Evaluating the Impact of Genetic Counseling and Testing with Signal Detection Methods

One measure of the impact of genetic counseling and testing (GCT) is the extent to which it fosters behavioral change that is consistent with mutation status. We describe and illustrate how two different signal detection methods, receiver operating characteristic (ROC) analysis and recursive partitioning, can be used in this context to evaluate the impact of GCT. We analyzed real screening behavior data obtained in the 12 months following GCT for Hereditary Nonpolyposis Colon Cancer (HNPCC) using these two different signal detection approaches. Each approach demonstrated that GCT had an impact on behavioral outcomes, and was effective in fostering behavioral outcomes appropriate to mutation status. The ROC approach demonstrated that GCT was effective because mutation positive and mutation negative individuals could be distinguished on the basis of the number of recommended screening behaviors. The recursive partitioning approach demonstrated that GCT was effective because there were generally high rates of adherence to screening guidelines among subjects. The recursive partitioning technique also identified four subgroups of subjects, each with distinct characteristics, for which tailored interventions could be developed to increase rates of adherence to screening guidelines. Signal detection methods are easily implemented and are useful techniques for evaluating the impact of GCT.     

Classification of Antisocial Behaviors Along Severity and Frequency Parameters

Antisocial behaviors were systematically classified along a hierarchy of seriousness or severity that also accounted for frequency of occurrence and heterogeneity of behaviors. Items from the CD and ODD schedules of the NIMH DISC-IV and from the Elliot Delinquency Scales were listed at specified frequencies. Nine mental health clinicians rated the level of seriousness of each alternative on a scale from 0 (trivial) to 5 (very serious). Reliability of the ratings was assessed. Over two thirds of the items showed excellent agreement among the raters, 8% showed poor agreement and 21% showed fair to moderate agreement. The overall reliability of a single rater’s score was 0.56 and the reliability of the average was 0.84. The classification meets high psychometric standards for reliability and has face validity. The final output provides a classification along a spectrum that takes into account severity, frequency of occurrence during the previous year, and presence of multiple behaviors. It is useful for classification purposes and for longitudinal tracking of antisocial behavior.     

Evaluating Genetic Counseling: Client Expectations,Psychological Adjustment and Satisfaction with Service

Periodic evaluations of genetic counseling services are useful for determining the effectiveness of counseling in meetings its psycho-educational aims, as well as identifying where improvements to the service may be made. This study aimed to evaluate the genetic counseling services provided by Genetic Services of Western Australia (GSWA) to determine the impact of counseling on client expectations, satisfaction with the service, and psychological adjustment, defined as wellbeing and perceived personal control (PPC). A total of 122 clients participated in a self-administered survey conducted pre- and post-counseling. Client expectations of the service as a means of providing information were met, and opportunities for counselors to meet client’s expectations of psychological support were identified. Furthermore, counseling was found to maintain and enhance psychological wellbeing of clients. The role of counseling in facilitating the development of PPC was a key contributor to a high sense of satisfaction in clients.     

Integrated versus segregated accounting and the magnitude effect in temporal discounting

Temporal discounting rates in humans generally decrease as the amount of reward increases, a phenomenon known as themagnitude effect. In the present study, we examined whether temporal discounting and the magnitude effect are related to segregation of choices in terms of gains or losses for waiting for or expediting receipt of a reward. Subjects (N = 24) responded to a series of hypothetical choices about amounts of money available either immediately or after a delay. The immediate and delayed amounts either were presented as integrated amounts in the baseline condition or were segregated as differential gains or losses for choosing delayed or expedited consumption (delay and speedup conditions, respectively). Temporal discounting rates decreased in the segregated conditions, in accord with the standard discounted utility model but contrary to the hypothesis that the subjects were choosing on the basis of reward differentials in the baseline condition. The size of the magnitude effect was comparable in the baseline and the delay conditions but decreased in the speed-up condition. These results challenge explanations of the magnitude effect in terms of an increasing proportional sensitivity property of the utility function (Loewenstein & Prelec, 1992) and the hypothesis that subjects choose on the basis of differentials even when the rewards are presented as integrated amounts.     

