Genetic Counseling in the Era of Genomics: What’s all the Fuss about?

As genomic sequencing becomes more widely available in clinical settings for diagnostic purposes, a number of genetic counseling issues are gaining precedence. The ability to manage these issues will be paramount as genetic and non-genetic healthcare professionals navigate the complexities of using genomic technologies to facilitate diagnosis and inform patient management. Counseling issues arising when counseling for diagnostic genomic sequencing were identified by four genetic counselors with 10 years of collective experience providing genetic counseling in this setting. These issues were discussed and refined at a meeting of genetic counselors working in clinical genomics settings in Melbourne, Australia. Emerging counseling issues, or variations of established counseling issues, were identified from the issues raised. Illustrative cases were selected where pre- and post-test genetic counseling was provided in clinical settings to individuals who received singleton or trio WES with targeted analysis. Counseling issues discussed in this paper include a reappraisal of how genetic counselors manage hope in the genomic era, informed consent for secondary use of genomic data, clinical reanalysis of genomic data, unexpected or unsolicited secondary findings, and trio sequencing. The authors seek to contribute to the evolving understanding of genetic counseling for diagnostic genomic sequencing through considering the applicability of existing genetic counseling competencies to managing emerging counseling issues and discussing genetic counseling practice implications.     

Sexual Harassment,Racial Harassment,and Well-Being among Asian American Women: An Intersectional Approach

ABSTRACT

Harassment of Asian American (AA) women has received little attention in popular culture and academic research despite their long legacy of sexualized racial stereotyping (e.g., Geisha, sexually submissive; Shimizu, 2007) and additional risk of mistreatment due to their membership in both marginalized gender and racial groups (Beale, 1970 Beale, F. (1970). Double jeopardy: To be Black and female. In T. C. Bambara (Ed.), The Black woman: An anthology (pp. 90–100). New York: New American Library. [Google Scholar]; Settles & Buchanan, 2014 Settles, I. H., & Buchanan, N. T. (2014). Intersectionality: Multiple categories of identity and difference. In V. Benet-Martinez and Y. Hong (Eds.), The Oxford Handbook of Multicultural Identity (pp. 160–180). New York, NY: Oxford University Press, Inc. [Google Scholar]). This study addresses this dearth of research using an intersectional theoretical framework to comprehensively examine sexual and racial harassment with a sample of AA women. Results validated the underlying factor structure of the Sexual Experiences Questionnaire (Fitzgerald, Gelfand, & Drasgow, 1995 Fitzgerald, L. F., Gelfand, M. J., & Drasgow, F. (1995). Measuring sexual harassment: Theoretical and psychometric advances. Basic and Applied Social Psychology, 17, 425–445. doi:10.1207/s15324834basp1704_2[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) and the Racial Acts, Crimes, and Experiences Scale (RACES; Bergman & Buchanan, 2008 Bergman, M., & Buchanan, N. T. (2008). Development of the Racial Acts, Crimes, and Experiences Survey (RACES). Unpublished instrument. [Google Scholar]) for AA women. Additionally, our results replicated previous research indicating that participants often reported experiencing behaviors that constitute harassment, but did not label them as such. This supports the use of behavioral measures over items that require individuals to label their experiences as harassment. Finally, we examined the associations between these forms of harassment and two indicators of psychological well-being, depression, and posttraumatic stress (PTS). Our results found that gender harassment was associated with more depression, whereas unwanted sexual attention, sexual coercion, and racial harassment were associated with increased PTS. This supports the utility of including both sexual and racial harassment in providing a more nuanced understanding of AA women’s harassment experiences overall and the relationship of harassment to psychological well-being. We discuss theoretical and clinical implications of these findings.     

