Gay, Lesbian, and Bisexual Patients’ Recommendations for Genetic Counselors: A Qualitative Investigation

Gay, lesbian, and bisexual (GLB) individuals comprise a growing patient population in genetic counseling. However, only one article from a genetic counseling journal provides empirical data on GLB patients' genetic counseling experiences and genetic counselor attitudes and practices regarding GLB patients. The present study, an extension of the aforementioned article, gathered further information about patients' genetic counseling experiences through semi-structured telephone interviews. Twelve of the previous study's 29 patient respondents (n?=?10 lesbian women, n?=?1 gay man, n?=?1 bisexual woman) participated. Interview questions concerned the use of medically inclusive forms, factors influencing patient disclosure, counselors' ability to relate to them, and their expectations of genetic counselors. Inductive analysis of the interviews yielded seven themes: 1) Medically inclusive forms with gender neutral terms are important; 2) Genetic counselor ability to relate to a GLB person depends more on the relationship established during the session and less on external symbols; 3) The presence of GLB-friendly symbols increases comfort when disclosing one's orientation; 4) Inclusion of the patient's partner is important and best done by encouraging their active participation in sessions; 5) When GLB patients disclose their orientation, they expect to be treated like any other patient; 6) Providers should ask about orientation if medically pertinent and the remaining discussion should take orientation into consideration; and 7) When a provider inquires about orientation it should be done in a safe and appropriate way. Illustrative quotations, genetic counseling practice implications, and research recommendations are presented.     

Breaking Difficult News in a Cross-cultural Setting: a Qualitative Study about Latina Mothers of Children with Down Syndrome

Giving difficult news to patients represents a common dilemma for health care professionals. Based on three decades of research, various authors have proposed guidelines outlining the ideal setting, delivery, and timing. Existing publications focus on patients of European descent and may not be applicable in cross-cultural settings. We explored perceptions of Spanish-speaking mothers who have a child with Down syndrome and how they preferred to receive the news of their child's diagnosis. We conducted semi-structured qualitative interviews (n?=?14), which were coded and analyzed by thematic networks to identify common themes. Six significant themes emerged: Cultural Belief System, Communication, Support/Lack of Support, Feelings Engendered, Medical Issues, and Medical System. One overarching theme of mother-child bonding encompassed all sub-themes. The mothers desired the news in a more positive, balanced light and with more complete explanations about the condition. Mothers felt excluded from the diagnostic process and wanted to be better informed about the need for diagnostic studies. Participants used religious beliefs to explain the reason for their child's condition. Many factors influenced Latina mothers' ability to bond initially with their children with Down syndrome. Ideally, these factors should be acknowledged during informing interviews to assist Latino families in adjustment.     

Mother and Child Depressive Symptoms in Youth with Spina Bifida: Additive, Moderator, and Mediator Models

The purpose of the study was to examine the extent to which parenting behaviors influence the relation between maternal and child depressive symptoms in youth with spina bifida and a comparison sample. Previous research has found that maternal depression not only negatively impacts the mother–child relationship, but also places the child at risk for developing depressive symptoms. However, certain parenting behaviors might buffer the association between maternal and youth depression. The influence of maternal depressive symptoms and parenting behavior (i.e., acceptance, behavioral control, psychological control) on youth depressive symptoms were examined in the context of three models: (1) an additive/cumulative risk model, (2) a moderator model, and (3) a mediator model. Data were examined longitudinally at five time points when youth were 8–9 through 16–17 years of age. Results supported an additive/cumulative risk model, but did not support the moderator or mediator models. Low maternal acceptance, high behavioral control, and high psychological control were risk factors for child depressive symptoms at several time points, with maternal depressive symptoms exerting an additional risk at later time points. A group difference between the spina bifida and comparison youth was not supported. Findings indicate that in general, maternal parenting behavior is salient throughout childhood and early adolescence, but maternal depressive symptoms do not exert an influence until mid-adolescence. Family interventions should aim to promote maternal mental health and maternal parenting behaviors to reduce the risk of the development of depressive symptoms in adolescence.     

Two Sides of the Same Coin? Viewing Altruism and Aggression Through the Adaptive Lens of Kinship

Are altruism and aggression polar opposites, or are they two sides of the same coin? In this review, the authors examine the evolved biological roots of these behaviors and focus on the psychology of kinship and how it can serve to bridge both behaviors. Drawing on inclusive fitness theory ( Hamilton, 1964 ), the kinship, acceptance, and rejection model of altruism and aggression (KARMAA; Webster, 2008 ), and a sociofunctional threat‐based approach to prejudice ( Cottrell & Neuberg, 2005 ), the authors propose that altruism and aggression can be viewed as two sides of the same coin depending on context and perspective. For example, a mother bear protecting her cubs by attacking a predator may be simultaneously exhibiting an act of altruism and aggression. After offering some empirical support for their view, the authors discuss the theoretical and practical implications of viewing altruism and aggression as related constructs at the intrapersonal, interpersonal, and intergroup levels.     

Specific language deficiencies in children with early onset hydrocephalus

Specific language abilities of children with early onset hydrocephalus were compared to nonhydrocephalic comparison groups. Ninety children, aged 5 to 7 years, composed six subject groups: three groups having a history of hydrocephalus due to spina bifida, prematurity-intraventricular hemorrhage, or aqueductal stenosis. and three comparison groups of children with spina bifida who had never been shunted, premature children with no hydrocephalus, and normal controls. Group performance scores were compared on measures of phonological awareness, semantics, fluency, and word retrieval. Children with hydrocephalus performed below their peers on all measures. These results indicate that early onset hydrocephalus has a substantial adverse impact on the development of a wide range of specific language abilities.     

