Risk Perception and Psychological Distress in Genetic Counselling for Hereditary Breast and/or Ovarian Cancer

Oncological Genetic Counselling (CGO) allows the identification of a genetic component that increases the risk of developing a cancer. Individuals’ psychological reactions are influenced by both the content of the received information and the subjective perception of their own risk of becoming ill or being a carrier of a genetic mutation. This study included 120 participants who underwent genetic counselling for breast and/or ovarian cancer. The aim of the study was to examine the relation between their cancer risk perception and the genetic risk during CGO before receiving genetic test results, considering the influence of some psychological variables, in particular distress, anxiety and depression. Participants completed the following tools during a psychological interview: a socio-demographic form, Cancer Risk Perception (CRP) and Genetic Risk Perception (GRP), Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT). The data seem to confirm our hypothesis. Positive and significant correlations were found between the observed variables. Moreover, genetic risk perception determined an increase in depressive symptomatology and cancer risk perception led to an increase in anxious symptomatology, specifically in participants during cancer treatment. The present results suggest the importance of assessing genetic and cancer risk perception in individuals who undergo CGO, to identify those who are at risk of a decrease in psychological well-being and of developing greater psychological distress.     

A dissociation between judged causality and imagined locations in simple dynamic scenes

To mentally extrapolate the trajectory of a moving object that disappears from sight, different sources of information can be exploited: memory of its last visible position, its inferred movement through time, and general understanding of the causal structure of the scene. It is often assumed that these cues are integrated into unified analog mental representations. In our experiment, participants predicted the position of an object that disappeared behind an occluder and estimated the degree to which the movement was caused by another object. They made considerable errors in predicting imagined displacements. Moreover, their predictions were misaligned with their judgments of causality. They predicted the positions of the invisible moving objects better in events that they judged less causally correct than in events that they judged more causally correct. These results suggest that physical and cognitive parameters of imagined dynamic events do not merge into unitary mental models simulating actual states of the world.     

Moral judgment in adults with autism spectrum disorders

The ability of a group of adults with high functioning autism (HFA) or Asperger Syndrome (AS) to distinguish moral, conventional and disgust transgressions was investigated using a set of six transgression scenarios, each of which was followed by questions about permissibility, seriousness, authority contingency and justification. The results showed that although individuals with HFA or AS (HFA/AS) were able to distinguish affect-backed norms from conventional affect-neutral norms along the dimensions of permissibility, seriousness and authority-dependence, they failed to distinguish moral and disgust transgressions along the seriousness dimension and were unable to provide appropriate welfare-based moral justifications. Moreover, they judged conventional and disgust transgressions to be more serious than did the comparison group, and the correlation analysis revealed that the seriousness rating was related to their ToM impairment. We concluded that difficulties providing appropriate moral justifications and evaluating the seriousness of transgressions in individuals with HFA/AS may be explained by an impaired cognitive appraisal system that, while responsive to rule violations, fails to use relevant information about the agent’s intentions and the affective impact of the action outcome in conscious moral reasoning.     

Too Naturalist and Not Naturalist Enough: Reply to Horsten

Leon Horsten has recently claimed that the class of mathematical truths coincides with the class of theorems of ZFC. I argue that the naturalistic character of Horsten’s proposal undermines his contention that this claim constitutes an analogue of a thesis that Daniel Isaacson has advanced for PA. I argue, moreover, that Horsten’s defence of his claim against an obvious objection makes use of a distinction which is not available to him given his naturalistic approach. I suggest a way out of the objection which is in line with the naturalistic spirit of Horsten’s proposal but which further weakens the analogy with Isaacson’s Thesis. I conclude by evaluating the prospects for providing an analogue of Isaacson’s Thesis for ZFC.

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A characterization of the concept of independence in knowledge structures

In knowledge space theory a knowledge structure provides a deterministic representation of the implications among the items in a given set Q. Concrete procedures for the efficient assessment of knowledge by means of a knowledge structure have been proposed by Doignon and Falmagne [Falmagne, J.-C., & Doignon, J.-P. (1988a). A class of stochastic procedures for the assessment of knowledge. British Journal of Mathematical and Statistical Psychology, 41, 1-23; Falmagne, J.-C., & Doignon, J.-P. (1988b). A markovian procedure for assessing the state of a system. Journal of Mathematical Psychology, 32, 232-258]. The primitive idea at the core of such procedures is that the (correct or wrong) answers of a student to a subset A⊆Q of items could be inferred from the answers to a subset B⊆Q of items that were previously presented to that student. Since B provides information about A, from the viewpoint of the teacher these two subsets are not independent. This idea of dependence vs. independence is formalized in this paper in terms of an independence relation on the power set of Q. A nice characterization of this relation allows to express an arbitrary knowledge structure as the combination of a number of substructures each of which is independent of each other. An algorithm is then proposed which checks for independence in a knowledge structure and decomposes this last into a collection of independent substructures.     

