The Laboratory-Clinician Team: A Professional Call to Action to Improve Communication and Collaboration for Optimal Patient Care in Chromosomal Microarray Testing

The International Standards for Cytogenomic Arrays (ISCA) Consortium is a worldwide collaborative effort dedicated to optimizing patient care by improving the quality of chromosomal microarray testing. The primary effort of the ISCA Consortium has been the development of a database of copy number variants (CNVs) identified during the course of clinical microarray testing. This database is a powerful resource for clinicians, laboratories, and researchers, and can be utilized for a variety of applications, such as facilitating standardized interpretations of certain CNVs across laboratories or providing phenotypic information for counseling purposes when published data is sparse. A recognized limitation to the clinical utility of this database, however, is the quality of clinical information available for each patient. Clinical genetic counselors are uniquely suited to facilitate the communication of this information to the laboratory by virtue of their existing clinical responsibilities, case management skills, and appreciation of the evolving nature of scientific knowledge. We intend to highlight the critical role that genetic counselors play in ensuring optimal patient care through contributing to the clinical utility of the ISCA Consortium's database, as well as the quality of individual patient microarray reports provided by contributing laboratories. Current tools, paper and electronic forms, created to maximize this collaboration are shared. In addition to making a professional commitment to providing complete clinical information, genetic counselors are invited to become ISCA members and to become involved in the discussions and initiatives within the Consortium.     

The design and analysis of state-trace experiments

State-trace analysis (Bamber, 1979) addresses a question of interest in many areas of psychological research: Does 1 or more than 1 latent (i.e., not directly observed) variable mediate an interaction between 2 experimental manipulations? There is little guidance available on how to design an experiment suited to state-trace analysis, despite its increasing use, and existing statistical methods for state-trace analysis are problematic. We provide a framework for designing and refining a state-trace experiment and statistical procedures for the analysis of accuracy data using Klugkist, Kato, and Hoijtink's (2005) method of estimating Bayes factors. The statistical procedures provide estimates of the evidence favoring 1 versus more than 1 latent variable, as well as evidence that can be used to refine experimental methodology.     

Videoconferencing psychotherapy: a systematic review

Individuals with mental health problems may face barriers to accessing effective psychotherapies. Videoconferencing technology, which allows audio and video information to be shared concurrently across geographical distances, offers an alternative that may improve access. We conducted a systematic literature review of the use of videoconferencing psychotherapy (VCP), designed to address 10 specific questions, including therapeutic types/formats that have been implemented, the populations with which VCP is being used, the number and types of publications related to VCP, and available satisfaction, feasibility, and outcome data related to VCP. After electronic searches and reviews of reference lists, 821 potential articles were identified, and 65 were selected for inclusion. The results indicate that VCP is feasible, has been used in a variety of therapeutic formats and with diverse populations, is generally associated with good user satisfaction, and is found to have similar clinical outcomes to traditional face-to-face psychotherapy. Although the number of articles being published on VCP has increased in recent years, there remains a need for additional large-scale clinical trials to further assess the efficacy and effectiveness of VCP.     

Neural correlates of automatic mood regulation in girls at high risk for depression

Daughters of depressed mothers are at significantly elevated risk for developing a depressive disorder themselves. We have little understanding, however, of the specific factors that contribute to this risk. The ability to regulate negative affect effectively is critical to emotional and physical health and may play an important role in influencing risk for depression. We examined whether never-disordered daughters whose mothers have experienced recurrent episodes of depression during their daughters' lifetime differ from never-disordered daughters of never-disordered mothers in their patterns of neural activation during a negative mood induction and during automatic mood regulation. Sad mood was induced in daughters through the use of film clips; daughters then recalled positive autobiographical memories, a procedure shown previously to repair negative affect. During the mood induction, high-risk girls exhibited greater activation than did low-risk daughters in brain areas that have frequently been implicated in the experience of negative affect, including the amygdala and ventrolateral prefrontal cortex. In contrast, during automatic mood regulation, low-risk daughters exhibited greater activation than did their high-risk counterparts in brain areas that have frequently been associated with top-down regulation of emotion, including the dorsolateral prefrontal cortex and dorsal anterior cingulate cortex. These findings indicate that girls at high and low risk for depression differ in their patterns of neural activation both while experiencing, and while repairing negative affect, and suggest that anomalies in neural functioning precede the onset of a depressive episode.     

