Psychological models in predicting uptake of prenatal screening

Abstract

The purpose of the current study was to determine which psychological models are most useful in predicting uptake of a prenatal screening test, maternal-serum alphafetoprotein screening for spina bifida and Down's syndrome. 1000 women eligible for the test completed standardised self-report questionnaires at two routine clinic visits to an antenatal clinic prior to the time when the test could take place. 902 underwent the screening test; 51 declined the test; and 47 did not undergo the test, giving no reason for this to staff. Knowledge of the test, the subjective expected utility attached to the test, and attitudes to doctors and medicine were all significant predictors of uptake behaviour. Results of a discriminant function analysis demonstrated distinct psychological processes underlying each of these three uptake behaviours, explaining 21% of the variance in uptake of screening. If uptake of screening is examined not as a dichotomous variable but as a group of behaviours, predictive models are identified accordingly. This would lead to rnodels of health-related behaviours as a heterogeneous rather than homogeneous phenomena, predicted and influenced by different causes.     

Modelling decisions to undergo genetic testing for susceptibility to common health conditions: An ancillary study of the Multiplex Initiative

New genetic tests reveal risks for multiple conditions simultaneously, although little is understood about the psychological factors that affect testing uptake. We assessed a conceptual model called the multiplex genetic testing model (MGTM) using structural equation modelling. The MGTM delineates worry, perceived severity, perceived risk, response efficacy and attitudes towards testing as predictors of intentions and behaviour. Participants were 270 healthy insured adults aged 25–40 from the Multiplex Initiative conducted within a health care system in Detroit, MI, USA. Participants were offered a genetic test that assessed risk for eight common health conditions. Confirmatory factor analysis revealed that worry, perceived risk and severity clustered into two disease domains: cancer or metabolic conditions. Only perceived severity of metabolic conditions was correlated with general response efficacy (β?=?0.13, p<0.05), which predicted general attitudes towards testing (β?=?0.24, p<0.01). Consistent with our hypothesised model, attitudes towards testing were the strongest predictors of intentions to undergo testing (β?=?0.49, p<0.01), which in turn predicted testing uptake (OR 17.7, β?=?0.97, p<0.01). The MGTM explained a striking 48% of the variance in intentions and 94% of the variation in uptake. These findings support use of the MGTM to explain psychological predictors of testing for multiple health conditions.     

Executive Functions in Preschool Children Born Preterm: Application of Cognitive Neuroscience Paradigms

Although children born preterm are at risk for neuropsychological impairments at school age and adolescence, including difficulties with visual motor integration, spatial/constructional skills, attention, arithmetic, and nonverbal executive functions, specific neuropsychological outcome has not been investigated adequately in preschoolers. Application of cognitive neuroscience tasks offers the opportunity to characterize early executive functions in young children born preterm. In a preliminary sample of 29 preschool children born preterm (M birth gestational age = 32.4 weeks), executive function outcome was compared to that of fullterm controls by contrasting performance on two prototypic delayed-response-type paradigms, Delayed Alternation and Spatial Reversal. Preschoolers born preterm correctly retrieved the reward on fewer trials on Delayed Alternation than did matched controls. Furthermore, preschool children born preterm used problem-solving strategies that included more perseverative errors than controls. These preliminary findings highlight the utility of cognitive neuroscience paradigms to understand neuropsychological outcome in preschool children born preterm and suggest areas of developmental vulnerability that may include dorsolateral prefrontal circuits.     

Prevalence and correlates of suicidal behavior among adult female victims of intimate partner violence

The prevalence and correlates of suicidal threats and attempts among 662 racially and ethnically diverse adult female victims of intimate partner violence (IPV) were studied. One in five women had threatened or attempted suicide during her lifetime. They observed that multiple logistic regression results indicated that women at greater risk of severe or potentially lethal assaults as measured by the Danger Assessment and those who reported having a chronic or disabling illness were more likely to have threatened or attempted suicide. A linear association was found between age and suicide threats/attempts, with younger women having increased odds. Finally, African American IPV victims were less likely to have threatened or attempted suicide as compared to Latina victims. Study implications are discussed.     

The midwife case: Do they “walk the talk”?

