Decision-Making About Inherited Cancer Risk: Exploring Dimensions of Genetic Responsibility

Since genetic information has implications for family members, some choices about genetic risk may be influenced by perceptions of responsibility to relatives. Drawing upon 25 semi-structured interviews with test recipients in Canada, this study explored decisions about inherited breast-ovarian and colon cancer. Qualitative data analysis revealed the pervasive significance of genetic responsibility in test decisions. We highlight three dimensions of genetic responsibility: 1) to know about the self for self; 2) to know about the self for others; 3) to know about the self to oblige others to know. It is argued that these dimensions of genetic responsibility have implications for test decisions, family relationships and other family members’ desire to know (or not know) and to act (or not act) with respect to their own genetic risk. In particular, genetic responsibility may play out as a framing of a relative’s moral obligation to know their risk that could obviate any interest they might have in not knowing. We conclude that perceptions of responsibility to—and of−other family members be thoroughly explored in genetic counseling sessions.     

Development of a Substance Abuse Consultation and Referral Service in an Academic Medical Center: Challenges, Achievements and Dissemination

Approximately 25% of US hospital beds are occupied by individuals with active substance use disorders (SUD). Acute medical hospitalization provides an opportunity to address SUDs and provide patient-centered intervention and referral for treatment. Nationally, some hospitals have developed substance abuse consultation departments to improve the care of hospitalized substance users. In this paper we describe the Addiction Psychiatry Service (APS) in a large urban hospital which provides bed-side SUD consultation, screening, intervention and referral to treatment. APS utilizes the multiple disciplines of psychology, social work and medicine to integrate substance abuse services throughout the hospital and educate future generations of medical and psychology trainees. We conclude with how the APS service is informing the development of similar programs in other academic departments within our hospital and best practice recommendations to further disseminate this service model.     

What is education? The inhibiting effect of three agendas in schooling

The article seeks to further debate on what we mean by education and how it is to be distinguished from incipient indoctrination. Starting from the politicisation of education, it draws attention to three powerful agendas impacting on the education systems of the West: positivism, utilitarianism, and inclusivism. Intertwined in various ways, these agendas have had the effect of silently restricting understanding of education, moving it closer to a form of control and policing. Some discussion of their impact on music education is given to help clarify what is at stake. A substantial critique of these agendas is then offered before concluding with a brief indication of a way forward.     

Fragmentation or Differentiation: Questioning the Crisis in Psychology

There is a recurrent discourse about the fragmentation of psychology and its crises as a science, which often leads to a disenchanted view about its future. To this discourse we oppose a developmental one, in which crises can be occasions for development, and in which development might imply differentiation. We first review why psychology can be said to be in crisis. We then situate the crisis in the pragmatics of doing psychology. Crises occur when psychologists have problems either working with other psychologists or with communities. We argue that collaborative research is a way to overcome these crises. Specifically we suggest three specific scientific activities that can lead to the development of psychology: collaborative research methods, the identification of nodal concepts that enable the bringing together of different approaches and disciplines, and the creation and maintenance of institutional spaces that enable creative, collaborative work.

Cracks in a postdisaster service delivery network

Poor linkage cracks are defined and identified empirically in a postdisaster service delivery network. These cracks exist when essential services are provided only by isolated or peripheral clusters of organizations. Network analysis is used to identify the isolated and peripheral clusters of organizations. Measures of experience in responding to disasters and service capacity are used to identify the organizations whose services are essential in the network. Cracks prevent the network from responding effectively in the aftermath of a disaster. Suggestions are made for using network analysis to identify cracks and to improve planning and coordination in all kinds of service networks. Collection of the data for this work was supported by the National Science Foundation (NSF), Societal Response to Earthquake Hazards Mitigation Program, Grant No. CEE-8314421. The analysis and writing were accomplised with support from the National Science Foundation, Grant No. BCS-8920472. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the National Science Foundation. An early version of this paper was presented at the annual meetings of the Midwest Sociological Society, Des Moines, Iowa, April 1991. This paper was distinctly improved through our response to extensive and perceptive suggestions given by the editor and reviewers of theAmerican Journal of Community Psychology. We thank them for the help.     