Domestic dogs (Canis familiaris) and the radial arm maze: Spatial memory and serial position effects

The present study investigated spatial memory in domestic dogs (Canis familiaris) through the use of a radial arm maze. The study consisted of a total of three separate experiments. In the first two experiments, the ability of the dogs to successfully remember previously unentered arms was evaluated. The third experiment was similar to the first two, but also examined the nature of the serial position effect. Performance in all three experiments was better than expected solely by random choices. Dogs showed a much better memory for spatial locations presented earlier in a spatial list compared with those presented in the middle. Based on the present results, we suggest that the radial arm maze assesses canine spatial memory and that dogs show a primacy effect. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Selectively friending: Racial stereotypicality and social rejection

Three studies show that people whose physical features are seen as more (versus less) racially stereotypical are more vulnerable to social rejection and exclusion from those outside their group. In Study 1, which used an online social networking site, Blacks perceived as more physically stereotypical were found to have fewer non-Black friends, compared to less-stereotypical Blacks. In Study 2, which used an experimental paradigm, requests for friendship made to non-Blacks by more-stereotypical Blacks were more likely to be rejected than those made by less-stereotypical Blacks. Finally, in a college dormitory, people judged to have more (vs. less) racially stereotypical physical features were found to interact less often with outgroup members. This work substantiates a growing body of research demonstrating that people who are perceived as more physically stereotypical of their racial group are particularly vulnerable to discriminatory treatment by outgroup members across a variety of life domains.     

A spectrum of shadowed mirroring

The central focus of this paper is to explore and extend Kohut's theory of maternal mirroring and to place it within the current context of psychoanalytic thinking. Kohut believed a child must experience "positive" mirroring from his or her mother in infancy and beyond to ensure development of a healthy self. Kohut alludes, however, to a possible situation in which the mother's face, metaphorically a mirror, can appear "faceless" to her child. From this I have inferred the concept of what I shall call "shadowed mirroring." Clinical and literary examples show that distorted, "shadowed" mirroring appears on a spectrum, with passive mirroring at one end and hostile (either verbal or nonverbal) mirroring on the other; some individuals experience both. I then consider how "shadowed mirroring," especially hostile mirroring, can be understood within the twin contexts of the overall mother-child relationship and present-day Intersubjective/Relational thinking that is both bidirectional and co-constructed. Shadowed mirroring can lead to severe personality dysfunction along the borderline-narcissistic range, as well as to difficulties in the areas of identity formation, failure of self-cohesiveness, and the blunting of certain humane qualities like empathy.     

Reactions to a survey among those who were and were not sexually assaulted while serving in the military

Surveys are among the most common methods for evaluating military sexual assault experiences among members of the U.S. military; however, little research has examined how receiving surveys about such sexual assaults might affect recipients. In the present sample of 530 active duty and veteran military personnel, just 10% reported unexpected upset, 11% reported regretting participation in the survey, and 22% reported benefitting from that participation overall. A minority of respondents with a history of sexual assault while in the military reported unexpected upset, although the prevalence was three times higher than that of participants without such history (24% vs 8%). There were no statistically significant differences in perceived regret and benefit of participation in the survey between those with and without a history of sexual assault while in the military. Although limited in number, male military sexual assault survivors (n = 8) were significantly more likely than female survivors to report being more upset by the survey than they had anticipated. Implications for future research are discussed.     

Understanding children's emotional processes and behavioral strategies in the context of marital conflict

Marital conflict is a distressing context in which children must regulate their emotion and behavior; however, the associations between the multidimensionality of conflict and children’s regulatory processes need to be examined. The current study examined differences in children’s (N = 207, mean age = 8.02 years) emotions (mad, sad, scared, and happy) and behavioral strategies to regulate conflict exposure during resolved, unresolved, escalating, and child-rearing marital conflict vignettes. Children’s cortisol levels were assessed in relation to child-rearing and resolved conflict vignettes. Anger and sadness were associated with escalating and child-rearing conflicts, fearfulness was related to escalating and unresolved conflicts, and happiness was associated with resolution. Anger was associated with children’s strategies to stop conflict, whereas sadness was associated with monitoring and avoidant strategies. Cortisol recovery moderated the link between fearfulness and behavioral regulation. These results highlight the importance of children’s emotions and regulatory processes in understanding the impact of marital conflict.