Initiation of Reflective Frames in Counseling for Huntingtons Disease Predictive Testing

Genetic professionals and clients are likely to assign different meanings to the extended format of the counseling protocols for predictive testing. In order to facilitate informed, client-centered decisions about the possibility of predictive testing, counselors routinely use the question format to initiate what we call "reflective frames" that invite clients to discuss their feelings and encourage them to adopt introspective and self-reflective stances toward their own experience--spanning the past, the present, and the hypothetical future. We suggest that such initiations of reflective frames constitute a key element of counselors' nondirective stance, although the exact nature of their formulations can be complex and varied. Examining 24 Huntington's Disease (HD) clinic sessions involving 12 families in South Wales with the tools of discourse analysis, our focus in this paper is twofold: (i) to propose a classification of six types of reflective questions (e.g. nonspecific invites, awareness and anxiety, decision about testing, impact of result, dissemination, and other) and to examine their distribution across the various clinic appointments, and (ii) to investigate the scope of these questions in terms of temporal and social axes. We link our analysis to the current debate within the genetic counseling profession about the merits of reflection- versus information-focused counseling styles and the need to abide by professionally warranted and institutionally embedded counseling protocols.     

Autonomy gone awry: a cross-cultural study of parents’ experiences in neonatal intensive care units

This paper examines parents experiences of medical decision-making and coping with having a critically ill baby in the Neonatal Intensive Care Unit (NICU) from a cross-cultural perspective (France vs. U.S.A.). Though parents experiences in the NICU were very similar despite cultural and institutional differences, each system addresses their needs in a different way. Interviews with parents show that French parents expressed overall higher satisfaction with the care of their babies and were better able to cope with the loss of their child than American parents. Central to the French parents perception of autonomy and their sense of satisfaction were the strong doctor–patient relationship, the emphasis on medical certainty in prognosis versus uncertainty in the American context, and the sentimental work" provided by the team. The American setting, characterized by respect for parental autonomy, did not necessarily translate into full parental involvement in decision-making, and it limited the rapport between doctors and parents to the extent of parental isolation. This empirical comparative approach fosters a much-needed critique of philosophical principles by underscoring, from the parents perspective, the lack of emotional work" involved in the practice of autonomy in the American unit compared to the paternalistic European context. Beyond theoretical and ethical arguments, we must reconsider the practice of autonomy in particularly stressful situations by providing more specific means to cope, translating the impersonal language of rights" and decision-making into trusting, caring relationships, and sharing the responsibility for making tragic choices.     

Dissociations between implicit and explicit memory in children: the role of strategic processing and the knowledge base

A review of the literature shows that explicit memory develops substantially from three years of age to adulthood, while implicit memory remains stable across this age range. Previously, this developmental dissociation has been attributed to different memory systems, or to confounds with perceptual vs. conceptual processing. Prompted by an alternative developmental framework, the experiments reported here provide evidence against both interpretations. Instead, it will be argued that (a) the implicit-explicit developmental dissociation reflects differences in strategic processing (strategy use and metamemory) across childhood and (b) that implicit memory can show development if a child's knowledge base in the tested domain is developing with age.     

Phantom ROC: Recollection rejection in a hybrid conjoint recognition signal detection model

The present experiments test predictions of dual process models with regards to recollection rejection using a model called phantom ROC. Participants studied pictures and then took a recognition test in which they were presented with targets (i.e., the exact picture presented), related lures (i.e., the same object but from a different angle), and unrelated lures (i.e., objects that had not been shown). For each item, participants answered both standard recognition and meaning recognition questions. In Experiment 1 participants studied pictures under either full attention or divided attention. In Experiment 2 some participants were told that no object was shown twice (i.e., mutual exclusivity instructions), while others were told that both camera angles might have been shown for some objects (no mutual exclusivity instructions). The present experiments provide three converging measures, all of which are consistent with dual process models that propose a recollection rejection mechanism.     

The relationship between the drive for muscularity and anthropometric measures of muscularity and adiposity

Researchers have found consistently positive associations between women's body dissatisfaction and the desire to be thin and anthropometric indices of the amount of body fat they care on their frame. However, with the increasing emphasis being given to men's body image concerns, such as the drive for muscularity, it is important to study the relationship between men's desire to become more muscular and the actual amount of muscle they carry on their frames. That is, because men who want to become muscular can achieve that through strength training, do those with a high drive for muscularity have a high level of muscle mass? We explored this issue in a sample of 100 college-aged men and found that only one of four anthropometric measure of muscularity (flexed bicep circumference) was predictive of engaging in muscularity-oriented behaviors, while none predicted attitudes about becoming more muscular. These findings suggest either that men's drive for muscularity is unrelated to their actual level of muscularity or that current anthropometric indices are not accurate enough for a significant relationship to emerge. Suggestions for future research and study limitations were discussed.     

Hangover frequency and risk for alcohol use disorders: evidence from a longitudinal high-risk study

Data from a prospective high-risk study (N=489; 51% with a family history of alcoholism) were used to test whether family history is associated with greater hangover proneness and whether hangover is a risk factor for alcohol use disorders. Hangover was more frequent in family-history-positive participants during the college years. Persons with an alcohol diagnosis showed excess hangover before earning a diagnosis. Year 1 hangover predicted alcohol use disorders at Years 7 and 11, even when family history, sex, Year 1 diagnoses, and Year 1 drinking were statistically controlled. Several nonhangover drinking symptoms failed to predict later diagnoses. Taken together, the findings suggest a need for further research and theory on the role of hangover in the etiology of drinking problems.     

Pushing against Gender Barriers

This article presents the case study of Lilija Otīlija Grīviņa's calling to China. Her ministry is one example of how the practice of mission facilitates self-identification, as a person responds to the call of God regardless of their gender. The major sources of the study are archive materials from the Liebenzell Mission and the Latvian Lutheran Church, as well as Grīviņa's newsletters published in Chinas Millionen. To provide theological background for the missionary service of women, the study also looks at the work of German missiologists Gustav Warneck and Theodore Christlieb. The research uses a main historical comparative methodology to uncover the development of thought of women missionaries in the specific historical context.     

Content development and initial psychometric analysis of the problematic hypersexuality scale

The purpose of this investigation was to develop an instrument to screen for the presence of problematic hypersexuality in a nonclinical sample of 357 adults residing in the United States. The problematic hypersexuality scale (PHS) was the product of this investigation and was designed to address the limitations of existing measures for this construct and gather psychometric evidence to support the intended uses of and claims drawn from this instrument. Empirical evidence for the use of the PHS as a screener was founded through factor analytic procedures, Rasch modeling, and the use of item response theory.     

Mapping the structure of perceptual and visual–motor abilities in healthy young adults

The ability to quickly detect and respond to visual stimuli in the environment is critical to many human activities. While such perceptual and visual–motor skills are important in a myriad of contexts, considerable variability exists between individuals in these abilities. To better understand the sources of this variability, we assessed perceptual and visual–motor skills in a large sample of 230 healthy individuals via the Nike SPARQ Sensory Station, and compared variability in their behavioral performance to demographic, state, sleep and consumption characteristics. Dimension reduction and regression analyses indicated three underlying factors: Visual–Motor Control, Visual Sensitivity, and Eye Quickness, which accounted for roughly half of the overall population variance in performance on this battery. Inter-individual variability in Visual–Motor Control was correlated with gender and circadian patters such that performance on this factor was better for males and for those who had been awake for a longer period of time before assessment. The current findings indicate that abilities involving coordinated hand movements in response to stimuli are subject to greater individual variability, while visual sensitivity and occulomotor control are largely stable across individuals.