Psychosocial Impact of a Positive Gene Result for Asymptomatic Relatives at Risk of Hypertrophic Cardiomyopathy

Families with a history of hypertrophic cardiomyopathy (HCM) may be offered genetic testing in addition to clinical surveillance. Asymptomatic family members who are gene positive (silent gene carriers) represent a new group of “patients” who may not develop HCM, with little evidence available to assist clinical management. This study explored experiences of HCM genetic testing to identify potential benefits and harms. Thirty-two individuals previously offered genetic testing for HCM were recruited. Semi-structured interviews were conducted face-to-face or by phone, and transcribed audio-recordings were coded using framework analysis. Key themes were as follows: (1) helping the next generation, (2) misunderstanding risk, (3) discrepancy between actual/perceived impact. Participants described multiple psychological (shock, worry, uncertainty) and behavioural (career, sport, insurance, family planning) consequences, depending on perceived risk. Most considered only the benefits of genetic testing for children or grandchildren, but there were some cases of significant adverse impact. The interpretation of the HCM genetic test result is variable for silent gene carriers and can lead to psychological and behavioural changes. The impact of a positive gene result may be mitigated by increased clarity of the clinical consequences and efforts to ensure informed decision-making, highlighting even further the important role of cardiac genetic counselling.     

Reduction of anxiety sensitivity in relation to nicotine withdrawal symptoms during smoking cessation: an examination among successful quitters

Anxiety sensitivity has been implicated as a potential risk factor for post-quit withdrawal symptoms. The present study examined relations between the extent of change in anxiety sensitivity and the course of nicotine withdrawal symptoms experienced during the initial two weeks of a quit attempt among treatment-seeking smokers. The sample consisted of 29 adult daily smokers (34% female; M_age = 47.7, SD = 13.1) who successfully quit and maintained their abstinence. After adjusting for the effects of gender, treatment condition, use of nicotine replacement therapy, nicotine dependence, alcohol use problems, baseline levels of anxiety sensitivity, and reductions in negative affect, greater reductions in anxiety sensitivity were related to faster decreases in withdrawal symptoms. The current data suggest that there may be merit to employ anxiety sensitivity reduction methods for the management of emergent withdrawal symptoms in smoking cessation treatment.     

Developing Behavioral Fluency with Movement Cycles Using SAFMEDS

The Precision Teaching term “movement cycle” refers to a behavior with a clearly observable movement and a distinct beginning and end. The present experiment examined whether behavior analysts and special education teachers could become fluent identifying movement cycles. A frequency-building intervention called SAFMEDS, an acronym for Say All Fast Minute Every Day Shuffled, required participants to see a picture of behavior on a laminated card and say the movement cycle. A multiple baseline multiple probe design with two groups of four participants revealed the effects of the intervention. Results showed a replication of effects with each group using equivalent SAFMEDS decks. The SAFMEDS intervention produced behavioral fluency and also fostered strong maintenance effects for a majority of the participants.     

Constraints on Multiple Object Tracking in Williams Syndrome: How Atypical Development Can Inform Theories of Visual Processing

The ability to track moving objects is a crucial skill for performance in everyday spatial tasks. The tracking mechanism depends on representation of moving items as coherent entities, which follow the spatiotemporal constraints of objects in the world. In the present experiment, participants tracked 1 to 4 targets in a display of 8 identical objects. Objects moved randomly and independently (moving condition), passed behind an invisible bar (occluded condition), or momentarily disappeared by shrinking (implosion condition). Scholl and Pylyshyn (1999) found that adults can track entities under the moving and occluded conditions, but not under implosion. This finding suggests that the tracking mechanism is constrained by the spatiotemporal properties of physical objects as they move in the world. In the present study, we adapt these conditions to investigate whether this constraint holds for people with severe spatial impairments associated with Williams syndrome (WS). In Experiment 1, we compare the performance of individuals with WS and typically developing (TD) adults. TD adults replicated Scholl and Pylyshyn’s findings; performance was no different between the moving and occluded conditions but was worse under implosion. People with WS had reduced tracking capacity but demonstrated the same pattern across conditions. In Experiment 2, we tested TD 4-, 5-, and 7-year-olds. People with WS performed at a level that fell between TD 4- and 5-year-olds. These results suggest that the multiple object tracking system in WS operates under the same object-based constraints that hold in typical development.     