Description and First Steps Toward the Empirical Validation of the Plan Formulation Method for Couples

The aim of this paper is to empirically assess the reliability of the plan formulation method for couples, a procedure for formulating the case, planning, and monitoring the couple therapies according to control-mastery theory. We hypothesized that when couples are looking for couple therapy, they have an unconscious couple’s plan for the therapy, which includes the couple’s goals; the pathogenic beliefs that the partners want to disprove; the traumas from which these beliefs originated and that the partners want to master; the vicious relational circles that make the couple suffer and that the couple wants to break; the virtuous relational circles that are expressions of the couple’s resources and that the couple wants to fuel; and the relational insights that may help the couple get better. Our study involved 15 couples treated by four experienced therapists. Four raters independently formulated each couple’s plan based on the first three sessions following a standard procedure, and we calculated the intraclass correlation for pooled judges’ ratings. For a subsample of three couples—who before and after treatment had completed the dyadic adjustment scale (DAS) and the outcome questionnaire-45.2 (OQ-45.2)—the compatibility of the therapists’ interventions with the couples’ and partners’ plans was assessed. The relationship between the ratings of compatibility, DAS and OQ-45.2, was assessed. The results showed excellent interjudge reliability for each couple’s plan formulation (average ICC?=?0.82), attesting to the validity of the procedure; and preliminary data on the therapeutic process suggested that therapists’ interventions compatible with couple’s plans could help partners achieve good outcomes.

     

Short-Term Inpatient DBT Combined with Metacognitive Interventions for Personality Disorders: A Pilot Acceptability and Effectiveness Study

This study aims at evaluating the effectiveness of an intensive 1-month residential treatment course in an Italian psychiatric unit for patients meeting criteria for personality disorders (PD). This study involved 189 patients consecutively admitted to the unit and assessed at admission and discharge. The inpatient program was based on Dialectical Behavior Therapy (DBT) combined with Metacognitive interventions. Primary outcome was a reduction of general symptom severity (as measured by SCL-90-R). Secondary outcomes were reduction in depression (BDI), interpersonal problems (IIP-47). Other outcomes were impulsivity (BIS-11), aggressiveness (AQ), and dissociation (DES). We found a significant reduction in symptom severity, as well as in depression, interpersonal problems, dissociation, impulsivity and aggressiveness. The size of this benefit was predicted mostly by number of criteria met at SCID-II and intake scores mostly for impulsiveness and dissociation. In conclusion, intensive 1-month residential DBT combined with metacognitive interventions can be effective in treating patients with any PD presenting with severe global suffering, prominent self-harm and suicidal risk.

     

Mental number line disruption in a right-neglect patient after a left-hemisphere stroke

A right-neglect patient with focal left-hemisphere damage to the posterior superior parietal lobe was assessed for numerical knowledge and tested on the bisection of numerical intervals and visual lines. The semantic and verbal knowledge of numbers was preserved, whereas the performance in numerical tasks that strongly emphasize the visuo-spatial layout of numbers (e.g. number bisection) was impaired. The behavioral pattern of error in the two bisection tasks mirrored the one previously described in left-neglect patients. In other words, our patient misplaced the subjective midpoint (numerical or visual) to the left as function of the interval size. These data, paired with the patient's lesion site are strictly consistent with the tripartite organization of number-related processes in the parietal lobes as proposed by Dehaene and colleagues. According to these authors, the posterior superior parietal lobe on both hemispheres underpins the attentional orientation on the putative mental number line, the horizontal segment of the intraparietal sulcus is bilaterally related to the semantic of the numerical domain, whereas the left angular gyrus subserves the verbal knowledge of numbers. In summary, our results suggest that the processes involved in the navigation along the mental number line, which are related to the parietal mechanisms for spatial attention, and the processes involved in the semantic and verbal knowledge of numbers, are dissociable.