Incidental Findings from Clinical Genome-Wide Sequencing: A Review

There are several unresolved challenges associated with the clinical application of genome-wide sequencing technologies. One of the most discussed issues is incidental findings (IF), which are defined as discoveries made as a result of genetic testing that are unrelated to the indication for the test. The discussion surrounding IF began in the context of research, which we have used to frame consideration of IF in the clinical context. There is growing consensus that analytically valid and medically actionable IF should be offered to patients, but whether and to what extent clinicians should disclose other kinds of IF is debated. While others have systematically reviewed the literature concerning genetic IF, previous reviews focus on ethical and research-related issues and do not consider the implications for the genetic counseling profession specifically. This review discusses the practical considerations, ethical concerns and genetic counseling issues related to IF, with a particular focus on clinical genome-wide sequencing. To date, the bulk of the literature with respect to IF in the clinical context consists of commentaries, reviews and case reports. There is a need for more empirical studies to provide a foundation for institutional protocols and evidence-based clinical practice standards.     

Sex and Gender in the 1980s Heavy Metal Scene: Groupies,Musicians, and Fans Recall Their Experiences

Groupies, heavy metal musicians, and highly devoted fans (metalheads) were some of the most salient identity groups for teenagers and emerging adults in the 1980s—the tail end of the Baby Boom and the beginning of the newly emerging Generation X. Met with appalled reactions from conventional society, the heavy metal scene nevertheless appeared to help at least some disenchanted youth negotiate turbulent times. The present study of 144 middle-aged 1980s groupies, metal fans, and professional musicians used both quantitative and qualitative data to develop insights into the developmental processes of these emerging adults of the 1980s. Metalheads described their childhood experiences, including maltreatment, their sexual and substance use activities in the 1980s, identity issues, and reported on current indicators of adjustment, such as education, mental health, and happiness. The results confirm that youth involved in the metal scene had high rates of substance use, risky sexual behaviors, and especially for groupies, traumatic childhood experiences, as well as drug dependence and sexual violence during their groupie days. However, despite their trauma and risky behaviors, participants were able to thrive and develop healthy adult lives, from which they look back fondly on those 1980s experiences. The richness of these data provide insights into the search for identity for marginalized youth, and provide hypotheses for future research on the understudied developmental processes of such adolescent style cultures.     

Is Probabilistic Evidence a Source of Knowledge?

We report a series of experiments examining whether people ascribe knowledge for true beliefs based on probabilistic evidence. Participants were less likely to ascribe knowledge for beliefs based on probabilistic evidence than for beliefs based on perceptual evidence (Experiments 1 and 2A) or testimony providing causal information (Experiment 2B). Denial of knowledge for beliefs based on probabilistic evidence did not arise because participants viewed such beliefs as unjustified, nor because such beliefs leave open the possibility of error. These findings rule out traditional philosophical accounts for why probabilistic evidence does not produce knowledge. The experiments instead suggest that people deny knowledge because they distrust drawing conclusions about an individual based on reasoning about the population to which it belongs, a tendency previously identified by “judgment and decision making” researchers. Consistent with this, participants were more willing to ascribe knowledge for beliefs based on probabilistic evidence that is specific to a particular case (Experiments 3A and 3B).     

Destructive Women and the Men Who Can't Leave Them: Pathological Dependence or Pathological Omnipotence?

Clinicians have focused more on the troubling issue of women who are dominated and abused by men than they have on those occasions where men are abused by women. While usually not involving physical abuse, the destructiveness of some women, expressed in terms of harsh and destructive verbal and interpersonal behavior can be so striking and persistent that it should remain of interest to psychoanalysts. This clinical paper examines two examples of male patients who, while accomplished in many spheres of their lives, are nevertheless engaged in marriages to women whose hateful behavior toward them is impossible to deny. Despite considerable awareness of how much they are damaged by their wives, they are either unwilling or unable to utilize separation and divorce as tools to protect themselves, with the ultimate goal of starting life again free of the persecutory other. The dynamics involved for men stuck in such dyads are considered, including the possible negative role of a systems approach to couples' therapy that assumes mutual responsibility for the couples' dysfunction and distress.     

Artifacts and natural kinds: children's judgments about whether objects are owned

People's behavior in relation to objects depends on whether they are owned. But how do people judge whether objects are owned? We propose that people expect human-made objects (artifacts) to be more likely to be owned than naturally occurring objects (natural kinds), and we examine the development of these expectations in young children. Experiment 1 found that when shown pictures of familiar kinds of objects, 3-year-olds expected artifacts to be owned and inanimate natural kinds to be non-owned. In Experiments 2A and 2B, 3-6-year-olds likewise had different expectations about the ownership of unfamiliar artifacts and natural kinds. Children at all ages viewed unfamiliar natural kinds as non-owned, but children younger than 6 years of age only endorsed artifacts as owned at chance rates. In Experiment 3, children saw the same pictures but were also told whether objects were human-made. With this information provided, even 3-year-olds viewed unfamiliar artifacts as owned. Finally, in Experiment 4, 4- and 5-year-olds chose unfamiliar artifacts over natural kinds when judging which object in a pair belongs to a person, but not when judging which the person prefers. These experiments provide first evidence about how children judge whether objects are owned. In contrast to claims that children think about natural kinds as being similar to artifacts, the current findings reveal that children have differing expectations about whether they are owned.