Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Effects of prolonged work on data entry speed and accuracy

In 2 experiments, participants used a keyboard to enter 4-digit numbers presented on a computer monitor under conditions promoting fatigue. In Experiment 1, accuracy of data entry declined but response times improved over time, reflecting an increasing speed-accuracy trade-off. In Experiment 2, the (largely cognitive) time to enter the initial digit decreased in the 1st half but increased in the 2nd half of the session. Accuracy and time to enter the remaining digits decreased across though not within session halves. The (largely motoric) time to press a concluding keystroke decreased over the session. Thus, through a combination of facilitation and inhibition, prolonged work affects the component cognitive and motoric processes of data entry differentially and at different points in practice.     

Psychopathy is related to negative affectivity but not to anxiety sensitivity

Although the hypothesis that psychopathic individuals are characterized by a reduced capacity for experiencing anxiety is central to many theories of psychopathy, most prior studies have examined anxiety and fear measures generally considered outdated in the literature. Moreover, prior findings are mixed, with several studies reporting no relationships between psychopathy and anxiety, and others suggesting negative relationships for the affective, interpersonal aspects of the disorder and positive relationships for the antisocial behavior dimension. To examine whether psychopathy dimensions are associated with contemporary measures of anxiety, the Anxiety Sensitivity Index and State Trait Anxiety Inventory-Trait scale were administered to 157 male inmates. Participants also completed the MMPI-derived Welsh Anxiety Scale (WAS), commonly used in psychopathy studies. Analyses provide no evidence for a negative relationship between psychopathy's affective, interpersonal factor and anxiety sensitivity after controlling for trait anxiety. Trait anxiety and WAS scores were positively associated with the antisocial behavior dimension of psychopathy. Findings do replicate prior relationships between the WAS and psychopathy, suggesting the WAS may measure aspects of negative affectivity that differ from anxiety.     

Predicting abuse in adolescent dating relationships over 1 year: the role of child maltreatment and trauma

Three mediators of the relationship between childhood maltreatment and dating violence perpetration during midadolescence (i.e., trauma-related symptoms, attitudes justifying dating violence, and empathy and self-efficacy in dating relationships) were tested over 1 year with a sample of students from 10 high schools (N = 1,317). Trauma-related symptoms had a significant cross-time effect on predicting incidents of dating violence for both boys and girls. Attitudes and empathy and self-efficacy did not predict dating violence over time, although they were correlated with such behavior at both time points. Child maltreatment is a distal risk factor for adolescent dating violence, and trauma-related symptoms act as a significant mediator of this relationship. The importance of longitudinal methodology that separates correlates from predictors is discussed.     

An outcome management program for extending advances in choice research into choice opportunities for supported workers with severe multiple disabilities

We evaluated an outcome management program for increasing choice opportunities provided by 2 job coaches for 5 supported workers with severe multiple disabilities in a community job. The program involved specifying and monitoring behavioral outcomes among workers and staff, training staff, and supportive and corrective feedback. Increased choice provision occurred for both job coaches across a 1-year period. Results indicate how outcome management can help translate advances in choice research into routine practice.     

Limits of the retrieval-inhibition construct: list segregation in directed forgetting

The authors hypothesized that retrieval inhibition in list method directed forgetting could be improved by presenting a task that maximized the segregation step of the retrieval-inhibition process. In Experiment 1, they presented lists of semantically related words in a list method directed-forgetting task to maximize retrieval inhibition. Contrary to predictions, this manipulation eliminated the directed-forgetting effect. The authors further investigated the results of Experiment 1 in Experiments 2 and 3 by manipulating recall instructions and by presenting lists that contained both a categorized and an unrelated list-half. They found directed-forgetting effects for semantically related word lists when participants were asked to recall only the TBR (to-be-remembered) items but not when participants were asked to recall both the TBF (to-be-forgotten) and TBR items. They also found that directed-forgetting effects were not produced when categorized items were presented in the 1st list.     

Comparisons of three different investigative interview techniques with young children

After viewing a film of a mother hitting her son, a film not seen by the college student interviewers, children were misinformed about a detail (via exposure to a misleading question) as well as explicitly coached to disclose 3 false details. The children were then interviewed by interviewers who had previously learned 1 of 3 different interviewing procedures: the Yuille Step-Wise Interview developed by J. C. Yuille, R. Hunter, R. Joffe, & J. Zapamiuk (1993); a doll play interview developed by Action for Child Protection Inc. (1994); or the Modified Structured Interview developed for this study. The Modified Structured Interview yielded more "where" information and was better at detecting if coaching had occurred. However, the interviewers were not very good at discriminating suggested versus coached versus correct witnessed information. The authors found that the deeper one digs for memories, the more one uncovers incorrect versus correct items. They concluded that although the Modified Structured Interview was superior to the techniques currently in use, cautions are necessary.     

Differential memory-preserving effects of reminders at 6 months

Although reactivation and reinstatement reminders differ procedurally, differences in their memory-preserving effects have been described as artifactual. In three experiments, we examined this conclusion. One hundred and twelve 6-month-olds learned an operant task, forgot it, received a reactivation or reinstatement reminder to recover the inactive memory, and were tested after increasing delays until they forgot it again. In Experiments 1a and 1b, a single reactivation reminder extended infants' memory of an operant mobile task for 2 weeks after reminding, but a single reinstatement extended it for 4 weeks, when testing was discontinued. In Experiment 2, a single reinstatement extended 6-month-olds' memory of an operant train task for 19 weeks after reminding, when infants were almost 1 year old. After reactivation, infants remember this task for only 2 weeks. The finding that the memory-preserving effect of reinstatement is greater by an order of magnitude suggests that procedural differences between the two reminders have functional significance.     

Variation in black anti-white bias and target distancing cues: factors that influence perceptions of "ambiguously racist" behavior

Experiment 1 indicated that when the White supervisor's negative treatment of a Black subordinate was unconstrained, participant race had no impact on attributions. Conversely, when the treatment was constrained, Black participants reported greater racist attributions than did White participants. Experiment 2 indicated that when the supervisor reported no response or a minimal negative response (i.e., indicating that he did not support his actions) after his negative treatment of the Black subordinate, Black participants reported greater racist attributions than did White participants. Conversely, when the supervisor's negative treatment was followed by a more extreme negative response, participant race had no impact on attributions. Experiment 3 indicated that Black participants were less likely than White participants to perceive a minimal negative response as reflecting a White supervisor's lack of support for his negative actions. Conversely, participant race had no impact on attributions of a Black supervisor's negative actions.