Case Report: Direct Access Genetic Testing and A False-Positive Result For Long QT Syndrome

We report the case of a woman who pursued direct access genetic testing and then presented with concerns regarding a positive test result for Long-QT syndrome. Although the result ultimately proved to be a false positive, this case illustrates that costs associated with follow-up of direct access genetic testing results can be non-trivial for both the patient and for health care systems. Here we raise policy questions regarding the appropriate distribution of these costs. We also discuss the possibility that, when confronted by a direct access genetic test result that reports high risk for one or more actionable diseases, a family physician might feel compelled to act out of a desire to avoid liability, even when information regarding the accuracy and validity of the testing were not easily accessible. This case outlines lessons that can easily be translated into clinical practice, not only by genetic counselors, but also by family physicians, medical specialists and members of the public.     

Marriage and Family Therapy Students’ Views on Including Weight Bias Training into Their Clinical Programs

Discussions about diversity rarely focus on overweight, obesity, and bias about body size (i.e., weight bias). These discussions allow students to develop self-awareness about how their biases can affect their clinical work, as well as the challenges and subsequent bias clients may face in their everyday lives and from clinical providers. One consequence of the rising prevalence of overweight and obesity in the United States is the increase in the level of weight bias and discrimination towards individuals who are overweight, which has been documented among mental and healthcare professionals. Thus, it is imperative that training programs integrate weight bias as a part of diversity training. The authors will review weight bias in mental and healthcare professions, and describe several trainings focused on self-awareness about weight bias. The purpose of this study was to pilot and evaluate a training program for marriage and family therapy (MFT) students about developing self-awareness around weight bias and working with clients who are overweight. Following the program, focus groups were conducted to explore participants’ experiences, learning, and feedback on the content and delivery method. Focus Group methodology was used to guide the analysis process. Four themes emerged: training program feedback, challenges for the MFT field, self-of-therapist, and etiology of weight loss/gain. Implications for MFT training programs are discussed.     

The Development and Testing of a New Version of the Cognitive Reflection Test Applying Item Response Theory (IRT)

The cognitive reflection test (CRT) is a short measure of a person's ability to resist intuitive response tendencies and to produce a normatively correct response, which is based on effortful reasoning. Although the CRT is a very popular measure, its psychometric properties have not been extensively investigated. A major limitation of the CRT is the difficulty of the items, which can lead to floor effects in populations other than highly educated adults. The present study aimed at investigating the psychometric properties of the CRT applying item response theory analyses (a two‐parameter logistic model) and at developing a new version of the scale (the CRT‐long), which is appropriate for participants with both lower and higher levels of cognitive reflection. The results demonstrated the good psychometric properties of the original, as well as the new scale. The validity of the new scale was also assessed by measuring correlations with various indicators of intelligence, numeracy, reasoning and decision‐making skills, and thinking dispositions. Moreover, we present evidence for the suitability of the new scale to be used with developmental samples. Finally, by comparing the performance of adolescents and young adults on the CRT and CRT‐long, we report the first investigation into the development of cognitive reflection. Copyright © 2015 John Wiley & Sons, Ltd.     

Movies on the couch: The MOVIE model of film therapy

Film therapy, the therapeutic use of movies in psychological therapies, is a growing area of interest to therapists and researchers. This paper discusses the benefits of film therapy and presents a method, the MOVIE model of film therapy, a widely applicable, trauma-informed framework for individual or group therapy, counsellor education and self-help. Film or cinema therapy is a highly accessible and relatable method for many diverse groups. The benefits identified include emotional processing, greater ease of dialogue, increased empathy, interpersonal learning, new perspectives and learning skills. Following the model's reflective steps, clients mindfully observe and voice their emotional and psychological responses to movie-watching; identify how the imagery, characters, themes and story symbolise personal experience; and consider any new possibilities that emerged for their own lives. The model is informed by a practice-focussed review of literature and draws on methods from mindfulness and experiential and narrative therapies. The steps are widely applicable in a range of settings and can be adapted across counselling modalities. Further research to consider the outcomes of using the model, alongside qualitative research on clients' experiences of working this way with film, is recommended.     

The impact of bundle comparisons on bundle preference

The bundling literature largely holds that a person's reaction to a given product bundle depends only on the characteristics of the products contained in the bundle. This paper, instead, proposes that people evaluate bundles in reference to other bundles that they have seen. Prior research indicates that people are sensitive to a bundle's “attribute inventory” or the aggregate level of comparable attributes possessed by its constituent products. We show that when people evaluate a bundle, they compare the attribute inventories that it offers to those offered by other bundles that they have seen. The resulting compositional comparisons can occur without changes to the products that comprise the target and contextual bundles, vary by attribute comparability and attentional focus, and coexist with (and at times reverse the effects of) well‐established product‐specific context effects, which are determined solely by the products and their attributes.     

Drinking to belong: The effect of a friendship threat and self-esteem on college student drinking

The current study examined how implicit and explicit self-esteem and time spent drinking with friends influence college student drinking after a friendship threat manipulation. Poisson regression analyses revealed that students with low implicit self-esteem showed a greater increase in alcohol consumption when drinking with friends after experiencing a friendship threat than in the control condition. These effects were not found among students with high implicit self-esteem. A similar, but weaker, pattern emerged when testing the independent effects of explicit self-esteem. We suggest that low self-esteem students are drinking because they lack the self-resources to deal with unmet belongingness needs. These findings suggest that low implicit self-esteem may be a risk factor for college student drinking.