Women’s Decision Making about Risk-Reducing Strategies in the Context of Hereditary Breast and Ovarian Cancer: A Systematic Review

Women who have a mutation in the BRCA1 or BRCA2 genes have up to an 87% lifetime risk of breast cancer and up to a 40% lifetime risk of ovarian cancer. Cancer prevention and early detection strategies are often considered by these women to address this heightened risk. Risk-reducing strategies include risk-reducing mastectomy and oophorectomy, breast and ovarian cancer screening, and chemoprevention. This systematic literature review summarizes the factors and contexts that influence decision making related to cancer risk-reducing strategies among women at high-risk for hereditary breast and ovarian cancer. In the 43 published research articles reviewed, three main types of factors are identified that influence high-risk women’s decisions about risk-reducing strategies: a) medical and physical factors, b) psychological factors and c) social context factors. How these factors operate in women’s lives over time remains unknown, and would best be elucidated through prospective, longitudinal research, as well as qualitative research.     

The Problems with Forbidding Science

Scientific research is subject to a number of regulations which impose incidental (time, place), rather than substantive (type of research), restrictions on scientific research and the knowledge created through such research. In recent years, however, the premise that scientific research and knowledge should be free from substantive regulation has increasingly been called into question. Some have suggested that the law should be used as a tool to substantively restrict research which is dual-use in nature or which raises moral objections. There are, however, some problems with using law to restrict or prohibit certain types of scientific research, including (i) the inherent imprecision of law for regulating complex and rapidly evolving scientific research; (ii) the difficulties of enforcing legal restrictions on an activity that is international in scope; (iii) the limited predictability of the consequences of restricting specific branches of scientific research; (iv) inertia in the legislative process; and (v) the susceptibility of legislators and regulators to inappropriate factors and influence. Rather than using law to restrict scientific research, it may be more appropriate and effective to use a combination of non-traditional legal tools including norms, codes of conduct, restrictions on publication, and scientist-developed voluntary standards to regulate problematic scientific research.     

Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology

A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.     

Be mindful in love: Exploring the interpersonal effects of spouse mindfulness on employee work and family outcomes

Mindfulness has received increasing attention from scholars and practitioners, and considerable research has demonstrated the intrapersonal effects of mindfulness at work or at home. Research to date, however, has overlooked potential interpersonal effects of mindfulness across the work and family domains. Drawing on the spillover-crossover model and the mindfulness literature, we investigate the effects of spouse mindfulness at home on employee work and family outcomes. We test our model using dyadic experience-sampling data collected from 125 focal employees and their spouses over 10 consecutive workdays. The results indicated that, at the within-person level, spouse mindfulness at home was positively associated with employee authentic emotional sharing at home, which, in turn, was positively associated with employee positive effect at home but negatively associated with employee negative affect at home. The results also indicated that spouse mindfulness at home had a positive indirect effect on family satisfaction at home and work engagement during the next morning through enhancing employee authentic emotional sharing at home. We discuss the implications of these findings and directions for the mindfulness research.     

A Cognitive-Behavioral Approach to Chronic Pain Management

More than one third of Americans suffer from recurring or persistent pain. Because this condition can result in depression, social isolation, disruption of intimate relationships, and prolonged disability, chronic pain sufferers may seek counseling. This article provides counselors with an introduction to the role of psychosocial processes in the experience of pain and offers assessment and intervention recommendations based on a cognitive-behavioral therapy approach to pain management.     

SEX-ROLE EGALITARIANISM SCALE

The Sex-Role Egalitarianism Scale (SRES) was developed to measure attitudes toward the equality of women and men across content domains representing marital, parental, employment, social–interpersonal–heterosexual, and educational roles. The instrument exists in four versions: two alternate 95-item full forms and two alternate 25-item abbreviated forms. Reliability indices derived from a classical test-theory approach, multifaceted generalizability procedures, and an item-response theory-based analysis all support consistency or precision of measurement. Evidence for convergent, discriminant, and nomological validity is presented, along with a series of recommendations for future psychometric and substantive research using the scale.     

Posttraumatic stress and depression: potential pathways to disease burden among heart failure patients

Background and Objectives: Posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) are associated with high disease burden. Pathways by which PTSD and MDD contribute to disease burden are not understood. Design: Path analysis was used to examine pathways between PTSD symptoms, MDD symptoms, and disease burden among 251 low-income heart failure patients. Methods: In Model 1, we explored the independent relationship between PTSD and MDD symptoms on disease burden. In Model 2, we examined the association of PTSD symptoms and disease burden on MDD symptoms. We also examined indirect associations of PTSD symptoms on MDD symptoms, mediated by disease burden, and of PTSD symptoms on disease burden mediated by MDD symptoms. Results: Disease burden correlated with PTSD symptoms (r = .41; p < .001) and MDD symptoms (r = .43; p < .001) symptoms. Both models fit the data well and displayed comparable fit. MDD symptoms did not mediate the association of PTSD symptoms with disease burden. Disease burden did mediate the relationship between PTSD symptoms and MDD symptoms. Conclusions: Results support the importance of detection of PTSD in individuals with disease. Results also provide preliminary models for testing longitudinal data in future studies.     

Engagement in Behavioral Parent Training: Review of the Literature and Implications for Practice

Engagement in behavioral parent training (BPT), including enrollment, attrition, attendance, within-session engagement, and homework completion, has long been a critical issue in the literature. Several estimates of various aspects of engagement have been suggested in the literature, but a systematic review of the available literature has never been accomplished. This review examines engagement data across 262 studies of BPT. Recruitment attrition, program attrition, attendance, and within-session engagement are examined across studies, with particular emphasis on the impact that SES, study purpose (efficacy vs. effectiveness), treatment format (individual vs. group), and age of child may have on those rates. Results of this review suggest that the significant amount of attrition occurs prior to enrollment in BPT, with at least 25 % of those identified as appropriate for BPT not enrolling in such programs. An additional 26 % begin, but drop out before completing treatment. Still the combined dropout rate of at least 51 % leaves at best half of identified parents completing treatment. While SES status had a small effect on attrition, other variables were not found to meaningfully impact engagement. Information on within-session engagement (homework and ratings of participation) was not often reported in studies. Key issues in this literature (e.g., varying definitions of engagement, limited attention to reporting key aspects of engagement) are discussed, and recommendations are made to further improve this important area of research and clinical practice.