Approaching Complex Cases With a Crisis Intervention Model and Teamwork

Patients referred for genetic counseling may be in a state of crisis, feeling as though they are incapable of making decisions about the management of their pregnancy, genetic testing options and/or life planning issues. The role of the genetic counselor is to assist a patient through this crisis state by increasing the patient's understanding and by helping to facilitate decision making and adjustment to those decisions. In this paper we present a clinical genetic counseling case that was complicated by numerous medical and psychosocial issues. The wide scope of this case required the involvement of both a prenatal and a medical genetic counselor. Working as a team we utilized a crisis intervention model. Our counseling focused on identifying and isolating the issues, providing factual information, setting a time frame for decisions to be made, and encouraging social support and emotion-focused coping strategies.     

The Effect of Examining Actual Products or Product Descriptions on Consumer Preference

Many consumers purchase products in stores, where they can physically examine and touch the items. In addition, consumers shop for products online or through direct mail, where they cannot physically examine and touch the merchandise. Building on an analysis of perceptual mechanisms involved in the sense of touch, we find that products with primarily material properties, such as clothing or carpeting, are more likely to be preferred in shopping environments that allow physical inspection than in those environments that do not. We also find that there is no difference in preference across the two environments for products with primarily geometric properties, such as packaged goods, for which vision is highly diagnostic. Furthermore, when the touch properties of a material product are verbally described, this reduces the difference in preference between the two environments.     

Improving Health Care Utilization, Improving Chronic Disease Utilization, Health Status, and Adjustment in Adolescents and Young Adults with Cystic Fibrosis: A Preliminary Report

We conducted a randomized clinical trial of a 3-session written self-disclosure intervention for patients with cystic fibrosis (CF). Patients (n = 39) who were at least 15 years of age and diagnosed with CF participated in the intervention. Participants in the intervention arm were asked to write in the health care setting about an important emotionally distressing issue of personal significance for a 20-min period of time and two additional 20-min writing episodes at the patient's home, which were prompted by telephone calls. Patients in the control condition received standard care alone. Findings revealed that the intervention resulted in a reduction of the number of days patients spent in the hospital over a 3-month period. The intervention did not have an impact on physiological (Forced Expiratory Volume and Body Mass Index or subjective markers of health status. These findings extend those of Pennebaker's (cf., J. Smyth, 1998) demonstrating an effect of the written-self-disclosure intervention on health care utilization. These preliminary findings are promising and justify further investigation of the modified intervention in other chronic illness populations.     

Attitude‐behaviour consistency: the role of group norms,attitude accessibility,and mode of behavioural decision‐making

The interplay between two perspectives that have recently been applied in the attitude area—the social identity approach to attitude‐behaviour relations (Terry & Hogg, 1996 ) and the MODE model (Fazio, 1990a )—was examined in the present research. Two experimental studies were conducted to examine the role of group norms, group identification, attitude accessibility, and mode of behavioural decision‐making in the attitude‐behaviour relationship. In Study 1 (N = 211), the effects of norms and identification on attitude‐behaviour consistency as a function of attitude accessibility and mood were investigated. Study 2 (N = 354) replicated and extended the first experiment by using time pressure to manipulate mode of behavioural decision‐making. As expected, the effects of norm congruency varied as a function of identification and mode of behavioural decision‐making. Under conditions assumed to promote deliberative processing (neutral mood/low time pressure), high identifiers behaved in a manner consistent with the norm. No effects emerged under positive mood and high time pressure conditions. In Study 2, there was evidence that exposure to an attitude‐incongruent norm resulted in attitude change only under low accessibility conditions. The results of these studies highlight the powerful role of group norms in directing individual behaviour and suggest limited support for the MODE model in this context. Copyright © 2003 John Wiley & Sons, Ltd.     

Attention to Sex in Psychological Research as Related to Journal Policy and Author Sex

From 1969 to 1974, Developmental Psychology, but not Child Development , specified that authors analyze for sex differences. The authors examined 503 studies published in Child Development and Developmental Psychology in 1971 and 1975. Sex of senior author, subjects and experimenter(s) were recorded for each study. If subjects of both sexes were used, the presence or absence of the following were noted: (a) analysis of sex differences; (b) hypotheses regarding sex differences; (c) mention of subjects' sex in the abstract. For single-sex-subject studies, mention of subjects' sex in the discussion or conclusion was noted. Using these data as dependent variables, chi-square analyses were performed comparing: (a) the two journals; (b) 1971 and 1975 authors; and (c) male and female authors. The findings were: (a) More attention was paid to sex in Developmental Psychology when the journal had a written editorial policy regarding this factor; (b) Evidence was mixed for increasing awareness of sex as a variable between 1971 and 1975; (c) Female authors were more aware of sex than were male authors in 1971 but not in 1975; (d) In both years, authors used own-sex subjects and experimenters more than those of the opposite sex; (e) Developmental psychologists, as compared to psychologists in other areas previously examined, were more sensitive to sex as a variable.     

Factors Associated with Delays of Days to Decades to Criminal Prosecutions of Child Sexual Abuse

Until the latter part of the 20th century, legal doctrines made it almost impossible to successfully prosecute in criminal court a case involving child sexual abuse (CSA), whether the complaint was timely or delayed. Many English-speaking countries have abrogated most formal legal barriers to prosecuting CSA cases, and courts are faced with the singular challenge of adjudicating sexual offenses against children that are reported to have happened years or decades earlier. We conducted analyses of 4,237 criminal complaints of CSA heard in Canadian criminal courts. There were several differences between timely and delayed prosecutions that led us to conclude that delayed prosecutions of CSA are common and due, in part, to the nature of the offense. Offense duration was associated with longer delays to prosecution. When the accused had access to the child through his position in the community, length of delay to prosecution was very long, particularly for male complainants. More research is needed on delayed CSA prosecutions, particularly given an apparent trend for jurisdictions to abolish barriers to criminal prosecutions of CSA that occurred years or decades earlier. Copyright © 2015 John Wiley & Sons, Ltd.     

Comorbid Substance Use and Anxiety Disorders in Adolescents

To explore the coexistence of substance use disorders and anxiety disorders in adolescents, we assessed adolescents presenting for treatment to an inpatient substance abuse treatment facility (SUH), an inpatient psychiatric treatment facility (IPH), and a community-based psychiatric facility (CMHC) for comorbid substance use and psychiatric diagnoses. Thirty subjects from each facility (N=90) were interviewed using the revised Child Schedule for Affective Disorders and Schizophrenia (K-SADS) and the Structured Clinical Interview DSM-III-R (SCID-R) for substance use diagnoses. Overall, comorbidity (anxiety and substance use disorders) prevalence was 67% (20/30) of adolescents in the SUH group, 33% (10/30) of the CMHC adolescents, and 33% (10/30) of the IPH adolescents. Alcohol and marijuana were the most frequently abused substances. Anxiety disorders commonly coexist with substance use disorders in adolescents. Early identification and treatment of anxiety disorders may in fact prevent substance abuse in this population.