Initiation of Reflective Frames in Counseling for Huntingtons Disease Predictive Testing

Genetic professionals and clients are likely to assign different meanings to the extended format of the counseling protocols for predictive testing. In order to facilitate informed, client-centered decisions about the possibility of predictive testing, counselors routinely use the question format to initiate what we call "reflective frames" that invite clients to discuss their feelings and encourage them to adopt introspective and self-reflective stances toward their own experience--spanning the past, the present, and the hypothetical future. We suggest that such initiations of reflective frames constitute a key element of counselors' nondirective stance, although the exact nature of their formulations can be complex and varied. Examining 24 Huntington's Disease (HD) clinic sessions involving 12 families in South Wales with the tools of discourse analysis, our focus in this paper is twofold: (i) to propose a classification of six types of reflective questions (e.g. nonspecific invites, awareness and anxiety, decision about testing, impact of result, dissemination, and other) and to examine their distribution across the various clinic appointments, and (ii) to investigate the scope of these questions in terms of temporal and social axes. We link our analysis to the current debate within the genetic counseling profession about the merits of reflection- versus information-focused counseling styles and the need to abide by professionally warranted and institutionally embedded counseling protocols.     

Ethics in construction project briefing

The research reported in this paper set out to investigate ethics in the initial stages of construction projects. Briefing is the first real contact stage between the commissioner (client/employer) of a project — at this stage a potential project — and those involved in project realization — the designers and, subsequently, the constructors. It is well known that early decisions are of greatest impact and so, the importance of the initial contacts, communications and consequent decisions are paramount. Different project participants are known to pursue individual objectives to varying degrees as well as possessing different perspectives and perceptions and operating/behaving in different ways. Hence, determination of the appropriate form, content etc. of a project is, inevitably, a matter of exercising value judgements and compromises and so, involves ethical considerations. A case study of a project through the briefing stage is reported and analysed, from initial contacts to scheme approval. It is apparent that a number of ethical concerns are manifest through the various actions of the major participants. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

The role of structural prediction in rapid syntactic analysis

A number of recent electrophysiological studies of sentence processing have shown that a subclass of syntactic violations elicits very rapid ERP responses, occurring within around 200 ms of the onset of the violation. Such findings raise the question of how it is possible to diagnose violations so quickly. This paper suggests that very rapid diagnosis of errors is possible specifically in situations where the diagnosis problem is tightly constrained by specific expectations generated before the critical word is presented. In an event-related potentials (ERP) study of visual sentence reading participants encountered violations of a word order constraint (...Max's of...) that has elicited early ERP responses in previous studies. Across conditions the illicit sequence was held constant, while sentence context was used to manipulate the expectation for a noun following the possessor Max's, by manipulating the possibility of ellipsis of the head noun. Results showed that the anterior negativity elicited by the word category violation was attenuated when the availability of ellipsis reduced the expectation for a noun in the position of the offending preposition of, with divergence between conditions starting around 200 ms after the onset of the violation. This suggests a role for structural expectations in accounting for very fast syntactic diagnosis processes.     

Contrasting two accounts of anxiety-linked attentional bias: selective attention to varying levels of stimulus threat intensity

Previous research has established that clinical anxiety patients and nonclinical populations with high levels of anxiety vulnerability characteristically orient attention toward moderately threatening stimuli. In contrast, populations with low levels of anxiety vulnerability typically orient attention away from such stimuli. The differing experimental predictions generated by 2 classes of hypothetical explanation for this anxiety-linked attentional discrepancy were tested, using attentional probe methodology to compare the attentional responses of high and low trait anxious individuals to facial stimuli of differing threat intensities. The results support the view that all individuals orient attention away from mildly threatening stimuli and toward strongly threatening stimuli, with differences in anxiety vulnerability reflecting the intensity of stimulus threat required to elicit the attentional vigilance response.     

