Who Is at Risk for Psychological Distress in Genetic Testing Programs for Hereditary Cancer Disorders?

Presymptomatic identification of disease gene carriers is becoming an increasingly common part of the clinical management of hereditary cancer disorders. With an expected increase in the number of requests for DNA testing and the limited resources for counseling, the amount of time genetic counselors are able to spend with test candidates will decrease. It is therefore important for counselors to identify persons at risk for psychological distress. Based on a review of experiences with Huntington disease and cancer patients, we describe factors likely to evoke distress in genetic cancer candidates. We also discuss the sometimes widely different ways that test candidates and their partners respond to genetic testing. By exploring risk factors for distress in relevant domains of the research, we can offer counselors guidelines for determining who may need extra counseling.     

Public good provision under environmental and social uncertainty

Social dilemmas face people with various kinds of uncertainty. To extend earlier research on environmental uncertainty in resource dilemmas (i.e. uncertainty about the resource size), the present experiment examines the effects of Environmental Uncertainty (low, high uncertainty about the provision point) and Social Uncertainty (low, high uncertainty about others' cooperation) in a public goods dilemma. In line with Social Comparison Theory, it was predicted and found that Environmental Uncertainty decreases cooperation only under High Social Uncertainty, but not under Low Social Uncertainty. The detrimental effects of Environmental Uncertainty can be counteracted by uncertainty reducing information on the provision point and/or on others' contributions as well. © 1998 John Wiley & Sons, Ltd.     

Habit,information acquisition,and the process of making travel mode choices

Three studies examined the role of habit on information acquisition concerning travel mode choices. On the basis of Triandis' (1980) model of attitude–behaviour relations it was expected that habit strength attenuates the elaborateness of choice processes. The studies focused on different phases in the choice process, namely the appreciation of situational cues and appreciation of choice option information. In line with expectations, it was found that, compared to weak habit participants, those who had a strong habit towards choosing a particular travel mode acquired less information and gave evidence of less elaborate choice strategies. It was attempted to break effects of habit by manipulating either accountability demands or level of attention. Although accountability demands raised the level of information acquisition, no interactions with habit were found. Enhanced attention to the choice process initially did override habit effects in a series of choice trials. However, in spite of this manipulation, chronic habit effects emerged during later trials. The results demonstrate the profound effects that habit may have on the appreciation of information about choice situations and choice options. ©1997 John Wiley & Sons, Ltd.     

To plan or not to plan? Goal achievement or interrupting the performance of mundane behaviors

The present experiment investigated cognitive and behavioral effects of planning (i.e. forming implementation intentions) on goal pursuit during the performance of mundane behaviors. Participants received the goal to collect a coupon halfway the hall from the lab to the cafeteria. Later, they were also given the task to go from the lab to the cafeteria. Thus participants had to attain a new goal by interrupting a mundane behavior. Some participants enriched their goal with implementation intentions, others did not. Results showed that participants who formed implementation intentions were more effective in goal pursuit than the control group. Importantly, the data suggest that the effects of planning on goal completion are mediated by a heightened mental accessibility of environmental cues related to the goal completion task. Copyright © 1999 John Wiley & Sons, Ltd.     

An alternating least squares method for the weighted approximation of a symmetric matrix

Bailey and Gower examined the least squares approximationC to a symmetric matrixB, when the squared discrepancies for diagonal elements receive specific nonunit weights. They focussed on mathematical properties of the optimalC, in constrained and unconstrained cases, rather than on how to obtainC for any givenB. In the present paper a computational solution is given for the case whereC is constrained to be positive semidefinite and of a fixed rankr or less. The solution is based on weakly constrained linear regression analysis.The authors are obliged to John C. Gower for stimulating this research.     

When sanctions fail to increase cooperation in social dilemmas: considering the presence of an alternative option to defect

Previous social dilemma research has shown that sanctioning defection may enhance cooperation. The authors argue that this finding may have resulted from restricting participants to two behaviors (cooperation and defection). In this article, the authors introduce the concept of a "social trilemma" (a social dilemma in which an alternative option to defect is present) and tested the effect of a sanction. The authors show that a sanction only increased cooperation and collective interests in the traditional social dilemma. In a social trilemma, the sanction failed because it caused some people to choose the alternative option to defect. Moreover, the results indicate that this was especially the case when people did not expect fellow group members to cooperate. In this case, the sanction even worked counterproductive because it decreased collective interests. It is concluded that allowing individuals to consider alternative options to defect can reveal the potential detrimental effects of sanctioning systems for the collective.     

Long-term retention of a theatrical script by repertory actors: the role of context.

Four actors were requested to perform Sartre's No Exit after a retention interval of more than 5 months. Their recall of the play was studied either with the spatial and visual contextual cues normally available during a performance or without such cues. Total recall was still considerable, equalling 85%. The number of paraphrases of, and inferences on, the original text was however quite large (32%), suggesting that the actors had learned their lines according to their meaning rather than as a result of rote memorisation. The context manipulation showed that actors' recall is facilitated by the availability of spatial-visual information, but only to a limited extent. The relative importance of textual and contextual cues in the long-term retention of a play is discussed.     

The hyperreality of clinical ethics: A unitary theory and hermeneutics

Medical ethics nowadays is dominated by a conception of ethics as the application of moral theories and principles. This conception is criticized for its depreciation of the internal morality of medical practice and its narrow view of external morality. This view reflects both a lack of interest in the empirical realities of medicine and a neglect of the socio-cultural value-contexts of medical ethical issues, including the creative development of a broader philosophical framework for a practicable medical ethics. Several alternative approaches and conceptions have been proposed. The unified clinical ethics theory, developed by Graber and Thomasma, is an interesting attempt to synthesize these alternative approaches. It correctly identifies as the crucial problem the present disconnectedness of medical ethics from theoretical philosophy as well as the practice of medicine. In this paper, however, it is argued that the unitary theory should take more serious attention to the hermeneutic character of medicine as well as ethics. This implies that the unitary theory must in fact transform itself into aninterpretive clinical ethics theory. The theoretical characteristics and practical consequences of an interpretive theory of medical ethics are discussed in the present paper.     

全球生命伦理学

探讨生命伦理学的起源,并阐述了不同理论支持者的观点,发现无论准确的生命伦理学历史起源是什么,目前生命伦理学已经变成了一种真正的全球现象。它在全世界具有重要的意义,因为人类不仅仅是欧洲人或亚洲人,也是世界公民和一个全球道德共同体的成员。生命伦理学对任何地方、任何人都是重要的,并不是因为它是"拿来"的,而是因为它提供了一个普遍的框架去解释和管理正在经历的变化,这个变化包括了目前所有的国家和文化。然而,这个框架的解释和应用必须依据本土环境。因此,现代生命伦理学具有全球性和本土特征的特点。