Systemically-Based Psychotherapeutic Techniques in Genetic Counseling

The uses of systemically-based psychotherapeutic methods in genetic counseling are discussed in the context of the origin of genetic counseling, the definition of genetic counseling, and the adjustments that one must make in order to implement these methods. Selected systemic methods which can be readily incorporated into genetic counseling are presented: use of genograms to explore family attitudes and beliefs about genetic risk, communications skills, and applications of family of origin work in genetic counseling. The need for research regarding the methodology and process of genetic counseling is presented with discussion of the need for theories of practice for genetic counseling.     

Monitoring of comprehension: The role of text difficulty in metamemory for narrative and expository text

The effect of text difficulty on metamemory for narrative and expository text was investigated. In Experiment 1, we found an interaction between type of text and type of question (thematic or detailed). For readers of narrative texts, correlations between predicted and actual performance were highest for detailed questions, but this pattern was reversed for readers of expository texts. Next, text difficulty was explored as a possible factor affecting metamemory accuracy. In Experiments 2 and 3, metamemory accuracy was a nonmonotonic function of text difficulty. Subjects made remarkably accurate predictions of future performance (meanG > .6) for both narrative and expository texts that were of intermediate difficulty (approximately a 12th-grade reading level). We propose anoptimum effort hypothesis, predicting greatest metamemory accuracy when the texts are of intermediate difficulty.     

Organizational characteristics of empowering community settings: A multiple case study approach

Although empowerment is often cited as a major guiding construct for community psychology, relatively little is known about the characteristics of empowering community settings. The current paper uses a multiple case study methodology to generate a number of key organizational characteristics of empowering community settings to guide future work in the area. In-depth, multilevel, longitudinal research was conducted on three empowering community settings: a religious fellowship, a mutual help organization for persons with severe mental illness, and an educational program for African American students. The organizational features found to characterize all three settings were (a) a belief system that inspires growth is strengths-based, and is focused beyond the self; (b) an opportunity role structure that is pervasive, highly accessible, and multifunctional (c) a support system that is encompassing, peer-based, and provides a sense of community; and (d) leadership that is inspiring, talented, shared, and committed to both setting and members. Limitations of the research are discussed, and directions for future research suggested.     

A time-limited group for patients with HIV infection and their partners

This paper presents the authors' experience coleading a time-limited group treatment for HIV-positive patients and their partners. Because of the impact of this disease not only on the infected person, but also on his or her partner, a couples group format was used. This 12-week group consisted of four couples, heterosexual and homosexual, of diverse ethnic and socioeconomic backgrounds. While the group focused primarily on couples' issues, individual concerns, conflicts, and experiences relating to the HIV diagnosis were also explored. Clinical vignettes demonstrate the process and benefits of this group experience.     

Trust and Missed Opportunities in International Relations

With the end of the Cold War, we must wonder whether there were missed opportunities to regulate the arms race and global competition, which nearly bankrupted the United States and contributed to the collapse of the Soviet Union. A missed opportunity for agreement is a situation where there was at least one alternative that the parties to a conflict preferred or would have preferred to nonagreement. Hard-core Realists argue that states compete for territory, arms, and influence because they have conflicting national interests. Soft-core Realists maintain that such conflicts are effects of international anarchy and uncertainty, and that states can cooperate contingent on reciprocity. I argue that states often fail to cooperate even when they have compatible preferences because policy-makers make incorrect inferences about the opponent's motives and intentions, a process that can be illuminated by social psychology. I present three alternative explanations of trust and distrust in international relations—rational choice, domestic structures, and social psychology. If policy-makers are prudent, they will assess the other's interests in observing an agreement as well as its reputation. Often, domestic political structures encourage leaders to promote distrust of an external enemy to legitimize their internal rule or foreign policy. Finally, distrust may lead policy-makers to dismiss the other side's cooperative signals or proposals. Distrust can be overcome by making a series of step-by-step agreements in which each side can test the other's good faith at limited cost, or through unilateral concessions as part of a consistent policy.     

The Effect of a Prejudice-Reduction Simulation on Attitude Change1

The effectiveness of a well-known prejudice-reduction simulation, “Blue Eyes-Brown Eyes,” was assessed as a tool for changing the attitudes of nonblack teacher education students toward blacks. The three outcomes were (a) virtually all of the subjects reported that the experience was meaningful for them; (b) the statistical evidence supporting the effectiveness of the activity for prejudice reduction was moderate; and (c) virtually all of the participants, as well as the simulation facilitator, reported stress from the simulation.     

The relaxation word of the day: A simple technique to measure adherence to relaxation

A new procedure of assessing adherence to home practice of relaxation is presented. The technique involved the subject identifying one of four possible relaxation words of the day at the end of a taped relaxation session. The method was employed to assess the relationship between adherence to relaxation and decline of blood pressure during a 10-session/8-week relaxation program involving 17 hypertensive subjects. No statistically significant relationship was found on either a short-term or a long-term basis. An advantage of the assessment technique is that it appears easily integrated into the overall therapeutic objective for relaxation therapy; a disadvantage is that the subject needs to comply not only with the relaxation schedule but also with the monitoring procedure.This research study was funded by NIH Grant HL27159.     

Measuring the effects of demand characteristics on the Beck Depression Inventory responses of college students

To determine whether Beck Depression Inventory (BDI) responses could be influenced by an instructional set or by changing the item order, 198 college students were randomly assigned to one of four conditions: instructions designed to facilitate or inhibit responding, along with standard vs. reordered symptom questions. A 2×2 ANCOVA found a main effect only for the inhibitory message. The suppression of scores by the inhibitor instructional set suggests caution regarding possible demand characteristics when using the BDI with this population and should be further studied with clinically symptomatic samples.     

Classroom behavior and the academic progress of learning disabled students

A total of 43 learning disabled (LD) students who were identified in grades 1–3 were followed up in their second year of special education services. Teachers completed the Classroom Behavior Inventory (CBI) for each LD student and for randomly selected classmates, and both groups of students were observed with the SCAN system in regular classroom settings. Group differences in teacher perceived task orientation, independence, and verbal expressiveness replicated previous findings with the CBI for this LD sample. SCAN observations partially replicated previous results in that LD children interacted with teachers more often than classmates. Multiple regression analyses indicated that both measures of behavior were predictive of reading achievement during year 1 when the LD children were identified, and that the CBI predicted academic progress from one year to the next. Both teacher ratings and observational evidence converged on the importance of task-oriented behavior, independent functioning, and socially appropriate behavior in understanding the poor achievement of LD students.     

Patient distortion in reporting outcome: A procedure for correcting patient outcome scores

Outcome scores that are provided by patient report are routinely used in therapy outcome studies. Despite their popularity they are usually viewed with suspicion since they are assumed to reflect a considerable amount of distortion. Two procedures for estimating patient distortion and for creating corresponding correction factors for outcome scores are presented. When either procedure was used to correct the outcome scores of 34 outpatients from six therapy groups in a process-outcome study, a number of significant correlations emerged where none had existed previously when uncorrected scores had been used. When a third correction procedure based on social desirability was used, significant correlations did not emerge. The findings have implications for correcting patient distortion in both individual and group therapy outcome studies.