Stakeholders’ Opinions on the Implementation of Pediatric Whole Exome Sequencing: Implications for Informed Consent

Advances in whole genome and whole exome sequencing (WGS/WES) technologies have led to increased availability in clinical settings. Currently, there are few guidelines relating to the process and content of informed consent for WGS/WES, nor to which results should be returned to families. To address this gap, we conducted focus groups to assess the views of professionals, parents, and adolescents for the future implementation of WES. The discussions assessed understanding of the risks and benefits of WES, preferences for the informed consent discussion, process for return of results, and the decision-making role of the pediatric patient. Professional focus group participants included bioethicists, physicians, laboratory directors, and genetic counselors. Parent focus groups included individuals with children who could be offered sequencing due to a potential genetic cause of the child’s condition. On-line discussion groups were conducted with adolescents aged 13–17 who had a possible genetic disorder. We identified discrepancies between professionals and patient groups regarding the process and content of informed consent, preference for return of results, and the role of the child in decision-making. Professional groups were concerned with the uncertainty regarding professional obligations, changing interpretation in genomic medicine, and practical concerns of returning results over time. Parent and adolescent groups focused on patient choice and personal utility of sequencing results. Each group expressed different views on the role of the child in decision-making and return of results. These discrepancies represent potential barriers to informed consent and a challenge for genetic counselors regarding the involvement of pediatric patients in decision-making and return of results discussions.     

National Guard Couples Communicating During Deployment: The Challenge of Effective Connection

Communication during a combat deployment has changed significantly in current times. Couples can now communicate with each other frequently and through multiple modes. Despite this greater availability of communication options, there remain unanswered questions related to how healthy deployment communication is best achieved between couples, particularly regarding navigating the uncertainty of deployment. In this qualitative study, we report on the experiences of 31 National Guard couples who endured a combat deployment in support of Operation Enduring Freedom. Couples were interviewed three months after the soldier returned from deployment. Through the lens of relational turbulence theory, we provide a conceptual framework related to effective and non-effective deployment communication, along with structural communication barriers in the military that may negatively affect the mental well-being of partners. Finally, we provide recommendations to guide couples through these difficult deployments.

     

Self-Imagery and Attentional Control Maintenance Factors of Social Anxiety: A Comparison of Trait and State Assessments

Journal of Psychopathology and Behavioral Assessment - Models of social anxiety (SA) posit that socially-evaluative fears may be maintained by biased cognitive processes such as attention and...     

Prior knowledge is more predictive of error correction than subjective confidence

Previous research has demonstrated that, when given feedback, participants are more likely to correct confidently-held errors, as compared with errors held with lower levels of confidence, a finding termed the hypercorrection effect. Accounts of hypercorrection suggest that confidence modifies attention to feedback; alternatively, hypercorrection may reflect prior domain knowledge, with confidence ratings simply correlated with this prior knowledge. In the present experiments, we attempted to adjudicate among these explanations of the hypercorrection effect. In Experiments 1a and 1b, participants answered general knowledge questions, rated their confidence, and received feedback either immediately after rating their confidence or after a delay of several minutes. Although memory for confidence judgments should have been poorer at a delay, the hypercorrection effect was equivalent for both feedback timings. Experiment 2 showed that hypercorrection remained unchanged even when the delay to feedback was increased. In addition, measures of recall for prior confidence judgments showed that memory for confidence was indeed poorer after a delay. Experiment 3 directly compared estimates of domain knowledge with confidence ratings, showing that such prior knowledge was related to error correction, whereas the unique role of confidence was small. Overall, our results suggest that prior knowledge likely plays a primary role in error correction, while confidence may play a small role or merely serve as a proxy for prior knowledge.     

