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.     

Immature cortical responses to auditory stimuli in specific language impairment: evidence from ERPs to rapid tone sequences

Event-related potentials (ERPs) to tone pairs and single tones were measured for 16 participants with specific language impairment (SLI) and 16 age-matched controls aged from 10 to 19 years The tone pairs were separated by an inter-stimulus interval (ISI) of 20, 50 or 150 ms. The intraclass correlation (ICC) was computed for each participant between the ERP to a single tone and the ERP to the tone pair. A high ICC indicates that the brain response to a tone pair is similar to that for a single tone. ICCs were significantly higher at short than at long ISIs. At 50-ms ISI, ICCs were higher for younger than older participants. Age and ISI interacted with SLI status: ERPs of older participants with SLI differed from age-matched controls, and resembled ERPs of younger controls, consistent with a theory of immature auditory processing in SLI.     

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.     

Phonologically mediated priming of preexisting and new associations in young and older adults

In 2 experiments, the authors investigated phonologically mediated priming of preexisting and new associations in word retrieval. Young and older adults completed paired word stems with the first word that came to mind. Priming of preexisting associations occurred when word-stem pairs containing homophones (e.g., beech-s____) showed more completions with the target (e.g., sand) relative to unrelated pairs (e.g., batch-s____), with more priming for subordinate than for dominant homophones. Priming occurred for new associations independent of dominance such that word-stem pairs containing homophones (e.g., beech-l____ and beach-l____) were completed with the same word (e.g., laugh) more often than unrelated pairs (e.g., beech-l____ and batch-l____). No age differences in phonologically mediated priming were found for either type of association, suggesting age equivalence in the use of bottom-up phonological connections.     

The Physical Appearance Ambiguous Feedback Scale (PAAFS): a measure for indexing body image related cognitive bias

Recent conceptualizations of body image disturbance have included an information processing model that includes a focus on an interpretive information processing bias. Study 1 involved the development and validation of a measure of appearance-based cognitive bias, the Physical Appearance Ambiguous Feedback Scale (PAAFS). In Studies 2 and 3, two samples of college females (n=313) were tested and the psychometric characteristics of the PAAFS were evaluated. Reliability was acceptable and convergence with measures of body image and eating disturbance was moderate. In Study 4, 313 college females completed the PAAFS in the laboratory based on an instructional content designed to induce processing bias. Preliminary evidence indicates that the PAAFS appears to be sensitive to instructional set manipulations and dispositional level of body dissatisfaction.     

An experimental test of the effect of weight-loss dieting on bulimic pathology: tipping the scales in a different direction

Although it is widely accepted that dieting increases the risk for bulimic pathology, this hypothesis has not been tested in a randomized experiment. Accordingly, the authors conducted an experimental test of the dietary restraint model by randomly assigning nonobese women (N = 82) to either a 6-week, low-calorie diet or a waitlist control condition. The diet intervention resulted in significant weight loss, confirming that dieting was successfully manipulated. Contrary to the restraint model, dieting resulted in significant decreases in bulimic symptoms relative to the control condition. Results converge with past findings from randomized obesity prevention and treatment trials and provide evidence that dieting does not promote bulimic pathology; rather, effective decreases in caloric intake appear to reduce bulimic symptoms.     

Limits of the retrieval-inhibition construct: list segregation in directed forgetting

The authors hypothesized that retrieval inhibition in list method directed forgetting could be improved by presenting a task that maximized the segregation step of the retrieval-inhibition process. In Experiment 1, they presented lists of semantically related words in a list method directed-forgetting task to maximize retrieval inhibition. Contrary to predictions, this manipulation eliminated the directed-forgetting effect. The authors further investigated the results of Experiment 1 in Experiments 2 and 3 by manipulating recall instructions and by presenting lists that contained both a categorized and an unrelated list-half. They found directed-forgetting effects for semantically related word lists when participants were asked to recall only the TBR (to-be-remembered) items but not when participants were asked to recall both the TBF (to-be-forgotten) and TBR items. They also found that directed-forgetting effects were not produced when categorized items were presented in the 1st list.     

Knowing in advance: the impact of prior event information on memory and event knowledge

We examined the influence of newly acquired information on children's memory and general representation of a personally experienced event. Thirty-five children between the ages of 5 and 7 years participated in the novel event (Visiting the Pirate). The day before participating, children were: (1) provided with new information specific to the up-coming event; (2) engaged in a discussion generally related to the event topic based on existing knowledge; or (3) discussed an unrelated topic. Advance information specific to the event led to better recall and, in particular, to better integration of the experience into a general event representation both soon after the event and at a follow-up interview 4 months later, whereas general discussion of the topic without the event specific information neither enhanced memory reports nor facilitated the integration of event information. Providing information in advance can have significant effects on memory and knowledge acquisition although many variables, including those relating to the specific content of the information, will affect this relation.