An Investigation of Genetic Counselors’ Testing Recommendations: Pedigree Analysis and the Use of Multiplex Breast Cancer Panel Testing

Genetic testing recommendations for hereditary breast and ovarian cancer involve pedigree analysis and consultation of testing guidelines. The testing landscape for hereditary cancer syndromes is shifting as multiplex panel tests become more widely integrated into clinical practice. The purpose of the current study was to assess how genetic counselors utilize pedigrees to make recommendations for genetic testing, to determine consistency of these recommendations with National Comprehensive Cancer Network (NCCN) Guidelines and to explore current use of multiplex panel testing. Sixty-nine genetic counselors were recruited through the National Society of Genetic Counselors Cancer Special Interest Group’s Discussion Forum. Participation involved pedigree analysis and completion of an online questionnaire assessing testing recommendations and use of multiplex panel testing. Pedigree analysis and test recommendations were scored for consistency with NCCN guidelines. The average score was 12.83/15 indicating strong consistency with NCCN guidelines. Participants were more likely to consider multiplex testing when pedigrees demonstrated highly penetrant dominant inheritance but were not indicative of a particular syndrome. Participant concerns about multiplex panel testing include limited guidelines for both testing eligibility and medical management. This study demonstrates high utilization of pedigree analysis and raises new questions about its use in multiplex genetic testing.     

How Gendered Attitudes Relate to Women’s and Men’s Sexual Behaviors and Beliefs

This study examines associations between endorsement of a sexual double standard, gender role attitudes, and sexual behaviors and beliefs. First year university students in the northeastern United States (N = 434; 52 % female; 33 % Black, 29 % Latino, 39 % White; ages 17–19) participated during their first year of college. Endorsement of a sexual double standard was associated with more conventionally gender-stereotyped sexual behaviors and beliefs, specifically, more sexual partners and fewer perceived barriers to condom use for young men, and more perceived barriers to condom use for young women. Women who were more conventional about men’s roles in society tended to use condoms less, whereas women who were more conventional about women’s roles tended to use condoms more. Men who were more conventional about men’s roles tended to have fewer sexual partners. Findings suggest the importance of examining gender’s role in sexual behaviors and beliefs by assessing multiple gendered attitudes, rather than simply considering biological sex.     

Posttraumatic Stress Following Acute Medical Trauma in Children: A Proposed Model of Bio-Psycho-Social Processes During the Peri-Trauma Period

Millions of children worldwide experience acute medical events. Children’s responses to these events range from transient distress to significant posttraumatic stress disorder symptoms (PTSS). While many models suggest explanations for the development and maintenance of PTSS in adults, very few have focused on children. Current models of child PTSS are primarily restricted to the post-trauma period, thus neglecting the critical peri-trauma period when screening and preventive interventions may be most easily implemented. Research on PTSS in response to pediatric medical trauma typically examines predictors in isolation, often overlooking potentially important interactions. This paper proposes a new model utilizing the bio-psycho-social framework and focusing on peri-trauma processes of acute medical events. Understanding the relationships among bio-psycho-social factors during peri-trauma can inform early identification of at-risk children, preventive interventions and clinical care. Recommendations for future research, including the need to examine PTSS in the context of multiple influences, are discussed.     

Predicting Bystander Behavior to Prevent Sexual Assault on College Campuses: The Role of Self-Efficacy and Intent

Bystander intervention has been increasingly applied to prevent sexual violence on college campuses. Its underlying theory assumes unidirectional relationships between variables, predicting that bystander behaviors (i.e., actions taken to intervene in sexual violence situations) will be influenced by bystander intentions (BI; i.e., likelihood to intervene in the future), which in turn will be affected by bystander efficacy (BE; i.e., confidence to intervene). One question for theory is whether a reciprocal relationship exists between BI and BE. We used structural equation modeling (SEM) with longitudinal data to test unidirectional and reciprocal causal relations between BI and BE. Participants (n = 1390) were students at a northeastern US university. Four models were examined using SEM: (1) a baseline model with autoregressive paths; (2) a model with autoregressive effects and BI predicting future BE; (3) a model with autoregressive effects and BE predicting future BI; and, (4) a fully cross‐lagged model. Results indicated that reciprocal causality was found to occur between BI and BE. In addition, a final model demonstrated indirect effects of a bystander intervention program on bystander behaviors through both BI and BE at different time points. Implications for theory and practice are described, and directions for future research discussed.     

Empathy and Its Role in Morality

In this paper, I will argue, contra Prinz, that empathy is a crucial component of our moral lives. In particular, I argue that empathy is sometimes epistemologically necessary for identifying the right action; that empathy is sometimes psychologically necessary for motivating the agent to perform the right action; and that empathy is sometimes necessary for the agent to be most morally praiseworthy for an action. I begin by explaining what I take empathy to be. I then discuss some alleged problems for empathy and explain why some argue that empathy is unnecessary and sometimes even problematic in the moral domain. Next, I criticize a prominent alternative to an empathy‐based morality. Finally, I argue that that empathy is sometimes epistemologically and psychologically necessary for doing the right thing and is sometimes necessary for moral worth. I conclude with a discussion of the important role of empathy in our everyday lives.     

Call for Research on Bystander Intervention to Prevent Sexual Violence: The Role of Campus Environments

An important next step for the field is to determine what setting‐level factors beyond the individual are critical to fostering campus environments that support pro‐social, helpful bystander intervention action to prevent sexual violence. Therefore, the purpose of this paper is to provide a research agenda to investigate key areas of the campus environment and their potential influence on bystander intervention. To create the research agenda, a number of steps were followed including: (1) systematically reviewing the larger bystander literature to identify key environmental areas, (2) assessing what research is available specific to college campuses and sexual assault in each of these areas, and (3) outlining future research to address each of these areas on college campuses and determine their applicability to sexual violence situations. Five main groups of factors were found to influence bystander intervention beyond the individual, group and situational levels, including: social norms, sense of community, pro‐social modeling, policies, and the physical environment. Certain areas of research on environmental influences on bystander intervention are more developed such as social norms, with little research on areas such as policies and the physical environment. However, further research is needed in each of the identified five areas to help identify how college campuses can support bystander intervention.