Exploring Genetic Counseling Communication Patterns: The Role of Teaching and Counseling Approaches

The educational and counseling models are often touted as the two primary professional approaches to genetic counseling practice. Yet, research has not been conducted to examine how these approaches are used in practice. In the present study, we conducted quantitative communication analyses of BRCA1 genetic counseling sessions. We measured communication variables that represent content (e.g., a biomedical focus) and process (e.g., passive listening) to explore whether genetic counselor approaches are consistent with prevailing professional models. The Roter Interaction Analysis System (RIAS) was used to code 167 pre-test genetic counseling sessions of members of a large kindred with an identified BRCA1 mutation. Three experienced genetic counselors conducted the sessions. Creating composite categories from the RIAS codes, we found the sessions to be largely educational in nature with the counselors and clients devoting the majority of their dialogue to providing biomedical information (62 and 40%, respectively). We used cluster analytic techniques, entering the composite communication variables and identified four patterns of session communication: Client-focused psychosocial, biomedical question and answer, counselor-driven psychosocial, and client-focused biomedical. Moreover, we found that the counselors had unique styles in which they combined the use of education and counseling approaches. We discuss the importance of understanding the variation in counselor communication to advance the field and expand prevailing assumptions.     

Predictors and outcomes of early motherhood in the Australian Longitudinal Study on Women's Health

Early motherhood is identified as a social problem, and having children at an early age is assumed to lead to psychological distress, welfare dependence and socioeconomic disadvantage. Analysis of responses from 9,689 young participants in the Australian Longitudinal Study on Women's Health was used to examine predictors and outcomes of early motherhood in Australia. Survey 1 (1996, aged 18 - 23) and Survey 2 (2000, aged 22 - 27), were used to categorize women as Childless, Existing Mothers (before Survey 1) and New Mothers (became mothers before Survey 2). Multivariate logistic regressions provided comparisons on sociodemographics, gynaecological variables, psychological wellbeing and health behaviours. Survey 1 data show that Existing Mothers experience socioeconomic disadvantages and unhealthy lifestyles. However, those who will go on to become mothers earlier than their peers already experience similar disadvantages. Further, the Survey 2 data show that, when these pre-existing disadvantages are controlled for, the additional deficits experienced by early mothers are relatively minor. Social disadvantage predisposes women to become mothers early, and to adopt unhealthy behaviours. However, young Australian women cope well with the challenges of early motherhood. In the longer term, unhealthy lifestyles and low education may lead to ill health and disadvantage, but early motherhood is not the initiator of this trajectory.     

Imitation of hierarchical action structure by young children

To provide the first systematic test of whether young children will spontaneously perceive and imitate hierarchical structure in complex actions, a task was devised in which a set of 16 elements can be modelled through either of two different, hierarchically organized strategies. Three-year-old children showed a strong and significant tendency to copy whichever of the two hierarchical approaches they witnessed an adult perform. Responses to an element absent in demonstrations, but present at test, showed that children did not merely copy the chain of events they had witnessed, but acquired hierarchically structured rules to which the new element was assimilated. Consistent with this finding, children did not copy specific sequences of actions at lower hierarchical levels.     

Parent-child value transmission among Chinese immigrants to North America: the case of traditional mate preferences

Parent-child similarities in traditional mate preferences were examined in Chinese immigrants to North America. Adult children (n = 63) rated their preferred mate characteristics. Children then completed measures of interdependence, family allocentrism, Chinese identity, and Asian values. Their parents (n = 63) also rated their own preferences for their child's spouse and their own Asian values. Parents reported greater preference for traditional mate characteristics than did their children. Parents' preferences were related to parents' own Asian values. Children's traditional mate preferences were predicted by their parents' preferences and their own family allocentrism. Family allocentrism was a marginally significant partial mediator of parent's influence on children's preferences. Family connectedness may, therefore, facilitate intergenerational transmission of values in immigrant Asian families.     

