Exploring Genetic Counseling Communication Patterns: The Role of Teaching and Counseling Approaches

The educational and counseling models are often touted as the two primary professional approaches to genetic counseling practice. Yet, research has not been conducted to examine how these approaches are used in practice. In the present study, we conducted quantitative communication analyses of BRCA1 genetic counseling sessions. We measured communication variables that represent content (e.g., a biomedical focus) and process (e.g., passive listening) to explore whether genetic counselor approaches are consistent with prevailing professional models. The Roter Interaction Analysis System (RIAS) was used to code 167 pre-test genetic counseling sessions of members of a large kindred with an identified BRCA1 mutation. Three experienced genetic counselors conducted the sessions. Creating composite categories from the RIAS codes, we found the sessions to be largely educational in nature with the counselors and clients devoting the majority of their dialogue to providing biomedical information (62 and 40%, respectively). We used cluster analytic techniques, entering the composite communication variables and identified four patterns of session communication: Client-focused psychosocial, biomedical question and answer, counselor-driven psychosocial, and client-focused biomedical. Moreover, we found that the counselors had unique styles in which they combined the use of education and counseling approaches. We discuss the importance of understanding the variation in counselor communication to advance the field and expand prevailing assumptions.     

A model for outpatient care

Chaplains have seriously discussed outpatient care for a number of years. This article describes a model of thorough and intentional outpatient care that is practiced in conjunction with an inpatient care to cancer populations. Rationales, values, institutional dynamics, and clinical care are discussed. Although the focus is on outpatient care where slightly more than 50% of personnel resources are invested, the care also occurs in the context of both inpatient care and follow-up care after discharge to home. A general model of spiritual and religious care and more specific models pertinent to hematopoietic stem cell transplant populations and general oncology populations are described. The models attend times of distress and times of "ordinary" and celebratory experiences, attend care of patient, caregiver, and staff.     

Anagram software for cognitive research that enables specification of psycholinguistic variables

Anagram tasks are frequently used in cognitive research, and the generation of new scrambled letter combinations is a task well suited to a software solution. Most available programs, however, do not allow experimenters to generate new anagrams flexibly or to characterize existing anagrams using psycholinguistic criteria. They also do not provide detailed information on their source dictionaries. We present anagram software that interfaces with CELEX2, an internationally recognized psycholinguistic database. This software allows users to capitalize on lexical variables and thus enables direct control of psycholinguistic features that may influence the cognitive processes involved in anagram solution.     

Studies of the vicarious traumatization of college students by the September 11th attacks: effects of proximity, exposure and connectedness

From mid-October 2001 through the end of November 2001, we collected fairly large sets of questionnaires from undergraduates at three public universities (Albany, NY, n = 507, Augusta, GA, n = 336, Fargo, ND, n = 526 ) to assess rate of acute stress disorder (ASD) and level of ASD symptoms following the September 11th attacks, rate of current posttraumatic stress disorder (PTSD) and level of PTSD symptoms, and current level of depressive symptoms resulting from the September 11th attacks. We also gathered information on exposure to media coverage of the attacks, connectedness to the World Trade Center (WTC) and personnel there, and degree of engagement in reparative acts such as giving blood, attending vigils. We found higher levels of ASD, ASD symptoms, PTSD and PTSD symptoms as a function of geographical proximity to New York City (and within the Albany site, proximity of students' homes) and gender. Exposure (hours of TV watched) was a predictor in some instances as was connectedness to WTC victims. ASD symptoms were the strongest predictor of subsequent PTSD symptoms. Path models accounted for over 60% of the variance in PTSD symptoms.     

Scientific misconduct and findings against graduate and medical students

Allegations of scientific misconduct against graduate students appear to have unique attributes in the detection, investigation, processes used and sanctions imposed vis-à-vis other populations against which misconduct is alleged and found. An examination of the cases closed by the Department of Health and Human Services' Office of Research Integrity and the National Science Foundation reveals that most of the allegations made against graduate and medical students are for falsification and fabrication. Further, additional processes are used in these cases, e.g., student judicial processes, more students are "set up" and more students admit misconduct. Finally, the sanctions imposed when a finding is made typically involve separation from the institution and the federal sanction ranges from none to debarment. Drawing upon the teachings and circumstances of cases involving graduate student peers is a good vehicle for illustrating the concepts and perils of misconduct to graduate students.     