CLIMATE CHANGE,LAUDATO SI', CREATION SPIRITUALITY,AND THE NOBILITY OF THE SCIENTIST'S VOCATION

This exploration into spirituality and climate change employs the “four paths” of the creation spirituality tradition. The author recognizes those paths in the rich teachings of Pope Francis’s encyclical, Laudato Si' and applies them in considering the nobility of the scientist's vocation. Premodern thinkers often resisted any split between science and religion. The author then lays out the basic archetypes for recognizing the sacredness of creation, namely, the Cosmic Christ (Christianity); the Buddha Nature (Buddhism); the Image of God (Judaism); the “Primordial Man” (Hinduism), as well as the premodern universal teaching of “God as Beauty.” He addresses the subject of evil which deserves serious attention in the face of the realities posed by climate change and the resistance to addressing them. In the concluding section, the author speaks of a new Order of the Sacred Earth that was launched in fall 2017 to gather persons of whatever spiritual tradition or none to devote themselves to preserving Mother Earth.     

The Role of Religious Coping and Resilience in Individuals With Dissociative Identity Disorder

Survivors with dissociative identity disorder (DID) often report a history of traumatic events in their lives. Past studies indicated a link between trauma, resilience, and spiritual coping in both positive and negative aspects of a survivor's life. This article includes a review of existing literature salient to these constructs in relation to i ndividuals with DID, as well as results from a study examining the relationships between these constructs and individuals with DID (N = 52). Implications are discussed based on the findings for counselors treating individuals with DID.     

Values and helping behavior: A study in four cultures

Values are important factors in determining individuals' behaviours. Previous studies have examined the relations between values and helping behaviour, but usually in the context of a single culture. The current study examines the relations between personal value types and helping behaviour among university students (N = 722) in four cultures (Germany, Scotland‐UK, Israel and Turkey). Across cultures, the value types of self‐transcendence versus self‐enhancement and conservation versus openness to change were positively related to helping. Specifically, self‐transcendence values were positively related, and self‐enhancement and openness to change values negatively related, to helping behaviour. The correlations pattern did not differ significantly between cultures.     

The lived experiences of individuals with Tourette syndrome or tic disorders: A meta‐synthesis of qualitative studies

There is a growing body of qualitative literature describing the lived experiences of people with tic disorders (TDs). The aim of this paper was to conduct a systematic review of this literature, synthesizing the perspectives of individuals on their experiences. Meta‐synthesis methodology was utilized to review and draw together findings from 10 articles, from which key concepts were extracted, and over‐arching themes generated. Six themes were identified to encompass the experience of TDs, including (1) cultural, semantic issues of the condition; (2) negative experiences in organizations and treatment; (3) the value and negative impact on interpersonal relationships; (4) personal identity in the constant presence of TDs; (5) concerns for the future; and (6) strategies to control and manage the observable presence of tics. Adaptive coping strategies were found to encompass continuous social adaptation, strategies to manage tics and social perceptions, self‐acceptance, advocacy, and support from others. The results highlighted the significant role of social and cultural issues related to understanding and stigma, which underpinned many of the lived experiences. Implications for clinical practice in supporting individuals with TDs were also highlighted.     

The nature of restructuring in insight: An individual-differences approach

The insightful problem-solving process has been proposed to involve three main phases: an initial representation phase, in which the solver inappropriately represents the problem; an initial search through the faulty problem space that may lead to impasse; and a postimpasse restructuring phase. Some theories propose that the restructuring phase involves controlled search processes, whereas other theories propose that restructuring is achieved through the automatic redistribution of activation in long-term memory. In this study, we used correlations between working memory (WM) span measures and problemsolving success to test the predictions of these different theories. One group of participants received a set of insight problems that allowed for a large initial faulty search space, whereas another group received a matched set that constrained the initial faulty search space in order to isolate the restructuring phase of the insightful process. The results suggest that increased ability to control attention (as measured by WM span tasks) predicts an individual’s ability to successfully solve problems that involve both the initial search phase and the restructuring phase. However, individual differences in ability to control attention do not predict success on problems that isolate the restructuring phase. These results are interpreted as supporting an automatic-redistribution-of-activation account of restructuring.