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.     

Relationships among team ability composition, team mental models, and team performance

This study examined the relationship between the similarity and accuracy of team mental models and compared the extent to which each predicted team performance. The relationship between team ability composition and team mental models was also investigated. Eighty-three dyadic teams worked on a complex skill task in a 2-week training protocol. Results indicated that although similarity and accuracy of team mental models were significantly related, accuracy was a stronger predictor of team performance. In addition, team ability was more strongly related to the accuracy than to the similarity of team mental models and accuracy partially mediated the relationship between team ability and team performance, but similarity did not.     

Selective attention for masked and unmasked emotionally toned stimuli: Effects of trait anxiety,state anxiety,and test order

We investigated selective attention for masked and unmasked, threat, and positively valenced words, in high trait anxious (HTA) and low trait anxious (LTA) individuals using the emotional Stroop colour‐naming task. State anxiety was varied within participants through the threat of electric shock. To investigate whether the sequencing of the state anxiety manipulation affected colour‐naming latencies, the ordering of the shock threat and shock safe conditions was counterbalanced across participants. The results indicated that the ordering of the state anxiety manipulation moderated masked and unmasked threat bias effects. Specifically, relative to LTA individuals, HTA individuals showed a threat interference effect, but this effect was limited to those who performed under the threat of shock in the later stages of the experiment. Irrespective of exposure mode and state anxiety status, all individuals showed interference for threat in the early stages of the experiment, relative to a threat facilitation effect in the later stages of the experiment. For the unmasked trials alone, the data also revealed a significant threat interference effect for the HTA group relative to the LTA group in the shock threat condition, and this effect was evident irrespective of shock threat order. The results are discussed with respect to the automatic nature of emotional processing in anxiety.     

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.     

Urbanization and Changing Perceptions of Responsibilities Among African Fathers

This study examined the effect of urbanization on 102 South African fathers' perceptions of their paternal responsibilities. Fathers were categorized as rural, transitional, or urban on the basis of a standardized interval measure of urbanization. Perceptions of paternal responsibilities were rank-ordered into three basic anthropologically sequential categories: breadwinner, governor, and family. Results indicated that rural, transitional, and urban fathers all viewed breadwinner responsibilities as most important but that urbanization had a significant effect on fathers' perceptions of their responsibilities.     

The Anomalous Wellbeing of Disabled People: A Response

Disabled people frequently find themselves in situations where their quality of life and wellbeing is being measured or judged by others, whether in decisions about health care provision or assessments for social supports. Recent debates about wellbeing and how it might be assessed (through subjective and/or objective measures) have prompted a renewed focus on disabled people’s wellbeing because of its seemingly ‘anomalous’ nature; that is, whilst to external (objective) observers the wellbeing of disabled people appears poor, based on subjective assessments, people with disabilities report a good quality of life. In this paper, I examine an article by the philosopher Dan Moller in which he seeks to explain this ‘disability paradox’. Despite agreeing with his analysis that there is more to what people value than happiness, his explanation reflects some of the difficulties presented in philosophical accounts which seek to understand the lives of disabled people: this includes an analysis which fails to problematise definitions of wellbeing and who has the ‘voice’ to do the defining; which negates the multiple identities and subject positions that disabled people occupy; and which lacks recognition of the social contexts which mediate disabled people’s lives. I suggest that there is a need to incorporate disabled people’s voices into research which deepens our empirical knowledge about the relationship between impairment and wellbeing, including the social circumstances that shape disabled people’s agency.