Identification of Individuals at Risk for Lynch Syndrome Using Targeted Evaluations and Genetic Testing: National Society of Genetic Counselors and the Collaborative Group of the Americas on Inherited Colorectal Cancer Joint Practice Guideline

Identifying individuals who have Lynch syndrome (LS) involves a complex diagnostic work up that includes taking a detailed family history and a combination of various genetic and immunohistochemical tests. The National Society of Genetic Counselors (NSGC) and the Collaborative Group of the Americas on Inherited Colorectal Cancer (CGA-ICC) have come together to publish this clinical practice testing guideline for the evaluation of LS. The purpose of this practice guideline is to provide guidance and a testing algorithm for LS as well as recommendations on when to offer testing. This guideline does not replace a consultation with a genetics professional. This guideline includes explanations in support of this and a summary of background data. While this guideline is not intended to serve as a review of LS, it includes a discussion of background information on LS, and cites a number of key publications which should be reviewed for a more in-depth understanding of LS. These guidelines are intended for genetic counselors, geneticists, gastroenterologists, surgeons, medical oncologists, obstetricians and gynecologists, nurses and other healthcare providers who evaluate patients for LS.     

Model selection and psychological theory: a discussion of the differences between the Akaike information criterion (AIC) and the Bayesian information criterion (BIC)

This article reviews the Akaike information criterion (AIC) and the Bayesian information criterion (BIC) in model selection and the appraisal of psychological theory. The focus is on latent variable models, given their growing use in theory testing and construction. Theoretical statistical results in regression are discussed, and more important issues are illustrated with novel simulations involving latent variable models including factor analysis, latent profile analysis, and factor mixture models. Asymptotically, the BIC is consistent, in that it will select the true model if, among other assumptions, the true model is among the candidate models considered. The AIC is not consistent under these circumstances. When the true model is not in the candidate model set the AIC is efficient, in that it will asymptotically choose whichever model minimizes the mean squared error of prediction/estimation. The BIC is not efficient under these circumstances. Unlike the BIC, the AIC also has a minimax property, in that it can minimize the maximum possible risk in finite sample sizes. In sum, the AIC and BIC have quite different properties that require different assumptions, and applied researchers and methodologists alike will benefit from improved understanding of the asymptotic and finite-sample behavior of these criteria. The ultimate decision to use the AIC or BIC depends on many factors, including the loss function employed, the study's methodological design, the substantive research question, and the notion of a true model and its applicability to the study at hand.     

False-belief understanding in 2.5-year-olds: evidence from two novel verbal spontaneous-response tasks

Recent research indicates that toddlers and infants succeed at various non-verbal spontaneous-response false-belief tasks; here we asked whether toddlers would also succeed at verbal spontaneous-response false-belief tasks that imposed significant linguistic demands. We tested 2.5-year-olds using two novel tasks: a preferential-looking task in which children listened to a false-belief story while looking at a picture book (with matching and non-matching pictures), and a violation-of-expectation task in which children watched an adult 'Subject' answer (correctly or incorrectly) a standard false-belief question. Positive results were obtained with both tasks, despite their linguistic demands. These results (1) support the distinction between spontaneous- and elicited-response tasks by showing that toddlers succeed at verbal false-belief tasks that do not require them to answer direct questions about agents' false beliefs, (2) reinforce claims of robust continuity in early false-belief understanding as assessed by spontaneous-response tasks, and (3) provide researchers with new experimental tasks for exploring early false-belief understanding in neurotypical and autistic populations.     

Cortical asymmetries in speech perception: what's wrong,what's right and what's left?

