The Effect of Experiential Knowledge on Construction of Risk Perception in Hereditary Breast/Ovarian Cancer

The purpose of this study was to explore the connection between experiential knowledge of hereditary breast/ovarian cancer and understandings of personal cancer risk. Using a qualitative research design, the investigator conducted in-depth interviews with 53 individuals (45 female, 8 male) from families at high-risk for hereditary breast/ovarian cancer. Study results showed that two forms of experiential knowledge, empathetic and embodied knowledge, were integral to participants constructions of their cancer risk. They also illustrated that knowledge derived from experience often took precedence over objective clinical estimates of risk. The paper discusses the clinical implications of these findings and suggests that counseling strategies, which expand upon patients lived experience and knowledge of the disease, may enhance communication of genetic risk. Assessment of experiential knowledge promises to suggest new ways to frame genetic information that will enable people to better understand their objective risk or to modify exaggerated and/or inaccurate risk perceptions.     

Illusory Conjunctions of Color and Motion With Shape Following Bilateral Parietal Lesions

The primate visual system responds to shapes, colors, and various other features more strongly in some brain areas than others. However, it remains unclear how these features are bound together so that an object with all its attributes is perceived. A patient (R.M.) with bilateral parietal-occipital lesions has been shown previously to miscombine the shape and color of items, making errors known as illusory conjunctions (ICs). In this study, we examined the effects of a third feature (motion) on this patient's IC rates. R.M. was presented with two letters that moved in different ways. He often reported seeing the shape of one of the letters with the other letter's motion. His performance on the same task with three features shows that correctly combining two features did not necessarily lead to correctly binding the third. These data support modularity of feature representations in the human brain and provide supporting evidence that spatial representations associated with the parietal lobe are necessary for normal feature integration.     

The Many Faces of Physician-Assisted Suicide

Physician-assisted suicide is a complex and controversial issue that touches on standards of medical practice, the balance between individual rights and the rights of the state, and our fears of death and pain. Supporters of assisted suicide propose it as an alternative to a lingering, highly technological death, and define it as the act of a physician who prescribes a lethal dose of a medication for a terminally ill patient, with the knowledge that the patient intends to commit suicide. The recent U.S. Supreme Court ruling upheld prohibitions against assisting in a suicide, but left open the possibility that in certain specific cases assisted suicide might be constitutionally protected. The Supreme Court's refusal to extend constitutional protection to assisted suicide was done in part to insure that public debate and legislative fact-finding would continue. As stated in Justice Rehnquist's majority opinion, ...Americans are engaged in an earnest and profound debate about the morality, legality and practicality of physician-assisted suicide (Washington v. Glucksberg, 96-110—Opinion, 1997, p. 26). As researchers, policy makers, and health care providers, we have an obligation to insure that political debate and empirical research are continuing and productive, and that this issue becomes more than just an occasion to play out ideological or personal differences.     

A sequential analysis of the mother-adolescent interactions of ADHD,ADHD/ODD,and normal teenagers during neutral and conflict discussions

The sequential interactions of three groups of teenagers conversing with their mothers during both neutral and conflict discussion situations were evaluated. Groups consisted of (1) attention deficit hyperactivity disorder (ADHD) alone (n =21), (2) ADHD with comorbid oppositional defiant disorder (ADHD/ODD; n =40), and (3) a community control group of adolescents (n =49). All groups had been followed concurrently for the past 8 to 10 years before being reevaluated in this study. Results indicated that (1) teens and parents in all groups interacted in a tightly linked manner, with the behavior of each member being significantly related only to the immediate antecedent behavior of the other; (2) mothers in all groups were more likely than teens to initiate positive behaviors; (3) teen interactions could be characterized as tit-for-tat while mothers could be typified as be-nice-and-forgive; (4) mother-teen dyads in the ADHD/ODD group displayed significantly higher rates of conflict behaviors than dyads in the other two groups, who did not differ significantly from each other on most measures; and (5) mothers in the ADHD/ODD group responded in a manner similar to their teens (greater negativity) and less like that of mothers in the other groups. The majority of conflict between ADHD children and their parents seemed due to comorbid ODD and such ODD is a family, not just a teen, characteristic.     

