Suicide prevention in the genetic counseling context

Utilizing a case report, this paper explores psychosocial aspects of suicidal intent in a woman seeking prenatal diagnosis. Using knowledge and practice of appropriate assessment, referral, and intervention procedures, the therapy team of genetic counselor and psychotherapist facilitated successful identification and management of this potentially suicidal client. The main counseling goals for the genetic counselor are to assess the situation adequately, decrease the immediate danger, and, with supervision and/or consultation, stabilize the seriously suicidal person until that individual can be triaged to mental health or medical professionals for treatment. The prevalence of suicide issues in genetic counseling contexts is unknown and reports mentioning suicidal ideation unusual in the genetic counseling literature. Is this reported case a rarity among genetic counseling referrals? Systematically collected information on the prevalence and resolution of suicidal issues in genetic counseling contexts would be helpful for those setting curricula for genetic counseling training programs, standards for professional certification exams, and policy and procedures manuals for clinical units.     

Reflective and ruminative processing of positive emotional memories in bipolar disorder and healthy controls

Recent evidence suggests that reflective (i.e., distanced-why), as compared to ruminative (i.e., immersed-why), processing of negative memories is associated with reductions in negative affect. The present study extended this line of work by examining the effect of these two processing conditions on positive memories among persons with bipolar disorder (BD; n = 27) and a healthy control group (CT; n = 27). After a resting baseline period, participants were instructed to recall a happy autobiographical memory. Using a within-subjects design, participants were asked to process the happy memory in two different experimental conditions (reflective, ruminative) while their experiential, behavioral, and autonomic responses were measured. Consistent with hypotheses, reflective processing was associated with lower self-reported positive affect, positive thoughts, and heart rate compared to ruminative processing for all participants. When current symptoms were controlled for, BD participants reported greater positive affect across both conditions relative to CT participants. Prospective studies are needed to test the extent to which processing of positive emotion contributes to the course of symptoms in bipolar disorder.     

Psychopathy and Identification of Facial Expressions of Emotion

The authors examined the association between psychopathy and identification of facial expressions of emotion. Previous research in this area is scant and has produced contradictory findings (Blair et. al., 2001, 2004; Glass & Newman, 2006; Kosson et al., 2002). One hundred and forty-five male jail inmates, rated using the Hare Psychopathy Checklist: Screening Version participated in a facial affect recognition task. Participants were shown faces containing one of five emotions (happiness, sadness, fear, anger, or shame) displayed at one of two different levels of intensity of expression (100% or 60%). The authors predicted that psychopathy would be associated with decreased affect recognition, particularly for sad and fearful emotional expressions, and decreased recognition of less intense displays of facial affect. Results were largely consistent with expectations in that psychopathy was negatively correlated with overall facial recognition of affect, sad facial affect, and recognition of less intense displays of affect. An unexpected negative correlation with recognition of happy facial affect was also found. These results suggest that psychopathy may be associated with a general deficit in affect recognition.     

Tacit coordination in monozygotic twins, dizygotic twins and virtual twins: Effects and implications of genetic relatedness

Game theorists have long been interested in why some partners are more successful at achieving mutual goals than others. The present study was conducted to determine if tacit coordination (non-negotiated consensus) varies as a function of genetic relatedness between social partners. The sample included 7–13-year-old monozygotic (MZ) twin pairs (n = 53), dizygotic (DZ) twin pairs (n = 85) and virtual twin (VT) pairs (n = 42; same-age unrelated siblings). Co-twin agreement on questions completed under individual and coordination conditions was compared across the three groups. MZ twins showed significantly greater overall agreement than DZ twins and VTs, using multiple criteria. The implications of these findings are considered with reference to behavioral-genetic and evolutionary theories of behavior.     

Testicular Cancer and Genetics Knowledge Among Familial Testicular Cancer Family Members

Purpose  

It was our aim to determine baseline levels of testicular cancer and genetics knowledge among members of families with Familial Testicular Cancer (FTC).     

Interactive Genetic Counseling Role-Play: A Novel Educational Strategy for Family Physicians

Background Family physicians (FPs) are increasingly involved in delivering genetic services. Familiarization with aspects of genetic counseling may enable FPs to help patients make informed choices. Purpose Exploration of interactive role-play as a means to raise FPs’ awareness of the process and content of genetic counseling. Methods FPs attending two large Canadian family medicine conferences in 2005 were eligible—93 participated. FPs discussed a case during a one-on-one session with a genetic counselor. Evaluation involved pre and post intervention questionnaires Results FPs’ baseline genetic knowledge was self-rated as uniformly poor. Baseline confidence was highest in eliciting family history and providing psychosocial support and lowest in discussing risks/benefits of genetic testing and counseling process. Post-intervention, 80% of FPs had better appreciation of family history and 97% indicated this was an effective learning experience. Conclusions Role-play with FPs is effective in raising awareness of the process and content of genetic counseling and may be applied to other health disciplines. This research was funded by: The Canadian Institutes of Health Research (CIHR) Institute of Genetics, The Genetics Education Project (funded by the Ontario Women’s Health Council), and GeneSens (funded by a CIHR Interdisciplinary Capacity Enhancement Team Grant).     

Adult helping qualities preferred by adolescents

Most studies of therapeutic alliance have focused on adult populations and been written from the therapist's perspective. Thus, there is a clear need for studies of therapeutic alliance that focus on adolescent populations from the perspective of the adolescents. The current study is an exploratory process investigation using a focus group methodology with a nonclinical sample of adolescents to determine which traits in adults might foster alliance, with the assumption that the same traits would apply to therapeutic settings. A content analytic approach was used and 12 adult qualities found to be preferred by adolescents from most to least cited were: respect, time shared, openness, role characteristics, recognition, guidance, identification, trust, freedom, like/ dislike, responsibility, and familiarity.     

Evolution of the Colored Eco-Genetic Relationship Map (CEGRM) for Assessing Social Functioning in Women in Hereditary Breast-Ovarian (HBOC) Families

The CEGRM was initially conceived as a simple, concise, visual representation of the social interaction domains of information, tangible services and emotional exchanges (Kenen, R., & Peters, J. (2001). J Genet Counsel, 10, 289–309). A blend of the genetic pedigree, genogram, and ecomap, the CEGRM was developed to facilitate contemporary genetic counseling goals. An exploratory pilot study of 20 subjects showed that it was feasible, comfortable and efficiently accomplished, and that the process was useful both for assessment and as an intervention with study participants (Peters, J. A., Kenen, R., Giusti, R., Loud, J., Weissman, N., & Greene, M. H. (2004). Am J Med Genet Part A, 130A, 258–264). Subsequently, we have extended the CEGRM to 150 women from hereditary breast/ovarian cancer (HBOC) families; three different investigators have successfully administered this tool. The preliminary findings from the exploratory study were confirmed in the larger sample. Engaging in the interactive, insight-promoting CEGRM process provides a novel tool for assessing the social context of genetic testing, and helping high-risk women better understand and integrate genetic information into their personal and family identities, health beliefs, and decisions.