Essential Elements of Genetic Cancer Risk Assessment, Counseling, and Testing: Updated Recommendations of the National Society of Genetic Counselors

Updated from their original publication in 2004, these cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of counseling at-risk individuals through genetic cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Familial Cancer Risk Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Essential components include the intake, cancer risk assessment, genetic testing for an inherited cancer syndrome, informed consent, disclosure of genetic test results, and psychosocial assessment. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Assessment of children's Type A behavior: relationship with negative behavioral characteristics and children and teacher demographic characteristics

Thirty-two teachers rated Type A behavior, using Matthews Youth Test for Health, (MYTH) and negative characteristics of hyperactivity, negative peer relations, social withdrawal, and depression in 105 children, between the ages of 6 and 11, from lower to middle class Black and White families. Children's age, gender, race, and socioeconomic status (SES) and teachers' gender, grade taught, and years of teaching experience were not related to teachers' MYTH ratings. However, White teachers rated children higher on Type A behavior than Black teachers. Controlling for teacher race effects, MYTH total scores, rather than reflecting a global negative view of the child, showed a strong overlap with hyperactivity and were differentiated from social withdrawal and depression. The MYTH Impatience/Aggression factor was highly related to hyperactivity and negative peer interactions; the Competitiveness factor was associated with a lack of social withdrawal. The conclusions verify the multidimensional nature of children's Type A behavior pattern and the importance of rater demographic characteristics in the assessment of children's behavior.     

Reliability and validity of a cost-efficient sociometric measure

Sociometric measures have been used frequently to measure social status; however, reliable sociograms for young children usually involve time-consuming administrations. A group-administered, peer-rating sociogram, the Sociometric Peer-Rating Scale (SPRS), was devised and given to 217 first and second graders. Concomitantly, teacher nominations of children most liked, aggressive, or withdrawn and behavioral observations of the high- and low-SPRS children were obtained. After 7 months, the SPRS was readministered. On a separate population of eight kindergarten children, this sociogram and a similar, individually administered sociogram were given. Normative data, test-retest reliability, and split-half reliability were reported. The test-retest reliability was comparable to the reported reliability of other peer-rating sociograms, and the SPRS correlated significantly with teacher ratings of aggressiveness and likability and with the individually administered sociogram. The number of positive interactions was significantly different for high-versus low-SPRS children. The usefulness of the SPRS as a measure of social competence was discussed.This research was submitted by the author in partial fulfillment of the requirements of a master's degree at the Florida State University.I would like to thank the Master's committee, Wallace Kennedy, William Pelham, and Joseph Torgesen, and the participating schools, Developmental Research School of Florida State University and Woodville Elementary School of the Leon County School District, for their assistance in this study.     

Social ties: subgroup differences in costs and benefits

Social ties can be stressful as well as supportive. Are these opposing effects linked, and can they help explain subgroup differences in the efficacy of social support? These questions were applied to data on social support in response to stressful life events. The subjects were 314 women randomly chosen from the registration list of a neighborhood health center in Boston. The data were from the initial interviews of a larger study. The findings include the following: The mobilization of social support was associated with better psychological well-being for women with greater personal resources, but not for those with lower levels of personal resources. Women with lower levels of personal resources were more distressed by life events in the lives of their significant others, especially as the number of these events increased. The subgroup effects of interpersonal support and stress on psychological well-being were independent, separate effects. In sum, women with greater material and psychological resources derived more beneficial support and suffered less stress from their social ties.     

SUCCESSIVE REVERSALS OF A CLASSICALLY CONDITIONED HEART-RATE DISCRIMINATION1

Rats were trained to criterion in successive reversals of a classically conditioned heart-rate discrimination. Criterion was attained more rapidly in the later reversals in the series than in the early reversals and the inter-problem learning curve was of the same general form as that found with successive instrumental discrimination reversal in the same species.     

Pavlovian extinction,phobias, and the limits of the cognitive paradigm

The slow or total lack of decrease in some autonomic responses during extinction in aversive conditioning and concomitant verbalizations of fear have remained a problem for learning theories and psychophysiology. Removal of the aversive stimulus should result in a rapid decrement in responding, as it does in cognitive and somatic systems. In laboratory analogues of phobia and clinical neurosis, however, such decreases do not occur in some autonomic responses and reported fear. In this article three areas of research are presented in which dissociations occur between cognitive and autonomie responses: 1) relational learning, 2) phobia, and 3) incubation. The data indicate that there are some important distinctions to be made concerning the properties of different psychological and physiological systems. These distinctions pertain to the differences between cognitive and noncognitive systems, between the two branches of the ANS, and between acquisition and extinction processes. These distinctions lead to a number of hypotheses concerning dissociations between response systems and have important implications for the understanding and treatment of neurosis.     

The influence of gender on occupational aspirations of kindergarten children

By updating and extending previous research on the effect of gender role socialization on occupational choices of children, this research found very sexstereotypical occupational preferences in a sample of 540 kindergarten children. The girls in the study selected occupations that averaged 87% female and the boys selected occupations averaging 84% male. The boys perceived a significantly wider range of vocational options than the girls. In a reversal condition, children were asked to pretend to be of the opposite sex. Most of the children selected occupations with sex ratios favoring their pretended sex; girls were slightly more stereotypic than boys. An unanticipated finding was the extremeness of reactions of the boys to the suggestion that they pretend to be girls. It is argued that current sex-role socialization fails to recognize the realities of the expanding participation of women in the paid labor force.     

Sex Differences in Clinical Pain: A Multisample Study

A recent meta-analysis of the experimental pain literature revealed effect sizes of .55 for pain threshold and .57 for pain tolerance, indicating a moderate difference in pain perception between men and women, with women reporting an increased sensitivity to pain. The current study investigated the relationship between sex and clinical pain ratings, in patients seeking care at a tertiary care facility. Five samples of chronic pain patients were recruited from several diverse clinics associated with the University of Florida. Analyses of clinical pain ratings revealed similar effect sizes for all samples, ranging from –.07 to –.25, indicating small differences, with women reporting higher levels of clinical pain. This is the first paper to report effect sizes for differences in report of pain in samples of chronic pain patients presenting for treatment at a tertiary care facility.