Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.     

Risk and Resistance Factors Associated with Paternal Adjustment to Obstetrical Brachial Plexus Injuries

This study aimed to identify risk and resistance factors associated with the psychological adjustment of fathers of children with obstetrical brachial plexus injuries (OBPI). Participants were 34 fathers of children with OBPI recruited from an Australian OBPI clinic. Measures completed were OBPI severity, disability related stress, family functioning and social support. Together the risk and resistance factors of severity and family functioning accounted for 28 % of the total variance in paternal psychological adjustment. Family functioning explained 12 % of the variance in psychological adjustment in addition to that explained by severity. These findings highlight the importance of considering paternal perceptions of OBPI severity and family functioning when providing health care to families of children with OBPI.     

The Rosenberg Self-Esteem Scale: A Bifactor Answer to a Two-Factor Question?

Despite its long-standing and widespread use, disagreement remains regarding the structure of the Rosenberg Self-Esteem Scale (RSES). In particular, concern remains regarding the degree to which the scale assesses self-esteem as a unidimensional or multidimensional (positive and negative self-esteem) construct. Using a sample of 3,862 high school students in the United Kingdom, 4 models were tested: (a) a unidimensional model, (b) a correlated 2-factor model in which the 2 latent variables are represented by positive and negative self-esteem, (c) a hierarchical model, and (d) a bifactor model. The totality of results including item loadings, goodness-of-fit indexes, reliability estimates, and correlations with self-efficacy measures all supported the bifactor model, suggesting that the 2 hypothesized factors are better understood as “grouping” factors rather than as representative of latent constructs. Accordingly, this study supports the unidimensionality of the RSES and the scoring of all 10 items to produce a global self-esteem score.     

Psychometric properties of an insomnia-specific measure of worry: the Anxiety and Preoccupation about Sleep Questionnaire

The aim of this study was to examine the psychometric properties of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), with a focus on factorial validity and internal consistency as well as discriminative, convergent, and association with sleep parameters and daytime impairment. Among a randomly selected sample from the general population (N = 5,000), 2,333 participants completed a survey on nighttime symptoms, daytime symptoms, health outcomes, and psychological processes. The study sample consisted of 1800 participants who did not fulfill criteria for another sleep disorder than insomnia. A two-factor solution, accounting for 70.7% of the variance, was extracted from the 10 APSQ items. One six-item factor determined worries about the consequences of poor sleep (α = .91); the second factor, with four items, assessed worries about the uncontrollability of sleep (α = .86). The two factors were significantly intercorrelated (ρ = .65) and significantly associated with the total APSQ (ρs = .97 and .76, respectively). The APSQ and the two subscales showed discriminant validity between three sleep status groups (normal sleep, poor sleep, and insomnia disorder; R(2) = .33-.41). The APSQ and the subscales demonstrated convergent validity with measures on cognitive arousal, sleep-related beliefs, anxiety, and depression. They also were significantly correlated with sleep parameters and daytime impairment. The findings suggest that the APSQ is a psychometrically sound instrument for assessing worry in insomnia.     

Anticipating Public Performance: Do Women Fear Appearing Intellectually Less Able?

Two ecologically valid studies involving anticipated public performance offer insight into women's tendencies to avoid placing their abilities under a spotlight. First, in an experimental study, women felt less comfortable than did men and experienced more personal risk when they anticipated that their test scores would be public. Second, in a naturalistic observational setting, students taking an experiential forensic psychology course were required to perform intellectually challenging activities in public. Women displayed more concern about the course requirements than did men, and subsequently dropped the course in disproportionate numbers. Higgins' (1997 ) regulatory focus theory provides a theoretical framework for interpreting the data.     

Phonological priming in adults who stutter

The purpose of this study was to compare the speed of phonological encoding between adults who stutter (AWS) and adults who do not stutter (ANS). Fifteen male AWS and 15 age- and gender-matched ANS participated in the study. Speech onset latency was obtained for both groups and stuttering frequency was calculated for AWS during three phonological priming tasks: (1) heterogeneous, during which the participants' single-word verbal responses differed phonemically; (2) C-homogeneous, during which the participants' response words shared the initial consonant; and (3) CV-homogeneous, during which the participants' response words shared the initial consonant and vowel. Response words containing the same C and CV patterns in the two homogeneous conditions served as phonological primes for one another, while the response words in the heterogeneous condition did not. During each task, the participants produced a verbal response after being visually presented with a semantically related cue word, with cue-response pairs being learned beforehand. The data showed that AWS had significantly longer speech onset latency when compared to ANS in all priming conditions, priming had a facilitating effect on word retrieval for both groups, and there was no significant change in stuttering frequency across the conditions for AWS. This suggests that phonological encoding may play no role, or only a minor role, in stuttering. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) describe previous research paradigms that have been used to assess phonological encoding in adults and children who stutter; (2) explain performance similarities and differences between adults who do and do not stutter during various phonological priming conditions; (3) compare the present findings to past research that examined the relationship between phonological encoding and stuttering.     

Neural adaptation across viewpoint and exemplar in fusiform cortex

The visual system has the remarkable ability to generalize across different viewpoints and exemplars to recognize abstract categories of objects, and to discriminate between different viewpoints and exemplars to recognize specific instances of particular objects. Behavioral experiments indicate the critical role of the right hemisphere in specific-viewpoint and -exemplar visual form processing and the left hemisphere in abstract-viewpoint and -exemplar visual form processing. Neuroimaging studies indicate the role of fusiform cortex in these processes, however results conflict in their support of the behavioral findings. We investigated this inconsistency in the present study by examining adaptation across viewpoint and exemplar changes in the functionally defined fusiform face area (FFA) and in fusiform regions exhibiting adaptation. Subjects were adapted to particular views of common objects and then tested with objects appearing in four critical conditions: same-exemplar, same-viewpoint adapted, same-exemplar, different-viewpoint adapted, different-exemplar adapted, and not adapted. In line with previous results, the FFA demonstrated a release from neural adaptation for repeated different viewpoints and exemplars of an object. In contrast to previous work, a (non-FFA) right medial fusiform area also demonstrated a release from neural adaptation for repeated different viewpoints and exemplars of an object. Finally, a left lateral fusiform area demonstrated neural adaptation for repeated different viewpoints, but not exemplars, of an object. Test-phase task demands did not affect adaptation in these regions. Together, results suggest that dissociable neural subsystems in fusiform cortex support the specific identification of a particular object and the abstract recognition of that object observed from a different viewpoint. In addition, results suggest that areas within fusiform cortex do not support abstract recognition of different exemplars of objects within a category.