The Psychosocial Impact of Undergoing Prophylactic Total Gastrectomy (PTG) to Manage the Risk of Hereditary Diffuse Gastric Cancer (HDGC)

Individuals identified as at high risk of developing Hereditary Diffuse Gastric Cancer (HDGC) are advised to undergo prophylactic surgery - have their stomach removed - in their early twenties. Research with (older) cancer patients who undergo gastrectomy for curative reasons suggests that gastric resection has a number of physical and psychosocial sequelae. Because it is difficult to extrapolate the findings of studies of older cancer patients to younger healthy patients who are considering prophylactic total gastrectomy (PTG), the aim of this qualitative interview study was to determine the psychosocial implications of undergoing prophylactic surgery to manage genetic risk. Fourteen men and 13 women from the UK’s Familial Gastric Cancer study who had undergone PTG were invited to participate in qualitative interviews. Most reported that undergoing surgery and convalescence was easier than anticipated. There was evidence that age affected experiences of PTG, with younger patients tending to report faster recovery times and more transient aftereffects. All saw the benefits of risk reduction as outweighing the costs of surgery. Surgery was described as having a range of physical impacts (disrupted appetite, weight loss, fatigue, GI symptoms) that had related psychological, social and economic implications. Those considering PTG need to be aware that its impact on quality of life is difficult to predict and negative sequelae may be ongoing for some individuals.     

Anxiety and Stress in Children Following an Earthquake: Clinically Beneficial Effects of Treatment with Micronutrients

This study examined the effects of micronutrients on children with clinically elevated stress and anxiety 23–36 months after experiencing a natural disaster (a major earthquake). A single-case multiple-baseline design allocated 14 children (7 males, 7 females; aged 8–11 years; 10 with formal anxiety-disorder diagnoses) randomly to 1, 2 or 3 week baselines. Participants then took eight capsules/day of a micronutrient formula (EMPowerplus) during an 8-week open-label trial. Assessment instruments were the Children’s Global Assessment Scale (CGAS), the Screen for Child Anxiety-Related Emotional Disorders (SCARED), the Pediatric Emotional Distress Scale (PEDS), and the Revised Children’s Manifest Anxiety Scale (RCMAS). Symptom severity declined slightly in baseline for some children and declined much more during intervention for all children. Effect sizes at end of treatment were ?1.40 (RCMAS), ?1.92 (SCARED), +1.96 (CGAS), and ?2.13 (PEDS). Modified Brinley plots revealed decreases in anxiety and improvements in overall functioning for 10 out of 11 completing participants. Side effects were mild and transient. The study provided evidence that treatment with a dietary supplement containing micronutrients reduced children’s post-disaster anxiety to a clinically significant degree. Future placebo-controlled randomized-controlled trials and treatment-comparison research is recommended to determine if this is true of anxiety in general.     

Eating disorders from parent to child: Mothers’ perceptions of transgenerational effect

Primary prevention focuses on the reduction of risk factors. Children of mothers with an eating disorder are a proven “at risk” group, because children internalise their experiences. Prevention in the field of eating disorders has as yet only addressed children of seven or eight upwards and only in school‐based programs which did not incorporate mothers. This project targeted mothers with an eating disorder who had children under the age of thirteen. The hypothesis is that if these mothers can be encouraged to change damaging behaviour that their children are likely to model, we can attempt to break the cycle of dysfunction. This is a qualitative and quantitive research project, carried out with standardised measures and semi‐structured interviews before and after a nineteen week therapy group, with six and twelve month follow ups. The group consisted of eight mothers. This paper describes the group and provides a case study of one participant. The initial analysis suggests that the support of a therapeutic group allowed this mother enough space for reflection. She became aware of her dysfunctional behaviour and was able to begin to understand the underlying reasons behind it. This led to an improvement in her own Eating Disorder (ED) and she was subsequently able to make change in her responses to her children's needs.     

