Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

Categorization and abstraction abilities in 3-year-old children: a comparison with monkey data

Three-year-old children were tested on three categorization tasks of increasing levels of abstraction (used with adult baboons in an earlier study): the first was a conceptual categorization task (food vs toys), the second a perceptual matching task (same vs different objects), and the third a relational matching task in which the children had to sort pairs according to whether or not the two items belonged to the same or different categories. The children were tested using two different procedures, the first a replication of the procedure used with the baboons (pulling one rope for a category or a relationship between two objects, and another rope for the other category or relationship), the second a task based upon childrens prior experiences with sorting objects (putting in the same box objects belonging to the same category or a pair of objects exemplifying the same relation). The children were able to solve the first task (conceptual categorization) when tested with the sorting into boxes procedure, and the second task (perceptual matching) when tested with both procedures. The children were able to master the third task (relational matching) only when the rules were clearly explained to them, but not when they could only watch sorting examples. In fact, the relational matching task without explanation requires analogy abilities that do not seem to be fully developed at 3 years of age. The discrepancies in performances between children tested with the two procedures, with the task explained or not, and the discrepancies observed between children and baboons are discussed in relation to differences between species and/or problem-solving strategies.     

Cognitive modeling analysis of decision-making processes in cocaine abusers

This article examines the theoretical basis of decision-making deficits exhibited by cocaine abusers in a laboratory decision-making task first described by Bechara, Damasio, Damasio, and Anderson (1994). A total of 12 male cocaine abusers and 14 comparison subjects performed the task, and the cocaine group performed significantly worse than the comparison group. A cognitive modeling analysis (Busemeyer & Stout, 2002) was used to estimate three parameters that measure importance of the cognitive, motivational, and response processes for determining the observed performance deficit. The results of this analysis indicated, for the first time, that motivational and choice consistency factors, but not learning/ memory were mainly responsible for the decision-making deficit of the cocaine abusers in this task.     

Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through 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 Cancer Genetic 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. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. 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.     

Changes in the structure of children's isometric force variability with practice

This study examined the effect of age and practice on the structure of children's force variability to test the information processing hypothesis that a reduction of sensorimotor system noise accounts in large part for age-related reductions in perceptual-motor performance variability. In the study, 6-year-olds, 10-year-olds, and young adults practiced on 5 consecutive days (15 trials/day), maintaining for 15-s trials a constant level of force (5 or 25% of maximum voluntary contraction) against an object using a pinch grip (thumb and index finger). With increasing age, the amount of force error and variability decreased, but the sequential structure of variability increased in irregularity. With practice, children reduced the amount of variability by changing the structure of the force output so as to be more similar to that of their older counterparts. The findings provide further evidence that practice-driven changes in the structure of force output, rather than a decline in the amount of white noise, largely account for age-related reductions in the amount of force variability.     

Text cohesion and metacomprehension: Immediate and delayed judgments

In three experiments, we examined comprehension judgments made after a piece of text had been read. We propose that such metacognitive judgments are based on the content of working memory at the exact moment of assessment. Generally speaking, this working metacognition hypothesis is in agreement with Koriat's cue utilization approach, which implies that different elements of information will be available (and used) depending on the moment at which a judgment is made. More specifically, our hypothesis focuses on the management of working memory during reading as a cause for cue (un)availability. In support of these views, the results of Experiment 1 showed that a cohesion manipulation affecting the comprehension of specific paragraphs influences judgments only on these paragraphs, and not on judgments on the whole text. In Experiment 2, we showed that an interfering task that takes place just before this paragraph judgment is made wipes out this cohesion effect. Experiment 3 showed, on the other hand, that the whole-text judgment may, nevertheless, be affected by text cohesion, provided that the readers keep an access to the text when the judgment is made. These results support the idea that working memory management makes different cues available for metacognitive ratings at different delays.     

Stabilization and destabilization of perception--action patterns influence the self-organized recruitment of degrees of freedom

The recruitment of an additional biomechanical degree of freedom in a unimanual rhythmic task was explored. Subjects were asked to synchronize adduction or abduction of their right index finger with a metronome, the frequency of which was increased systematically. In addition, haptic contact on or off the metronome beat was provided. Results showed that the pattern exhibiting the highest intrinsic stability recruited the vertical plane more than did the less stable one. Moreover, presence and location of haptic contact modulated coordination stability and therefore induced changes in the recruitment of the vertical plane. Thus, a trade-off was shown between coordination stability on the horizontal plane and recruitment of the vertical one. These findings suggest that recruitment of degrees of freedom is governed by general principles of coordination dynamics.     

Processing reduced word forms: the suffix restoration effect

Listeners cannot recognize highly reduced word forms in isolation, but they can do so when these forms are presented in context (Ernestus, Baayen, & Schreuder, 2002). This suggests that not all possible surface forms of words have equal status in the mental lexicon. The present study shows that the reduced forms are linked to the canonical representations in the mental lexicon, and that these latter representations induce reconstruction processes. Listeners restore suffixes that are partly or completely missing in reduced word forms. A series of phoneme-monitoring experiments reveals the nature of this restoration: the basis for suffix restoration is mainly phonological in nature, but orthography has an influence as well.