Abusive relationships: Is a new category for traumatization needed?

The concept of a spectrum of posttraumatic disorders has been postulated by a variety of major contributors to the field of psychotraumatology. Although Posttraumatic Stress Disorder (PTSD) is one trauma-based mental health disorder, there are other posttraumatic illnesses that do not qualify for PTSD, nor are they accurately described by other diagnostic categories in the DSM-IV. The present paper proposes and delineates a new syndrome, entitled Posttraumatic Relationship Syndrome (PTRS), which is a function of the experience of trauma in the context of an emotionally intimate relationship. It differs from PTSD in four fundamental ways: (1) the nature of the Stressor criterion; (2) the response to the Stressor; (3) the inclusion of a category of relational symptoms; and (4) the way of coping with the trauma (i.e., it lacks the emotional numbing and avoidance of stimuli associated with the trauma). The latter is the most salient difference as it involves a qualitatively different experience of the “world of trauma”-a primarily conscious experience in PTRS and an often unconscious experience in PTSD.     

A longitudinal study of implicit and explicit memory in old persons

Decline in explicit memory with advancing age is a common finding, but it is unclear whether implicit memory (repetition priming) declines or remains stable. Meta-analyses of studies that examined differences between extreme groups (young-old), typically at a single point in time and on a single test, suggest that a mild reduction in priming occurs with advancing age. The authors examined explicit memory and priming, on multiple tests over 4 annual data-collection waves, in a large group of older persons without dementia at baseline. Explicit memory declined significantly, but priming remained stable. Findings indicate that explicit memory and priming are dissociable on the basis of age-related change and that mildly reduced priming is not an inevitable consequence of growing older.     

The 1996 Mount Everest tragedy: contemplation on group process and group dynamics

In May 1996, one of the most tragic Mt. Everest climbing seasons was about to unfold, and five climbers would perish in the "Death Zone" miles above the earth's surface. This article considers the events from a group dynamic and group process perspective in an attempt to understand what might have been happening to the group members. We summarize the events through the writings of two chroniclers. We then discuss creating the group, leadership, diversity and subgrouping, scapegoating, and multiple interpretations through an interpersonalist/psychodynamic framework.     

Compared to what? Effects of categorization on hedonic contrast

Test stimuli are rated less “good” following very good context stimuli than when presented either alone or following neutral context stimuli. This diminution in rating is calledhedonic contrast. In two experiments, the degree of hedonic contrast depended on how subjects were instructed to categorize context and test stimuli. Contrast was substantially attenuated if context and test stimuli were said to belong to different categories. The effect was demonstrated for beverages (Experiment 1) and birds (Experiment 2). Stimuli’s hedonic ratings were far less affected by other stimuli declared to belong to a different category than by stimuli declared to belong to a common category.     

Universal sex differences in the desire for sexual variety: tests from 52 nations, 6 continents,and 13 islands

Evolutionary psychologists have hypothesized that men and women possess both long-term and short-term mating strategies, with men's short-term strategy differentially rooted in the desire for sexual variety. In this article, findings from a cross-cultural survey of 16,288 people across 10 major world regions (including North America, South America, Western Europe, Eastern Europe, Southern Europe, Middle East, Africa, Oceania, South/Southeast Asia, and East Asia) demonstrate that sex differences in the desire for sexual variety are culturally universal throughout these world regions. Sex differences were evident regardless of whether mean, median, distributional, or categorical indexes of sexual differentiation were evaluated. Sex differences were evident regardless of the measures used to evaluate them. Among contemporary theories of human mating, pluralistic approaches that hypothesize sex differences in the evolved design of short-term mating provide the most compelling account of these robust empirical findings.