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.     

Relationship between short- and long-term memory and short- and long-term extinction

Both the acquisition and the extinction of memories leave short- and long-term mnemonic traces. Here, we show that in male Wistar rats, the short-term memory for a step-down inhibitory avoidance task (IA) is resistant to extinction, and that its expression does not influence retrieval or extinction of long-term memory. It has been known for some time that short- and long-term inhibitory avoidance memory involve separate and parallel processes. Here we show that, instead, short-term extinction of IA long-term memory is the first step towards its long-term extinction, and that this link requires functional NMDA receptors and protein synthesis in the CA1 region of the dorsal hippocampus at the time of the first CS-no US presentation.     

Is the victim Max (Planck) or Moritz? How victim type and social value orientation affect dishonest behavior

Does the potential victim of dishonest behavior—a family or a bank, a pensioner or an insurance firm—affect the propensity to engage in such behavior? We investigate the effect of victim type—an individual person or an impersonal institution—on dishonest behavior and test whether it interacts with potential perpetrators' social value orientation (prosocial or proself). In a between‐subjects design, we allowed experimental participants (N = 368) to misreport private information in order to increase (decrease) their profit (loss) at the expense of either another participant or the experimenter's budget. Both prosocials and proselfs engaged in dishonesty, but proselfs did so much more. Furthermore, prosocials reduced their dishonesty when the victim was another person, rather than an institution, but proselfs did not. A direct implication is that the dishonesty of prosocials may be curbed by increasing the salience of the adverse effect their dishonesty has on other individual people but that such interventions will not be effective for proselfs. In contrast with recent results, we did not find a general effect of increased dishonesty under a loss (vs. gain) frame.     

Effects of Psychological Distance and Need for Cognitive Closure on Impression Formation

Based on theoretical and empirical similarities between Construal level theory of psychological distance and the Need for cognitive closure (NFC) theory, it could be hypothesized that psychological distance and NFC represent constructs that overlap to some degree. Since both theories describe judgmental behavior in terms of schematic processing, we hypothesized that primacy effect, a schema-driven phenomenon, is strengthened under the heightened NFC and psychological distance. We tested this hypothesis in an impression formation experiment while manipulating psychological distance and measuring NFC. Low NFC and psychological closeness reflect preference for situationally specific, contextually rich information, and therefore their joint effect resulted in reliance on all available information regardless of their position in a sequence. High NFC and psychological distance produced a preference for clear, schematic, stable knowledge, and therefore weighed first information more, which resulted in the primacy effect.     

Mapping the interplay among cognitive biases,emotion regulation,and depressive symptoms

Cognitive biases and emotion regulation (ER) difficulties have been instrumental in understanding hallmark features of depression. However, little is known about the interplay among these important risk factors to depression. This cross-sectional study investigated how multiple cognitive biases modulate the habitual use of ER processes and how ER habits subsequently regulate depressive symptoms. All participants first executed a computerised version of the scrambled sentences test (interpretation bias measure) while their eye movements were registered (attention bias measure) and then completed questionnaires assessing positive reappraisal, brooding, and depressive symptoms. Path and bootstrapping analyses supported both direct effects of cognitive biases on depressive symptoms and indirect effects via the use of brooding and via the use of reappraisal that was in turn related to the use of brooding. These findings help to formulate a better understanding of how cognitive biases and ER habits interact to maintain depressive symptoms.     

Individual differences in cognitive control over emotional material modulate cognitive biases linked to depressive symptoms

Deficient cognitive control over emotional material and cognitive biases are important mechanisms underlying depression, but the interplay between these emotionally distorted cognitive processes in relation to depressive symptoms is not well understood. This study investigated the relations among deficient cognitive control of emotional information (i.e. inhibition, shifting, and updating difficulties), cognitive biases (i.e. negative attention and interpretation biases), and depressive symptoms. Theory-driven indirect effect models were constructed, hypothesising that deficient cognitive control over emotional material predicts depressive symptoms through negative attention and interpretation biases. Bootstrapping analyses demonstrated that deficient inhibitory control over negative material was related to negative attention bias which in turn predicted a congruent bias in interpretation and subsequently depressive symptoms. Both shifting and updating impairments in response to negative material had an indirect effect on depression severity through negative interpretation bias. No evidence was found for direct effects of deficient cognitive control over emotional material on depressive symptoms. These findings may help to formulate an integrated understanding of the cognitive foundations of depressive symptoms.     

Age differences in personality traits across cultures: self‐report and observer perspectives

Using self‐report measures, longitudinal studies in the US and cross‐sectional studies from many cultures suggest that the broad factors of Neuroticism, Extraversion, and Openness to Experience decline from adolescence to adulthood, whereas Agreeableness and Conscientiousness increase. Data are inconsistent on the rate of change during adulthood, and on the generalizability of self‐report findings to informant ratings. We analysed cross‐sectional data from self‐reports and informant ratings on the Revised NEO Personality Inventory in Czech (N = 705) and Russian (N = 800) samples. Some curvilinear effects were found, chiefly in the Czech sample; informant data generally replicated self‐reports, although the effects were weaker. Although many of the details are not yet clear, there appear to be pan‐cultural trends in personality development that are consistent with the hypothesis of intrinsic maturation. Copyright © 2004 John Wiley & Sons, Ltd.