Direct-to-Consumer Personal Genomic Testing: A Case Study and Practical Recommendations for “Genomic Counseling”

Technological advances and information-seeking consumers have pushed forward the movement of direct-to-consumer (DTC) genetic testing. Just like with other types of testing, there are potential risks, benefits and limitations. A major limitation of DTC testing is the incomplete view it provides regarding lifetime risk for common, complex diseases, since most tests only analyze 1–2 single nucleotide polymorphisms (SNPs) and do not include evaluation of medical or family histories, which is necessary to risk assessment. Further, it is not currently well-established whether personal genomic testing results will lead toward improved health behaviors, adverse psychological effects or potential overuse of the health care system. To display these and other issues, we present an in-depth case study of an individual who ordered DTC genetic testing and subsequently sought genetic counseling. This case presents a unique learning experience for the field of genomic counseling, as the patient did not fit the typical assumptions regarding ‘early adopters’ of DTC testing. It also allowed the genetics health care providers involved in the case to identify gaps in current genetic counseling practice that need to be filled and approaches to employ for successful delivery of genomic counseling. Based on our experience, we developed practical recommendations for genomic counseling, which include novel approaches to case preparation, use of electronic tools during the counseling session, and focusing on education as the major component of the genomic counseling session, in order to provide patients with the knowledge necessary to independently interpret and understand large amounts of genomic testing information provided to them.     

“He Cursed, and I Got Angry:” Beliefs About Anger Among Adolescent Male Offenders in India

Cultural influences in the experience and expression of emotions have been widely recognized, although systematic studies of emotion-related beliefs in culturally diverse families have been scarce. The purpose of the present exploratory study was to examine beliefs about anger among a group of adolescent male offenders in India temporarily residing in a pre-sentencing institution. In particular, adolescent offenders (n = 14) were individually interviewed about their beliefs concerning causes and concomitants of, and behavioral responses to, one’s own and others’ anger, as well as family patterns of anger expression that are crucial in understanding socialization processes. Although some of the themes reflected in their narratives parallel the beliefs of educated, middle-class, non-offender youth in India (e.g., social inappropriateness of anger), as well as those of offenders in other parts of the world (e.g., aggressive behavior as a common response to anger), beliefs about various aspects of anger specific to this subculture of offender youth also emerged. In particular, perceived violations of family honor were cited as the most common elicitors of anger, and although anger was considered ‘bad’ it was expressed through aggression. The findings of this study highlight the need to develop a culturally informed theory of emotions, and relatedly, to develop culturally sensitive interventions for anger management that can be incorporated as a part of rehabilitation efforts for offender youth in India.     

A Mediated Moderation Model of Conformative Peer Bullying

We investigated the relationship between conformative peer bullying and issues of peer conformity among adolescents. This relationship is examined through the establishment of a mediated moderation model for conformative peer bullying using structural equation modeling in a sample of 391 second-year middle school students in Seoul, South Korea. We found that peer pressure and resistance to peer influence interact with one another to affect antisocial conformity, which then affects conformative peer bullying, thereby establishing its mediated moderation effect. The results suggest that conformative peer bullying that encourages and assists active bullies is affected by antisocial conformity; moreover, an individual’s capacity to resist peer influence plays a protective role against peer conformity, and this must be acknowledged as a significant influence in conformative peer bullying among adolescents.     

After School Care for Children on the Autism Spectrum

Few programs exist for after school care designed to support children with Autism Spectrum Disorder (ASD). Not only do parents often depend on after school care, but also children with ASD are likely to benefit from opportunities to generalize skills in an authentic setting and interact with typically developing peers. This lack of support occurs at a time during which there is increasing research and community awareness regarding the need for high quality after school programs to support typically developing children. This study investigates reported experiences with and needs for after school care by parents of children with ASD. Survey results (N = 54) revealed that the majority of parents surveyed desired after school programs within their child’s school but are often denied access to such services or received low quality care for their child in after school programs. Recommendations are provided for future research and program development.     