Asian American families' collectivistic coping strategies in response to 9/11

Our study investigated the use of individualistic and collectivistic coping strategies among Asian American family members of victims of the World Trade Center (WTC) attacks on September 11th, 2001. Interviews were conducted with 11 Asian Americans who had lost a member of their family in the WTC attacks. Using the Discovery-Oriented Research analysis (Mahrer, 1988), results indicated that Asian Americans utilized the following collectivistic coping methods to deal with their losses: individualistic coping, familial coping, intracultural coping, relational universality, forbearance, fatalism/ spirituality, and indigenous healing methods. Additionally, our research found that cultural stigmata, privacy issues, and lack of culturally responsive counselors were factors in participants not utilizing available mental health services. Implications for culturally appropriate services, counseling, and research are discussed.     

Moderator effects of cognitive ability and social support on the relation between race-related stress and quality of life in a community sample of black Americans

The current study examined the combined moderating effects of cognitive ability and social support on the relation between race-related stress and quality of life in a sample of Black Americans. Participants (N = 323) were administered the Wonderlic Personnel Test (WPT; E. F. Wonderlic Associates, Inc., 1983), the Multidimensional Social Support Scale (MDSS; Winefield, Winefield, & Tiggemann, 1992), the Index of Race-Related Stress-Brief (Utsey, 1999), and the WHOQOL-BREF (The WHO Group, 1998). The findings indicated that cognitive ability and social support, conjointly, moderated the relation between individual and cultural race-related stress and quality of life for Black Americans in the current sample. The paper concludes by discussing the study's findings, limitations, and by offering recommendations for future research related to this area of inquiry.     

A cross-cultural investigation of cognitions and depressive symptoms in adolescents

Adolescents (N=2,272) from Hong Kong and the United States provided information regarding their depressive symptoms, cognitions (self-efficacy, negative cognitive errors, and hopelessness), and stressful events between 2 surveys 6 months apart. Depressive symptoms and hopelessness were higher, and self-efficacy and negative cognitive errors were lower in Hong Kong than in the United States. Cognitions were associated with concurrent depressive symptoms and predicted depressive symptoms 6 months later in both cultures. The "reverse" model was also supported with more variance predicted by depressive symptoms to later cognitions than from cognitions to depressive symptoms. There was some support for the hypothesis that self-efficacy is less salient in collective compared with individualistic cultures. These findings extend cognitive theories of depression to a non-Western culture.     

How jurors use and misuse character evidence

The Federal Rules of Evidence allow defendants to offer testimony about their good character, but that testimony can be impeached with cross-examination or a rebuttal witness. It is assumed that jurors use the defense's character evidence (CE) to form guilt and conviction judgments but use impeachment evidence only to assess the character witness's credibility. Two experiments tested these assumptions by presenting mock jurors with various forms of CE and impeachment. Participants made trait ratings for the character witness and defendant and guilt and conviction judgments. Positive CE did not affect guilt or conviction judgments, but cross-examination caused a backlash in which judgments were harsher than when no CE was given. Using path analysis, the authors tested a model of the process by which CE and impeachment affect defendant and witness impressions and guilt and conviction judgments. Implications for juror decision making are discussed.     

Psychological contract and organizational citizenship behavior in China: investigating generalizability and instrumentality

This study examined the generalizability of psychological contract forms observed in the West (D. M. Rousseau, 2000) to China. Using 2 independent samples, results confirmed the generalizability of 3 psychological contract forms: transactional, relational, and balanced. This study also examined the nature of relationships of psychological contracts with organizational citizenship behavior (OCB). In particular, this study explored the role of instrumentality as a mediating psychological process. The authors found evidence that instrumentality mediates the relationship of relational and balanced forms with OCB; however, the transactional contract form is directly related to OCB. The authors discuss the implications of these results for the meaning of psychological contracts and OCB in China and raise issues for future research.