Psychological Interventions and Genetic Testing: Facilitating Informed Decisions About BRCA1/2 Cancer Susceptibility

Genetic testing for inherited cancer susceptibility, based on the recently identified. BRCA1 and BRCA2 genes, will soon be available on a large scale. However, at present, genetic test results do not lead to clearly indicated diagnostic or preventive measures, and the nature of the psychological impact of BRCA1/2 testing is still largely unknown. This uncertainty, combined with preliminary evidence suggesting significant individual differences in reactions to genetic susceptibility feedback, constitutes a unique challenge for any individual contemplating such testing. We outline the nature of this challenge and then propose an intervention strategy designed to help individuals make deeply processed and psychologically well-informed decisions with regard to their genetic susceptibility. The intervention is guided by recent research findings and theory on the cognitive–emotional processing of cancer-risk information. Specifically, the goal is to prepare the individual for genetic testing by (1) cognitively and emotionally activating, or preliving, the individual's potential reactions to testing feedback; (2) facilitating accurate appraisal of the individual's cognitive–emotional reactions; and (3) enabling the individual to process these reactions through the use of well-established clinical techniques.     

Infantile stimulation and its effects on frustration- and fear-motivated behavior in rats

Infant rats that were either removed from the nest each day (handled) or left undisturbed (nonhandled) were, in adulthood, given 72 food-reinforced runway acquisition trials followed by 24 trials of extinction training with or without shock. Handled and nonhandled control animals were given runway training without food reinforcement. Reinforced rats ran faster than nonreinforced rats, and handled rats ran faster than nonhandled rats during the initial trials of runway acquisition irrespective of the reinforcement condition. Nonhadled rats stopped running sooner than handled rats when shock was introduced in the goalbox, but differences between handled and nonhandled rats given extinction training without shock were small. Results of a second experiment showed no differences between handled and non-handled rats in the magnitude of the depression effect after an incentive shift. It was concluded that infantile handling had little effect on frustration-motivated behavior, but did affect fear-motivated behavior.     

Mentoring Nurses in Familial Cancer Risk Assessment and Counseling: Lessons Learned From a Formative Evaluation

Background. As familial cancer genetic services moves into community practice increased numbers of trained health professionals are needed to counsel individuals seeking cancer risk information. Nurses have been targeted to provide cancer risk assessment and counseling. To help prepare nurses for this role, a 5-day training in familial cancer risk assessment and counseling followed by a long-distance mentorship to support continued skill development in the work environment was conducted by Fox Chase Cancer Center, Philadelphia, PA. Methods. Four cohorts (N = 41) have completed the training and were randomized to either an immediate or delayed mentorship. A formative evaluation assessed the nurse’s ability to consult with other genetic health professionals and build self-efficacy in counseling skills via responses to questionnaire. A post-mentorship interview evaluated the usefulness, timing and length of the mentorship. Results. For both groups, there was a statistically significant improvement in self-efficacy for all skills from baseline to 6 months and an increased number of nurses consulting with genetic health professionals. All the nurses reported the value of the mentorship and those with less cancer risk counseling experience prior to the training needed support and resources for further skill and program development. Lessons learned from this formative evaluation are provided.     

Lexicality and phonological similarity: A challenge for the retrieval‐based account of serial recall?

The retrieval‐based account of serial recall () attributes lexicality, phonological similarity, and articulatory suppression effects to a process where long‐term representations are used to reconstruct degraded phonological traces. Two experiments tested this assumption by manipulating these factors in the recall of four‐ and five‐item lists of words and non‐words. Lexicality enhanced item recall (IR), but only affected position accuracy (PA) for five‐item lists under suppression. Phonological similarity influenced both words and non‐words, and produced impaired PA in silent and suppressed conditions. Consistent with the retrieval‐based account, words and non‐words of high word‐likeness appear subject to redintegration. However, some findings, like suppression not reducing the phonological similarity impairment in suppressed conditions, present challenges for the retrieval‐based account and other models of serial recall.     

“I Think Most of Society Hates Us”: A Qualitative Thematic Analysis of Interviews with Incels

Sex Roles - Involuntary celibates, or “incels,” have received increased public attention in past years, likely as a result of media reports that link incels to incidents of mass...     

A Phenomenological Grounding of Feminist Ethics

The central hypothesis of this paper is that the phenomenology of Merleau-Ponty offers significant philosophical groundwork for an ethics that honours key feminist commitments – embodiment, situatedness, diversity and the intrinsic sociality of subjectivity. Part I evaluates feminist criticisms of Merleau-Ponty. Part II defends the claim that Merleau-Ponty’s non-dualist ontology underwrites leading approaches in feminist ethics, notably Care Ethics and the Ethics of Vulnerability. Part III examines Merleau-Ponty’s analyses of embodied percipience, arguing that these offer a powerful critique of the view from nowhere, a totalizing God’s-eye-view with pretensions to objectivity. By revealing the normative structure of perceptual gestalts in the intersubjective domain, he establishes the view from everywhere. Normativity is no longer deferred to higher authorities such as duty, utility or the valorized virtue, but through the perceptual gestalt it is returned to the perceiving embodied subject. This subject, defined by inherent intersubjectivity, is thereby vulnerable to others and has the capacity for care.     

Stephen Scher and Kasia Kozlowska: Rethinking health care ethics

Theoretical Medicine and Bioethics -     

Correction to: Stephen Scher and Kasia Kozlowska: Rethinking health care ethics

Theoretical Medicine and Bioethics - The originally published review of this book did not include the information that an electronic version is available.