Beyond Consent: Building Trusting Relationships With Diverse Populations in Precision Medicine Research

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: (1) Address the role of history and experience on trust, (2) engage concerns about potential group harm, (3) address cultural values and communication barriers, and (4) integrate patient values and expectations into oversight and governance structures.     

Development and validation of a brief self-report measure of trauma exposure: the Trauma History Screen

Although information about individuals' exposure to highly stressful events such as traumatic stressors is often very useful for clinicians and researchers, available measures are too long and complex for use in many settings. The Trauma History Screen (THS) was developed to provide a very brief and easy-to-complete self-report measure of exposure to high magnitude stressor (HMS) events and of events associated with significant and persisting posttraumatic distress (PPD). The measure assesses the frequency of HMS and PPD events, and it provides detailed information about PPD events. Test-retest reliability was studied in four samples, and temporal stability was good to excellent for items and trauma types and excellent for overall HMS and PPD scores. Comprehensibility of items was supported by expert ratings of how well items appeared to be understood by participants with relatively low reading levels. In five samples, construct validity was supported by findings of strong convergent validity with a longer measure of trauma exposure and by correlations of HMS and PPD scores with posttraumatic stress disorder (PTSD) symptoms. The psychometric properties of the THS appear to be comparable or better than longer and more complex measures of trauma exposure.     

A Retrospective Survey of Childhood Experiences

The present study introduces a balanced survey of a range of behavioral and emotional experiences to assess impressions of a person’s childhood. Ninety-one undergraduates and 70 of their parents rated exposure to positive and negative social and solitary experiences. The survey demonstrated acceptable internal consistency and 4-week test–retest reliability, and scores correlated with Zimbardo’s Time Perspective Inventory of temporally based beliefs and values, Batcho’s inventory of personal nostalgia, and Holbrook’s measure of historical nostalgia. Correlations with time perspective and nostalgia inventories suggest that favorable impressions of childhood are associated with benefits such as social connectedness, personal continuity, and health-promoting behaviors and adverse impressions with less adaptive impacts such as unsatisfactory relationships, discontinuity, and distress. Ratings of social experiences were correlated more closely with childhood happiness than were solitary experiences. The Childhood Survey shows promise as a tool to expand the exploration of childhood experiences beyond adverse events to encompass components that comprise a happy childhood.     

Mixing measures: testing an assumption of the attention network test

The human attention system has been subdivided into three networks that appear to be functionally and anatomically independent: alerting, orienting, and executive control. The Attention Network Test (ANT) is a quick and easy tool that measures the efficiency of these three networks by averaging reaction time and accuracy scores across several different cue and flanker conditions. Using ANOVAs and correlation procedures, we found that (a) intranetwork correlations were surprisingly low, and (b) Cue X Flanker interactions were found within alerting, orienting, and executive control measures. Taken together, these findings highlight the interaction between the three networks and the potential difficulty in accurately measuring them with this task.     

Displaced aggression is alive and well: a meta-analytic review

Content analysis of 122 social psychology textbooks confirmed that displaced aggression received a surge of attention immediately following J. Dollard, L. W. Doob, N. E. Miller, O. H. Mowrer, and R. R. Sears (1939), but subsequent interest sharply declined. Contemporary texts give it little attention. By contrast, meta-analysis of the experimental literature confirms that it is a robust effect (mean effect size = +0.54). Additionally, moderator analyses showed that: (a) The more negative the setting in which the participant and target interacted, the greater the magnitude of displaced aggression; (b) in accord with N. E. Miller's (1948) stimulus generalization principle, the more similar the provocateur and target, the more displaced aggression; and (c) consistent with the contrast effect (L. Berkowitz & D. A. Knurek, 1969), the intensity of initial provocation is inversely related to the magnitude of displaced aggression.     

The effect of personal relevance and approach-related action expectation on relative left frontal cortical activity

Past research using a variety of methods has suggested that the frontal cortex is asymmetrically involved in the experience and expression of positive (or approach motivational) and negative (or withdrawal motivational) affects, with the left frontal region being involved in positive affects (or approach) and the right frontal region being involved in negative affects (or withdrawal). However, some studies have failed to replicate these effects, leaving many scientists questioning the meaning of the past supportive findings. To examine these inconsistencies in results, we tested the hypothesis that increasing the personal relevance of the stimuli and approach motivational intensity would increase relative left frontal activation. Results supported the predictions. Moreover, by showing the predicted effects with anger-inducing stimuli, the results demonstrated that motivational direction, rather than affective valence, accounts for asymmetrical frontal cortical activity.     

Interpreting spatial terms involves simulating interactions

Recent research in spatial language has demonstrated that the interpretation of a spatial term depends not only on the geometry of the configuration of the objects being spatially related, but also on extrageometric information, including information about the objects and their interaction. Such effects could emerge from activation of general knowledge of the association between the objects; thus, they should be widely observed. In contrast, they could be more restricted, emerging only in situations in which the spatial language task positions objects in a manner that is consistent with a simulation of their interaction. In two experiments, we test each of these ideas and demonstrate that extrageometric information augments geometric information in the interpretation of spatial terms only when the situation enables the interaction.     

Cholinergic modulation of trace conditioning trained in serial compound: A developmental analysis

In four experiments the effects of serial compound conditioning on responding to a trace-conditioned CS were evaluated using a fear conditioning paradigm. The subjects were 18- and 25-day-old Sprague-Dawley rats, previously shown to exhibit little or no trace fear conditioning. Here, animals as young as 18 days of age were shown to be capable of trace conditioning between a visual CS1 and a shock US, provided the trace interval was filled with a non-target CS2 during serial conditioning trials (CS1-->CS2-->US). To explore cholinergic mechanisms involved in trace and serial conditioning, additional experiments assessed conditioned responding following pre-training administration of the muscarinic receptor antagonist scopolamine. Scopolamine produced a dose-dependent reduction in responding to the trace CS1, regardless of whether subjects were trained with standard trace (CS1-->trace interval-->US) or serial (CS1-->CS2-->US) trials. Responding to CS2 was unaffected by scopolamine. These data suggest that central cholinergic systems are functional in the young animals, but are not normally sufficiently activated by standard trace conditioning procedures. The results suggest that serial compound conditioning can promote trace conditioning in young rats, as it does in adults, perhaps by enhancing cholinergic activity during training. Implications for the late ontogenetic emergence of trace conditioning as it relates to maturation of neural pathways and their role in the potentiating effects of a gap filler are discussed.