Mindfulness Among Genetic Counselors Is Associated with Increased Empathy and Work Engagement and Decreased Burnout and Compassion Fatigue

Genetic counselors experience high rates of compassion fatigue and an elevated risk for burnout, both of which can negatively impact patient care and retention in the profession. In other healthcare professions, mindfulness training has been successfully used to address similar negative psychological sequelae and to bolster empathy, which is the foundation of our counseling work. We aimed to assess associations between mindfulness and key professional variables, including burnout, compassion fatigue, work engagement, and empathy. Data were collected via an anonymous, online survey that included validated measures of mindfulness and these key professional variables. The survey was completed by 441 genetic counselors involved in direct patient care. Half of the respondents (50.1%) reported engaging in yoga, meditation, and/or breathing exercises. Mindfulness was positively correlated with work engagement (r?=?0.24, p?<?0.001) and empathy (as measured through four subscales: perspective taking (r?=?0.15, p?=?0.002), empathic concern (r?=?0.11, p?=?0.03), fantasy (r?=???0.11, p?=?0.03) and personal distress (r?=???0.15, p?=?0.001)). Mindfulness was negatively correlated with compassion fatigue (r?=???0.48, p?<?0.001) and burnout (r?=???0.50, p?<?0.001). Given these findings, mindfulness training may be a valuable addition to graduate and continuing education for genetic counselors. The integration of mindfulness into the genetic counseling field will likely improve professional morale and well-being, while promoting workforce retention and bolstering the relational and counseling aspects of our clinical work.     

The Head,the Heart,and Hysteria in Jeanne Flore's <Emphasis Type="Italic">Tales and Trials of Love</Emphasis> (c. 1542)

This essay examines a challenge to common literary representations of female mental illness in the Early Modern period—the hysterical woman—in a collection of French short stories contemporary to Vesalius's De Fabrica: Jeanne Flore's Tales and Trials of Love (1542). Jeanne Flore's tales depict several mentally disturbed female protagonists, young women prone to paroxysms of madness and self-mutilation. This study maintains that while Tales and Trials of Love superficially participates in the literary tradition that grew out of those accepted social and medical beliefs, it also questions the long-accepted paradigm of female hysteria and points to a shift in the socio-medical climate. Jeanne Flore's fictional narratives suggest that mental illness no longer consists in the realignment of a uterine imbalance, but rather in the telling of personal stories, a precursor to psychoanalysis and narrative medicine.     

Diabetes distress,illness perceptions and glycaemic control in adults with type 2 diabetes

The emotional distress associated with adjusting to and living with diabetes has been termed diabetes distress. Diabetes distress is associated with glycaemic control but interventions to reduce diabetes distress have failed to consistently improve diabetes control. Various illness perceptions have previously been linked with both diabetes distress and glycaemic control but interrelationships between these features have not been previously investigated. We hypothesised that illness perceptions mediate the relationship between diabetes distress and glycaemia. Participants with type 2 diabetes attending diabetes outpatient clinics (n = 84) provided demographic and clinical information and completed the Diabetes Distress Scale-17 and the Brief Illness Perceptions Questionnaire. Using regression analysis we demonstrated that the illness perceptions of personal control, regimen-related distress, socioeconomic status and insulin use were significant contributors in the final model predicting HbA_1c. Higher levels of personal control were associated with better glycaemic control. Conversely, regimen-related distress was associated with hyperglycaemia. Mediation analyses showed that the relationship between regimen-related distress and HbA_1c was mediated by personal control. Our work suggests that psychological interventions designed to reduce diabetes distress may be more efficacious in improving glycaemic control if they address an individual’s perception of personal control.     

Messianic language in trans public speech*

ABSTRACT

This essay examines how two trans public figures, Lou Sullivan and Jennifer Finney Boylan, try to realize the need for transgender legibility through messianic rhetoric. Messianism is a site of contention in queer theory, between advocates for either antirelational queer theory or queer utopianism. This essay sees messianic rhetoric as a strategy found in the public speech and writing of Sullivan and Boylan, each of whom instrumentalize it to achieve legibility. Such rhetoric works to the political end of broader transgender acceptance. However, it also relies upon a flattening of trans life into a monolith. Messianic rhetoric legitimates a singular narrative of “how to be trans” through excluding other possibilities. Public speech that rejects this universalizing messianic impulse is possible. The zine “Fucking Trans Women” represents such a possibility, focusing attention on experience and pleasure over narrative linearity, thus providing one path forward for trans public speech.     