Compatibility effects based on stimulus and response numerosity

Four choice reaction time experiments documented a stimulus-response (S-R) compatibility effect involving the numbers of stimuli and responses. In Experiment 1, the stimulus consisted of one or two tones, and the correct response was either one or two taps of a response key. Responses were much faster with a compatible S-R assignment, in which the number of taps matched the number of tones, than with an incompatible assignment in which these numbers mismatched. Experiments 2 and 3 replicated this effect, using visual stimuli and bimodal stimuli, respectively, suggesting that auditory/manual rhythmic compatibility is not essential to it. Experiment 4 showed that an analogous but smaller effect is obtained when stimuli are the digits 1 and 2. This new numerosity-based compatibility effect has general theoretical implications regarding the mechanisms responsible for compatibility effects and practical implications for interface design.     

Linguistically mediated visual search: The critical role of speech rate

Recent studies have shown that the presentation of concurrent linguistic context can lead to highly efficient performance in a standard conjunction search task by the induction of an incremental search strategy (Spivey, Tyler, Eberhard, & Tanenhaus, 2001). However, these findings were obtained under anomalously slow speech rate conditions. Accordingly, in the present study, the effects of concurrent linguistic context on visual search performance were compared when speech was recorded at both a normal rate and a slow rate. The findings provided clear evidence that the visual search benefit afforded by concurrent linguistic context was contingent on speech rate, with normal speech producing a smaller benefit. Overall, these findings have important implications for understanding how linguistic and visual processes interact in real time and suggest a disparity in the temporal resolution of speech comprehension and visual search processes.     

Attentional preparation based on temporal expectancy modulates processing at the perceptual level

Research that uses simple response time tasks and neuroimaging has emphasized that attentional preparation based on temporal expectancy modulates processing at motor levels. A novel approach was taken to study whether the temporal orienting of attention can also modulate perceptual processing. A temporal-cuing paradigm was used together with a rapid serial visual presentation procedure, in order to maximize the processing demands of perceptual analysis. Signal detection theory was applied in order to examine whether temporal orienting affects processes related to perceptual sensitivity or to response criterion (indexed byďand beta measures, respectively). If temporal orienting implies perceptual preparation, we would expect to observe an increase in perceptual sensitivity (ď) when a target appeared at expected, rather than unexpected, time intervals. Indeed, our behavioral results opened the possibility that focusing attention on time intervals not only enhances motor processing, as has been shown by previous research, but also might improve perceptual processing.     

Sequential task predictability in task switching

Many studies of task switching have found that a prolonged preparation time reduces switch costs. An alternative manipulation of task preparation is based on sequential task predictability, rather than preparation time. In Experiments 1 and 2 of the present study, participants performed explicitly instructed task sequences (i.e., AABB) and were then transferred to a random sequence. The observed benefit of predictability-based task preparation was not switch specific. In Experiment 3, the participants changed from random to predictable tasks. The observed predictability benefit again was not switch specific. The data thus suggest that task switching does not necessarily require a switch-specific reconfiguration process. Rather, task-specific control processes may be needed in both task switches and repetitions.     

Cross-cultural similarities and differences in North Americans’ geographic location judgments

We examined some potential causes of bias in geographic location estimates by comparing location estimates of North American cities made by Canadian, U.S., and Mexican university students. All three groups placed most Mexican cities near the equator, which implies that all e influenced by shared beliefs about the locationthree groups wers of geographical regions relative to global reference points. However, the groups divided North America into different regions and differed in the relative accuracy of the estimates within them, which implies that there was an influence of culture-specific knowledge. The data support a category-based system of plausible reasoning, in which biases in judgments are multiply determined, and underscore the utility of the estimation paradigm as a tool in cross-cultural cognitive research.