A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder

This study examined the efficacy of guided self-help based on dialectical behaviour therapy (DBTgsh) for binge eating disorder (BED). Individuals (88.3% female; mean 42.8 years) were randomized to DBTgsh (n = 30) or wait-list (WL; n = 30). DBTgsh participants received an orientation, DBT manual, and six 20-min support calls over 13 weeks. All participants were assessed pre- and post-treatment using interview and self-report; also, DBTgsh participants were re-assessed six months post-treatment. At treatment end, DBTgsh participants reported significantly fewer past-month binge eating episodes than WL participants (6.0 versus 14.4) and significantly greater rates of abstinence from binge eating (40.0% versus 3.3%). At six-month follow-up, DBTgsh participants reported significantly improved quality of life and reduced ED psychopathology compared to baseline scores. In addition, most improvements in the DBTgsh group were maintained, although binge eating abstinence rates decreased to 30%. These preliminary positive findings indicate that DBTgsh may offer an effective, low-intensity treatment option for BED.     

Perceptions of High-Risk Care and Barriers to Care Among Women at Risk for Hereditary Breast and Ovarian Cancer following Genetic Counseling in the Community Setting

Data are limited regarding barriers to care among women, with or at risk for hereditary breast and ovarian cancer (HBOC), following genetic counseling in the community setting. Using a telephone survey, we retrospectively addressed perceptions of post-genetic counseling medical care and barriers to care among 69 at-risk women from the non-academic setting. Of these, all agreed that following cancer screening recommendations was better than not following them; none felt recommendations were too difficult to follow; all believed screening would help keep them healthy; 57% believed screening would prevent cancer. Twenty-five percent noted discomfort with breast imaging; 29% found ovarian cancer screening uncomfortable. Close to a quarter of participants reported difficulty deciding whether or not to undergo risk-reducing mastectomy while 10% noted difficulty deciding for or against bilateral salpingo-oophorectomy. There were no perceived major barriers to care, although 38% felt that screening reminders would be helpful, and 10% needed more help in following through with care. Overall, participants believed that they were benefiting from their post-genetic counseling medical care. This work identified HBOC-related support needs to include: informational resources that promote improved understanding of cancer risk and high-risk management; screening reminder systems; and decision support tools.     

Building a Tool to Identify Risk for Lynch Syndrome Among Individuals Presenting for Screening Colonoscopy

The goal of this work was to build and pilot-test a user-friendly Lynch syndrome risk assessment tool among individuals presenting for routine screening colonoscopy. Participants included adults presenting to a private practice-based, open-access endoscopy unit. Working with health literacy experts and gastroenterologists, and based on established criteria, we developed a simplified tool to assess Lynch syndrome risk, pre-procedure. A pilot-test of the tool assessed its: 1) clinical utility; 2) patient-reported usability; and 3) feasibility. The tool, in paper format, was written at a 9th grade reading level and included instructions for use followed by seven Lynch syndrome risk-related questions, structured such that one “Yes” response signified potential risk. A pilot-test of the tool among 334 patients revealed that 29 met criteria for Lynch syndrome risk. Of these, following telephone review of their responses, risk was confirmed in 9 patients (3% of total). The tool was reported as easy-to-use and was seen as feasible for use. Limitations include: 1) the need for infrastructure to distribute and collect the tool and 2) the availability of knowledgeable staff to review tool responses, confirm risk, and facilitate appropriate referral for genetic counseling. These data suggest that the tool affects assessment of Lynch syndrome risk among the routine colon cancer screening population.     

Placing a text in context

Can readers accurately retrieve information about the context in which text comprehension occurs? If so, does their memory for context vary with their level of comprehension? Participants studied ambiguous passages in a high-knowledge or low-knowledge condition. They were then asked to remember the spatial location of individual sentences, the color of a border surrounding the passage, or the color of a shirt worn by the experimenter. Recall protocols were collected after participants answered the context question. Knowledge about the topic of the text facilitated both contextual retrieval and recall. Moreover, contextual retrieval and recall were correlated, primarily in the high-knowledge condition. The results suggest that personal experiences accompanying comprehension are encoded in memory along with text meaning and have implications for theories of source monitoring.     

