Training Genetic Counsellors to Deliver an Innovative Therapeutic Intervention: their Views and Experience of Facilitating Multi-Family Discussion Groups

Innovations in clinical genetics have increased diagnosis, treatment and prognosis of inherited genetic conditions (IGCs). This has led to an increased number of families seeking genetic testing and / or genetic counselling and increased the clinical load for genetic counsellors (GCs). Keeping pace with biomedical discoveries, interventions are required to support families to understand, communicate and cope with their Inherited Genetic Condition. The Socio-Psychological Research in Genomics (SPRinG) collaborative have developed a new intervention, based on multi-family discussion groups (MFDGs), to support families affected by IGCs and train GCs in its delivery. A potential challenge to implementing the intervention was whether GCs were willing and able to undergo the training to deliver the MFDG. In analysing three multi-perspective interviews with GCs, this paper evaluates the training received. Findings suggests that MFDGs are a potential valuable resource in supporting families to communicate genetic risk information and can enhance family function and emotional well-being. Furthermore, we demonstrate that it is feasible to train GCs in the delivery of the intervention and that it has the potential to be integrated into clinical practice. Its longer term implementation into routine clinical practice however relies on changes in both organisation of clinical genetics services and genetic counsellors’ professional development.     

Treating Depression Among Adolescent Perinatal Women With a Dialectical Behavior Therapy–Informed Skills Group

Depression is a prevalent and impairing problem affecting both women and offspring during the perinatal (pregnancy and the postpartum) period. Despite this, few studies have examined treatments for perinatal adolescents with depressive symptoms. The present study examined the feasibility and preliminary outcomes of a dialectical behavioral therapy (DBT) informed skills group among depressed adolescent perinatal women (N = 25) recruited from both a public health parent education program and an adolescent obstetric clinic. A brief composite case example is included to illustrate how DBT skills were taught, practiced, and applied. Findings suggest the intervention was credible, acceptable, and associated with improvement in depression. Challenges with feasibility of enrolling and retaining adolescent perinatal women were evident, as approximately half of the enrolled participants did not complete the study. This study provides preliminary evidence that a DBT-informed skills group may be a promising intervention for depressed adolescent perinatal women and points to important directions for clinical practice and research, including treatment engagement and retention.     

DNA Testing for Family Reunification in Canada: Points to Consider

Countries have adopted different laws, policies, and practices that allow immigration officers to request in certain cases DNA tests to confirm biological relationships in the context of family reunification. In Canada, Citizenship and Immigration Canada has adopted a policy of suggesting DNA testing only as a last resort in cases where no documentary evidence has been submitted or where the evidence provided is deemed unsatisfactory. However, in practice, there have been concerns on the increasing use of DNA tests in family reunification processes of nationals from certain regions including Africa, Asia, and Latin America. Moreover, the Immigration and Refugee Protection Regulations (IRPR) presents a biological definition of family as a determinant of parenthood in the context of family reunification that is inconsistent with the psychosocial definition used in provincial family laws. Although there are cases that can justify the request for DNA tests, there are also significant social, legal, and ethical issues, including discrimination and unfair practices, raised by this increasing use of genetic information in immigration. This policy brief identifies points to consider for policymakers regarding the use of DNA testing in Canadian family reunification procedures. These include (1) the need to refine the policy of “using DNA testing as a last resort” and its implementation, (2) the need to modify the definition of “dependent child” under the IRPR to reflect the intrinsic reality of psychosocial family ties, and (3) the importance of conducting more research on the use of DNA testing in other immigration contexts.     

Life Trajectories, Genetic Testing, and Risk Reduction Decisions in 18–39 Year Old Women at Risk for Hereditary Breast and Ovarian Cancer

This qualitative study identified four life trajectories that influenced the decision in young women to have genetic testing for mutations in BRCA1/2 and subsequent risk reduction decisions after receiving a positive mutation result. Fifty nine women between the ages of 18–39 years were interviewed in this grounded theory study, 44 of those tested were found to have a mutation in either BRCA1 or BRCA2. Of those with a mutation, 23 had no history of cancer and 21 had a breast cancer diagnosis. Analysis of the 44 participants tested found that risk reducing decisions were related to the life trajectories that preceded genetic testing. These life trajectories included: 1) Long-standing awareness of breast cancer in the family, 2) Loss of one’s mother to breast cancer at a young age, 3) Expression of concern by a health care provider, and 4) Personal diagnosis of breast cancer. Understanding possible influences behind decision making for genetic testing and risk reduction in young women may assist health care providers in offering age appropriate guidance and support.     

