Characterizing Clinical Genetic Counselors’ Countertransference Experiences: an Exploratory Study

Countertransference (CT) refers to conscious and unconscious emotions, fantasies, behaviors, perceptions, and psychological defenses genetic counselors experience in response to any aspect of genetic counseling situations (Weil 2010). Some authors theorize about the importance of recognizing and managing CT, but no studies solely aim to explore genetic counselors’ experiences of the phenomenon. This study examined the extent to which clinical genetic counselors’ perceive themselves as inclined to experience CT, gathered examples of CT encountered in clinical situations, and assessed their CT management strategies. An anonymous online survey, sent to NSGC members, yielded 127 usable responses. Participants completed Likert-type items rating their CT propensities; 57 of these individuals also provided examples of CT they experienced in their practice. Factor analysis of CT propensities tentatively suggested four factors: Control, Conflict Avoidance, Directiveness, and Self-Regulation, accounting for 38.5% of response variance. Thematic analysis of CT examples yielded five common triggers: general similarity to patient, medical/genetic similarity, angry patients, patient behaves differently from counselor expectations, and disclosing bad news; six common manifestations: being self-focused, projecting feelings onto the patient, intense emotional reaction to patient, being overly invested, disengagement, and physical reaction; five CT effects: disruption in rapport building, repaired empathy, over-identification, conversation does not reach fullest potential, and counselor is drained emotionally; and three management strategies: recognizing CT as it occurs, self-reflection, and consultation. Results suggest CT is a common experience, occurring in both “routine” and emotionally complex cases. Training programs, continuing education, and peer supervision might include discussion of CT, informed by examples from the present study, to increase genetic counselor awareness and skills for managing the phenomenon.     

Greed is good? Student disciplinary choice and self-reported psychopathy

The idea of the organisational psychopath has become not only popular in recent times, but increasingly relevant, thanks to the alleged role of high-profile members of the commercial sector in the global recession. To test the proposition that self-reported sub-clinical psychopathy might be disproportionately more common amongst those people electing to study commerce/business at University, 903 first-year students enrolled in a range of academic degrees completed a survey containing Levenson’s Self-Report Psychopathy Scale (Levenson, Kiehl, & Fitzpatrick, 1995) and Paulhus’ (1991) Balanced Inventory of Desirable Responding. Even after accounting for social desirability, commerce students reported higher levels of primary psychopathy than other students, regardless of sex.     

Psychometric evaluation of the Drive for Muscularity Scale in a community-based sample of Scottish men participating in an organized sporting event

As the drive for muscularity is an important construct for researchers involved in understanding men's body image, having reliable and valid measures of the construct is essential. This study assessed the Drive for Muscularity Scale (DMS) in a community-based sample of 594 Scottish men participating in an organized running event. Exploratory factor analysis revealed two subscales (Muscularity-oriented body image and Muscularity behavior) as well as a higher-order factor. Both subscales and the total score had acceptable levels of internal consistency, test–retest reliability, and construct validity. These findings provide support for the DMS as a measure of the drive for muscularity in men. It is recommended that, in future, careful consideration is given to the distinction between muscularity attitudes and behavior.     

Pharmacologic and Behavioral Withdrawal From Addictive Drugs

ABSTRACT— Recent theories suggest that drug withdrawal does not motivate drug use and relapse. However, data now show that withdrawal produces complex changes over time in at least two symptoms (i.e., negative affect and urges) that are highly predictive of relapse. Evidence suggests that falling levels of the drug in the blood and interruption of the drug self-administration ritual both affect these symptoms. Both of these forms of withdrawal motivate renewed drug use in addicted individuals.     

Sόnar Calling GJ273B: The Argumentative Issue of METI

Since active messaging to targeted extraterrestrial bodies is an ongoing practice, it is difficult to see how current scientific arguments have the ability to influence actions which have independent economic and institutional structures. The article analyzes what structures of argumentation might have an effect on on-going and future METI, as well as the type of theological reflection that would likely contribute to this discussion.     

Video Review of Moment by Moment: The Healing Journey of Molly Hale

Moment by Moment: The Healing Journey of Molly Hale by Dorothy Fadiman (Director), 2003, available from Concentric Media, PO Box 1414, Menlo Park, CA 94026, VHS tape, 57 minutes, $29.95 (individual), $99.00 (library/university).     