Developing cognitions about race: White 5‐ to 10‐year‐olds' perceptions of hardship and pain

White American adults assume that Blacks feel less pain than do Whites, but only if they believe that Blacks have faced greater economic hardship than Whites. The current study investigates when in development children first recognize racial group differences in economic hardship and examines whether perceptions of hardship inform children's racial bias in pain perception. Five‐ to 10‐year‐olds (N = 178) guessed which of two items (low versus high value) belonged to a Black and a White child and rated the amount of pain a Black and a White child would feel in 10 painful situations. By age 5, White American children attributed lower‐value possessions to Blacks than Whites, indicating a recognition of racial group differences in economic hardship. The results also replicated the emergence of a racial bias in pain perception between 5 and 10. However, unlike adults', children's perceptions of hardship do not account for racial bias in pain perception.     

Selection of macroreference frames in spatial memory

Spatial memories are often hierarchically organized with different regions of space represented in unique clusters within the hierarchy. Each cluster is thought to be organized around its own microreference frame selected during learning, whereas relationships between clusters are organized by a macroreference frame. Two experiments were conducted in order to better understand important characteristics of macroreference frames. Participants learned overlapping spatial layouts of objects within a room-sized environment before performing a perspective-taking task from memory. Of critical importance were between-layout judgments thought to reflect the macroreference frame. The results indicate that (1) macroreference frames characterize overlapping spatial layouts, (2) macroreference frames are used even when microreference frames are aligned with one another, and (3) macroreference frame selection depends on an interaction between the global macroaxis (defined by characteristics of the layout of all learned objects), the relational macroaxis (defined by characteristics of the two layouts being related on a perspective-taking trial), and the learning view. These results refine the current understanding of macroreference frames and document their broad role in spatial memory.     

Christianity: Maidservant to War?

In this multi‐book review article, the author examines three new texts that make the case for a deeper, richer understanding of the Christian tradition of nonviolence. All three authors argue that traditions of nonviolence, and misgivings and suspicion regarding the sanctioned shedding of blood, are central to the understanding and practice of Christianity, and deserve to be taken more seriously by researchers and practitioners alike.     

Selflessness as a Foundation of Spiritual Transcendence: Perspectives From the Neurosciences and Religious Studies

Although of increasing scientific interest, the neurologic foundations of spiritual experiences remain ambiguous due to the neurological complexity of such experiences and the lack of a clear taxonomy of “spiritual experiences.” A previously proposed preliminary neuropsychological model of spirituality (Johnstone & Glass, 2008) suggests that decreased self-orientation (or increased selflessness), associated with reduced right hemisphere/right parietal lobe (RH/RPL) functioning, serves as a neuropsychological foundation of spiritual transcendence (defined as the ability to emotionally and cognitively connect with higher powers beyond the self or experience cosmic unity). This model was based on research that indicates that transcendent spiritual experiences are related to reduced activation of portions of the RH/RPL during religious rituals (e.g., Buddhist meditation, Christian prayer), as well as research that indicates that individuals with RH/RPL dysfunction report increased transcendence. This model has been supported by research with other populations (e.g., brain injury, epilepsy, tumor) and technologies (e.g., repetitive transcranial magnetic stimulation), although limitations in the model persist. The current article addresses such weaknesses by demonstrating the existence of “spiritual transcendence” as a psychometrically valid construct, identifying specific self-orientation processes (e.g., physical self, mental self, autobiographical self) that may serve as a foundation for transcendence, and explaining how transcendent experiences can involve both a decreased and enhanced sense of the self. To further support the model, citations from the texts of multiple faith traditions are offered to illustrate the importance of selflessness in transcendent experiences across diverse religions. Suggestions for future research and practical implications are offered.     

A Comparison of Telephone Genetic Counseling and In-Person Genetic Counseling from the Genetic Counselor’s Perspective

Growing demand for and limited geographic access to genetic counseling services is increasing the need for alternative service delivery models (SDM) like telephone genetic counseling (TGC). Little research has been done on genetic counselors’ perspectives of the practice of TGC. We created an anonymous online survey to assess whether telephone genetic counselors believed the tasks identified in the ABGC (American Board of Genetic Counseling) Practice Analysis were performed similarly or differently in TGC compared to in person genetic counseling (IPGC). If there were differences noted, we sought to determine the nature of the differences and if additional training might be needed to address them. Eighty eight genetic counselors with experience in TGC completed some or all of the survey. Respondents identified differences in 13 (14.8 %) of the 88 tasks studied. The tasks identified as most different in TGC were: “establishing rapport through verbal and nonverbal interactions” (60.2 %; 50/83 respondents identified the task as different), “recognizing factors affecting the counseling interaction” (47.8 %; 32/67), “assessing client/family emotions, support, etc.” (40.1 %; 27/66) and “educating clients about basic genetic concepts” (35.6 %; 26/73). A slight majority (53.8 %; 35/65) felt additional training was needed to communicate information without visual aids and more effectively perform psychosocial assessments. In summary, although a majority of genetic counseling tasks are performed similarly between TGC and IPGC, TGC counselors recognize that specific training in the TGC model may be needed to address the key differences.