A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

"Shhh! We're tryin' to concentrate": attention and environmental distracters in novel word learning

The authors' purpose in this study was to evaluate the role of attention, as a central dimension of temperament, in children's real-time acquisition of novel vocabulary. Environmental distractions were administered to 47 22-month-old children as they acquired novel vocabulary in a fast-mapping task. Two distraction conditions impeded novel word acquisition, but only 1 impeded attention allocation. Attention allocation was correlated with novel word acquisition under conditions of distraction, but not in their absence. Results suggest that attention allocation is especially important for word learning under conditions of distraction. Given that in their day-to-day lives children often encounter new words amid a host of environmental distractions, children with constitutionally fewer attentional resources, such as temperamentally difficult children, may be at a vocabulary-learning disadvantage.     

Tenderness and Steadiness: Relating Job and Interpersonal Demands and Resources With Burnout and Physical Symptoms of Stress in Canadian Physicians

This study examined the extent to which job and interpersonal demands and resources are associated with burnout and physical symptoms of stress among Canadian physicians. Using the job demands‐resources (JD‐R) model, we predicted that demands would be more strongly related to emotional exhaustion and physical symptoms, whereas resources would be more strongly related to personal accomplishment and decreased depersonalization. The findings reveal that communication skills and emotional labor contributed to the explained variances beyond workload and work–life conflict (as job demands), as well as autonomy, predictability, and understanding (as job resources). The predictors were differentially associated with the outcome variables in a manner that is consistent with the JD‐R model. Implications for physician well‐being and improved patient outcomes are discussed.     

A Developmental Trajectory in Implicit Memory is Revealed by Picture Fragment Completion

Dissociations between performance on implicit and explicit tasks have often been taken as evidence that different neural structures subserve the two types of memory. One such dissociation involves developmental differences that emerge in explicit tasks, but which appear to be absent in implicit tasks. Such findings are consistent with the idea that implicit memory is subserved by a more primitive system that evolves earlier at both phylogenetic and ontogenetic levels. The present paper reviews previous studies that claimed to find evidence that implicit memory is fully developed in very young children. Issues of measurement error, ceiling effects, and insufficient power brought up questions about those studies with respect to the developmental issue. The present study compares performance on implicit (picture fragment completion) and explicit (free recall and recognition) memory tasks with groups ranging in age from 5–28 years. We find a reliable developmental trend in both implicit and explicit performance in which the former cannot be attributed to the operation ofexplicit memory processes. Thus, we conclude that implicit memory, like explicit memory, develops with age.     

Prospective memory: The relative effects of encoding,retrieval, and the match between encoding and retrieval

Previous prospective memory studies have revealed some important features of encoding, retrieval, and the match between the encoding and the retrieval that contribute to prospective memory performance. However, these studies have not provided evidence concerning the relative importance of these three factors because no study has investigated all three in a single design. We developed a laboratory-based paradigm that allowed us to manipulate different characteristics of encoding, retrieval, and the match between encoding and retrieval simultaneously in a single experiment. The results of eight experiments showed that all three factors have an influence on prospective memory performance, but that the match between encoding and retrieval has a significantly larger influence than either encoding or retrieval factors.     

More than One Way to be Happy: A Typology of Marital Happiness

This study utilized observational and self‐report data from 57 happily married couples to explore assumptions regarding marital happiness. Suggesting that happily married couples are not a homogeneous group, cluster analyses revealed the existence of three types of couples based on their observed behaviors in a problem‐solving task: (1) mutually engaged couples (characterized by both spouses' higher negative and positive problem‐solving); (2) mutually supportive couples (characterized by both spouses' higher positivity and support); and (3) wife compensation couples (characterized by high wife positivity). Although couples in all three clusters were equally happy with and committed to their marriages, these clusters were differentially associated with spouses' evaluations of their marriage. Spouses in the mutually supportive cluster reported greater intimacy and maintenance and less conflict and ambivalence, although this was more consistently the case in comparison to the wife compensation cluster, as opposed to the mutually engaged cluster. The implications of these typologies are discussed as they pertain to efforts on the part of both practitioners to promote marital happiness and repair marital relations when couples are faced with difficulties.     

