Minding the Genes: a Multidisciplinary Approach towards Genetic Assessment of Cardiovascular Disease

Genetic assessment for inherited cardiovascular disease (CVD) is increasingly available, due in part to rapid innovations in genetic sequencing technologies. While genetic testing is aimed at reducing uncertainty, it also produces awareness of potential medical conditions and can leave patients feeling uncertain about their risk, especially if there are ambiguous results. This uncertainty can produce psychological distress for patients and their families undergoing the assessment process. Additionally, patients may experience psychological distress related to living with inherited CVD. In order to more effectively manage the psychosocial challenges related to genetic assessment for CVD, a multidisciplinary model expanded to include psychologists and other allied health professionals is outlined. A case study is provided to illustrate how psychological distress can manifest in a patient living with inherited CVD, as well as proposed psychological management of this patient. Finally, a guide for genetic counselors is provided to aid in identifying and managing common psychological reactions to genetic assessment for CVD.     

Reducing infant immunization distress through distraction.

Infant procedural distress is largely understudied, and there is a dearth of empirically supported interventions in the child health psychology literature. This study examined nurse-directed distraction for reducing infant immunization distress. Ninety infants and their parents were randomly assigned to a distraction condition (i.e., nurses used stimuli to divert infants' attention) or a typical care condition. Outcome measures were an observational scale, parent and nurse ratings, and infant heart rate. Results indicated that infants engaged in distraction and that distraction reduced their behavioral distress; however, ratings and heart rate were inconclusive. Analyses of procedural phases indicated that infants exhibited elevated distress immediately prior to and during an injection, but this distress was fleeting.     

Biopsychosocial Factors Associated with Parenting Stress in Pediatric Sickle Cell Disease

Caregivers of children with sickle cell disease (SCD) experience significant physical and emotional hardship with their child’s disease management. Little is known about the potential contributors to parenting stress in pediatric SCD. The present study aimed to identify child and caregiver biopsychosocial factors associated with disease-related parenting stress in pediatric SCD. Participants included 74 caregiver-youth dyads. Parenting stress was associated with increased child pain frequency, more missed school days, and increased healthcare utilization, and inversely correlated with caregiver mental health and social-emotional functioning. Parenting stress also partially explained the relationship between child pain frequency and healthcare utilization after controlling for parent depression and anxiety. Parenting stress may play a unique and critical role in pediatric SCD and underscore the impact parenting stress may have on youth in medical and academic settings. Further research is warranted to determine risk factors and appropriate interventions for parenting stress to improve comprehensive patient care.

     

The Propensity for Abusiveness Scale (PAS) as a Predictor of Affective Priming to Anticipated Intimate Conflict

The current study used the Propensity for Abusiveness Scale (PAS; Dutton, 1995) to predict emotional response to conflict among university students. The participants were 162 first- and second-year undergraduate students at the University of British Columbia. Participants listened to taped conflict and filled out a battery of questionnaires. The PAS correlates significantly with pre-anger, anxiety, subanger, and general arousal levels, suggesting that a type of emotional priming takes place when persons high on the PAS know they are about to be exposed to an interpersonal conflict. It is concluded that anticipation of intimate conflict appears to heighten negative affect in some young adults and that this response may interfere with future intimate conflict-resolution strategies.     

The visual perception of distance ratios outdoors

We conducted an experiment to evaluate the ability of 32 younger and older adults to visually perceive distances in an outdoor setting. On any given trial, the observers viewed 2 environmental distances and were required to estimate the distance ratio—the length of the (usually) larger distance relative to that of the shorter. The stimulus distance ratios ranged from 1.0 (the stimulus distances were identical) to 8.0 (1 distance interval was 8.0 times longer than the other). The stimulus distances were presented within a 26 m × 60 m portion of a grassy field. The observers were able to reliably estimate the stimulus distance ratios: The overall Pearson r correlation coefficient relating the judged and actual distance ratios was 0.762. Fifty-eight percent of the variance in the observers’ perceived distance ratios could thus be accounted for by variations in the actual stimulus ratios. About half of the observers significantly underestimated the distance ratios, while the judgments of the remainder were essentially accurate. Significant modulatory effects of sex and age occurred, such that the male observers’ judgments were the most precise, while those of the older males were the most accurate.     

Pharmacological manipulations of brain catecholamines and the aggressive behavior induced by marihuana in REM-sleep-deprived rats

A marihuana extract, apomorphine, and amphetamine provoked in rats previously deprived of REM sleep for 96 hr an upright position with the animals pawing each other as in fighting. Nondeprived rats injected with the drugs did not show this aggressive behavior. The marihuana-treated animals also bit vigorously a rod introduced into the cage, a fact not observed with the apomorphine-treated rats. These data suggest that the marihuana aggressiveness could at least partially be mediated through the brain catecholamines. Haloperidol, chlorpromazine, α-methyl-p-tyrosine, and reserpine decreased the marihuana aggressiveness of the deprived rats. Increase of dopamine concentration by previous treatment with Dopa potentiated aggressiveness. Blockade of norepinephrine synthesis by FLA-63 was ineffective in reducing marihuana aggressiveness in the REM-sleep-deprived rats. Actually, in these animals aggressiveness appreared even without the marihuana injection. Phenoxybenzamine partially blocked marihuana aggressiveness but also severely depressed the rats. However, 20 mg/kg alone succeeded in provoking aggressiveness in the deprived rats. It is suggested that in rats with neural excitability heightened by previous REM-sleep deprivation dopamine facilitates aggressive behavior, an effect inhibited by porepinephrine. This hypothesis would imply that marihuana induces aggressiveness in REM-sleep-deprived rats by inhibiting, through an as yet unknown mechanism, the central norepinephrine system.     

Perfectionism, depression, and academic performance

In samples of 30 Canadian and 117 American undergraduates, academic performance was more strongly correlated with perfectionism scores (Revised Almost Perfect Scale) (r = .20 and -.17) than with those on self-reported depression (CES-Depression) (r = -.09).