The Effects of Implicit Theories on Exercise Motivation

This study investigated whether type of implicit theory about athletic coordination would influence motivation to persist at a novel exercise task in the face of difficulty. Fifty college students were told that we were testing a new type of exercise and were given one of two theories about the nature of athletic coordination. Some participants were told that athletic coordination was mostly learned (incremental condition), while others were told that athletic coordination was genetically determined (entity condition). Participants initially experienced success and then difficulty while following videos containing the new exercise. Consistent with predictions, results showed that participants given an incremental theory of athletic coordination reported greater motivation and self-efficacy and less negative affect in the face of difficulty than those given an entity theory. Implications of these findings are discussed.     

The relationship among the transtheoretical model of behavioral change,psychological distress,and diet attitudes in obesity: Implications for primary care intervention

Obesity is prevalent but undertreated in primary care. Family practice volunteer outpatients (N=454) were administered the Stage of Change for Weight (URICA), the Brief Symptom Inventory (BSI), and the Diet Readiness Test (DRT) to assess the relationship between these variables and obesity. The body mass index (BMI) was used to classify obesity revealing 197 patients with elevated BMI's. There was no significant difference between the obese and the nonobese on any of the psychological measures. The obese reported significantly more difficulty setting diet goals and less control over their eating, ate more to emotional situations, and exercised less than the nonobese. The obese sample (46.7%) reported being in the Action stage of change for weight management. Implications for intervention in primary care include targeting attitudes (DRT) and dispelling physician attitudes that obese individuals have increased levels of psychological distress. Addressing Stage of Change for weight management can facilitate tailoring the appropriate intervention when used in concert with the DRT variables.     

REVERSAL OF BASELINE RELATIONS AND STIMULUS EQUIVALENCE: II. CHILDREN

In a systematic replication of a study using college-student subjects (Pilgrim & Galizio, 1990), 5- to 7-year-old children learned two conditional discriminations (i.e., A1B1, A2B2, A1C1, and A2C2) in a two-choice arbitrary match-to-sample task and showed the emergence of two three-member equivalence classes (A1B1C1 and A2B2C2). Baseline conditional discrimination performances were quickly controlled by reversals of the AC reinforcement contingencies (i.e., choosing Comparison Stimulus C2 was reinforced given Sample A1, and choosing C1 was reinforced given Sample A2) when the reversals were introduced in restricted baselines. On reflexivity, symmetry, and transitivity/equivalence probes following the reversal, there was some limited indication of equivalence-class reorganization (i.e., A1B1C2 and A2B2C1) in keeping with the concurrently performed baseline relations for 2 of 5 subjects, but the predominant pattern across probe trials was one of inconsistent conditional control. These findings suggest that, given similar challenges, equivalence-class performances may be more easily disrupted in young children than in adults.     

Implicit diagnosticity in an information-buying task. How do we use the information that we bring with us to a problem?

Past research suggests that people may make use of diagnosticity information when explicit data regarding P(D | H) and P(D | ? H) are given to them. However, people fall victim to pseudodiagnosticity biases and ignore P(D | ? H) when such data must be actively sought. This series of four experiments utilized judgment problems in which subjects have knowledge of P(D | ? H) but must recognize the relevance of that knowledge for the judgment at hand. It was hypothesized that subjects who genuinely understood the role of P(D | ? H) in hypothesis testing would respond to this manipulation of implicit diagnosticity by exhibiting greater confidence and lesser information buying when given evidence of relatively high diagnosticity. In the first three studies, subjects attempted to judge the guilt or innocence of suspects in several fictional crimes. In the fourth experiment, subjects attempted to judge the club membership status of students at their own university. Greater amounts of information were bought when the only available information was of low diagnosticity. Subjects also expressed greater confidence in judgments made using highly diagnostic information. However, within the legal scenario, sensitivity to diagnosticity was dependent upon the implication of the cues received. Results are discussed with respect to Bayesian probability, expected value theory, and a confidence criterion model of information purchasing.