Personality, Social Networks, and Perceived Social Support among Alcoholics: A Structural Equation Analysis

ABSTRACT In this study we tested relations among personality characteristics, social network properties, and perceived social support both concurrently and prospectively. A sample of 294 men in treatment at a Department of Veterans Affairs Alcohol Treatment Unit was assessed during treatment and 3 months after discharge. Results of the cross-sectional structural equation analyses indicated that the personality characteristics of extraversion and neu-roticism were related to both social network properties and perceived social support. Characteristics of the alcoholic's social network were also related to perceived availability of support. Longitudinal analyses of perceived social support after treatment indicated that two social network properties (size of the network and the proportion of confidants) were predictive net of initial levels of social support. Extraversion and neuroticism were found to be indi-rectly related to perceived social support at Time 2 through their effects on social network properties and perceived social support during treatment. Implications of these findings for models of the nature and determinants of perceived social support are discussed.     

Attribution of responsibility for rape: The influence of observer empathy,victim resistance,and victim attractiveness

The purpose of the present study was to investigate the influence of a rape victim's physical attractiveness and resistance to rape on subjects' attributions of responsibility for the crime, certainty of the defendant's guilt, and social perceptions of the rape victim and defendant. Subjects' pretrial empathy toward rape victims and rapists was assessed by scores on the Rape Empathy Scale (RES). In addition to significant sex differences in attributions of responsibility for the incident, subjects' pretrial empathy toward rape victims and rapists was predictive of their perceptions of the rape victim, the defendant, and the rape incident. Victim resistance and attractiveness effects were significant in that subjects responded least favorably to the unattractive rape victim, particularly when she resisted the rape by fighting with her attacker. Male subjects and subjects who exhibited low empathy toward the rape victim were more responsive to subtle manipulations of victim resistance and attractiveness than were females and high RES subjects. Several explanations for these results focus on the cognitive and affective responses of subjects. The implications of the study are discussed in relation to societal attitudes toward rape and the role of sexrole stereotyping, which fosters these attitudes.The present research was supported by National Institutes of Health Biomedical Research Support Grant #5-SO7-RRO7127-09 and National Science Foundation Grant #SES-8012316 to Sheila R. Deitz. The authors express their appreciation to Nancy Williams, Joanne Moran, Bill Willging, David Small, David Waldman, and Robert Kingsley for their assistance in data collection and analysis.Correspondence should be sent to Sheila R. Deitz, now at Institute of Law, Psychiatry, and Public Policy, University of Virginia, Box 100, Blue Ridge Hospital, Charlottesville, Virginia 22901. Copies of the Rape Empathy Scale and an extended report on the reliability and validity of scale are available from this author.     

Situational moderators of gender differences in reward allocations

This experiment investigated the impact of four variables, hypothesized to convey cues as to sex-role appropriate behavior, on gender differences in reward allocations between self and a co-worker. These variables were: expectations for future interactions with the co-worker, sex of co-worker, type of reward, and type of allocation decision. Males and females were asked to indicate how they would allocate money or course points between themselves and a same or opposite sex co-worker with inferior performance. Females allocated either type of reward more equitably than males when making independent allocations. When making joint (zero-sum) allocations, however, both sexes allocated rewards more equitably with a same-sex co-worker than with an opposite-sex co-worker when future interaction with the co-worker was expected. Grades were seen as more important than money by both sexes, and both men and women allocated course points more equitably than money. Type of reward did not, however, differentially affect men's and women's allocation patterns. Overall, independent allocations were more equitable than joint allocations. Results are discussed as suggesting that gender differences in reward allocations are not a result of inherent personality differences between the sexes but rather reflect the influence of situational factors that can arouse sex-role specific self-presentational concerns.