Development and Pilot Testing of a Decision Aid for Genomic Research Participants Notified of Clinically Actionable Research Findings for Cancer Risk

Germline genomic testing is increasingly used in research to identify genetic causes of disease, including cancer. However, there is evidence that individuals who are notified of clinically actionable research findings have difficulty making informed decisions regarding uptake of genetic counseling for these findings. This study aimed to produce and pilot test a decision aid to assist participants in genomic research studies who are notified of clinically actionable research findings to make informed choices regarding uptake of genetic counseling. Development was guided by published literature, the International Patient Decision Aid Standards, and the expertise of a steering committee of clinicians, researchers, and consumers. Decision aid acceptability was assessed by self-report questionnaire. All 19 participants stated that the decision aid was easy to read, clearly presented, increased their understanding of the implications of taking up research findings, and would be helpful in decision-making. While low to moderate levels of distress/worry were reported after reading the booklet, a majority of participants also reported feeling reassured. All participants would recommend the booklet to others considering uptake of clinically actionable research findings. Results indicate the decision aid is acceptable to the target audience, with potential as a useful decision support tool for genomic research participants.     

Resilience,Life Events,and Well-Being During Midlife: Examining Resilience Subgroups

Developmental midlife processes involve resilience, changing challenges, and perceptions of getting older. In Study I and II, the Managing Life Survey resulted in growth, managing uncertainty, objectivity, adversity, and strategy use subscales. In Study II, resilience subgroups were identified. High and non-religious resilience groups had significantly higher averages for MLS subscales, time orientations, grit, life satisfaction; and significantly lower averages for adversity and negative event scores, compared to other groups. Noteworthy findings herein consist of (1) differences across resilience groups, with spiritual strategies emerging as an important discriminator; (2) the role of future perspectives on well-being characterizing early midlife; (3) the influence of growth and purpose on well-being characterizing late midlife; and (4) the cumulative effect of education on life satisfaction in late midlife. The results herein are consistent with the psychological benefits of moderate levels of challenge; with developmental differences across early and late midlife, and with Socioemotional Selectivity Theory.     

Attachment styles and clinical correlates in people at ultra high risk for psychosis

Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.     

Discounting: A practical guide to multilevel analysis of choice data

Multilevel modeling provides the ability to simultaneously evaluate the discounting of individuals and groups by examining choices between smaller sooner and larger later rewards. A multilevel logistic regression approach is advocated in which sensitivity to relative reward magnitude and relative delay are considered as separate contributors to choice. Examples of how to fit choice data using multilevel logistic models are provided to help researchers in the adoption of these methods.     

“Inside out”: Appraisals for achievement emotions from constructive,positive, and negative feedback on writing

Even with the recent surge of research on achievement emotions, few studies have investigated emotions in feedback situations and the appraisals associated with such emotions. The purpose of this study was to examine emotion appraisals of constructive criticism, negative, and positive feedback, to aid us in determining whether these appraisals differed by feedback type. In a task asking them to provide open-ended responses as they imagined receiving feedback on a writing task, undergraduates (N?=?270) gave reasons for why they might experience unpleasant emotions from positive feedback and pleasant emotions from negative feedback along with reasons for both pleasant and unpleasant emotions emanating from constructive feedback. Open coding of responses yielded categories for each emotion-feedback pairing that, across all emotions, were collapsed into five appraisal categories: feedback suggests ways to improve, a mismatch between feedback and task exists, feedback targets the self or one’s ability, feedback says something about the relationship between feedback giver and receiver, and the task is judged for its value. Distributions of appraisal categories distinguished constructive feedback from positive and negative feedback. Implications are drawn for control-value theory and for classroom feedback practices.     

An Indecent Proposal: The Dual Functions of Indirect Speech

People often use indirect speech, for example, when trying to bribe a police officer by asking whether there might be “a way to take care of things without all the paperwork.” Recent game theoretic accounts suggest that a speaker uses indirect speech to reduce public accountability for socially risky behaviors. The present studies examine a secondary function of indirect speech use: increasing the perceived moral permissibility of an action. Participants report that indirect speech is associated with reduced accountability for unethical behavior, as well as increased moral permissibility and increased likelihood of unethical behavior. Importantly, moral permissibility was a stronger mediator of the effect of indirect speech on likelihood of action, for judgments of one's own versus others' unethical action. In sum, the motorist who bribes the police officer with winks and nudges may not only avoid public punishment but also maintain the sense that his actions are morally permissible.     

