If We Build It … Will They Come? – Establishing a Cancer Genetics Services Clinic for an Underserved Predominantly Latina Cohort

Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina⁶ (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used     

Measuring How We Preach What We Practice: Psychoeducational Change in Depressed Inpatients

This study investigated the relationship between acquisition of psychoeducational principles and symptomatic improvement in depressed in-patients. One hundred and twenty-three inpatients hospitalized on a Cognitive Therapy Unit were administered the Test of Cognitive Behavioral Principles (TCBP) and the Beck Depression Inventory at admission and discharge. It was predicted that the TCBP scores would be higher at discharge than at pre-testing at admission. Further, it was hypothesized that the higher TCBP scores at post-test would be significantly correlated with lower Beck Depression Inventory scores at post-test. The results revealed that inpatients' TCBP scores improved over the course of treatment supporting the first hypothesis. However, the data did not support the second hypothesis as there was not a significant relationship between the TCBP scores and the BDI scores at discharge. The results are discussed in terms of clinical, theoretical, and methodological implications.     

Naturalistic evaluation of suicidal ideation: variability and relation to attempt status

Suicidal ideation has been thought to have a relatively stable course across weeks and months. However, daily changes in levels of ideation have not been adequately examined despite the importance of potential variability clinically and conceptually. For example, it has been suggested that variability in suicidal ideation may become less closely tied to variability in other mood symptoms (e.g., depression, hopelessness) among individuals with multiple suicide attempts. The present report had two related goals: (1) to prospectively evaluate suicidal ideation and related mood symptoms, and (2) to determine whether suicide attempt status predicted a decreased association between ideation and other mood symptoms. Non-clinical participants (N=108) with varying levels of suicidal ideation and number of previous suicide attempts completed the beck hopelessness scale (BHS), beck depression inventory (BDI), and suicide probability scale (SPS) every day for 4 weeks. Findings suggested considerable variability in suicidal ideation, especially for multiple attempters. Multiple attempt status predicted a decreased association between suicidal ideation and depression, although the results were only marginally significant. These findings have implications for conceptual models of suicide risk as well as assessment and treatment of suicidal individuals.     

Direct Comparison of Episodic Encoding and Retrieval of Words: An Event-related fMRI Study

Functional magnetic resonance imaging (fMRI) was used to compare directly episodic encoding and retrieval. During encoding, subjects studied visually presented words and reported via keypress whether each word represented a pleasant or unpleasant concept (intentional, deep encoding). During the retrieval phase, subjects indicated (via keypress) whether visually presented words had previously been studied. No reliable differences were found during the recognition phase for words that had been previously studied and those that had not been studied. Areas preferentially active during encoding (relative to retrieval) included left superior frontal cortex, medial frontal cortex, left superior temporal cortex, posterior cingulate, left parahippocampal gyrus, and left inferior frontal gyrus. Regions more active in retrieval than encoding included bilateral inferior parietal cortex, bilateral precuneus, right frontal polar cortex, right dorsolateral prefrontal cortex, and right inferior frontal/insular cortex.     

Studies of open-loop pointing in the presence of induced motion

In the present research, we examined the influence of induced motion (IM) on open-loop pointing responses and the possibility that IM alters the registration of either eye or trunk position. In two experiments, subjects tracked a dot that oscillated vertically while a rectangular stimulus oscillated horizontally. The pairing of frame and dot motion caused the dot to appear to move on a slant, due to IM. In the first experiment, the subjects made judgments of the apparent slant of the dot's motion and, on separate trials, pointed open loop at the apparent location of the dot at the endpoints of its motion. Both responses were influenced by IM, although the effect on dot localization was less than the amount predicted by the IM, as indicated by the slant responses. Results were similar immediately following IM and after a 5-sec delay. In the second experiment, the subjects pointed open loop either at the apparent location of the endpoints of the tracked dot's motion or at the apparent location of one of three other briefly flashed stationary dots. The pointing responses directed toward the fixated IM target were influenced by IM to a greater extent than the responses directed toward the stationary dots. The results of the two experiments are inconsistent with the hypothesis that the effect of IM on open-loop pointing at the IM target results completely from altered perception of either eye or trunk position, since misregistration of either would be expected to influence, in a similar fashion, pointing at both the tracked dot and the briefly flashed, stationary targets.     

A reappraisal of medieval mysticism & hysteria

This paper examines the historical association between medieval mysticism and asceticism and the psychopathological condition of hysteria. We first review the particular forms of medieval mysticism and asceticism that seem to have inspired modern psychiatrists and reductive historians to dismiss these phenomena as indubitably neurotic behaviours. Then we review the concept of hysteria as it evolved during the last two centuries for points of convergence with mysticism. Finally, we question the validity of value-laden diagnostic formulations in the domain of personality assessment. A few highly dramatic but culturally endorsed religious behaviours occuring in an otherwise well functioning individual does not constitute a basis for any psychiatric diagnosis, let alone a condemnatory characterological one such as hysteria. We propose a perspective for looking at medieval mystical states of mind and behaviours in context that moves beyond ahistoric assumptions that employ modern Western standards as the yardstick for medieval health and illness.     

Influence of Levels of Abstractness on Reasoning Ability

Judgment by students of faculty effectiveness have relied, for the most part, on subjectively expressed responses to a series of “effectiveness traits” (cues). Simple averaging schemes have summarized the aggregate judgments, often resulting in (a) treating all cues as if they were of equal importance, and (b) inattention to the effects or measurement of individual differences of judges.

Multiple regression was used in this study to derive (empirically) individual cue utilization patterns (i.e., weights) for 10 effectiveness traits. Ss were compared to their subjectively expressed judgment scheme. Results indicate that Ss were moderately successful in expressing their actual cue utilization patterns; however, different judgment schemes were clearly observed.     

Parental Stress and Children’s Social and Behavioral Outcomes: The Role of Abuse Potential over Time

Parental stress is a well-established risk factor for adverse child outcomes, including the development of aggression, externalizing behavior problems, and anxiety, as well as compromised emotional coping, impaired social cognition, and diminished treatment response. Abuse potential represents a mechanism by which parental stress may impact child social competence and behavior; evidence links parental stress to abuse potential, and abuse potential to a range of negative child social competence and behavioral outcomes. The current study assessed relationships between parental stress, abuse potential, and child social and behavioral outcomes over time. Parents of children ages 2–6 years (N?=?610, 44% girls) reported on perceived parental stress and attitudes towards abuse and neglect, as well as child social competence and behavior problems, before and after a caregiver-directed, community-based intervention. Changes in parental stress, abuse potential, and child social and behavioral outcomes were examined using panel analyses, while controlling for intervention effects and demographic variables. Parental stress predicted child social competence, anxiety/withdrawal, and anger/aggression over time; while the links between stress and anxiety/withdrawal, and stress and social competence, were mediated by child abuse potential, the link between stress and anger/aggression was not mediated by child abuse potential. Findings suggest that abuse potential represents a mechanism by which parental stress and child social and behavioral outcomes are linked. Further, screening for child social competence deficits may identify children at risk for abuse, as well as parents in need of services to reduce stress.