Over the past 30 years hemispheric asymmetries in speech perception have been construed within a domain-general framework, according to which preferential processing of speech is due to left-lateralized, non-linguistic acoustic sensitivities. A prominent version of this argument holds that the left temporal lobe selectively processes rapid/temporal information in sound. Acoustically, this is a poor characterization of speech and there has been little empirical support for a left-hemisphere selectivity for these cues. In sharp contrast, the right temporal lobe is demonstrably sensitive to specific acoustic properties. We suggest that acoustic accounts of speech sensitivities need to be informed by the nature of the speech signal and that a simple domain-general vs. domain-specific dichotomy may be incorrect.     

Approach motivation as incentive salience: perceptual sources of evidence in relation to positive word primes

Four experiments (total N = 391) examined predictions derived from a biologically based incentive salience theory of approach motivation. In all experiments, judgments indicative of enhanced perceptual salience were exaggerated in the context of positive, relative to neutral or negative, stimuli. In Experiments 1 and 2, positive words were judged to be of a larger size (Experiment 1) and led individuals to judge subsequently presented neutral objects as larger in size (Experiment 2). In Experiment 3, similar effects were observed in a mock subliminal presentation paradigm. In Experiment 4, positive word primes were perceived to have been presented for a longer duration of time, again relative to both neutral and negative word primes. Results are discussed in relation to theories of approach motivation, affective priming, and the motivation-perception interface.     

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

To Analyze or Not to Analyze: The Treatment of a Severely Disturbed Four-Year-Old Boy

This article summarizes the treatment of a severely disturbed four-year-old boy who represents the widening scope of child analysis—a boy whose exposure to an array of traumas undermined his ego development, distorted his object relations, and interfered with his developmental progression. Earlier generations of analysts would have viewed such a child as possessing too many ego deviations or deficits to be considered analyzable. Such traditional ideas about analyzability are at odds with more recent research, however. Thus, Fonagy's and Target's (1996 Fonagy, P.. and Target, M. 1996. Predictors of outcome in child psychoanalysis: A retrospective study of 763 cases at the Anna Freud centre. J. Amer. Psychoanal. Assn., 44: 27–77. [PubMed], [Web of Science ®] , [Google Scholar]) research found child analysis to be the optimal treatment for children with severe and complex psychopathology. This article presents analytic material that supports this research and demonstrates (1) that severely disturbed children are analyzable and capable of deep and meaningful change, (2) that early intervention is imperative, (3) that an analytic framework involving four or more sessions per week is essential in containing and regulating affect, (4) how functioning as a developmental object helps build the necessary mental structures to experience conflict, (5) that serving as a developmental object does not have to preclude the development of transference or a psychoanalytic process, and (6) that the analyst's gender can play an important role in promoting development and facilitating treatment.     

Doing as they would do: How the perceived ethical preferences of third-party beneficiaries impact ethical decision-making

Although unethical behavior often benefits third-parties not directly complicit in the misconduct, not all beneficiaries welcome these ill-gotten benefits. We investigate whether actors consider the ethical preferences of potential beneficiaries or rely solely on their own ethical predispositions when making decisions that affect others. Three studies demonstrate that the perceived ethical preferences of these beneficiaries can substantially influence the likelihood that actors behave unethically on their behalves. These studies show that actors consider the ethical preferences of beneficiaries only when their own ethical disposition is outcome-based.     

Screening for Psychopathy: Validation of the Psychopathic Personality Inventory-Short Form with Reference Scores

The current study reports validation results for the Psychopathic Personality Inventory (PPI) and its subscales, and for a newly developed PPI-Short Form (PPI-SF) in forensic and non-forensic populations. We also provide criterion reference scores for the PPI and the PPI-SF. In Study 1, we used PPI data from 1,065 participants and supplementary PCL-R data from a subsample of 91 forensic offenders. Mokken scale analysis was used to construct the PPI-SF. In Study 2, PPI-SF and PCL-R data were collected from 60 participants. The study yielded promising but preliminary support for the construct validity of the PPI and the PPI-SF. The PPI-SF is of interest for risk assessment because of its (a) strong relationship with the PCL-R total score and (b) subscales known for their predictive value for violence and criminal recidivism.