Descending from the Summit: Aftercare Planning for Adolescents in Wilderness Therapy

Despite substantial gains adolescents and families can make in the intensely therapeutic and structured environment of wilderness therapy, regression is still a significant risk at the time of discharge. Accordingly, intentional and comprehensive aftercare planning is crucial to support adolescents and families internalize the changes begun in wilderness therapy. Wilderness therapy is a powerful and focused intervention, but it is not the solution. This article describes why most adolescents leaving wilderness therapy programs transition to longer-term, residential therapeutic schools and programs upon discharge. Although intentional separation of parents and children might appear counterintuitive, these settings often provide the least-restrictive environment. Their therapeutic benefit is explained using Bowen theory and the trans-theoretical model of change. Considerations for a successful aftercare plan are identified, including the importance of the family therapeutic process in supporting adolescent clinical growth, and when going home upon discharge is recommended. Lastly, suggestions are offered for treatment providers to support families making difficult aftercare decisions.     

In and Out of the House. Housing Hau in Sønderborg and Frederikssund

This article deals with houses and objects. Based on anthropological fieldwork on materiality in two well-off neighbourhoods in Denmark, the starting point are localisations of global flows in the privacy of houses. Filters and control showed out to be a major theme concerning the passages of things in and out of houses; these passages follow two rules: “something in means something else out” and “what comes in must be activated”. Openness and transparency showed out to be important themes concerning the house; there is a tendency towards large windows, few inner walls and large rooms, which are both poly-functional and poly-social. Furthermore, the filtering mechanisms for objects and the openness of the house are related to virtual flows from computers, telephones and televisions. Classical anthropological theories are used to understand this subject matter: the concept of haul (the spirit of the thing), exchange and social relations at large.

Core knowledge and its limits: The domain of food

Adults, preschool children, and nonhuman primates detect and categorize food objects according to substance information, conveyed primarily by color and texture. In contrast, they perceive and categorize artifacts primarily by shape and rigidity. The present experiments investigated the origins of this distinction. Using a looking time procedure, Experiment 1 extended previous findings that rhesus macaques (Macaca mulatta) generalize learning about novel food objects by color over changes in shape. Six additional experiments then investigated whether human infants show the same signature patterns of perception and generalization. Nine-month-old infants failed to detect food objects in accord with their intrinsic properties, in contrast to rhesus monkeys tested in previous research with identical displays. Eight-month-old infants did not privilege substance information over other features when categorizing foods, even though they detected and remembered this information. Moreover, infants showed the same property generalization patterns when presented with foods and tools. The category-specific patterns of perception and categorization shown by human adults, children, and adult monkeys therefore were not found in human infants, providing evidence for limits to infants’ domains of knowledge.     

Do amnesic patients with Korsakoff’s syndrome use feedback when making decisions under risky conditions? An experimental investigation with the Game of Dice Task with and without feedback

We investigated the role of feedback processing in decision making under risk conditions in 50 patients with amnesia in the course of alcoholic Korsakoff's syndrome (KS). Half of the patients were administered the Game of Dice Task (GDT) and the remaining 25 patients were examined with a modified version of the GDT in which no feedback was provided. Patients' results in the GDT and in the modified version were compared with that of 50 healthy subjects of whom 25 subjects performed the original GDT and 25 performed the modified version. While performance on the original GDT was superior to performance on the modified GDT in healthy subjects, KS patients performed similarly on both the GDT with and GDT without feedback. Performance on both task versions was correlated with categorization and set-shifting. The findings indicate that amnesic patients do not profit from receiving feedback for their decisions in explicit risk conditions.     

A developed nature: a phenomenological account of the experience of home

Though “dwelling” is more commonly associated with Heidegger’s philosophy than with that of Merleau-Ponty, “being-at-home” is in fact integral to Merleau-Ponty’s thinking. I consider the notion of home as it relates to Merleau-Ponty’s more familiar notions of the “lived body” and the “level,” and, in particular, I consider how the unique intertwining of activity and passivity that characterizes our being-at-home is essential to our nature as free beings. I argue that while being-at-home is essentially an experience of passivity—i.e., one that rests in the background of our experience and provides a support and structure for our life that goes largely unnoticed and that is significantly beyond our “conscious” control—being-at-home is also a way of being to which we attain. This analysis of home reveals important psychological insights into the nature of our freedom as well as into the nature of the development of our adult ways of coping and behaving.     

The effects of feature-label-order and their implications for symbolic learning

Symbols enable people to organize and communicate about the world. However, the ways in which symbolic knowledge is learned and then represented in the mind are poorly understood. We present a formal analysis of symbolic learning-in particular, word learning-in terms of prediction and cue competition, and we consider two possible ways in which symbols might be learned: by learning to predict a label from the features of objects and events in the world, and by learning to predict features from a label. This analysis predicts significant differences in symbolic learning depending on the sequencing of objects and labels. We report a computational simulation and two human experiments that confirm these differences, revealing the existence of Feature-Label-Ordering effects in learning. Discrimination learning is facilitated when objects predict labels, but not when labels predict objects. Our results and analysis suggest that the semantic categories people use to understand and communicate about the world can only be learned if labels are predicted from objects. We discuss the implications of this for our understanding of the nature of language and symbolic thought, and in particular, for theories of reference.