Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective

The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in situations in which clients have presented information from other sources that is potentially discrepant with information given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly complex case is also analyzed and reflected on.     

Predictive Genetic Testing for Hereditary Breast and Ovarian Cancer: Psychological Distress and Illness Representations 1 Year Following Disclosure

This prospective study evaluates emotional functioning and illness representations in 68 unaffected women (34 carriers/34 noncarriers) 1 year after predictive testing for BRCA1/2 mutations when offered within a multidisciplinary approach. Carriers had higher subjective risk perception of breast cancer than noncarriers. Carriers who did not have prophylactic oophorectomy had the highest risk perception of ovarian cancer. No differences were found between carriers and noncarriers regarding perceived seriousness and perceived control of breast and ovarian cancer. Mean levels of distress were within normal ranges. Only few women showed an overall pattern of clinically elevated distress. Cancer-specific distress and state-anxiety significantly decreased in noncarriers from pre- to posttest while general distress remained about the same. There were no significant changes in distress in the group of carriers except for ovarian cancer distress which significantly decreased from pre- to posttest. Our study did not reveal adverse effects of predictive testing when offered in the context of a multidisciplinary approach.     

Construct validity of the Balloon Analog Risk Task (BART): associations with psychopathy and impulsivity

To continue research assessing the validity of the Balloon Analog Risk Task (BART) as a measure of risk taking, the BART was administered to a nonforensic sample of individuals with varying levels of psychopathic characteristics. Construct validity of the BART was evaluated by measuring risk-taking behavior in relation to self-reported psychopathy, anxiety, psychophysiological data, and demographic variables. Supporting the construct validity of the BART, while controlling for variance accounted for by interrelated variables in the context of hierarchical regression analyses, higher self-reported psychopathy was significantly predictive of increased risk taking on the BART. Findings also revealed interesting gender differences in self-reported psychopathy and a trend for men to engage in riskier behavior. Limitations and research directions are presented.     

Looking at the rope when looking for the snake: Conceptually mediated eye movements during spoken-word recognition

Participants’ eye movements to four objects displayed on a computer screen were monitored as the participants clicked on the object named in a spoken instruction. The display contained pictures of the referent (e.g., a snake), a competitor that shared features with the visual representation associated with the referent’s concept (e.g., a rope), and two distractor objects (e.g., a couch and an umbrella). As the first sounds of the referent’s name were heard, the participants were more likely to fixate the visual competitor than to fixate either of the distractor objects. Moreover, this effect was not modulated by the visual similarity between the referent and competitor pictures, independently estimated in a visual similarity rating task. Because the name of the visual competitor did not overlap with the phonetic input, eye movements reflected word-object matching at the level of lexically activated perceptual features and not merely at the level of preactivated sound forms.     

Influence of virtual reality training on the roadside crossing judgments of child pedestrians

The roadside crossing judgments of children aged 7, 9, and 11 years were assessed relative to controls before and after training with a computer-simulated traffic environment. Trained children crossed more quickly, and their estimated crossing times became better aligned with actual crossing times. They crossed more promptly, missed fewer safe opportunities to cross, accepted smaller traffic gaps without increasing the number of risky crossings, and showed better conceptual understanding of the factors to be considered when making crossing judgments. All age groups improved to the same extent, and there was no deterioration when children were retested 8 months later. The results are discussed in relation to theoretical arguments concerning the extent to which children's pedestrian judgments are amenable to training.     

Intuition and autism: a possible role for Von Economo neurons

Von Economo neurons (VENs) are a recently evolved cell type which may be involved in the fast intuitive assessment of complex situations. As such, they could be part of the circuitry supporting human social networks. We propose that the VENs relay an output of fronto-insular and anterior cingulate cortex to the parts of frontal and temporal cortex associated with theory-of-mind, where fast intuitions are melded with slower, deliberative judgments. The VENs emerge mainly after birth and increase in number until age 4 yrs. We propose that in autism spectrum disorders the VENs fail to develop normally, and that this failure might be partially responsible for the associated social disabilities that result from faulty intuition.     

Using criminalization and due process to reduce scientific misconduct

The issue of how to best minimize scientific misconduct remains a controversial topic among bioethicists, professors, policymakers, and attorneys. This paper suggests that harsher criminal sanctions against misconduct, better protections for whistleblowers, and the creation of due process standards for misconduct investigations are urgently needed. Although the causes of misconduct and estimates of problem remain varied, the literature suggests that scientific misconduct-fraud, fabrication, and plagiarism of scientific research-continues to damage public health and trust in science. Providing stricter criminal statutes against misconduct is necessary to motivate whistleblowers and deter wrongdoers, and the provision of basic due process protections is necessary for ensuring a fair and balanced misconduct investigation.     

Use of interactive voice response (IVR) technology in health research with children

This article reports on the feasibility of using interactive voice response (IVR) technology to obtain daily reports of attitudes toward alcohol and tobacco use among children 9–13 years of age. Two studies were conducted. The first was an investigation of the use of IVR technology to obtain daily data from a sample of primary school children over a period of 8 weeks. The second was an extension of the research to a large sample of primary and secondary school children in urban and rural areas who provided daily data over a 4-week period. Retention and compliance rates comparable to those obtained with adults were evident in both studies, supporting the feasibility of this technology with children. The results are discussed in relation to the benefits of this methodology for health research, particularly for studies of sensitive topics conducted with children and adolescents.     

A prospective examination of body image and smoking cessation in women

This study prospectively examined body image in a community sample of women smokers (N = 141, 89% European–American, M age = 39.5, M BMI = 25.5) participating in a 12-week randomized smoking cessation trial. Participants completed measures assessing subjective and perceptual aspects of body image. Regression analyses showed that subjective body image was predictive of smoking rate at the end of treatment. A MANCOVA revealed that perceptual body image (body size estimation) significantly predicted smoking cessation. Quitting smoking actually worsened body image, although these results were no longer significant after controlling for weight gain. Results support the theory that a negative body image may hamper cessation attempts. In addition, weight gain during smoking cessation may adversely impact body image and lead to an increased risk for relapse.