A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

COMT genotype influences prefrontal response to emotional distraction

Early studies of genetic effects on brain activity have been conducted to investigate primarily either the influence of polymorphisms in dopaminergic genes, especially the catechol-O-methyltransferase (COMT) gene, on prefrontal cognitive processes such as working memory, or that of polymorphisms in the serotonin transporter gene on the amygdala response to threatening stimuli. Here, we address genetic influences on the neural systems underlying cognitive-affective interactions. Specifically, we assess the effect of the COMT val¹⁵⁸met polymorphism on frontal regulation of attention under emotional distraction. Healthy volunteers were scanned while performing a house-matching task with affectively negative versus neutral distractors. Effects of val allele load were examined on frontal regions associated with attentional control and emotion regulation, and on parahippocampal regions associated with perception of houses. As we predicted, val load correlated positively with activity in control- and task-related regions during performance under emotional distraction. These findings provide an initial step toward identifying genetic contributions to interindividual variability in recruitment of mechanisms that regulate affective processing.     

Exploring the effect of stress on mood, self-esteem, and daily habits with psychology graduate students

There are few empirical studies on the issues of psychology graduate students beyond dissertation research. Data from a sample of 65 psychology graduate students were analyzed to explore how stress relates to self-esteem, mood, and daily habits (eating, sleeping, smoking, exercise, and alcohol consumption). The results suggest that sleep patterns, exercise habits, and negative mood were significant correlates and predictors of stress. Findings prompt further investigation of the effects of the stress on psychology graduate students, which might aid in developing interventions leading to increased productivity, satisfaction, and global well-being for both graduate students and faculty.     

Is poor frequency modulation detection linked to literacy problems? A comparison of specific reading disability and mild to moderate sensorineural hearing loss

Specific reading disability (SRD) is now widely recognised as often being caused by phonological processing problems, affecting analysis of spoken as well as written language. According to one theoretical account, these phonological problems are due to low-level problems in auditory perception of dynamic acoustic cues. Evidence for this has come from studies showing poor discrimination of frequency-modulated from unmodulated tones. We measured frequency modulation detection limens (FMDLs) in 16 children with specific reading disability (SRD group), 16 children with mild to moderate hearing loss (SNH group) and 16 age-matched controls (CA group) aged 8-14. To obtain information about possible mechanisms used in frequency modulation detection, FMDLs were measured at modulation rates of 2 and 20 Hz, both in the absence and the presence of amplitude modulation, intended to force listeners to rely, if possible, upon phase-locking cues. Although both the SNH and SRD groups showed a trend for elevated FMDLs at both 2 and 20 Hz, these differences reached statistical significance for the SNH group alone. However, the SNH group had no evidence of literacy impairments. This study thus shows that impairments in perceiving dynamically modulated auditory stimuli do not necessarily lead to difficulty in learning to read.     

Possible knowledge of unknown truth

Fitch’s argument purports to show that for any unknown truth, p, there is an unknowable truth, namely, that p is true and unknown; for a contradiction follows from the assumption that it is possible to know that p is true and unknown. In earlier work I argued that there is a sense in which it is possible to know that p is true and unknown, from a counterfactual perspective; that is, there can be possible, non-actual knowledge, of the actual situation, that in that situation, p is true and unknown. Here I further elaborate that claim and respond to objections by Williamson, who argued that there cannot be non-trivial knowledge of this kind. I give conditions which suffice for such non-trivial counterfactual knowledge.     

The Relation between Individual and Group Conflicts in Psychotherapy

Abstract

I describe three constellations of group life and group process: resistance, rebellion, and refusal. In resistance, an individual or group remains antagonistic to conscious but not unconscious thinking, the latter manifested in derivatives, including symbol and symptom formation, transference–countertransference, and enactment. Rebellion functions on the level of conscious thinking, manifested in challenge, defiance, and the possibility of sociopolitical action. The basic premises and values of the group and/or leader are at the center of the controversy, to be addressed on that level. Refusal establishes a mental boundary between what is considered appropriate and inappropriate. Unconsciousaswellasconscious processes of feeling, thinking, and meaning making are refused entry, left undeveloped, rejected, or obstructed. Working with refusal requires appreciating how and why the mind and its thinking operations are being suspended. The theoretical framework is applied to a case example.