The Effect of Perceived Locomotor Constraints on Distance Estimation

Two experiments were conducted to examine the ways in which the visual estimation of distance to a target is affected by constraints perceived to be placed on the subsequent locomotion to the target without vision. We hypothesized that an appraisal of impending effort would play a role in ascertaining the distance to be walked. In Experiment 1, the amount of resistance to walking was variable and unpredictable. One group of subjects performed against relatively low resistance, whereas another group performed against substantially greater resistance. In the low-resistance condition, no significant differences in CE, VE, time to target, or number of steps to target were found between any of the eight combinations of predictable or unpredictable resistances during walking. In the high-resistance condition, however, significant differences were found for CE and number of strides to target when resistance varied unpredictably during walking. Experiment 2 was similar in design but required subjects to walk with combinations of normal or short steps after they had viewed the target knowing only the gait type that would be used to begin locomotion. No differences in CE, VE, or time to target were found between four different combinations of gait type and predictability, under subjectively controlled conditions. When the step constraints were externally imposed, however, differences were found for CE. None of the results from either experiment, in which the number of strides needed to reach the target or the predictability of gait did not change from normal, supported the hypothesis that motor output requirements are necessary in forming a mental representation of the target position that can be used to walk to the target with eyes closed. Whichever locomotor technique was used to walk the estimated distance in these cases, the representation was able to be used independently. When walking mechanics were altered by externally imposed constraints, however, the success at reaching the estimated target position was reduced. These latter results are consistent with those obtained using up, down, and level walking and support the premise that mental representations used in blind walking are linked to the locomotor mechanics afforded by environmental conditions.     

Confounding of Big Five Personality Assessments in Emotional Disorders by Comorbidity and Current Disorder

Foremost cross‐sectional studies of personality in common mental disorders show similar Big Five trait profiles [i.e. high neuroticism (N), low conscientiousness (C) and low extraversion (E)]. It remains undecided whether this lack of distinct personality profiles is partly due to comorbidity among disorders or contamination by current state. Using data from the Netherlands Study of Depression and Anxiety, we investigated 1046 participants with panic disorder (PD), social anxiety disorder (SAD) and/or major depressive disorder (MDD) and 474 healthy controls. Personality traits at baseline and two‐year follow‐up were assessed with the NEO‐Five Factor Inventory. The Composite International Diagnostic Interview was used to determine the presence of emotional disorders at baseline and at two‐year follow‐up; the Life Chart Interview determined symptom severity in the month prior to baseline and during follow‐up. By analysing pure cases and investigating the effects in remitted cases, PD participants were found to be higher in N, but not lower in E and C than controls. Pure PD participants were also lower in N and higher in E than SAD and MDD participants. Both SAD and MDD participants were characterized by high levels of N and low levels of E, irrespective of comorbidity or current disorder state. Future studies should be more attentive to confounding of personality profiles by comorbidity and state effects. Copyright © 2012 John Wiley & Sons, Ltd.     

A Dyadic View of Support in Marriage: The Critical Role of Men’s Support Provision

This study examined how sensitive support provision and receipt were related to marital outcomes in a sample of 57 happily married, middle-class couples from the Midwestern U.S. To assess how observed supportive behaviors may be differentially associated with self-reported support satisfaction, marital love, and marital conflict for men and women, we utilized a series of Actor Partner Interdependence Models (APIM). This dyadic approach revealed significant gender differences regarding how the supportive role enacted (i.e., provider versus recipient) contributed considerably to marital outcomes. Specifically, husbands’ sensitive support provision significantly predicted both spouses’ support satisfaction. Additionally, husbands’ sensitive support provision was significantly associated with wives’ marital love. Wives’ reported conflict was predicted by the combination of both providing and receiving sensitive support. For husbands’ outcomes, husbands’ own sensitive support provision was most critically associated with their reporting greater love and less conflict. These findings reveal notable gender differences as men’s ability to provide sensitive support was critical not only to their wives’ marital outcomes, but to their own as well. Our results build upon and extend the literature implicating the importance of examining gender differences in supportive interactions in marriage. Moreover, our findings suggest that simultaneous consideration of spousal support receipt and provision is critical when seeking to understand how support is related to marital outcomes for men and women.     

Thought listing and endorsement measures of self-referential thinking in test anxiety

Abstract

The primary purpose of the present study was to examine cognitive reactions of high and low test-anxious subjects while performing a task of extreme difficulty. A sample of 44 subjects (28 females, 16 males) attempted a difficult analogies task and then reported their thoughts during the task. Subjects also completed the Sarason Test Anxiety Scale and several other self-report measures of their cognitive reactions to the task. Thought listings were classified according to their referent (self, task, or unrelated) and their valence (positive, negative, or neutral). Correlational analyses were then performed with the various measures and revealed an association between test anxiety and reports of negative thoughts involving the self. Test anxiety was not related significantly to the number of thoughts involving the task nor to actual performance on the task. However, test-anxious subjects did report more negative expectancies for their performance and greater cognitive interference during the task. Negative self-expectancies were also related to more negative self thoughts, fewer positive self thoughts, and fewer positive task-related thoughts. The results are interpreted as further evidence for both the role of negative self-related cognitions in the experience of test anxiety and the usefulness of unstructured measures in anxiety research.