Effects of the stress of marathon running on implicit and explicit memory

We tested the idea that real-world situations, such as the highly strenuous exercise involved in marathon running, that impose extreme physical demands on an individual may result in neurohormonal changes that alter the functioning of memory. Marathon runners were given implicit and explicit memory tasks before or immediately after they completed a marathon. Runners tested immediately upon completing the marathon showed impairment in the explicit memory task but enhancement in the implicit memory task. This postmarathon impairment in explicit memory is similar to that seen with amnesic patients with organic brain damage. However, no previous studies have shown a simultaneous enhancement in the implicit memory task, as shown by the marathon runners in the present study. This study indicates that human memory functioning can be dynamically altered by such activities as marathon running, in which hundreds of thousands of healthy normal individuals routinely partake.     

Perceptions of Type 1 Diabetes among Affected Youth and their Peers

Management of type 1 diabetes (T1D) involves balancing several components including diet, exercise, and medication. Peer involvement in management tasks is an important, but understudied, issue in T1D. This study presents results of a preliminary examination of perceptions of disease management in youth with T1D and their peers. Data were collected using a mixed methods (qualitative and quantitative data) approach during medical education time at a camp for youth with T1D and their peers. Results suggest that both youth with T1D and their peers believe that peers need more information about medical consequences of having diabetes. Further, youth with T1D and their peers would like coaching on how peers may help the child with T1D manage their illness better. Results provide preliminary ideas for intervention (i.e., including peers, assessing social support) in the medical setting as well as ideas for future research (i.e., examining relationships among perceptions and gender, time since diagnosis).     

WOMEN'S INTENTIONS REGARDING, AND ACCEPTANCE OF, SELF-SEXUALIZING BEHAVIOR

No known research has examined women's acceptance of self-sexualizing behaviors, which includes the use of catwalks at dance clubs, taking pole dance classes, and wearing clothing with sexually suggestive statements. Structural equation modeling assessed the links between choosing sexually objectifying media, internalized appearance ideals, and self-objectification to self-sexualizing behaviors and general acceptance of sexualizing behavior among 207 female university students. Media choice predicted one's own behavioral intentions and the acceptance of others' sexualizing behavior. Neither internalized appearance ideals nor self-objectification mediated these relations. Hyperfemininity and sexism were tested as individual difference variables predicting these variables. Hyperfemininity added to the prediction of self-sexualizing behaviors and general acceptance of sexualizing behavior, whereas sexism did not. Our results indicate that sociocultural ideals of women's sexual attractiveness predict women's intentions regarding, and acceptance of, sexualizing behavior. Self-sexualizing behavior may have negative consequences, including the lack of subjective experience of one's sexuality.     

“Think Athletic Director, Think Masculine?”: Examination of the Gender Typing of Managerial Subroles Within Athletic Administration Positions

To examine the influence of gender stereotyping of administration positions in intercollegiate athletics, the present study evaluated the gender typing of managerial subroles by undergraduate and graduate sport management students from two northeastern universities in the U.S. (59 women, 189 men). Participants indicated importance of managerial subroles for the positions of athletic director, life skills coordinator, and compliance coordinator. Participants rated masculine managerial subroles as most important for athletic director, however feminine managerial subroles were rated of similar importance for both the life skills coordinator and the athletic director. There were no differences between women and men on evaluation of the importance of managerial subroles across all positions. Results of the current study provide some support for role congruity theory within athletic administration.     

Effects of Resolving to Change One's Own Behavior: Expectations vs. Experience

The “false-hope syndrome” suggests that unrealistic expectations are responsible for the cycle of repeated failure and renewed efforts at self-change characterizing many self-changers. Our hypotheses were that: (1) committing to a particular self-change task would inflate initial expectations, (2) participants would be unsuccessful relative to their expectations, and (3) more elevated expectations would lead to more negative outcomes. Participants were randomly assigned to either increase their physical activity or reduce their stress through meditating or were assigned to a no-change control group. In accordance with Hypotheses 1 and 2, exercise participants had more positive expectations about their resolutions immediately after committing to them, and both exercise and meditation participants were unsuccessful relative to their expectations. With respect to Hypothesis 3, however, having more positive expectations about one's resolution did not predict a worse outcome.