A Comparative Analysis of the Psychological Literature on Collaboration Between Clergy and Mental-Health Professionals—Perspectives from Secular and Religious Journals: 1970–1999

A search of the psychological literature was conducted to obtain a better understanding of the issues surrounding collaboration between clergy and psychologists. An electronic search of PsycINFO for 1970–1999 ultimately yielded 52 articles in secular journals and 37 articles in religiously oriented journals that discussed collaboration. Whereas interest in collaboration peaked in religious journals during the 1980's, the number of articles on collaboration appearing in secular journals increased significantly from 1970 to 1999. Content analysis confirmed six major themes about collaboration found by A. J. Weaver, K. J. Flannelly, L. T. Flannelly, and J. E. Oppenheimer (2003). One of the most common themes was the clergy's role as frontline mental-health workers, which was mentioned significantly more often in secular than religious journals. The need for greater education and knowledge was also mentioned significantly more often in secular than religious journals. Insufficient knowledge or education was frequently seen as an obstacle to collaboration. Other factors affecting collaboration are discussed.     

Retrieval during learning facilitates subsequent memory encoding

In multiple-list learning, retrieval during learning has been suggested to improve recall of the single lists by enhancing list discrimination and, at test, reducing interference. Using electrophysiological, oscillatory measures of brain activity, we examined to what extent retrieval during learning facilitates list encoding. Subjects studied 5 lists of items in anticipation of a final cumulative recall test and did either a retrieval or a no-retrieval task between study of the lists. Retrieval was from episodic memory (recall of the previous list), semantic memory (generation of exemplars from an unrelated category), or short-term memory (2-back task). Behaviorally, all 3 forms of retrieval enhanced recall of both previously and subsequently studied lists. Physiologically, the results showed an increase of alpha power (8-14 Hz) from List 1 to List 5 encoding when no retrieval activities were interpolated but no such increase when any of the 3 retrieval activities occurred. Brain-behavior correlations showed that alpha-power dynamics from List 1 to List 5 encoding predicted subsequent recall performance. The results suggest that, without intermittent retrieval, encoding becomes ineffective across lists. In contrast, with intermittent retrieval, there is a reset of the encoding process for each single list that makes encoding of later lists as effective as encoding of early lists.     

Intentional suppression of unwanted memories grows more difficult as we age

People often encounter reminders to memories that they would prefer not to think about. When this happens, they often try to exclude the unwanted memory from awareness, a process that relies upon inhibitory control. We propose that the ability to regulate awareness of unwanted memories through inhibition declines with advancing age. In two experiments, we examined younger and older adults' ability to intentionally suppress retrieval when repeatedly confronted with reminders to an experience they were instructed to not think about. Older adults exhibited significantly less forgetting of the suppressed items compared to younger adults on a later independent probe test of recall, indicating that older adults failed to inhibit the to-be-avoided memories. These findings demonstrate that the ability to intentionally regulate conscious awareness of unwanted memories through inhibitory control declines with age, highlighting differences in memory control that may be of clinical relevance in the aftermath of unpleasant life events.     

School Counselors as Social Capital: The Effects of High School College Counseling on College Application Rates

Using social capital theory as a framework, the authors examined data from the Educational Longitudinal Study of 2002 (Ingels, Pratt, Rogers, Siegel, & Stutts, 2004) to investigate how student contact with high school counselors about college information and other college‐related variables influence students' college application rates. In addition to some college‐related variables, the number of school counselors and student contacts were significant predictors of college application rates. Implications for school counselors and counselor training are included.     

Category priming with aliens: analysing the influence of targets' prototypicality on the centre surround inhibition mechanism

Marginally perceptible prototypes as primes lead to slowed reactions to related category exemplars as compared to unrelated ones. This at first glance counterintuitive finding has been interpreted as evidence for a particular mechanism of lateral inhibition, namely the centre surround inhibition mechanism. We investigated the semantic surround of category labels by experimentally manipulating the prototypicality of stimuli. Participants first learned two new categories of fantasy creatures in a 5-day-long learning phase before they worked through a semantic priming task with the category prototypes as primes and category exemplars as targets. For high-prototypical targets we observed benefit effects from related primes, whereas for low-prototypical targets we observed cost effects. The results define when the centre surround inhibition mechanism is applied, and furthermore might explain why previous studies with word stimuli (i.e., material that prevents experimental manipulation of prototypicality) observed mixed results concerning the prototypicality of targets.