Information Processing in the Context of Genetic Risk: Implications for Genetic-Risk Communication

Communicating genetic-risk information is fraught with difficulties, and there are no universally accepted guidelines for clinical practice. In this paper, we suggest that information-processing models may offer some guidance for the communication of genetic risk. The paper reviews selected literature from health and social psychology, including defensive reactions to threatening health information, the Extended Parallel Process Model (EPPM) and Self Affirmation Theory. Ultimately, it presents the Heuristic-Systematic Model (HSM) of information processing as a useful perspective from which to view genetic-risk communication. Through our review of this literature, we identify some of the variables found to influence the systematic or heuristic processing of risk information and note their relevance to genetic counseling contexts. We suggest that systematic information processing is conducive to informed decision-making, as well as improved understanding of risk information. Clinical practice implications derived from our review of these literatures are noted.     

Familiarization effects for bilingual letter detection involving translation or exact text repetition.

In two experiments, English-Spanish bilinguals read passages, performing letter detection on some passages by circling target letters as they read. Detection passages were sometimes familiarized (primed) by prior reading of the same passage or a translation of it. Participants detected letters in English passages in Experiment 1 and in Spanish passages in Experiment 2. For both experiments, a missing letter effect occurred (depressed detection accuracy on frequent function words relative to less frequent content words). Familiarization promoted overall improvements in letter detection only for English passages, suggesting that reprocessing benefits depend on high language fluency. For Spanish passages, cognates engendered greater error rates than noncognates; the visual similarity of Spanish and English cognates apparently enabled faster identification of Spanish cognates in a way unaffected by familiarization of the whole text passage. Priming by familiarized text was significantly higher when the passages were in the same language than when they were in different languages, suggesting that the reprocessing benefits are at the word level instead of the semantic level. These results are consistent with the GO model of reading (Greenberg, Healy, Koriat, & Kreiner, 2004) but require an expanded consideration of attention redistribution processes in that model.     

Mind over matter: cognitive - behavioral determinants of emotional distress in multiple sclerosis patients

Given the high incidence and unique symptomatology of depression in multiple sclerosis (MS) patients, the current study examined the role of cognitive and behavioral variables in predicting psychosocial adjustment in this population, in order to suggest psychotherapeutic interventions tailored specifically to MS patients. Data from 329 MS patients indicated that problem solving coping, acceptance coping, and challenge appraisals were associated with positive psychological adjustment (i.e., high life satisfaction, low depression and anxiety), whereas variables measuring disease severity (i.e., illness duration, subjective health status, and self-reported disability) were not associated with adjustment. These findings suggest that MS patients' psychological outcomes are more related to controllable cognitive and behavioral factors than to the physical effects of the disease. Consequently, it is expected that interventions that target these specific coping strategies and cognitive appraisals will be effective in treating the emotional effects of MS.     

School readiness and later achievement

Using 6 longitudinal data sets, the authors estimate links between three key elements of school readiness--school-entry academic, attention, and socioemotional skills--and later school reading and math achievement. In an effort to isolate the effects of these school-entry skills, the authors ensured that most of their regression models control for cognitive, attention, and socioemotional skills measured prior to school entry, as well as a host of family background measures. Across all 6 studies, the strongest predictors of later achievement are school-entry math, reading, and attention skills. A meta-analysis of the results shows that early math skills have the greatest predictive power, followed by reading and then attention skills. By contrast, measures of socioemotional behaviors, including internalizing and externalizing problems and social skills, were generally insignificant predictors of later academic performance, even among children with relatively high levels of problem behavior. Patterns of association were similar for boys and girls and for children from high and low socioeconomic backgrounds.     

Novel Labels Increase Category Coherence,But Only When People Have the Goal to Coordinate

From infancy, we recognize that labels denote category membership and help us to identify the critical features that objects within a category share. Labels not only reflect how we categorize, but also allow us to communicate and share categories with others. Given the special status of labels as markers of category membership, do novel labels (i.e., non‐words) affect the way in which adults select dimensions for categorization in unsupervised settings? Additionally, is the purpose of this effect primarily coordinative (i.e., do labels promote shared understanding of how we categorize objects)? To address this, we conducted two experiments in which participants individually categorized images of mountains with or without novel labels, and with or without a goal of coordination, within a non‐communicative paradigm. People who sorted items with novel labels had more similar categories than people who sorted without labels only when they were told that their categories should make sense to other people, and not otherwise. We argue that sorters' goals determine whether novel labels promote the development of socially coherent categories.     

Next Generation Sequencing is the Impetus for the Next Generation of Laboratory-Based Genetic Counselors

Next generation sequencing (NGS) is dramatically increasing the number of clinically available genetic tests and thus the number of patients in which such testing may be indicated. The complex nature and volume of the reported results requires professional interpretation of the testing in order to translate and synthesize the meaning and potential benefit to patients, and genetic counselors are uniquely suited to provide this service. The increased need for genetic counselors in this role, coupled with the time required and a limited number of trained and available counselors presents a challenge to current models for making genetic testing available to patients and their healthcare providers effectively and efficiently. The employment of genetic counselors at genetic/genomic laboratories is one model to expand the resources for providing this service. In this article, we briefly review the advent of NGS and its clinical applications, examine the core skills of genetic counselors and delineate the expanding roles and responsibilities of laboratory-based genetic counselors. We also propose changes to the genetic counseling training program curriculum to account for the increasing opportunities for genetic counselors to contribute and thrive within genetic testing laboratories.     

More than just child’s play: symbolic expressions of illness and spirit

While spiritual well-being is integral to health, little is known about the spiritual lives of children in the context of illness. Because the spiritual is often a hidden domain of life, exploration of the topic can be challenging, especially when dealing with children. Language is not always sufficient for describing such deeply held experiences, even for adults. Therefore, finding creative ways to elicit experiences of the spiritual is important when attempting to gain a more robust understanding of this phenomenon. Drawing from a larger study that used hermeneutic phenomenology to explore spirituality among ill children, this paper provides an interpretation of ill children’s play experiences and describes how these experiences provide a means of uncovering the spiritual in children’s everyday lives as they cope with life-threatening illness. Findings also provide insight into how play can be used in the promotion of spiritual well-being.