Development and Evaluation of a Decision Aid for BRCA Carriers with Breast Cancer

BRCA+ breast cancer patients face high risk for a second breast cancer and ovarian cancer. Helping these women decide among risk-reducing options requires effectively conveying complex, emotionally-laden, information. To support their decision-making needs, we developed a web-based decision aid (DA) as an adjunct to genetic counseling. Phase 1 used focus groups to determine decision-making needs. These findings and the Ottawa Decision Support Framework guided the DA development. Phase 2 involved nine focus groups of four stakeholder types (BRCA+ breast cancer patients, breast cancer advocates, and genetics and oncology professionals) to evaluate the DA's decision-making utility, information content, visual display, and implementation. Overall, feedback was very favorable about the DA, especially a values and preferences ranking-exercise and an output page displaying personalized responses. Stakeholders were divided as to whether the DA should be offered at-home versus only in a clinical setting. This well-received DA will be further tested to determine accessibility and effectiveness.     

Modulatory influence of dopamine receptors on consolidation of object recognition memory

The role of dopamine receptors in regulating the formation of recognition memory remains poorly understood. Here we show the effects of systemic administration of dopamine receptor agonists and antagonists on the formation of memory for novel object recognition in rats. In Experiment I, rats received an intraperitoneal (i.p.) injection of vehicle, the selective D1 receptor agonist SKF38393 (1.0 and 5.0mg/kg), or the D2 receptor agonist quinpirole (1.0 and 5.0mg/kg) immediately after training. In Experiment II, rats received an injection of vehicle, the dopamine receptor antagonist SCH23390 (0.1 and 0.05 mg/kg), or the D2 receptor antagonist raclopride (0.5 and 0.1mg/kg) before training, followed by an injection of vehicle or the nonselective dopamine receptor agonist apomorphine (0.05 mg/kg) immediately after training. SKF38393 at 5mg/kg produced an enhancement of novel object recognition memory measured at both 24 and 72 h after training, whereas the dose of 10mg/kg impaired 24-h retention. Posttraining administration of quinpirole did not affect 24-h retention. Apomorphine enhanced memory in rats given pretraining raclopride, suggesting that the effect was mediated by selective activation of D1 receptors. The results indicate that activation of D1 receptors can enhance recognition memory consolidation. Importantly, pharmacological activation of D1 receptors enhanced novel object recognition memory even under conditions in which control rats showed significant retention.     

Can Constructive Thinking Predict Decision Making?

We assume that executive function constitutes an integrated set of cognitive processes that mediate working memory, planning, inhibition, flexibility, and decision making. Despite the acknowledged theoretical connection between executive function processes and emotional intelligence, such relationships have rarely been investigated. The purpose of this study was to examine the potential relationship between constructive thinking, conceived as a component of emotional intelligence, and executive function, as indexed by various existing neuropsychological and experimental instruments. We used the Constructive Thinking Inventory as a measure of emotional intelligence. We found that some constructive thinking subscales were able to predict distinct executive function variables. Emotional Coping, Categorical Thinking, and Esoteric Thinking subscales explained performance on various measures of executive function. Thus, we conclude that intervention programs designed to train a specific component of emotional intelligence, namely constructive thinking, could also facilitate performance in executive function processes, and vice versa. Copyright © 2011 John Wiley & Sons, Ltd.     

The Prevalence of Spirituality, Optimism, Depression, and Fatalism in a Bi-ethnic Stroke Population

To provide insight into the reduced post-stroke all-cause mortality among Mexican Americans, we explored ethnic differences in the pre-stroke prevalence of (1) spirituality, (2) optimism, (3) depression, and (4) fatalism in a Mexican American and non-Hispanic white stroke population. The Brain Attack Surveillance in Corpus Christi (BASIC) project is a population-based stroke surveillance study in Nueces County, Texas. Seven hundred ten stroke patients were queried. For fatalism, optimism, and depression scales, unadjusted ethnic comparisons were made using linear regression models. Regression models were also used to explore how age and gender modify the ethnic associations after adjustment for education. For the categorical spirituality variables, ethnic comparisons were made using Fisher's exact tests. Mexican Americans reported significantly more spirituality than non-Hispanic whites. Among women, age modified the ethnic associations with pre-stroke depression and fatalism but not optimism. Mexican American women had more optimism than non-Hispanic white women. With age, Mexican American women had less depression and fatalism, while non-Hispanic white women had more fatalism and similar depression. Among men, after adjustment for education and age, there was no ethnic association with fatalism, depression, and optimism. Spirituality requires further study as a potential mediator of increased survival following stroke among Mexican Americans. Among women, evaluation of the role of optimism, depression, and fatalism as they relate to ethnic differences in post-stroke mortality should be explored.     