Pulling faces: an investigation of the face-distortion aftereffect

After adaptation to a face distorted to look unnaturally thin or fat, a normal face appears distorted in the opposite direction (Webster and MacLin 1999 Psychonomic Bulletin & Review 6 647-653). When the adapting face is oriented 45 degrees from vertically upright and the test face 45 degrees in the opposite direction, the axis of perceived distortion changes with the orientation of the face. The magnitude of this aftereffect shows a reduction of approximately 40% from that found when both adapting and test faces are tilted identically. This finding suggests that to a large degree the aftereffect is mediated not by low-level retinotopic (image-based) visual mechanisms but at a higher level of object-based processing. Aftereffects of a similar magnitude are obtained when adapting and test images are both either upright or inverted, or for an upright adapter and an inverted test; but aftereffects are smaller when the adapter is inverted and the test upright. This pattern of results suggests that the face-distortion aftereffect is mediated by object-processing mechanisms including, but not restricted to, configurational face-processing mechanisms.     

Re-exposure to studied items at test does not influence false recognition

In two experiments, we investigated whether re-exposure to previously studied items at test affects false recognition in the DRM paradigm. Furthermore, we examined whether exposure to the critical lure at test influences memory for subsequently presented study items. In Experiment 1, immediately following each studied DRM list, participants were given a recognition test. The tests were constructed such that the number of studied items preceding the critical lure varied from zero to five. Neither false recognition for critical lures nor accurate memory for studied items was affected by this manipulation. In Experiment 2, we replicated this pattern of results under speeded conditions at test. Both experiments confirm that exposure to previously studied items at test does not affect true or false recognition in the DRM paradigm. This pattern strongly suggests that retrieval processes do not influence false recognition in the DRM paradigm.     

Executive and visuospatial sketchpad resources in euthymic bipolar disorder: Implications for visuospatial working memory architecture

Visuospatial working memory theory is used to interpret the cognitive impairment in euthymic bipolar disorder. Such patients show deficits in the Corsi Blocks Test (CBT) and executive control. To understand these deficits, 20 euthymic bipolar patients and controls were administered the CBT, Visual Patterns Test (VPT), and a new visual memory task designed to make minimal demands on executive resources. Initial analyses validated the visual memory task and implicated executive involvement in the CBT and VPT. Subsequent analyses on a number of tests confirmed CBT and executive deficits while performance was normal on the VPT and visual memory test. ANCOVA indicated that impaired executive function underpinned patients' CBT performance. Implications for the interface between executive and slave systems of working memory are discussed.     

Dopaminergic modulation of the persistence of one-trial hippocampus-dependent memory

The persistence of new memory traces in the hippocampus, encoded following appropriate activation of glutamatergic receptors and the induction of synaptic plasticity, can be influenced by heterosynaptic activation of neuromodulatory brain systems. We therefore investigated the effects of a hippocampus-specific blockade of dopamine D1/D5 receptors on the persistence of spatial memory encoded in one trial using a delayed matching-to-place (DMP) task in a watermaze in which rats learn a new escape location each day. A within-subjects design was used such that both short (20 min) and long (6 h) retention intervals, and both drug (SCH23390, a D1/D5 receptor antagonist) and vehicle (aCSF) infusions were tested on different days in the same animals. Bilateral intrahippocampal infusion of SCH23390 (5 microg in 1 microL per side) prior to trial 1 (encoding) caused a differential impairment as a function of memory delay-with no effect during trial 2 (memory retrieval) after a 20-min interval, but a block of memory at 6 h. Further experiments revealed that infusion of SCH23390 immediately after trial 1 had no effect on retention 6 h later, and the poor memory seen at long retention intervals when the drug was present at encoding was not due to a state-dependent failure of retrieval. These results suggest that activation of D1/D5 receptors during memory encoding is necessary for the formation of a persistent memory trace in the hippocampus. The complementary effects of D1/D5 receptor blockade on the persistence of LTP and the duration of memory are consistent with the idea that changes in synaptic strength underlie memory.