Expertise depends on hours and hours of practice within a field before a state of proficiency is achieved. Normally, expert skills involve bodily knowledge associated to the practices of a field. Interactional expertise, i.e. the ability to talk competently about the field, however, is not causally dependent on bodily proficiency. Instead, interactional experts are verbally skilled to an extent that makes them impossible to distinguish from so-called contributory experts, the experienced practitioners. The concept of interactional expertise defines linguistic skills as contingent on bodily knowledge. However, recent neuropsychological findings make it plausible that “first-person”-related neural activations would be relevant with respect to the subjects' verbal output, at least when subjects address concepts that refer to tangible objects. Using imitation games, we explore and expand on the apparently arbitrary relation between bodily experiences and linguistic skills in midwifery. In alignment with several findings within grounded cognition studies, the results presented suggest that somehow personal experiences make a linguistic difference, noticeable to contributory experts.     

Perceptions of morality and competence in (non)interdependent games

Individuals’ actions and their stated beliefs affect how others perceive them. In a prisoner’s dilemma, a defector who expects others to cooperate is perceived as less moral than a defector who expects others to defect; a cooperator who expects others to defect is perceived as less competent than a cooperator who expects others to cooperate (Experiment 1). This pattern suggests that in a context of interdependence, a stated expectation that the behavior of others will resemble one’s own may protect one’s social reputation. When outcomes are not interdependent, expectations do not moderate the effects of behavior on reputation (Experiment 2). In such a context, inductive reasoning is sufficient to explain social projection. Both types of results are replicated in a modified N-person social dilemma (Experiment 3), further validating the inductive-reasoning hypothesis.     

Scale validation via quantifying item validity using the Dm index

While most validity indices are based on total test scores, this paper describes a method for quantifying the construct validity of items. The approach is based on the item selection technique originally described by Piazza in 1980. Unfortunately, Piazza's P2 index suffers from some substantial limitations. The Dm coefficient provides an alternative which can be used for item selection and provides a validity index for a set of items. The index is similar to that of traditional criterion-related validity indices. Criterion-related validity is used to demonstrate the accuracy of hypothesized relations of the measure with outcome variables of interest in research and practice. This method may be useful when the sample of items or persons is small, rendering more traditional approaches such as factor analysis or item response theory inappropriate. An example of how to use the technique is provided.     

Perspective taking and prejudice reduction: the mediational role of empathy arousal and situational attributions

This research was designed to examine whether perspective taking promotes improved intergroup attitudes regardless of the extent that stereotypic perceptions of outgroups are endorsed, as well as examining the mechanisms (attributional or empathy related) by which perspective taking motivates improved intergroup attitudes. Participants were presented with an interview segment where an African American interviewee discussed the difficulties experienced as a result of his membership in a negatively stereotyped group. Materials were presented in a 2 (perspective taking: other focused or objective focused) × 2 (target stereotypicality: confirming or disconfirming) between participants design. Findings revealed that the manipulation of target stereotypicality influenced subsequent stereotype endorsement; those exposed to a stereotype confirming target later endorsed more stereotypic perceptions of African Americans than did those exposed to a stereotype disconfirming target. However, perspective taking promoted improved intergroup attitudes irrespective of stereotypicality; those encouraged to adopt the perspective of the target later reported more favourable intergroup attitudes than did those who remained detached and objective listeners. Whereas empathy partially mediated the relation between perspective taking and intergroup attitudes, situational attributions were a stronger and more reliable mediator. Copyright © 2003 John Wiley & Sons, Ltd.     

Doing It Differently: Unleashing Student Creativity

Student assignments and assessment – is there life beyond the ten‐page essay? Drawing on the theory of multiple intelligences and experience with an assignment in which students were asked to address course content in anything but an essay, the author considers the challenges and virtues of a creative format that does not rely exclusively on linguistic intelligence. The process, presentations, and evaluative approach employed in an assignment that called upon student creativity in a “Women and the Bible” course are described, and pedagogical and practical considerations explored. The analysis of a particularly memorable student submission reveals layers of complexity seldom achieved in a conventional essay format.     

Perceptions and Punishments of Workplace Aggression: The Role of Aggression Content,Context, and Perceiver Variables1

Aggressiveness and sanctioning ratings made by 360 undergraduates to scenarios of workplace aggression suggest that aggressor gender, occupational status of aggressor relative to the target of aggression, and type of aggression content (i.e., hostility, obstructionism, or overt) affected these ratings. The results support hypothesized main effects for aggression content and aggressor gender, and also a significant interaction between occupational status and aggressor gender. However, the results failed to confirm hypotheses that perceiver variables (e.g., trait aggression) would add significantly to the prediction of either aggressiveness ratings or sanctioning ratings. Implications for policy formation to manage aggressive individuals in organizations are discussed.