Parkinson’s Disease: Patients’ Knowledge,Attitudes, and Interest in Genetic Counseling

The objective of this study was to assess the genetics knowledge of patients with Parkinson’s disease (PD), and to explore their attitudes on genetic testing and interest in genetic counseling. We surveyed 158 patients from the University of Maryland Parkinson’s Disease and Movement Disorders Center. Patients averaged a score of 63% on general genetics knowledge and 73% on PD genetics knowledge. Participants had an overall positive attitude toward genetic testing: 80% believed that the use of genetic tests among people should be promoted, and 83% would undertake genetic test for PD if it was available. Patients reported a high interest to discuss the benefits, risks, and impacts of genetic testing for PD (mean sum score?=?26, range?=?9–35), and 43% patients expressed interest in meeting with a genetic counselor. Multivariate regression analysis showed that patients who had more positive attitudes toward genetic testing for PD were more interested in meeting with a genetic counselor (β?=?0.6, p?<?0.001). This study is the first to demonstrate an interest in genetic counseling among patients with PD. Our findings demonstrate a new niche for genetic counselors to support patients in clarifying gaps or misconceptions in knowledge about PD genetics as well as the possible risks, benefits, and limitations of genetic testing.     

Finding a Balance: Reconciling the Needs of the Institution,Patient, and Genetic Counselor for Optimal Resource Utilization

The current practice of cancer genetic counseling is undergoing widespread change and scrutiny. While there are clinical resources for genetic counselors (GCs) regarding the delivery of cancer genetic services, there is limited literature regarding effective management of a genetic counseling clinical program. We have developed administrative tools to manage a large team of GCs at a single academic medical center over a period of increasing demand for genetics services, with the initial aim of decreasing wait time for urgent genetic counseling visits. Here, we describe the three main elements of the clinical operations: Balancing patient volume between GCs, scheduling tracks for both routine and urgent appointments, and a team of triaging GCs to ensure appropriate patient referrals. For each of these elements, we describe how they have been modified over time and present data to support the utility of these strategies. The preliminary evidence offered here suggests that these tools allow for an equitable distribution of patient volume between team members, as well as the timely and accurate scheduling of urgent patients. As a result of the experiences presented here, other genetic counseling programs grappling with similar issues should be aware that it is possible to shift clinical operations to serve certain patient populations in a more timely fashion while keeping both providers and GC staff satisfied.     

The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication

Parents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11?h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

Single Parenthood and Adolescent Sexual Outcomes

Research suggests that children of single parents are at heightened risk of precocious sexual behavior, STDs, and other risky sexual outcomes. However, few such studies have addressed the type of single-parent family (single mother or single father), or differences across other-sex parent–child dyads. While gender essentialist models assume differences among youth living only with mothers or with fathers, constructivist models propose more flexible modes of parenting that lead to more similar outcomes. Using data from the National Longitudinal Study of Adolescent to Adult Health (n?=?2570) on youth between the ages of 15 and 19, we compared sexually-related outcomes among adolescents, both boys and girls, who lived with a single mother or a single father. These outcomes include sexual intercourse and knowledge, use of contraception, attitudes toward intimacy and pregnancy, and diagnosis of sexually-transmitted diseases. The results from linear and logistic regression models indicated few differences between single-mother and single-father families, or between same-sex and opposite-sex parent–child matches, using p values of .05 or smaller. Our results called into question essentialist models that posit higher risks for adolescents living with a particular parent or with an opposite-sex parent.     

Intergenerational Transfers: Associations with Adult Children’s Emotional Support of Their Parents

This study investigates how different factors in regard to intergenerational relationships are associated with emotional support given by adults to their parents. The analysis focuses on adult children and their parents in a representative German sample. Data were obtained from the second wave of the German Family Panel (pairfam) consisting of 2064 women and 1841 men. Results show that transfer of emotional support by the adult children was especially associated not only with received emotional support from parents, but also with affection, conflicts, and expectations concerning parents. A moderator analysis focuses on gender and showed differences for the association between given support by adults and conflicts between mothers and fathers. For the offspring, no gender effects were found.     

Validation Study of the Portuguese Version of the Family Problem Solving Communication (FPSC) Index

Within family stress theories, the way in which families communicate about their hardships and issues is crucial for the family’s stress management and functioning. In the current study, we sought to validate the Portuguese version of the Family Problem Solving Communication (FPSC) Index and examine its psychometric properties. Developed within the context of the resiliency model of family stress, adjustment and adaptation, the FPSC is a ten-item self-report measure that assesses the family communication patterns that are likely to play a role in the family’s coping with hardships and difficulties. The participants were 332 individuals between 18 and 76 years who completed the FPSC and self-report measures of family hardiness and family functioning. A confirmatory factor analysis supported the original FPSC bifactorial structure, indicating the presence of two dimensions, Affirmative Communication and Incendiary Communication. Correlations between the scale’s total score and its dimensions with the measures of family hardiness and family functioning attested to its convergent validity. Furthermore, the index demonstrated respectable to very good internal consistency and temporal stability. In conclusion, the Portuguese version of the FPSC is a valid and reliable instrument that can support the development of future empirical studies focused on family problem solving communication, especially with regard to family adaptation in different contexts of adversity.     

The effects of smiling on perceived age defy belief

It is a common belief that smiling makes people appear younger. Empirical findings, however, suggest that smiling faces are actually perceived as older than neutral faces. Here we show that these two apparently contradictory phenomena can co-exist in the same person. In the first experiment, participants were first asked to estimate the ages of a series of smiling or neutral faces. After that, they were asked to estimate the average age of the set of neutral and smiling faces they had just evaluated. Finally, they were asked what effect smiling has on one’s perceived age. In the experimental session, smiling faces were perceived as older than neutral faces. Nevertheless, after the experiment, consistent with their retrospective evaluations, participants recalled smiling faces as being younger than the neutral faces. Experiment 2 replicated and extended these results to a set of emotional expressions that also included surprised faces. Smiling faces were again perceived as older than neutral faces, which were in turn perceived as older than surprised faces. Again, retrospective evaluations were consistent with the belief that smiling makes people look younger. The findings show that this belief, well-rooted in popular media, is a complete misconception.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

Adoptive versus Mixed Families: Child Adjustment,Parenting Stress and Family Environment

Recent research in adoption has considered the factors and processes that underlie the adjustment of children and families. However, little research has been conducted on certain types of adoptive families, specifically on families with both adoptive and biological children often designated as mixed families. This subject is addressed by the present study which also analyzes the association between the type of adoptive family and children’s outcomes—prosocial and problem behavior—parenting stress and the relational family environment. It also examines whether children’s gender, age at adoption and the number of children in the home moderate these effects. 102 parents of adoptive children (ACF) 33 parents of both adoptive and biological children (ABCF) and 102 parents of biological children (BCF) participated in the study. Target-children were aged from 6 to 12 years. The Portuguese versions of the SDQ-P, PSI-SF and FES (Interpersonal Relationship dimension) were used. Results showed that the type of adoptive family—ACF and ABCF—significantly explained the variance of children’s behavioral problems and parenting stress. The child’s gender was shown to moderate the relationship between ACF parents and their perception of child’s prosocial behavior. The results give relevant clues as to the importance of distinct outcomes in adoptive families—ACF and ABCF—compared to families with only biological children and should, therefore, be a resource for professionals involved in the adopters’ suitability assessment and adoption intervention.