The Affective Temperaments: Differences between Adolescents in the Big Five Model and Cloninger’s Psychobiological Model of Personality

Positive (PA) and negative affect (NA) are indicators or markers of well-being that also reflect stable emotional- temperamental dispositions. In three different studies, self-reported affect was measured by the Positive Affect and Negative Affect Schedule (PANAS). The PANAS measures affect as two separate dimensions and was therefore used to generate four affective temperaments (AFTs): self-actualizing (high PA and Low NA), high affective (high PA and high NA), low affective (low PA and low NA), and self-destructive (low PA and high NA). The present set of studies investigated differences in personality between AFTs in an adolescent sample (N?=?398). Personality was measured by two different models: The Big Five and Cloninger’s psychobiological model. The interaction of PA and NA was expected to reveal differences and similarities in intrapersonal behavior measured by both models of personality. The results show that low NA adolescents reported lower levels of neurotic behavior than high NA adolescents. Nevertheless, despite the experience of high NA respectively, low PA, high and low affective reported higher Self-Directedness than self-destructive adolescents. Implications of the AFTs framework are discussed.     

La Vie en Rose: High Levels of Well-Being and Events Inside and Outside Autobiographical Memory

The present study examined adolescents’ interpretation and memory for stimuli inside and outside autobiographical memory in relation to high and low levels of Subjective (SWB) and Psychological Well-Being (PWB). Participants (69 high school pupils), identified as being either the 5 % upper or the 5 % lower scorers from 687 pupils who self-reported SWB and PWB, were asked to recall and list the most positive and negative life events during the past year. Words in a short story were used to assess events outside autobiographical memory. The high well-being groups remembered more positive than negative life events. Conversely to the other groups, the high PWB group interpreted positive and negative life events equally and had no preference for recognition of positive words. The number of words rated as positive predicted false recognition of positive words among the high well-being groups. Thus, suggesting important cognitive differences and similarities related to SWB and PWB.     

Breaking Confidentiality to Report Adolescent Risk-Taking Behavior by School Psychologists

School psychologists often break confidentiality if confronted with risky adolescent behavior. Members of the National Association of School Psychologists (N = 78) responded to a survey containing a vignette describing an adolescent engaging in risky behaviors and rated the degree to which it is ethical to break confidentiality for behaviors of varying frequency, intensity, and duration. Respondents generally found it ethical to break confidentiality when risky adolescent behaviors became more dangerous or potentially harmful, although there was considerable variability between respondents. Significant gender effects were found between male and female respondents for alcohol use, and a significant Form Type (i.e., male or female vignette) × Frequency/Duration interaction was observed for antisocial behaviors. School psychologists could benefit from further training in ethical decision making because these ethical dilemmas are not always clear-cut.     

Obstacle Crossing Differences Between Blind and Blindfolded Subjects After Haptic Exploration

Little is known about the ability of blind people to cross obstacles after they have explored haptically their size and position. Long-term absence of vision may affect spatial cognition in the blind while their extensive experience with the use of haptic information for guidance may lead to compensation strategies. Seven blind and 7 sighted participants (with vision available and blindfolded) walked along a flat pathway and crossed an obstacle after a haptic exploration. Blind and blindfolded subjects used different strategies to cross the obstacle. After the first 20 trials the blindfolded subjects reduced the distance between the foot and the obstacle at the toe-off instant, while the blind behaved as the subjects with full vision. Blind and blindfolded participants showed larger foot clearance than participants with vision. At foot landing the hip was more behind the foot in the blindfolded condition, while there were no differences between the blind and the vision conditions. For several parameters of the obstacle crossing task, blind people were more similar to subjects with full vision indicating that the blind subjects were able to compensate for the lack of vision.     

The superego and its vicissitudes in contemporary society

Assuming that psychic reality and social phenomena are two sides of the same social totality, this article attempts to discuss the building up of the concept of superego in the Freudian text emphasizing its social roots and the function it performs as the representative of the symbolic law. Critical turning points in the development of the concept are presented and possible theoretical consequences of Freud's argument in “Civilization and its Discontents” are questioned when considered against the background of our present society determined by globalization and consumption. The author concludes by suggesting that the contemporary superego may represent an erractic reaction against the conditions prevalent in the social realm. Thus it appears to be rather the heir to the initial state of helplessness than the result of a paternal identification. That could account for its role as the representative of the symbolic law.