Learning new vocabulary in German: the effects of inferring word meanings,type of feedback,and time of test

In the present study, introductory-level German students read a simplified story and learned the meanings of new German words by reading English translations in marginal glosses versus trying to infer (i.e., guess) their translations. Students who inferred translations were given feedback in English or in German, or no feedback at all. Although immediate retention of new vocabulary was better for students who used marginal glosses, students who inferred word meanings and then received English feedback forgot fewer translations over time. Plausible but inaccurate inferences (i.e., those that made sense in the context) were more likely to be corrected by students who received English feedback as compared with German feedback, providing support for the beneficial effects of mediating information. Implausible inaccurate inferences, however, were more likely to be corrected on the delayed vocabulary test by students who received German feedback as compared with English feedback, possibly because of the additional contextual support provided by German feedback.     

The effects of prior knowledge on the encoding of episodic contextual details

A positive relationship between prior knowledge and item memory is a consistent finding in the literature. In the present study, we sought to determine whether this relationship extends to episodic details that are present at the time of encoding, namely source memory. Using a novel experimental design, we were able to show both between- and within-subjects effects of prior knowledge on source memory. Specifically, the results revealed that the degree of prior knowledge positively predicted memory for source specifying contextual details. In addition, by including two conditions in which attention was divided either at encoding or retrieval, we were able to show that prior knowledge influences memory by affecting encoding processes. Overall, the data suggest that a priori knowledge within a specific domain allows attentional resources to be allocated toward the encoding of contextual details.     

Participation and Attrition in a Coping Skills Intervention for Adolescent Girls with Inflammatory Bowel Disease

The current study examined factors associated with adolescent and parent participation in a coping skills intervention for adolescent girls with inflammatory bowel disease (IBD) and examined factors associated with attrition related to intermittent missing data. Thirty-one adolescent girls with IBD and their parents enrolled in the intervention. Psychosocial and disease factors related to participation in the 6-week web component of the coping skills intervention were examined as were baseline group differences between those who provided post-treatment data and those who did not. Adolescents experiencing more difficulties related to their disease and psychosocial functioning participated less in the web component of the treatment intervention. Families who attrited had higher baseline levels of parental catastrophic thoughts, parenting stress, and adolescent depression. Families experiencing greater levels of psychological and disease-related difficulties may be at risk for low participation and eventual dropout from pediatric IBD psychological treatment interventions.     

Gender Differences in the Social Functioning of Adolescents with Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) has been associated with social difficulties. Boys with IBD may have increased risk for social problems due to delayed growth and puberty, but gender differences in social functioning have not been investigated. This study examined gender differences in multiple areas of social functioning for adolescents with IBD compared to healthy adolescents. Participants were 92 adolescents 11-17?years (50 with IBD, 42 healthy) and parents who completed questionnaires assessing social functioning. IBD was associated with poorer social functioning in the areas of social competence and social problems. Boys with IBD had worse social competence, with no gender differences for social problems. Gender predicted the use of social contact as a coping strategy, but no significant group differences were found for other areas of social functioning. Adolescents with IBD experience significant social difficulties in some areas, and boys are at risk for poor social competence. However, previously reported social difficulties may not extend to all areas of social functioning.     

Associations Between Positive Development in Late Adolescence and Social, Health, and Behavioral Outcomes in Young Adulthood

Little is known about positive development across the transition from adolescence to young adulthood. The purpose of this paper was to use longitudinal data from a large community sample, the Australian Temperament Project, to investigate prospective associations between positive development at age 19?C20?years and changes in social, health, and behavioral outcomes at 23?C24?years. Data from 890 young adults (61.7% women) were analyzed using path analysis. Emotional health, physical well-being, friendship quality, reduced antisocial behavior, and positive development in young adulthood were predicted by higher levels of positive development in late adolescence, after controlling for baseline levels of respective outcomes, gender, and family socioeconomic status. Parent relationship quality and alcohol use were not significantly predicted. Based on these findings, interventions promoting positive development during adolescence should be investigated as a potential means of yielding positive social, health, and behavioral consequences well into young adulthood.