Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

Cognitive modeling analysis of decision-making processes in cocaine abusers

This article examines the theoretical basis of decision-making deficits exhibited by cocaine abusers in a laboratory decision-making task first described by Bechara, Damasio, Damasio, and Anderson (1994). A total of 12 male cocaine abusers and 14 comparison subjects performed the task, and the cocaine group performed significantly worse than the comparison group. A cognitive modeling analysis (Busemeyer & Stout, 2002) was used to estimate three parameters that measure importance of the cognitive, motivational, and response processes for determining the observed performance deficit. The results of this analysis indicated, for the first time, that motivational and choice consistency factors, but not learning/ memory were mainly responsible for the decision-making deficit of the cocaine abusers in this task.     

Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Changes in the structure of children's isometric force variability with practice

This study examined the effect of age and practice on the structure of children's force variability to test the information processing hypothesis that a reduction of sensorimotor system noise accounts in large part for age-related reductions in perceptual-motor performance variability. In the study, 6-year-olds, 10-year-olds, and young adults practiced on 5 consecutive days (15 trials/day), maintaining for 15-s trials a constant level of force (5 or 25% of maximum voluntary contraction) against an object using a pinch grip (thumb and index finger). With increasing age, the amount of force error and variability decreased, but the sequential structure of variability increased in irregularity. With practice, children reduced the amount of variability by changing the structure of the force output so as to be more similar to that of their older counterparts. The findings provide further evidence that practice-driven changes in the structure of force output, rather than a decline in the amount of white noise, largely account for age-related reductions in the amount of force variability.     

Large errors, but no depth compression, in walked indications of exocentric extent

Observers can sight a target 20 m away or more and then walk to it accurately without vision. In contrast to this good performance, this article shows that walked indications of the exocentric separation of two locations exceed the required values by over 70% when vision is obscured. Significantly, these large errors are coupled with a robust lack of depth foreshortening, even under conditions in which visual matches and verbal estimates of extent exhibit strong evidence of depth compression. This article presents evidence that the overshooting errors are due largely to recalibration of locomotor control produced by prolonged exposure to nonvisual walking. The robust lack of depth foreshortening, meanwhile, could reflect a corresponding isotropy in the spatial representation controlling the walking response. More research is needed to confirm this interpretation, however.     

Cognitive vulnerability to depression: a taxometric analysis

Although there is increasing support for the hypothesis that negative cognitive styles contribute vulnerability to depression, it remains unclear how best to conceptualize the heterogeneity in cognitive vulnerability to depression. Specifically, does this heterogeneity reflect quantitative or qualitative differences among individuals? The goal of this study was to address this question by examining whether the underlying structure of cognitive vulnerability to depression is best conceptualized as dimensional or categorical. Taxometric analyses provided consistent support for the dimensional nature of negative cognitive styles. It appears, therefore, that cognitive vulnerability to depression is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Despite this, the strength of the relationship between negative cognitive styles and depressive symptoms does appear to vary as a function of where along the cognitive style continuum one falls.     

Phonologically mediated priming of preexisting and new associations in young and older adults

In 2 experiments, the authors investigated phonologically mediated priming of preexisting and new associations in word retrieval. Young and older adults completed paired word stems with the first word that came to mind. Priming of preexisting associations occurred when word-stem pairs containing homophones (e.g., beech-s____) showed more completions with the target (e.g., sand) relative to unrelated pairs (e.g., batch-s____), with more priming for subordinate than for dominant homophones. Priming occurred for new associations independent of dominance such that word-stem pairs containing homophones (e.g., beech-l____ and beach-l____) were completed with the same word (e.g., laugh) more often than unrelated pairs (e.g., beech-l____ and batch-l____). No age differences in phonologically mediated priming were found for either type of association, suggesting age equivalence in the use of bottom-up phonological connections.     

The Physical Appearance Ambiguous Feedback Scale (PAAFS): a measure for indexing body image related cognitive bias

Recent conceptualizations of body image disturbance have included an information processing model that includes a focus on an interpretive information processing bias. Study 1 involved the development and validation of a measure of appearance-based cognitive bias, the Physical Appearance Ambiguous Feedback Scale (PAAFS). In Studies 2 and 3, two samples of college females (n=313) were tested and the psychometric characteristics of the PAAFS were evaluated. Reliability was acceptable and convergence with measures of body image and eating disturbance was moderate. In Study 4, 313 college females completed the PAAFS in the laboratory based on an instructional content designed to induce processing bias. Preliminary evidence indicates that the PAAFS appears to be sensitive to instructional set manipulations and dispositional level of body dissatisfaction.