Genetic Counseling/Consultation in South-East Asia: A Report from the Workshop at the 10th Asia Pacific Conference on Human Genetics

This paper reports on the workshop ‘Genetic Counseling/Consultations in South-East Asia’ at the 10^th Asia Pacific Conference on Human Genetics in Kuala Lumpur, Malaysia, in December 2012. The workshop brought together professionals and language/communication scholars from South-East Asia, and the UK. The workshop aimed at addressing culture- and context-specific genetic counseling/consultation practices in South-East Asia. As a way of contextualizing genetic counseling/consultation in South-East Asia, we first offer an overview of communication-oriented research generally, drawing attention to consultation and counseling as part of a communicative continuum with distinctive interactional features. We then provide examples of genetic counseling/consultation research in Hong Kong. As other countries in South-East Asia have not yet embarked on communication-oriented empirical research, we report on the current practices of genetic counseling/consultation in these countries in order to identify similarities and differences as well as key obstacles that could be addressed through future research. Three issues emerged as ‘problematic’: language, religion and culture. We suggest that communication-oriented research can provide a starting point for evidence-based reflections on how to incorporate a counseling mentality in genetic consultation. To conclude, we discuss the need for creating a platform for targeted training of genetic counselors based on communication-oriented research findings.     

Psychosocial Predictors of Health Status and Health Care Costs among People with Fibromyalgia

The purpose of the present study was to examine the effects of psychosocial characteristics on health status and the relationship between health status and health care use and costs in a group of people with fibromyalgia (FMS) over a 1-year period. The participants were 600 members of a large health maintenance organization. Demographic characteristics (age, education, employment status, ethnicity and income), need variables (comorbid conditions and baseline health status), and psychosocial variables (self-efficacy, helplessness, coping, and depression) were examined. Better health status at baseline, use of emotion-focused coping, and higher self-efficacy predicted better health status the following year. Higher health care use at baseline, being Caucasian, being older, and having more co-morbid conditions predicted higher health care use at 1 year. Only health care costs at baseline predicted health care costs the following year. Our results indicate that health care use and cost tend to be stable. Intense interventions focused on changing patterns of health care use and methods for coping with the change need to be developed and tested.     

The Use of Early Recollections for Assessing Life Style and Diagnosing Psychopathology

Early Recollections (ER) were studied within the context of Adlerian theory. ER were obtained from 10 psychotics, 10 neurotics, and 10 normals. Three Adlerian clinicians wrote Life Style (LS) summaries on the basis of these ER. Matching LS summaries to ER records, these three Adlerians plus seven other clinicians (Freudian, eclectic, Adlerian) attained significant matching accuracy, several beyond the .0001 level of significance. LS formulations based on ER are thus shown to be reliably communicable to a wide range of professional workers. However, none of the five clinicians (three Adlerians and two eclectics) who made diagnoses of psychopathology on the. basis of the ER records were able to attain above chance accuracy of diagnosis. Results were interpreted within the framework of Adlerian theory.     

E-Therapy: Ethical Considerations of a Changing Healthcare Communication Environment

This paper outlines the current ethical guidelines for electronic therapy services, and the sufficiency and implications of these guidelines in a culturally diverse population as found in the United States. The paper limits the discussion of ethical deliberations to: what is considered adequate competency to practice mental health therapy electronically; the disclosure and identity verification requirements; confidentiality issues when different social norms exist; the social responsibility of public institutions or individuals; and issues that relate to miscommunication due to different cultural or educational backgrounds. It concludes that since E-Therapy helps to reach underserved populations and significantly reduces costs associated with mental health services, compliance with ethical guidelines must be enforced to benefit from the latest communication technologies. This paper is relevant for various professions related to psychology and psychotherapy, including pastors and pastoral counselors, because various forms of E-therapy are emerging in the 21st century and can serve as resources for “E-pastoral counseling.”     

Comparison of Dreams in Individual and Group Psychotherapy

This article gives specific reasons and evidence why group psychotherapy is the treatment of choice for addictions. Utilizing object relations theory and the self-psychology of Kohut, the authors present a model of group psychotherapy that combines these perspectives with those of Yalom's interactional group psychotherapy. Agreeing with Kohut and other object relation theorists, the authors view addiction as a condition that is the result of a person's misguided attempts at self-repair because of deficits in psychic structure. Vulnerability of self is the consequence of developmental failures and deprivation. Substance abuse only exacerbates this condition leading to exaggerated difficulty in regulation of affect, self-care, and characterological pathology. Abstinence is usually required as the first step in arresting this process and establishing a treatment regimen that will allow the vulnerabilities of the self to be altered and restored. This article suggests that this recovery and treatment process is best accomplished in a group therapy setting that is conducted within the guidelines of the principles of object relations theory and a modified version of Yalom's interactional group therapy format.     

