Risk Perception,Worry and Satisfaction Related to Genetic Counseling for Hereditary Cancer

In this multi center study, genetic counseling for hereditary cancer was evaluated by assessing patients’ worry, perceived risk of developing cancer and satisfaction with genetic counseling. An overall aim was to identify characteristics of vulnerable patients in order to customize genetic counseling. In addition, agreement between patients’ and counselors’ scores was measured. A total of 275 Norwegian patients were consecutively recruited, and 213 completed questionnaires before and after genetic counseling. Patients’ perceived risk decreased after the genetic counseling session. There was incongruence between risk perception expressed as a percentage and in words. Patients were significantly less worried after counseling. Higher levels of worry were predicted by low instrumental satisfaction with counseling, high degree of perceived risk of developing cancer and younger age. In conclusion, counselors met the patients’ psychological needs to a satisfactory degree during counseling. However, patients did not fully understand their risk of developing cancer.     

Living with Hereditary Non-polyposis Colorectal Cancer; Experiences from and Impact of Genetic Testing

Hereditary non-polyposis colorectal cancer (HNPCC) is one of our most common cancer syndromes and an increasing number of individuals live in families with verified hereditary cancer. We conducted an interview study to explore experiences from and perceived impact on life after genetic testing for HNPCC. Three major themes emerged: reactions and emotions, family relations and implications for life. Among the reactions described were suspecting heredity, feelings of guilt, the importance of experiential knowledge, and coping strategies. The impact on family relations was related to perceived responsibility for conveying information, encountering different reactions among family members, and difficulties in communication and relations. The implications described included uncertainty, adaptation, new choices and changes in life, family planning issues, and experiences of surveillance programs. We suggest that the themes and sub-themes identified should be taken into account during genetic counselling in order to facilitate the spread of information and to prepare family members for the impact on life that knowledge about hereditary cancer may have.     

Kierkegaard's Phenomenology of Spirit

Kierkegaard's preoccupation with a separation between the ‘inner’ and the ‘outer’ runs through his work and is widely thought to belong to his rejection of Hegel's idealist monism. Focusing on The Concept of Irony and Either/Or, I argue that although Kierkegaard believes in various metaphysical distinctions between inside and outside (the inwardness of faith and the outwardness of ethics and language; the inwardness of emotion and the outwardness of behavior), he nonetheless understands the task of the philosopher as that of making outside and inside converge in a representation. Drawing on Hegel's philosophy of art, I show that Kierkegaard's project in both of these books is the aesthetic project of revealing the inner essence of something in its outward appearance. Kierkegaard's portrait of Socrates in The Concept of Irony is a phenomenology of the spirit of irony. My interpretation adds a new dimension to our understanding of Kierkegaard's aesthetics and his relation to Hegel; it presents him as a follower of Plato, whom he is usually thought to have dismissed; and it uncovers a deep connection between Kierkegaard's first two books, which are never read in conjunction.     

Integrating Web-Based Applications into Aged Care: Two Case Studies and Discussion

In anticipation of the growing need for adequate mental health care for older adults in residential aged care facilities, psychologists are challenged to overcome several barriers that impede the uptake and delivery of their services in such settings. Information and communication technologies (ICT) have strong potential to overcome some of these barriers by supporting the delivery of evidence-based psychosocial treatments for common psychogeriatric issues. This paper presents two case studies that illustrate when and how psychologists can use various ICT applications (e.g., tablet devices, web-based applications) integrated with cognitive behavioural and reminiscence-based therapies. Both case studies demonstrate that ICT can effectively support the therapeutic alliance, enhance therapeutic engagement, and individualize treatment delivery to accommodate the needs of elderly patients. It is hoped that these case studies will encourage clinicians to consider using ICT to augment therapy with their elderly patients.     

Professional values and their development among trainees in psychoanalytic psychotherapy1

Forty-six psychotherapy students in three groups at one training institute for psychoanalytic psychotherapy in Sweden were asked to fill out a questionnaire about important influences on their professional development during their three-year training and afterwards. The questionnaire was distributed on three occasions during the training program and on one later occasion. Twenty-one students responded to the questionnaire on all four occasions. Working with patients in therapy, getting supervision, and participating in personal psychotherapy were viewed as the three most important influences on the students. The importance attributed to specialist literature and technical skills seemed to increase over time during the training, while the influences of experiences in personal life and personal qualities decreased. These changes in reported views were reversed in the initial years after graduation. Concerning assets, the students valued the ability to be containing and emphatic as the most important, but in their first years as licensed psychotherapists assigned more importance to the ability to create contact. The training program led to a change over time in a higher rating for the importance of technical and methodological attributes and less emphasis on personal characteristics and experiences. Most of the changes reported during training tended to be reversed afterwards.     

