Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Effectiveness of the Hamilton Anxiety Rating Scale with Older Generalized Anxiety Disorder Patients

To expand the collection of instruments available for assessment of anxiety in the elderly, this report examined the original and revised Hamilton anxiety scales in a sample of 50 older adults diagnosed with Generalized Anxiety Disorder (GAD) and 93 normal community participants (ages 55–82). Although the revised anxiety scale had better discriminant validity (lower correlation with the revised Hamilton depression scale) than the original anxiety and depression scales, a considerable amount of shared variance still existed (41% shared variance, GAD sample alone; 17% control sample alone; 74% shared variance, both samples combined). Near-perfect group classification was possible using 7 items from the original anxiety scale and 10 items from the revised anxiety scale. Results are discussed in light of their implications for use of the Hamilton anxiety rating scale with older anxiety-disordered patients.     

Peak Performance of Business Leaders: An Experience Parallel to Self-Actualization Theory

To investigate peak performance, 40 business leaders described personal experiences through interviews and the Privette Experience Questionnaire. In order to discriminate processes of peak performance from personality attributes of business leaders, their questionnaire data were compared with parallel data from a sample of 41 university men. Multivariate analyses of variance of factors and items and follow-up analyses indicated that scores differed but not on defining attributes. The peak performance dyad—full focus and clear sense of self—and aspects of peak experience—significance and fulfillment—were endorsed by both samples. Business leaders endorsed sociability and personal discipline and denied playfulness more than the university men, who endorsed fluidity. The relation of peak performance to self-actualization theory is discussed.     

Local and Global Sources of Control in Pigeon Delayed Matching-to-sample Performance

The present study employed a behavioural detection approach to investigate the combined effects of sample duration and sample presentation frequency on delayed matching accuracy of pigeons. Experiment 1 showed that when both samples were exposed at each of the two possible durations within a two-alternative, delayed matching session, discriminability was higher to the longer duration sample than to the short-duration sample, as found when sample duration is varied between sessions. Experiment 2's asymmetrical procedure increased bias toward the more frequent of the two samples but had no influence on discriminability. Initial discriminability was higher to samples exposed for longer durations, irrespective of stimulus presentation frequency. The results suggest qualitatively different effects of the two sources of stimulus control under consideration: Sample duration (a local or within-trial manipulation) exerted its effect on discrimination of the stimuli, whereas sample presentation frequence (a global factor) exerted its major effect on response bias. An interpretation of the data in terms of Blough's (1996) analysis of errors in matching tasks suggests that the amount of behaviour under control of the sample stimulus markedly changed with different sample durations. The analysis also showed that the biasing manipulation exerted most of its effect on the portion of behaviour outside of control by the critical stimulus. We argue that theoretical accounts of delayed matching performance need to consider both local and global factors as determinants of matching accuracy.     

Do interpersonal features of social anxiety influence the development of depressive symptoms?

This study is a prospective examination of possible interpersonal features of social anxiety that might predict increases in depressive symptoms. It was hypothesised that social anxiety would be associated with avoidance of expressing emotion, lack of assertion, and interpersonal dependency and that these dysfunctional interpersonal styles would predict depressive symptoms one year later while controlling for Time 1 depressive symptoms. One hundred and two undergraduates completed interview and self-report measures of these interpersonal styles in addition to measures of social anxiety and depressive symptoms. Results indicated that social anxiety was associated with all three interpersonal styles. However, only avoidance of expressing emotions predicted Time 2 depressive symptoms. Theoretical implications of these results are discussed.     

The Phenomenology of Rheumatology: Disability,Merleau‐Ponty,and the Fallacy of Maximal Grip

This paper charts the concepts of grip and the bodily auxiliary in Maurice Merleau‐Ponty to consider how they find expression in disability narratives. Arguing against the notion of “maximal grip” that some commentators have used to explicate intentionality in Merleau‐Ponty, I argue that grip in his texts functions instead as a compensatory effort to stave off uncertainty, lack of mastery, and ambiguity. Nearly without exception in Phenomenology of Perception, the mobilization of “grip” is a signal of impending loss, and is offered as a strategy for managing failure rather than as an example of sure‐footed mastery. I read Merleau‐Ponty alongside Mary Felstiner's Out of Joint: A Public and Private Story of Arthritis to explore these other, attenuated dimensions of grip. Finally, the paper turns to Harriet McBryde Johnson's memoir Too Late to Die Young as an example of a way of thinking disabled embodiment otherwise.     

Development of a measure of the experience of being bullied in youth

The Personal Experiences Checklist (PECK) was developed to provide a multidimensional assessment of a young person's personal experience of being bullied that covered the full range of bullying behaviors, including covert relational forms of bullying and cyber bullying. A sample of 647 school children were used to develop the scale, and a 2nd sample of 218 children completed the PECK and a battery of measures of bullying (including peer nomination), anxiety, depression, and self-esteem, to provide validity evidence. Test-retest reliability was assessed in a further sample of 78 students. Four factors emerged from a principal axis factoring consistent with the domains of relational-verbal bullying, cyber bullying, physical bullying, and bullying based on culture and were confirmed with confirmatory factor analysis. The data also supported a higher order bullying factor with direct effects on these 4 factors. All PECK scales showed good to excellent internal consistency (Cronbach's α range = .78-.91) and adequate test-retest reliability (range r = .61-.86). Most, but not all, expected relations were found with alternative methods of assessing bullying and measures of psychopathology. Taken together, the PECK provides a promising comprehensive and behaviorally focused dimensional measure of bullying.     

Treatment of PTSD in Older Adults: Do Cognitive-Behavioral Interventions Remain Viable?

The literature examining trauma among older adults is growing, but little is known about the efficacy of empirically supported interventions for PTSD within this population. Clinical writing on this topic often implies that cognitive-behavioral treatments may be ineffective or inappropriate for older adults with PTSD given physical and/or cognitive vulnerabilities. Review of the limited research in this area, however, provides little support for the claim that cognitive-behavioral interventions are ineffective in treating PTSD among the elderly. In an effort to explicate specific issues related to treatment process and outcome among older survivors of trauma, a case series is presented outlining the treatment of three older adults within the context of a structured, cognitive-behavioral group intervention. Observations from this case series suggests that cognitive-behavioral interventions continue to be useful in treating PTSD with this population. Specific treatment issues unique to older adults are explored and recommendations for future research are discussed.     

A Basic Bivariate Structure of Personality Attributes Evident Across Nine Languages

Here, two studies seek to characterize a parsimonious common‐denominator personality structure with optimal cross‐cultural replicability. Personality differences are observed in all human populations and cultures, but lexicons for personality attributes contain so many distinctions that parsimony is lacking. Models stipulating the most important attributes have been formulated by experts or by empirical studies drawing on experience in a very limited range of cultures. Factor analyses of personality lexicons of nine languages of diverse provenance (Chinese, Korean, Filipino, Turkish, Greek, Polish, Hungarian, Maasai, and Senoufo) were examined, and their common structure was compared to that of several prominent models in psychology. A parsimonious bivariate model showed evidence of substantial convergence and ubiquity across cultures. Analyses involving key markers of these dimensions in English indicate that they are broad dimensions involving the overlapping content of the interpersonal circumplex, models of communion and agency, and morality/warmth and competence. These “Big Two” dimensions—Social Self‐Regulation and Dynamism—provide a common‐denominator model involving the two most crucial axes of personality variation, ubiquitous across cultures. The Big Two might serve as an umbrella model serving to link diverse theoretical models and associated research literatures.