How Risk is Perceived, Constructed and Interpreted by Clients in Clinical Genetics, and the Effects on Decision Making: Systematic Review

As an individual’s understanding of their genetic risk may influence risk management decisions, it is important to understand the ways in which risk is constructed and interpreted. We systematically reviewed the literature, undertaking a narrative synthesis of 59 studies presenting data on the ways in which individuals perceive, construct and interpret their risk, and the subsequent effects. While most studies assessed perceived risk quantitatively, the combined evidence suggests individuals find risk difficult to accurately quantify, with a tendency to overestimate. Rather than being a stand-alone concept, risk is something lived and experienced and the process of constructing risk is complex and influenced by many factors. While evidence of the effects of perceived risk is limited and inconsistent, there is some evidence to suggest high risk estimations may adversely affect health and lead to inappropriate uptake of medical surveillance and preventative measures by some individuals. A more focused approach to research is needed with greater exploration of the ways in which risk is constructed, along with the development of stronger theoretical models, to facilitate effective and patient-centered counseling strategies.     

Description of Exemplar Cases in the Intensive Mental Health Program: Illustrations of Application of the Therapeutic Model

We describe cases from the clinical records in the Intensive Mental Health Program to illustrate the diverse presenting problems, intervention strategies, therapeutic process, and outcomes for children receiving services in this school-based, community-oriented treatment model. Cases reflect varying degrees of treatment response and potential factors that influence the fluctuating levels of emotional disturbance and impaired functioning in the home, school, and community.     

Hypnotic Validation of Two Hand Test Scoring Categories

When emotions of aggression and affection were hypnotically induced in seven college students, they produced corresponding increases on the Aggression and Affection scores of the Hand Test.     

The relationship between indecisiveness and eye movement patterns in a decision making informational search task

Indecisiveness is a trait‐related general tendency to experience decision difficulties across a variety of situations, leading to decision delay, worry, and regret. Indecisiveness is proposed (Rassin, 2007) to be associated with an increase in desire for information acquisition and reliance on compensatory strategies—as evidenced by alternative‐based information search—during decision making. However existing studies provide conflicting findings. We conducted an information board study of indecisiveness, using eye tracking methodology, to test the hypotheses that the relationship between indecisiveness and choice strategy depends on being in the early stage of the decision making process, and that it depends on being in the presence of an opportunity to delay choice. We found strong evidence for the first hypothesis in that indecisive individuals changed shift behavior from the first to the second half of the task, consistent with a move from greater to lesser compensatory processing, while the shift behavior of decisive individuals suggested lesser compensatory processing over the whole task. Indecisiveness was also related to time spent viewing attributes of the selected course, and to time spent looking away from decision information. These findings resolve past discrepancies, suggest an interesting account of how the decision process unfolds for indecisive versus decisive individuals, and contribute to a better understanding of this tendency. Copyright © 2009 John Wiley & Sons, Ltd.