The role of thought-content and mood in the preparative benefits of upward counterfactual thinking

Upward counterfactual thoughts identify how a prior outcome could have been better and have been shown to improve subsequent performance. Both the identification of corrective actions (content-specific effects) and the more general mobilization of effort as a result of negative affect (content-neutral effects) have been suggested to underlie performance benefits. The results of three experiments presented here indicate that counterfactual thoughts have broad benefits for performance, independent of their content and beyond the effects of planning. These benefits were consistently dependent upon the experience of negative affect, but were eliminated when negative affect could be (mis)attributed to an intervening task. This misattribution effect is consistent with the operation of a mood-as-input process in which affect informs judgments of goal progress. Overall, the findings suggest that the benefits of upward counterfactual thinking reflect more broad attempts to improve following a subjectively unsatisfactory performance.     

Perspective taking instructions and self-other overlap: Different motives for helping

In two studies (N’s = 57 and 115), we demonstrate that type of perspective-taking instruction (“imagine self” vs. “imagine other”) differentially affects two motives for helping: self-other overlap and empathic concern. Imagine-self instructions produce greater self-other overlap than imagine-target and objective instructions, while both types of perspective-taking instruction promote empathic concern relative to an objective condition. In Study 2, imagine-self instructions indirectly increased the likelihood of helping via empathic concern and self-other overlap, while imagine-target instructions led indirectly to greater helping only through empathic concern. We discuss how different perspective-taking instructions may implicate different emotional and motivational paths to increasing helping.     

A Bifactor Model of Anxiety Sensitivity: Analysis of the Anxiety Sensitivity Index-3

The purpose of the current study was to investigate the fit of a bifactor model of the Anxiety Sensitivity Index-3 (ASI-3; Taylor et al. Psychological Assessment, 19, 176–188, 2007) as well as to examine measurement invariance of the ASI-3 across gender. Participants were undergraduate students from the University of Cincinnati (n?=?954; 63 % female). Results indicated that the bifactor model was the best fit to the data, and that this model of AS is fully invariant in terms of gender. The current findings suggest that anxiety sensitivity consists of a general factor and three independent group factors (rather than a higher-order factor with three correlated lower-order factors). The ASI-3 subscales from the bifactor model however did not provide incremental predictive utility above and beyond the general AS factor with respect to an external anxiety criterion. Related research and clinical implications are discussed.     

A Methodological Examination of Emotion Inductions in Borderline Personality Disorder: A Comparison of Standardized Versus Idiographic Stimuli

Emotional reactivity is conceptualized as a core feature of borderline personality disorder (BPD) and has been subject to substantial empirical research. The laboratory methods used to elicit emotional reactivity in BPD have varied and findings across studies have been mixed. At present, there is little research evaluating the relative efficacy of different methods in eliciting emotional reactivity in BPD. Thus, the current study examined differences in emotional reactivity among individuals with BPD in response to standardized and idiographic stimuli, and across three specific emotions (sadness, fear, and anger). Individuals with BPD, social anxiety disorder, and healthy controls viewed film clips (i.e., standardized stimuli) or engaged in a personally-relevant imagery task (i.e., idiographic stimuli) while self-reported and physiological indices (skin conductance response and respiratory sinus arrhythmia) of emotion were collected. Results indicated that BPD participants displayed greater reactivity of sadness and anger (but not fear) in response to the idiographic versus standardized stimuli, a pattern that was not exhibited by the other two groups. These findings might explain some of the mixed evidence to date and suggest that idiographic sadness and fear inductions may be more effective for individuals with BPD.     

SAwSu: An Integrated Model of Associative and Reinforcement Learning

Successfully explaining and replicating the complexity and generality of human and animal learning will require the integration of a variety of learning mechanisms. Here, we introduce a computational model which integrates associative learning (AL) and reinforcement learning (RL). We contrast the integrated model with standalone AL and RL models in three simulation studies. First, a synthetic grid‐navigation task is employed to highlight performance advantages for the integrated model in an environment where the reward structure is both diverse and dynamic. The second and third simulations contrast the performances of the three models in behavioral experiments, demonstrating advantages for the integrated model in accounting for behavioral data.