Reconsidering Advertising Literacy as a Defense Against Advertising Effects

It is widely assumed that advertising literacy makes children less susceptible to advertising effects. However, empirical research does not provide convincing evidence for this view. In this article, we explain why advertising literacy as it is currently defined (i.e., conceptual knowledge of advertising) is not effective in reducing children's advertising susceptibility. Specifically, based on recent insights on children's advertising processing, we argue that due to the affect-based nature of contemporary advertising, children primarily process advertising under conditions of low elaboration and, consequently, are unlikely to use their advertising knowledge as a critical defense. Moreover, literature on cognitive development suggests that children's ability to use advertising knowledge as a defense will be further limited by their immature executive functioning and emotion regulation abilities. Therefore, we argue that the current conceptualization of advertising literacy needs to be extended with two dimensions: advertising literacy performance, which takes into account the actual use of conceptual advertising knowledge, and attitudinal advertising literacy, which includes low-effort, attitudinal mechanisms that can function as a defense under conditions of low elaboration. We conclude our article with specific directions for future research and implications for the ongoing societal and political debate about children and advertising.     

Subspace K-means clustering

To achieve an insightful clustering of multivariate data, we propose subspace K-means. Its central idea is to model the centroids and cluster residuals in reduced spaces, which allows for dealing with a wide range of cluster types and yields rich interpretations of the clusters. We review the existing related clustering methods, including deterministic, stochastic, and unsupervised learning approaches. To evaluate subspace K-means, we performed a comparative simulation study, in which we manipulated the overlap of subspaces, the between-cluster variance, and the error variance. The study shows that the subspace K-means algorithm is sensitive to local minima but that the problem can be reasonably dealt with by using partitions of various cluster procedures as a starting point for the algorithm. Subspace K-means performs very well in recovering the true clustering across all conditions considered and appears to be superior to its competitor methods: K-means, reduced K-means, factorial K-means, mixtures of factor analyzers (MFA), and MCLUST. The best competitor method, MFA, showed a performance similar to that of subspace K-means in easy conditions but deteriorated in more difficult ones. Using data from a study on parental behavior, we show that subspace K-means analysis provides a rich insight into the cluster characteristics, in terms of both the relative positions of the clusters (via the centroids) and the shape of the clusters (via the within-cluster residuals).     

Observational Context of Mother-Child Interaction: Impact of a stress Context on Emotional Availability

Previous studies have found that a stressful observational context challenges the mother-child relationship, thus highlighting negative interactive behavior. However, the impact of observational context has only been investigated in infants and preschoolers without specifically using the Emotional Availability Scales. Nor have they explored whether the association of mother-child interaction with children’s emotional or behavioral problems depends on the observational context. We observed 140 mothers and their five to 12-year-old children in non-stressful free play and in a stressful task context. In general, dyads showed higher emotional availability in the task context compared to the free play. Specifically, mothers showed higher levels of Sensitivity, Structuring and Nonhostility, but lower levels of Nonintrusiveness during the task compared to the free play context; children showed higher levels of Responsiveness during the task than during free play. After controlling for dyadic stress, contextual effects decreased for all dimensions of emotional availability. The association of mother-child interaction with child problem behavior depended on the observational context. Specifically, we found maternal emotional availability during free play to be more strongly associated with child problem behavior than during the stressful task; however, emotional availability of the child was more strongly associated with problem behavior when obtained during the task. We conclude that context impacts on mother-child interactive behavior and also on the association of mother-child-interaction and child behavior. Stress is a relevant contextual factor influencing mother-child interactive behavior.     

Screening for Eating Disorders in Undergraduate Women: Norms and Validity of the Spanish Version of the Eating Disorder Examination Questionnaire (EDE-Q)

The purpose of this investigation was to examine the internal consistency reliability and the convergent validity of the Spanish version of the Eating Disorder Examination Questionnaire (EDE-Q) and to provide EDE-Q norms for Spanish undergraduate women. Seven hundred eight college women, aged 18–30 years, volunteered to complete the EDE-Q, BSQ and EDI-2. Satisfactory internal consistency for the four subscales and the global score of the EDE-Q was obtained (Cronbach’s α ≥ .81). The EDI-2 Drive for Thinness and Body Dissatisfaction subscales and the BSQ global factor score correlated highly and positively with the corresponding EDE-Q subscales (r ≥ .72). Average scores, standard deviations and percentile ranks for the raw EDE-Q subscales and data on the occurrence of binge eating and compensatory behaviors are presented. Most of these values were lower than those found in other non-European developed countries. Results support the satisfactory internal consistency and convergent validity of the Spanish version of the EDE-Q. Lower scores in EDE-Q subscales suggest the need to study a lower cut-off point for clinical significance in Spanish college women. These data will help clinicians and researchers to interpret the EDE-Q scores of college women in Spain.     

Offener und verdeckter Narzissmus

Psychoanalytic theories and clinical practice refer to 2 types of narcissism which differ in the visibility of the narcissistic features: while overt narcissism is observable in open behaviour, covert narcissism is concealed behind an insecure appearance. This distinction was tested empirically by relating the two types of narcissism to self-esteem and the attachment dimensions avoidance and anxiety. Patients in a psychosomatic out-patient department (n=102) were examined with self-report measure. Overt narcissism is associated with a high, covert narcissism with a low self-esteem. Furthermore, while overt narcissism is not related to the attachment dimensions, covert narcissism is accompanied by high levels of attachment anxiety. The results support the theory that narcissism is divided into 2 subtypes which have different profiles in terms of self-esteem and attachment.