Transformational education for psychotherapy and counselling: a relational dynamic approach

ABSTRACT

An evolving relational dynamic approach to psychotherapy and counselling education is described. Key themes integrated within the approach are the learning community and transformational relationships. Learning is a reciprocal change process involving students, teachers, supervisors and therapists in overlapping learning communities. Drawing on evidence that effective outcomes in therapy correlate with effective aspects of the therapeutic relationship, the relational dynamic approach emphasises the findings of attachment and intersubjectivity theorists. The intersubjective matrix of infant/caregiver and client/therapist is mirrored and embodied in the relational ethos of training and actively engaged in group supervision. An emphasis on embodied relating is discussed, drawing on infancy studies and recent neuroscientific findings     

Approaches to Research on Intersectionality: Perspectives on Gender, LGBT, and Racial/Ethnic Identities

Intersectionality theories, or the recognition of multiple interlocking identities, defined by relative sociocultural power and privilege, constitute a vital step forward in research across multiple domains of inquiry. This special issue, which extends Shields (2008) contribution in Sex Roles, provides an opportunity to reflect on past, present, and future promise in intersectionality scholarship. To provide a common ground for this work, each paper in this special issue addresses the intersections of gender; lesbian, gay, bisexual, and transgender (LGBT); and racial/ethnic identities and related experiences. In this introduction, we (1) provide an overview of definitions and conceptualizations of intersectionality, (2) discuss the various approaches utilized in this issue to conceptualize and assess gender, LGBT, and racial/ethnic identities, (3) describe how these conceptualizations and assessments were translated into analyses of intersectionality, and (4) close with a discussion of some additional approaches and considerations intended to advance intersectionality research.     

Cognitive and neuropsychological underpinnings of relational and conjunctive working memory binding across age

The ability to form associations (i.e., binding) is critical for memory formation. Recent studies suggest that aging specifically affects relational binding (associating separate features) but not conjunctive binding (integrating features within an object). Possibly, this dissociation may be driven by the spatial nature of the studies so far. Alternatively, relational binding may simply require more attentional resources. We assessed relational and conjunctive binding in three age groups and we included an interfering task (i.e., an articulatory suppression task). Binding was examined in a working memory (WM) task using non-spatial features: shape and colour. Thirty-one young adults (mean age = 22.35), 30 middle-aged adults (mean age = 54.80) and 30 older adults (mean age = 70.27) performed the task. Results show an effect of type of binding and an effect of age but no interaction between type of binding and age. The interaction between type of binding and interference was significant. These results indicate that aging affects relational binding and conjunctive binding similarly. However, relational binding is more susceptible to interference than conjunctive binding, which suggests that relational binding may require more attentional resources. We suggest that a general decline in WM resources associated with frontal dysfunction underlies age-related deficits in WM binding.     

International Exchange Training in Genetic Counseling: An Exploration of the Value in Exchange Experiences

International exchange training in genetic counseling is increasing, but research examining these experiences is lacking. In this study 309 genetic counseling students and genetic counselors completed an anonymous survey investigating six major research questions: (1) How prevalent are international genetic counseling experiences? (2) What types are pursued and why? (3) What supports and barriers exist? 3) What are the demographic characteristics of individuals accruing international experience? (5) Does international experience promote professional development? and (6) Do genetic counseling students and professionals perceive international experiences as beneficial? Most respondents were Caucasian females born in one of 25 countries. The most prevalent experiences involved either clinical observation or clinical training. Common motivations for pursuing international experience were personal growth, exposure to a different healthcare system, and travel opportunities. Outcomes included professionally-relevant experience and personal growth. Barriers included finances, limited availability of opportunities, and for those without international experience, family responsibilities. Additional findings, practice and training implications, and research recommendations are provided.     

Girls’ Spatial Skills and Arithmetic Strategies in First Grade as Predictors of Fifth-Grade Analytical Math Reasoning

This study investigated longitudinal pathways leading from early spatial skills in first-grade girls to their fifth-grade analytical math reasoning abilities (N = 138). First-grade assessments included spatial skills, verbal skills, addition/subtraction skills, and frequency of choice of a decomposition or retrieval strategy on the addition/subtraction problems. In fifth grade, girls were given an arithmetic fluency test, a mental rotation spatial task, and a numeric and algebra math reasoning test. Using structural equation modeling, the estimated path model accounted for 87% of the variance in math reasoning. First-grade spatial skills had a direct pathway to fifth-grade math reasoning as well as an indirect pathway through first-grade decomposition strategy use. The total effect of first-grade spatial skills was significantly higher in predicting fifth-grade math reasoning than all other predictors. First-grade decomposition strategy use had the second strongest total effect, while retrieval strategy use did not predict fifth-grade math reasoning. It was first-grade spatial skills (not fifth-grade) that directly predicted fifth-grade math reasoning. Consequently, the results support the importance of early spatial skills in predicting later math. As expected, decomposition strategy use in first grade was linked to fifth-grade math reasoning indirectly through first-grade arithmetic accuracy and fifth-grade arithmetic fluency. However, frequency of first-grade decomposition use also showed a direct pathway to fifth-grade arithmetic reasoning, again stressing the importance of these early cognitive processes on later math reasoning.