Teachers' and coaches' role perceptions for supporting young people's mental health: Multiple group path analyses

Teachers and youth sports coaches are in prominent positions to support young people and their mental health. However, the way these professionals perceive their roles is likely to be a powerful influence on such behaviour. This article investigates and compares the effect of four types of role perceptions—role breadth, instrumentality, efficacy, and discretion—on teachers' and coaches' engagement in helping behaviour that supports young people's mental health through promotion, prevention, and early intervention. An online survey was completed by 117 teachers and 131 coaches. Results from three multiple group path analyses revealed role breadth, instrumentality, and efficacy significantly influenced teachers' and coaches' helping behaviour. The extent to which role perceptions predicted helping behaviour did not differ between teachers and coaches. Assisting teachers and coaches to carry out promotion, prevention, and early intervention behaviour increases young people's access to mental health support and may help to reduce the burden of mental health problems among Australian young people.     

Reading Proficiency and Comparability of Mathematics and Science Scores for Students From English and Non-English Backgrounds: An International Perspective

The purpose of this research is to examine the comparability of mathematics and science scores for students from English language backgrounds (ELB) and non-English language backgrounds (NELB). We examine the relationship between English reading proficiency and performance on mathematics and science assessments in Australia, Canada, the United Kingdom, and the United States. The findings indicate a strong relationship with reading proficiency accounting for up to 43% of the variance in mathematics and up to 79% in science. In all comparisons, ELB students either outperformed NELB students or performed at the same level. However, when statistical adjustments were made for reading proficiency, in both mathematics and science, the score gap between the groups became statistically non-significant in three out of the four countries. These findings point to differences in score meaning in mathematics and science assessments and limitations in comparing performances of ELB and NELB.     

More Than Happy to Help? Customer‐Focused Emotion Management Strategies

This paper investigates the impact of customer service representative (CSR) customer‐focused emotion management strategies on expressed customer emotions, beyond the influences of emotional contagion. We propose that problem‐focused strategies (situation modification and cognitive change) are likely to reduce the intensity of negative customer emotions and increase the intensity of positive customer emotions, whereas emotion‐focused strategies (attentional deployment and modulating the emotional response) will have the opposite impact. Further, we propose that customer negative emotions will affect the choice of strategies CSRs employ. Based on evaluator ratings of recorded customer service calls (N= 228), our findings confirmed the positive effects of problem‐focused strategies and the negative effects of emotion‐focused strategies on customer‐expressed emotions. In addition, we found that initial customer emotions affected the strategy used by the CSR, whereby negative emotions expressed by the customer reduced the use of the most effective strategy and increased the use of the least effective strategy.     

“I Wouldn’t Classify Myself as a Patient”: The Importance of a “Well-being” Environment for Individuals Receiving Counseling about Familial Cancer Risk

Many individuals receiving genetic counseling are healthy with no need for clinical cancer services. We have recently relocated our cancer genetic clinic to a small house on the outskirts of a hospital site which incorporates many elements proven to be important in creating a “well-being” environment. This study explored participants’ perceptions of such an environment. Eleven semi-structured telephone interviews were conducted with women who had attended the new cancer genetic clinic. All were at high risk of familial cancer, five were gene carriers and three had a personal diagnosis of cancer. The new clinic was perceived to be less medical and more relaxing than other clinics, encouraged other family members to attend in support of the attendee and did not appear to impede information comprehension. The importance of not being made to feel like an ill patient was apparent. A desire for a quiet area allowing time for reflection whilst waiting for, and following, counseling was identified. A poorly designed counseling area could reduce the quality of the interaction between patient and counselor. Consideration of specific environmental design features may promote individuals’ well-being and make those attending genetic counseling feel less like “patients.” Larger studies should seek to explore further the potential associations between factors such as environmental design, psychological well-being and comprehension of risk information.