Love as a Problem of Knowledge in Kierkegaard's Either/Or and Plato's Symposium

At the end of the essay “Silhouettes” in Either/Or, Kierkegaard writes, “only the person who has been bitten by snakes knows what one who has been bitten by snakes must suffer.” I interpret this as an allusion to Alcibiades' speech in Plato's Symposium. Kierkegaard invites the reader to compare Socrates with Don Giovanni, and Alcibiades with the seducer's women. Socrates' philosophical method, in this light, is a deceptive seduction: just as Don Giovanni's seduction leads his conquests to unhappy love—what Kierkegaard terms “reflective sorrow”—so the elenctic method leads Socrates' interlocutors to aporia, not to knowledge. I offer a critique of Socrates' ironic stance as a philosopher, which stance is reflected in the theory of love he presents in the Symposium, and suggest that philosophy should be modeled on the romantic love of persons—a love that can be reciprocated—not the love of an impersonal Form, a one-sided love.     

Blameworthiness as Deserved Guilt

It is often assumed that we are only blameworthy for that over which we have control. In recent years, however, several philosophers have argued that we can be blameworthy for occurrences that appear to be outside our control, such as attitudes, beliefs and omissions. This has prompted the question of why control should be a condition on blameworthiness. This paper aims at defending the control condition by developing a new conception of blameworthiness: To be blameworthy, I argue, is most fundamentally to deserve to feel guilty. Being blamed by someone else is not necessarily harmful to the wrongdoer. The blame might not be expressed, or the wrongdoer might not care. But to blame oneself necessarily involves suffering. This conception of blameworthiness explains why the control condition should obtain: We are morally blameworthy for A only if A was (directly or indirectly) under our control because (a) to be blameworthy is to deserve to feel guilty, (b) to feel guilty is to suffer, and (c) one deserves to suffer for A only if A was under one’s control.     

Language asymmetry and auditory attention in young adulthood after being born small-for-gestational age or with cardio-pulmonary resuscitation at birth.

A dichotic listening test with consonant-vowel syllables was used to assess language asymmetry and shift of attention in 42 young adults who had been in need of cardio-pulmonary resuscitation at birth, with a mild or moderate clinical course during the neonatal period (n = 31), or were born small-for-gestational age (SGA; n = 11) and compared with healthy controls (n = 17). All the participants were followed up prospectively and displayed no neurological or developmental deficits at 18 months of age. All the groups had an expected right-ear advantage during a baseline condition with no instructions to shift attention. The SGA group and the moderate resuscitated group displayed clear signs of an attenuation of the right-ear advantage and they were also less able to modify the ear preference in forced-attention conditions, compared with the control group. The main finding was that the groups with the most severe pre- and perinatal complications were also most affected on the dichotic listening test at adult age.     

Relaxation versus cognitive therapies for dental fear--a psychophysiological approach.

By separating 127 adult dental-phobic patients according to fear etiology and psychophysiologic response style, the authors investigated the outcome of 2 dental fear treatments. Before and after either relaxation or cognitively oriented treatment, subjects were exposed to neutral and fear-relevant video sequences while the subjects' forehead muscle tension, heart rate, and skin conductance were recorded. Pre- to postintervention differences in self-reported dental fear, general fear, and trait anxiety were analyzed together with psychophysiological data. Both treatments resulted in a significant reduction of dental fear. Despite significant interaction effects of Treatment Modality x Psychophysiological Response Style, it could not be concluded that patients with different fear etiologies or response styles benefit differentially from the 2 treatments given.     

Interictal and postictal performances on dichotic listening test in children with focal epilepsy

Dichotic listening test (DL) is an important tool to disclose speech dominance in healthy subjects and in clinical cases. The aim of this study was to probe if focal epilepsy in children reveals a corresponding suppression of the ear reports contralateral to seizure onset site. Thus, 15 children and adolescents with clinically and electroencephalographically diagnosed focal epilepsy selected for left-hemisphere speech dominance without mental retardation were compared to matched controls according to age, gender, IQ and handedness. All children were assessed with DL for three times: Interictally (t(0)), postictally 5' (t(1)) and 1h (t(2)). At t(0), all groups revealed a right ear advantage (REA), indicating a left-hemisphere speech dominance. There was a continuous increase in right correct score (REC) over the trials for normal controls. Five minutes postictally, there was an abrupt decrease in REC with a sustained left ear correct score (LEC) for children with epilepsy, independent of which side suffered from seizures. This effect was maintained even after 1h. Thus, in children with left-hemisphere speech dominance the epileptic discharges caused a suppression of REC regardless of origin. The seizures may have a prolonged impact on attention and auditory perception for a considerable time after consciousness has been regained.