American Psychiatric Association: Position Statement on Firearm Access,Acts of Violence and the Relationship to Mental Illness and Mental Health Services

The American Psychiatric Association, (“APA”), with more than 36,000 members at present, is the Nation's leading organization of physicians who specialize in psychiatry. APA provides for education and advocacy and develops policy through Position Statements. It promotes enhanced knowledge of particular topics relevant to psychiatric practice and patient care through Resource Documents. Since 1993, the APA has developed various positions and resource materials related to firearms and mental illness, incorporating evolving themes as new issues emerge. This paper reflects the APA's 2014 Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services.     

Counseling Multiple‐Heritage Couples

Multiple‐heritage couples are one of the fastest growing client populations in the United States. These partnerships are defined by intersecting ethnic, racial, linguistic, and religious differences. They are challenged by societal perceptions, stereotypes, and other pressures associated with being in a multiple‐heritage pairing. This article discusses strengths in the multiple‐heritage union brought about by the understanding of diverse viewpoints. Finally, the article identifies specific strategies, such as couples relationship education, to resolve and confront inherent differences. Las parejas multiculturales son uno de los grupos demográficos de clientes de mayor crecimiento en los Estados Unidos. Este tipo de parejas se define por la intersección de diferencias étnicas, raciales, lingüísticas y religiosas. Sus miembros enfrentan desafíos a causa de las percepciones sociales, los esterotipos y otras presiones asociadas con tener una pareja multicultural. Este artículo discute los puntos fuertes en una unión multicultural, facilitados por la comprensión de puntos de vista diversos. Finalmente, el artículo identifica estrategias específicas, como por ejemplo la educación en relaciones de pareja, para resolver y afrontar las diferencias intrínsecas.     

Relations between virtues and positive mental health in a Korean population: A Multiple Indicators Multiple Causes (MIMIC) model approach

A Multiple Indicators Multiple Causes (MIMIC) approach was applied to investigate the relationship between virtues and positive mental health as determined using the Character Strength Test and the Mental Health Continuum‐Short Form. The study participants were 876 college students (54% women; overall mean age [SD] 21.50 years [2.35]) recruited from introductory psychology courses at two universities in Seoul. Findings revealed that the intellectual virtues of college students predicted subjective well‐being according to all emotional, social and psychological measures. Results are discussed in the context of previous work using the Values in Action classification of virtues and character strengths. In addition, implications regarding understanding the nature and possible origins of positive mental health are outlined.     

Impulsive behaviour in interpersonal encounters: Associations with quarrelsomeness and agreeableness

Associations between impulsivity and interpersonal behaviours have rarely been examined, even though impulsivity may disrupt the flow of social interactions. For example, it is unknown to what extent the commonly used Barratt Impulsiveness Scale (BIS‐11) predicts impulsive behaviour in social situations, and how behaving impulsively during interpersonal encounters might influence levels of quarrelsomeness and agreeableness. In this study, 48 healthy working individuals completed the BIS‐11 and recorded their behaviour in social situations using event‐contingent recording. Record forms included items representing quarrelsome, agreeable, and impulsive behaviours. BIS‐11 motor impulsiveness scores predicted impulsive behaviour in social situations. Impulsive behaviour was associated, in different interactions, with both agreeableness and quarrelsomeness. Behaving impulsively in specific interactions was negatively associated with agreeableness in participants with higher BIS‐11 motor impulsiveness and positively associated with agreeableness in participants with lower BIS‐11 motor impulsiveness. Impulsive quarrelsome behaviour may cause interpersonal problems. Impulsive agreeable behaviour may have positive effects in individuals with low trait impulsivity. The idea that there are between‐person differences in the effects of state impulsivity on the flow of social interaction deserves further study.