Ethical dilemmas in testing for late onset conditions: reactions to testing and perceived impact on other family members

This paper examines some of the ethical dilemmas that arise when testing for the late onset, untreatable condition of Huntington disease (HD) specifically now that technology allows us to test younger generations of the family for the mutant gene. Drawing on interview data from families with Huntington disease, the reactions to testing and perceived impact on other family members are considered. These are discussed in the light of the possible lowering of the age of test applicants. This potentially raises problems for a younger generation as they are confronted with reproductive decisions that the older generation did not have to face. It also means that individuals have the prospect of living with knowledge of a future illness for much longer.     

Fabry disease in genetic counseling practice: recommendations of the National Society of Genetic Counselors

The objective of this document is to provide health care professionals with recommendations for genetic counseling and testing of individuals with a suspected or confirmed diagnosis of Fabry disease, with a family history of Fabry disease, and those identified as female carriers of Fabry disease. These recommendations are the opinions of a multicenter working group of genetic counselors, medical geneticists, and other health professionals with expertise in Fabry disease counseling, as well as an individual with Fabry disease who is a founder of a Fabry disease patient advocacy group in the United States. The recommendations are U.S. Preventive Task Force Class III, and they are based on clinical experience, a review of pertinent English-language articles, and reports of expert committees. This document reviews the genetics of Fabry disease, the indications for genetic testing and interpretation of results, psychosocial considerations, and references for professional and patient resources. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a healthcare provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

The daily inventory of stressful events: an interview-based approach for measuring daily stressors

This study introduces the Daily Inventory of Stressful Events (DISE), an interview-based approach to the measurement of multiple aspects of daily stressors through daily telephone interviews. Using a U.S. national sample of adults aged 25 to 74 (N = 1,031), the prevalence as well as the affective and physical correlates of daily stressors are examined. Respondents had at least one daily stressor on 40 percent of the study days and multiple stressors on 11 percent of the study days. The most common class of stressors was interpersonal tension followed by work-related stressors for men and network stressors (events that occur to close others) for women. Stressors that involved danger of loss were more prevalent than stressors in which loss actually occurred. Regression analyses showed that specific types of daily stressors such as interpersonal tensions and network stressors were unique predictors of both health symptoms and mood.     

A conceptual model of cultural predictors of anxiety among Japanese American and part-Japanese American adolescents

A model integrating Japanese ethnicity, cultural identity, and anxiety was developed and assessed in Japanese American and part-Japanese American high school seniors (N = 141). Using measures from the Hawaiian High Schools Health Survey, the model incorporated the State-Trait Anxiety Inventory, the Major Life Events Scale, and the Japanese Culture Scale (JCS). Japanese American adolescents scored higher on the JCS and reported fewer anxiety symptoms than part-Japanese American adolescents. Predictors for anxiety were being Japanese American versus part-Japanese American, income, and culturally intensified events. A significant interaction of behavior by self-identification was obtained. The model had good overall fit, suggesting that cultural identity formation may contribute to anxiety experienced particularly by adolescents of mixed heritage.     

Psychological and family factors associated with suicidal ideation in pre-adolescents

To assess the psychological and family factors associated with suicidal ideation in pre-adolescent children, we studied a sample of 361 students, average age 9 years old. Two groups were formed, on the basis of the presence (n = 34) or absence (n = 44) of suicidal ideation. Suicidal ideation was assessed with the Children's Depression Inventory and the Children's Depression Rating Scale-Revised. Depression, hopelessness, self-esteem, and perceived family environment were compared in both the suicidal ideation and the control groups. Students with suicidal ideation generally presented greater depressive symptoms and hopelessness, and lower self-esteem and family expressiveness, although there were differences both between sexes, and when the variable depression was controlled. Identifying these risk factors in pre-adolescents may have an impact on prevention of suicidal behavior at higher risk ages.     

Review of quantity and types of spirituality research in three health care databases (1962-1999): implications for the health care ministry

Using computer technology to identify the term "spiritual," these researchers present results of the 2306 citations and compare five criteria discovered with research reported in four pastoral counseling journals. The authors note the limitations of such a search and the possible implications of the findings for health care ministry.     

From majority to minority and vice versa: the asymmetrical effects of losing and gaining majority position within a group

Two studies examined the effects of stable, partially changed, and completely changed majority and minority positions within a group on perception and evaluation of the group. It was hypothesized that loss of majority position (majority-to-minority change) would have stronger effects than gain of majority position (minority-to-majority change). The hypothesized asymmetrical effect was demonstrated in that loss of majority position decreased perception of group-self similarity, group attraction, and expectations for positive interactions with the group, whereas a corresponding gain of position did not increase them. Thus immediately following changes, the group is especially fragile because disintegrative forces created by the loss of majority position are stronger than integrative forces created by the gain of majority position.     

Cross-cultural evidence for the fundamental features of extraversion

Psychologists have not determined the defining characteristics of extraversion. In four studies, the authors tested the hypothesis that extraversion facets are linked by reward sensitivity. According to this hypothesis, only facets that reflect reward sensitivity should load on a higher order extraversion factor. This model was tested against a model in which sociability links the facets. The authors also tested the generalizability of the model in a diverse sample of participants from 39 nations, and they tested the model using widely used extraversion scales. Results of all studies indicate that only facets that reflect reward sensitivity load on a higher order extraversion factor and that this factor correlates strongly with pleasant affect. Although sociability is undoubtedly an important part of extraversion, these results suggest that extraverts' sociability may be a by-product of reward sensitivity, rather than the core feature of the trait.