Person-environment transactions in youth drinking and driving

Drinking and driving is a significant health risk behavior for adolescents. This study tested mechanisms by which disinhibited personality traits (impulsivity and sensation seeking) and aspects of the adolescent home/social environment (parental monitoring and alcohol accessibility) can influence changes in drinking and driving behavior over time. Two hundred two high school age youths were assessed at 2 time points, approximately 8 months apart. Zero-inflated Poisson regression analyses were used to test (a) an additive model, where personality and environmental variables uniquely predict drinking and driving engagement and frequency; (b) a mediation model, where Time 2 environmental variables mediate the influence of disinhibited personality; and (c) an interaction model, where environmental factors either facilitate or constrain the influence of disinhibited personality on drinking and driving. Results supported both the additive and interaction model but not the mediation model. Differences emerged between results for personal drinking and driving and riding with a drinking driver. Improving our understanding of how malleable environmental variables can affect the influence of disinhibited personality traits on drinking and driving behaviors can help target and improve prevention/intervention efforts.     

Guided saccades modulate face- and body-sensitive activation in the occipitotemporal cortex during social perception

Functional magnetic resonance imaging (fMRI) has identified distinct brain regions in ventral occipitotemporal cortex (VOTC) and lateral occipitotemporal cortex (LOTC) that are differentially activated by pictures of faces and bodies. Recent work from our laboratory has shown that the strong LOTC activation evoked by bodies in which the face is occluded is attenuated when the occlusion is removed. We hypothesized that this attenuation may occur because subjects preferentially fixate upon faces when present in the scene. Here, we experimentally manipulated subjects’ fixations while they viewed a static picture of a character whose face, hand, and torso were continuously visible throughout each run. The subject’s saccades and fixations were guided by a small fixation cross that made discrete jumps to a new location every 500 ms. Subjects were instructed to follow the fixation cross and make a button press whenever it changed size. In a series of blocks, the fixation cross shifted from locations on the face, on the hand, and to locations on a background image of a phase-scrambled face. In a second study, the fixation cross moved similarly, but the hand locations were changed to locations along the character’s body or torso. A localizer task was used to identify face- and body-sensitive regions of LOTC. Body-sensitive regions were strongly activated when the subjects’ saccades were guided over the character’s torso relative to when the saccades were guided over the character’s face. Little to no activity occurred in the body-sensitive region of LOTC when the subjects’ saccades were guided over the character’s hand. The localizer task was unable to differentiate body-sensitive regions in lateral VOTC from face-sensitive regions, or body-sensitive regions in medial VOTC from flower-sensitive regions. Guided saccades over the body strongly activated both lateral and medial VOTC. These results provide new insights into the function of body-sensitive visual areas in both LOTC and VOTC, and illustrate the potential confounding influence of uncontrolled eye movements for neuroimaging studies of social perception.     

An Investigation of Genetic Counselor Experiences in Peer Group Supervision

Peer supervision groups have been studied in counseling fields including psychotherapy and social work. However, limited research exists regarding genetic counselor peer supervision groups. In the present study five major research questions were investigated: (1) How prevalent is peer group supervision among genetic counselors? (2) What motivates genetic counselors to join and continue to seek peer group supervision? (3) What comprises the content, agenda, and structure of group meetings? (4) What are participants’ perceptions of group dynamics, including conflicts, cohesion, and leadership? and (5) What are the perceived benefits and limitations of participating in peer group supervision? A total of 214 genetic counselors completed an online survey, and 70 (34.8%) reported being involved currently in peer group supervision. Fifteen of these 70 respondents were interviewed regarding their experiences in peer group supervision. Inductive analysis of their responses yielded 11 domains and 37 categories. Practice implications and research recommendations are discussed.     

Using mediational models to explore the nature of tobacco motivation and tobacco treatment effects

Various theories have proposed mechanisms for drug motivation and relapse. For instance, negative reinforcement theories focus on the alleviation of withdrawal. However, other theories and some data cast doubt on the importance of withdrawal as a motivator of addictive drug use. Using data from a randomized double-blind placebo-controlled smoking cessation treatment study (N=608), this research examined the impact of withdrawal on drug motivation and the ability to maintain abstinence. Withdrawal was experimentally manipulated by randomly assigning participants to receive active bupropion versus placebo. Mediation analyses revealed that active bupropion reduced the amount of withdrawal and craving that individuals reported in the 1st week post quit; modest support was also found for smaller declines in positive affect. These effects, in turn, were all positively associated with posttreatment abstinence. These results implicate withdrawal as an important factor in motivating persistent tobacco use.