A Multi-Case Report of the Pathways To and Through Genetic Testing and Cancer Risk Management for BRCA Mutation-Positive Women Aged 18–25

Much of the extant literature addressing the psychosocial aspects of BRCA1/2 mutation testing and risk management aggregates mutation carriers of all ages in study recruitment, data analysis, and interpretation. This analytic strategy does not adequately address the needs of the youngest genetic testing consumers, i.e., women aged 18–25. Despite low absolute cancer risk estimates before age 30, BRCA1/2 mutation-positive women aged 18–25 feel vulnerable to a cancer diagnosis but find themselves in a management quandary because the clinical utility of screening and prevention options are not yet well defined for such young carriers. We present three cases, selected from a larger study of 32 BRCA1/2 mutation-positive women who completed or considered genetic testing before age 25, to demonstrate the unique developmental, relational and temporal influences, as well as the challenges, experienced by very young BRCA mutation-positive women as they complete genetic testing and initiate cancer risk management. The first case describes the maturation of a young woman whose family participated in a national cancer registry. The second addresses the experiences and expectations of a young woman who completed genetic testing after learning that her unaffected father was a mutation carrier. The third case highlights the experiences of a young woman parentally bereaved in childhood, who presented for genetic counseling and testing due to intense family pressure. Together, these cases suggest that BRCA1/2-positive women aged 18–25 are challenged to reconcile their burgeoning independence from their families with risk-related support needs. Loved ones acting in ways meant to care for these young women may inadvertently apply pressure, convoluting family support dynamics and autonomous decision-making. Ongoing support from competent healthcare professionals will enable these young women to remain informed and receive objective counsel about their risk-management decisions.     

Understanding the Behavioral Determinants of Mental Health Service Use by Urban, Under-Resourced Black Youth: Adolescent and Caregiver Perspectives

Black adolescents with mental health problems are less likely than non-Black adolescents with mental health problems to receive treatment, primarily for non-financial reasons including negative perceptions of services and providers, and self-stigma associated with experiencing mental health problems. To better understand these obstacles, 16 adolescents and 11 caregivers, recruited from two K-8th grade elementary-middle schools, participated in four focus groups guided by the unified theory of behavior to explore mental health help-seeking behaviors and perceptions of mental health services. In the focus groups, caregivers acknowledged more positive attitudes about seeking mental health services than adolescents, but both expected the experience of actually doing so to be negative. Adolescents and caregivers also acknowledged social norms that inhibit their mental health help-seeking. Therefore, we conclude that interventions targeting expectancies and social norms might increase the connection of urban, under-resourced Black adolescents and their families to mental health services, and be particularly important given the long-term consequences of untreated mental health problems for this group.     

Complex span and n-back measures of working memory: A meta-analysis

Working memory is a construct of primary relevance to many areas of psychology. Two types of tasks have been used to measure working memory, primarily in different research areas: Complex span tasks are commonly used in behavioral studies in the cognitive and individual-differences literature, whereas n-back tasks have been used more frequently in cognitive neuroscience studies investigating the neural underpinnings of working memory. Despite both categories of tasks being labeled as “working memory” measures, previous empirical studies have provided mixed evidence regarding the shared amount of overlapping processes between complex span and n-back tasks. The present meta-analysis showed that the complex span and n-back tasks are weakly correlated, although significant heterogeneity across studies was observed. A follow-up analysis of unpublished data indicated that the sample composition affects the relationship between the complex span and n-back tasks, following the law of diminishing returns. Finally, a separate meta-analysis indicated that the simple span and n-back tasks are correlated to the same extent as are the complex span and n-back tasks. The present findings indicate that the complex span and n-back tasks cannot be used interchangeably as working memory measures in research applications.     

I just love the attention: implicit preference for direct eye contact

Seven studies used the Implicit Association Test to measure preference for gaze direction. For faces with neutral expressions, people clearly preferred eyes looking towards them compared to eyes gazing to the right or left (Experiment 1). This preference remained for faces shown turned to the side (Experiment 2) and upside-down (Experiment 3). Even angry faces were preferred with direct compared to averted gaze (Experiments 4 and 5). Furthermore, preference for eye contact did not correlate to performance on the Reading the Mind in the Eyes Test (RMET) or the Autism Quotient (AQ); note performance on the RMET and the AQ was only weakly correlated although both are claimed to measure social cognition. When the faces were replaced by coloured shapes (Experiment 6) or arrows (Experiment 7) people showed a weaker preference for the category label “looking at you” versus “looking to the side”. Overall, people revealed a robust preference for direct rather than averted gaze which generalized across face pose and expression. Together with a weaker preference for arrows pointing towards them, this is consistent with people having an implicit preference for self-directed attention.     

Differential attentional allocation and subsequent recognition for young and older adult faces

Studies examining own-age recognition biases report inconsistent results and often utilize paradigms that present faces individually and in isolation. We investigated young and older adults' attention towards young and older faces during learning and whether differential attention influences recognition. Participants viewed complex scenes while their eye movements were recorded; each scene contained two young and two older faces. Half of the participants formed scene impressions and half prepared for a memory test. Participants then completed an old/new face recognition task. Both age groups looked longer at young than older faces; however, only young adults showed an own-age recognition advantage. Participants in the memory condition looked longer at faces but did not show enhanced recognition relative to the impressions condition. Overall, attention during learning did not influence recognition. Our results provide evidence for a young adult face bias in attentional allocation but suggest that longer looking does not necessarily indicate deeper encoding.     

Neuroethics,confidentiality, and a cultural imperative in early onset Alzheimer disease: a case study with a First Nation population

The meaningful consideration of cultural practices, values and beliefs is a necessary component in the effective translation of advancements in neuroscience to clinical practice and public discourse. Society’s immense investment in biomedical science and technology, in conjunction with an increasingly diverse socio-cultural landscape, necessitates the study of how potential discoveries in neurodegenerative diseases such as Alzheimer disease are perceived and utilized across cultures. Building on the work of neuroscientists, ethicists and philosophers, we argue that the growing field of neuroethics provides a pragmatic and constructive pathway to guide advancements in neuroscience in a manner that is culturally nuanced and relevant. Here we review a case study of one issue in culturally oriented neuroscience research where it is evident that traditional research ethics must be broadened and the values and needs of diverse populations considered for meaningful and relevant research practices. A global approach to neuroethics has the potential to furnish critical engagement with cultural considerations of advancements in neuroscience.     

British semantic differential responses on world powers

Investigating stereotypes associated with world powers, 28 men and 28 women at a British university rated 24 world powers using the semantic differential. Significance tests show the relationship of the powers to concepts assumed to measure the Evaluative, Potency, and Activity factors. Three-dimensional models show the relative positioning by men and by women. Results indicate (1) general agreement between men and women; (2) superpowers close to BAD and STRONG; (3) countries associated with war and strife closer to BAD, WEAK, and PASSIVE. Comparisons were made with an American sample. The need for doing further stereotype studies over time was stressed.