Talking about Disability in Prenatal Genetic Counseling: A Report of Two Interactive Workshops

Women are commonly offered testing in pregnancy to determine the health of their baby. An important component of informed decision-making about prenatal testing is provision of relevant, accurate, meaningful information concerning the conditions that are being tested for—many of which, such as Down syndrome, are associated with a varying degree of physical and intellectual disability. A range of health professionals, including genetic counselors, may provide information and support throughout the testing process, but available data suggest that discussion of disability is frequently absent or limited. To investigate genetic counselors’ perceptions of this situation and identify potential barriers to discussion we facilitated interactive workshops at the 2007 National Society of Genetic Counselors Annual Education Conference (NSGC) and the 2008 European Meeting on Psychosocial Aspects of Genetics (EMPAG). Working groups identified relevant psychosocial issues and impediments to discussion (NSGC) or used a two-part scenario to promote discussion (EMPAG) and reported findings in notes and a closing plenary discussion. Inductive content analysis revealed that participants considered informed decision making to be a major reason for presenting information about disabilities in prenatal genetic counseling and endorsed the value of including information about daily life with Down syndrome and other disabilities. However, they identified three broad types of impediments to such discussion: counseling issues concerning the most appropriate manner to discuss disability under the complex circumstances of prenatal genetic counseling, less than optimal training and experience in addressing these issues, and perceived limitations in the participants’ knowledge and understanding of life with disability. Our analysis of the responses from the workshop participants and additional thoughts on these issues have led us to develop recommendations for further research, training and clinical practice.     

Direct‐Supervision and Remote‐Supervision Jails: A Comparative Study of Psychosocial Factors1

The direct‐supervision style correctional facility has been offered as a design that provides a better atmosphere for staff and inmates. Prior research has shown minor support in favor of the general environment created by direct‐supervision facilities. However, the claims of benefits associated with direct supervision far outweigh the number of empirical research studies on the design. This research examined corrections officers' and inmates' feelings of boredom, perceived control, aggression, attitudes toward each other, and stress in a direct‐supervision style facility and a remote‐supervision style facility. Results from 164 inmates and 82 correctional officers showed that staff in the direct‐supervision facility reported elevated levels of perceived control, less anger and hostility, and less boredom.     

Alternate methods and software for calculating interobserver agreement for continuous observation data

Portable electronic data collection devices permit investigators to collect large amounts of observational data in a form ready for computer analysis. These devices are particularly efficient for gathering continuous data on multiple behavior categories. We expect that the increasing availability of these devices will lead to greater use of continuous data collection methods in observational research. This paper addresses the difficulties encountered when calculating traditional interobserver agreement statistics for continuous, multiple-code scoring. Two alternative strategies are described that yield interobserver agreement values based on the exact time of behavior code entries by the primary and secondary observers.Work on this paper was supported in part by NICHD Grants P01HD15051 and R01HD17650 and Office of Special Education and Rehabilitation Services Grant G008302980.     

Negative priming between pictures and words in a selective attention task: Evidence for semantic processing of ignored stimuli

This study examined the processing of ignored pictures and words when attention was directed to a different picture or word. Previous work by Tipper (1985) demonstrated that the priming effect of an ignored picture on a subsequent categorically related picture is inhibitory. This effect was termednegative priming. Tipper concluded that ignored pictures achieved abstract categorical levels of internal representation, and that these representations were inhibited during selection of a simultaneously presented picture. This conclusion, however, was premature. Observation of the figures used by Tipper suggests that objects within a category have greater structural similarity than do objects in different categories. The negative priming effect could therefore be at a structural level of representation. The present study examined priming across symbolic domains (pictures and words) where there was no structural relationship between objects. Negative priming was again observed and was equivalent to the negative priming observed within symbolic domain. These data suggest that ignored drawings and words do achieve abstract categorical levels of representation, and that the mechanisms underlying negative priming operate at, or beyond, this level.     

Explaining the Social and Psychological Impacts of a Nuclear Power Plant Accident1

This research investigates the antecedents of psychosocial impacts of the TMI nuclear power plant accident. A model of factors that are hypothesized to affect impact levels is developed and configured to approximate a hypothetical causal sequence. Using data from the Nuclear Regulatory Commission telephone survey, the technique of path analysis is used to test relationships in the model. The results show that the antecedents explain 12% of the variance in individual stress, 45% of the variance in family disruption, and 16% of the variance in perceived community change. The analysis shows that the TMI specific attitudes and sensitivity to radiation risks are strong antecedents of impacts. Although general attitudes toward nuclear power have minor indirect effects, it appears that situational experiences with the accident are the major contributors toward explaining impact levels.     

Gender differences,mediation, and disciplinary styles in children's responses to television

A sample of kindergarten and first-grade children was studied in a research center and at school to determine the extent to which family communication mediated their comprehension of television, as well as a series of cognitive skills necessary for such comprehension. Separate analyses were conducted for boys and girls, and results indicated that certain styles of family mediation facilitated comprehension more effectively for boys than for girls. Additionally, differential effects of two styles of discipline were found for each sex.This research was funded by a grant to Jerome and Dorothy Singer from the John D. and Catherine T. MacArthur Foundation entitled Television and Family Living Patterns.     

The recall and use of belief statements as bases for judgments: Some determinants and implications

When people are asked to report their beliefs in a (target) statement, they may search memory for other, “informational” propositions that bear on its validity, and may use their beliefs in these propositions as bases for their judgments. Several factors were hypothesized to affect the particular propositions that subjects are likely to recall under such conditions. Subjects first familiarized themselves with a list of informational and target propositions. Then, they reported either their beliefs in these propositions or their attitudes toward them. In a second session 1 week later, they recalled as many of the propositions as they could. Both informational and target statements were better recalled when the informational propositions were unlikely to be true. In addition, the target statements were better recalled when the informational propositions associated with them had unclear implications for their validity. Recall of one proposition was more likely to cue the recall of the other when subjects had previously reported belief in the target proposition (rather than attitudes toward it). However, it was more likely to occur when subjects had reported attitudes toward the informational proposition (rather than beliefs in it). The effects of these variables were interpreted in terms of their mediating influence on the strength of association between the informational proposition and both (a) the target proposition and (b) contextual and environmental cues in the situation where target beliefs are reported.     

Cumulative and local odds-ratio measures of uniformity of association in two-way ordered contingency tables

The cumulative odds-ratio model of uniformity of association in a two-way ordered contingency table is studied, and compared with Goodman's local odds-ratio model. It is shown that the cumulative model can be adapted to the deletion of cells, particularly deletion of diagonal cells in square tables, and an example of the improvement of fit obtained is given, and compared with the fit of the local model. The sensitivity of both models to collapse of categories and to changes in marginal totals is discussed, suggesting criteria for choosing between them. The Appendix describes simple computational algorithms for both models, based on minimizing the likelihood ratio over a range of trial parameters.