repeated administrations.     

The health of employed women and men: work,family, and community correlates

Research into clarifying the relationship between social roles and health has increasingly focused on studying the particular circumstances in which occupying multiple roles may enhance or diminish well‐being. This study examined the association between a general measure of well‐being—self‐rated health—and the perceived quality of work, family and community in a sample of employed urban‐dwelling Canadians in a mid‐size city, and whether the nature of the association differed for men and women. Few gender differences were found in the perceived quality of work, family and community. However, men and women differed significantly in the specific type of quality measures associated with general health. For women, satisfaction with one's partner/spouse and in the money available to meet basic family needs had a stronger association with self‐rated health. For men, the significant correlates were satisfaction with family relationships (other than one's partner) and the community physical environment. For both women and men, a more socially cohesive community was associated with better self‐rated health. Copyright © 2006 John Wiley & Sons, Ltd.     

How America Justifies Its War: A Modern/Postmodern Aesthetics of Masculinity and Sovereignty

The lies about the reasons for the U.S. war against Iraq provoked no mass public outcry in the United States against the war. What is the process of justification for this war, a process that seems to need no reasons? Mann argues that the process of justification is not a process of rational deliberation but one of aesthetic self‐constitution, of rebuilding a masculine national identity. Included is a feminist reading of the National Defense University document Shock and Awe.     

Defining Moments: Catalysts for Professional Development

In this series of papers, 17 genetic counselors describe defining moments, that is, personal experiences or events that led to a further realization of themselves as genetic counselors. These experiences, both positive and negative, describe a significant impact on the authors' professional growth and development. A call for papers was issued through the National Society of Genetic Counselors listserv and through the Journal of Genetic Counseling in 2001. This call resulted in the following 15 papers in which the authors were asked to describe the nature of a defining moment and how it affected their professional identity and practice. The authors provided an account of the experience or event, what it was about the experience that made it a defining moment, how it affected them personally and professionally, and if a defining moment was negative, how they were able to derive positive outcomes. Implications of these defining moments for other genetic counselors are discussed in a concluding paper.     

“Hey,let me hold your guns for a while”: A qualitative study of messaging for firearm suicide prevention

A recommended component of suicide prevention is encouraging at‐risk individuals to voluntarily and temporarily reduce access to firearms and other lethal methods. Yet delivering counseling on the topic can be difficult, given the political sensitivity of firearm discussions. To support such counseling, we sought to identify recommended framing and content of messages about reducing firearm access for suicide prevention. Through qualitative interviews with firearm owners and enthusiasts, we identified key points for use in framing (identity as a gun owner, trust, voluntary and temporary storage, and context and motivation) and specific content (preference for “firearm” over “gun,” and legal issues such as background checks for transfers). These findings build on prior work and should enhance efforts to develop and deliver effective, acceptable counseling and—ultimately—prevent firearm suicide.     

Using ethnographic methods for development of culture-specific interventions

Cultural specificity is considered important in developing effective school- and community-based interventions. This article illustrates the use of ethnographic research to enhance understanding of students' cultural experiences and facilitate the development of culturally specific interventions. Ethnographic data were collected during formative and intervention phases of a school-based mental health promotion project. Data were coded using an interactive deductive-inductive process. Culture specificity was defined as the integration of etic (universal) and emic (culture-bound) perspectives. Four culture-specific themes were identified: adult-sanctioned behaviors and practices, adolescents' perspectives about the present and aspirations for the future, and societal factors. These themes encompassed code categories reflecting cultural attitudes, beliefs, customs, expectations, norms, and values; and reflected the ecological framework that guided the research. Future research is needed to address the use of combined etic-emic conceptualizations of culture in the development of culture-specific interventions.     

Impact of cognitive-behavioral therapy for panic disorder on comorbidity: a controlled investigation

This study examined the effects of cognitive-behavioral therapy (CBT) for principal panic disorder with or without agoraphobia, on comorbidity in 30 individuals (16 female). To test the hypothesis that improvements in co-existing conditions were not due to spontaneous fluctuations across time, patients receiving immediate CBT were compared to those assigned to wait list (n = 11). Results indicated clinician-rated severity of comorbid specific phobia declined significantly following immediate CBT compared to no change after wait list. The number of patients without comorbidity of any severity increased after immediate CBT, with no such increase following wait list. However, the groups did not differ in the frequency of additional diagnoses or overall severity of comorbidity. In the total sample, results indicated reductions in comorbidity by 9-month follow-up, with marked declines in the severity of comorbid generalized anxiety disorder (GAD), social and specific phobia. Our findings suggest that targeted CBT for panic disorder has beneficial effects on comorbidity over the longer term and that some of its immediate effects exceed those due to the passage of time alone.