Waiting for the next Shoe to Drop: The Experience of Parents of Children with Fanconi Anemia

Fanconi Anemia (FA) is a rare genetic disease that generally affects children and results in bone marrow failure requiring blood or marrow transplantation for survival. A unique feature of the condition is the long, often many years, waiting period between genetic diagnosis and treatment. This qualitative study looked at the lived experience of parents confronting their child’s diagnosis of FA. We aimed to describe factors which parents found helpful or detrimental during the waiting time period and to recommend strategies to support families who will have these experiences in the future. Categories that emerged were: parents’ emotional responses, thoughts about FA (which occurred daily for most parents), sources of stress, mechanisms of coping, family dynamics and responses that were supportive and non-supportive. We found that most parents experience stress, uncertainty, and active surveillance throughout the course of the illness. Healthcare professionals, and especially physicians, were agents of both the most and least supportive experiences of parents. Parents described family centered team care as helpful throughout the illness and health professional education as a priority need.     

Counseling Adolescents and the Challenges for Genetic Counselors

Genetic counselors may have an important role in helping the adolescent make an informed decision with regard to genetic testing and in helping them to adjust to genetic risk information. However, counseling techniques that are used with adults may not be always be suited to the adolescent population. Adolescence is a time of development during which separation from the family and formation of identity is achieved. The process of this development may impact the genetic counseling relationship. Family relationships may have a strong influence on the client's decision to have genetic testing. Additionally, it may be difficult to engage the client as adolescents may not have the ability to think abstractly and consider the short and long term consequences of genetic testing. It is helpful therefore to discuss the counseling process and techniques that may be useful when counseling these clients. This paper presents two case studies that illustrate some of the difficulties that may occur when counseling adolescents for genetic testing. The authors' have reflected on their clinical experience with these clients and this is presented here to add to the growing literature on this subject.     

From Survivor to Thriver: A Pilot Study of an Online Program for Rape Victims

Approximately 15% to 20% of women have been victims of rape and close to a third report current rape-related PTSD or clinically significant depression or anxiety. Unfortunately, very few distressed rape victims seek formal help. This suggests a need to develop alternative ways to assist the many distressed victims of sexual violence. Online treatment programs represent a potentially important alternative strategy for reaching such individuals. The current paper describes a pilot evaluation of an online, therapist-facilitated, self-paced cognitive behavioral program for rape victims. Five college women with current rape-related PTSD were recruited to complete the From Survivor to Thriver (S to T) program in a lab setting over the course of 7 weeks. After completing the program, 4 participants reported clinically significant reductions in PTSD symptoms and no longer met criteria for PTSD. All participants reported clinically significant reductions in vulnerability fears and 4 reported significant reductions in negative trauma-related cognitions. Implications of the results for further development of the S to T program and how clinicians could utilize this program in treating rape-related PTSD are discussed.     

Eye movements reveal rapid concurrent access to factual and counterfactual interpretations of the world

Imagining a counterfactual world using conditionals (e.g., If Joanne had remembered her umbrella . . .) is common in everyday language. However, such utterances are likely to involve fairly complex reasoning processes to represent both the explicit hypothetical conjecture and its implied factual meaning. Online research into these mechanisms has so far been limited. The present paper describes two eye movement studies that investigated the time-course with which comprehenders can set up and access factual inferences based on a realistic counterfactual context. Adult participants were eye-tracked while they read short narratives, in which a context sentence set up a counterfactual world (If . . . then . . .), and a subsequent critical sentence described an event that was either consistent or inconsistent with the implied factual world. A factual consistent condition (Because . . . then . . .) was included as a baseline of normal contextual integration. Results showed that within a counterfactual scenario, readers quickly inferred the implied factual meaning of the discourse. However, initial processing of the critical word led to clear, but distinct, anomaly detection responses for both contextually inconsistent and consistent conditions. These results provide evidence that readers can rapidly make a factual inference from a preceding counterfactual context, despite maintaining access to both counterfactual and factual interpretations of events.     

Evidence of automatic processing in sequence learning using process-dissociation

This paper proposes a way to apply process-dissociation to sequence learning in addition and extension to the approach used by Destrebecqz and Cleeremans (2001). Participants were trained on two sequences separated from each other by a short break. Following training, participants self-reported their knowledge of the sequences. A recognition test was then performed which required discrimination of two trained sequences, either under the instructions to call any sequence encountered in the experiment "old" (the inclusion condition), or only sequence fragments from one half of the experiment "old" (the exclusion condition). The recognition test elicited automatic and controlled process estimates using the process dissociation procedure, and suggested both processes were involved. Examining the underlying processes supporting performance may provide more information on the fundamental aspects of the implicit and explicit constructs than has been attainable through awareness testing.     

Concrete Construction Employees: When Does Procedural Fairness Shape Self‐Evaluations?1

According to the Group Value Model, group authorities and procedures communicate symbolic information to people about whether the group values or respects them. Employees for a concrete construction company completed a questionnaire about their work experiences in either English or Spanish. Among employees who identified more strongly with the concrete construction company, the quality of supervisor treatment predicted employees' feelings of respect and personal self-efficacy. Further, for employees who identified with the company, feeling respected by their colleagues mediated the relationship between fair treatment by a single supervisor and self-efficacy. Even when the working context encourages short term and instrumental goals, these results suggest that employees who identify with the company still care about fair treatment because of the self-relevant information it communicates to them.     

Effects of Directed Thinking on Intentions to Engage in Beneficial Activities: Idea Generation or Mental Simulation?

How might people best persuade themselves to engage in beneficial activities, such as dieting, exercise, and studying? One strategy is to think about actions. Another strategy is to think about reasons. In previous research, students who were directed to think about actions increased their study intentions more than did students who were directed to think about reasons. The present experiment tested whether thinking about actions was effective because of idea generation (coming up with the thoughts) or because of mental simulation (imagining the scenarios). In immediate and delayed measures, directed thinking about actions (but not reasons) proved generally more effective when students focused on mental simulation than when they focused on idea generation. Theoretical and applied implications are discussed.     

My Child Is Better Than Average: The Extension and Restriction of Unrealistic Optimism1

The purpose of the current study was to determine whether parents make unrealistic evaluations of children and what factors predict these evaluations. Parents of 5‐ and 6‐year‐olds rated their child's risk for various positive and negative outcomes, temperament, and health and behavior problems. Parents also completed an adult attachment measure. Parents appeared to give relatively little consideration to realistic constraints when predicting their child's future. Parents scoring higher on attachment avoidance were less optimistic that their child would attain positive outcomes and avoid negative outcomes, consistent with the view that optimism is a motivated phenomenon. Greater child internalizing behaviors also were associated with less parental optimism for positive outcomes. Findings have implications for the delivery of health messages to parents.