Primary Care Providers’ Responses to Patient-Generated Family History

Family health history is one of the best predictors of an individual’s risk for common disease, yet it is underutilized in routine care. Although the Surgeon General has recommended consumers record their family health history and share it with their health care provider, providers’ perceptions of patient-generated family histories are unknown. To learn more about providers’ experience with and perceptions about patient-generated family histories, we mailed surveys to 301 providers and had a response rate of 24% (n = 68). Seventy-three percent felt a patient-generated computer pedigree would improve their ability to assess risk as compared to their current methods. Seventy percent felt a patient-generated computer pedigree would either have no effect on or would increase the number of patients that could be seen in a day. Results suggest that providers appreciate the potential benefits of patient-generated family histories. Genetic counselors and nurses are in a prime position to promote and facilitate the use of patient-generated family health histories in routine care.     

Bulimic Eating Disorders in Primary Care: Hidden Morbidity Still?

The current study examined the features of women with bulimic-type eating disorders (n = 24) attending primary care in two smaller urban regions of the USA. The assessment included measures of eating disorder psychopathology, medical comorbidity, impairment in role functioning, potential barriers to treatment and actual use of health services. Eating disorders, primarily variants of bulimia nervosa and binge eating disorder not meeting formal diagnostic criteria, were associated with marked impairment in psychosocial functioning. Although two-thirds of participants recognized a problem with their eating, less than 40% had ever sought treatment from a health professional for an eating or weight problem and only one in ten had sought such treatment from a mental health specialist. Only one-third had ever been asked about problems with eating by a primary care practitioner or other health professional. However, more than 80% had sought treatment from a health professional for symptoms of anxiety or depression. Most reported some degree of discomfort in discussing eating problems with others, and half reported that they would not be truthful about such problems if asked. Having an eating disorder was associated with several chronic medical conditions, including joint pain, gastrointestinal problems and fatigue. Although the small sample size limits any firm conclusions, the findings suggest that the health burden of bulimic-type eating disorders is substantial but remains largely hidden. Efforts may be needed to improve the eating disorders “mental health literacy” of both patients and primary care practitioners in order to facilitate early, appropriate intervention.     

Early trauma,negative affect,and anxious attachment: the role of metacognition

Background and Objectives: Metacognition is linked to the etiology and maintenance of negative emotions and psychological disorder in the Self-Regulatory Executive Function Model. Although there is significant evidence supporting the model, little is currently known about the situational factors for developing dysfunctional metacognitions. The current study explored the hypothesis that early aversive experiences might be important and also tested if metacognitions could mediate the relationship between such experiences and psychological symptoms. Design and Methods: Three hundred and fifty non-clinical adults completed a retrospective early trauma measure, as well as measures of current metacognitive beliefs, negative affect, and anxious attachment. Results: Early emotional abuse positively and significantly correlated with several metacognitive belief dimensions but other forms of early trauma did not. Metacognition fully mediated the relationship between emotional abuse and negative affect. Anxious attachment was also positively and significantly associated with metacognitive beliefs and specific relationships remained after controlling for early emotional abuse and current negative affect. Conclusions: Findings are consistent with the ideas that: (i) early negative experiences, and emotional abuse in particular, could be a factor in the formation of problematic metacognitions and (ii) these metacognitions may be important in determining the effects of abuse on subsequent psychological symptoms.     

Childhood Emotional Abuse and Psychological Distress in Gay and Bisexual Men

Despite the high prevalence of childhood emotional abuse (CEA) and adult psychological distress (depression and anxiety) among gay and bisexual men (GBM), there is little research examining the relationships among these variables. This study examined internalized homophobia (IH) as a mediator between CEA and psychological distress in a sample of 286 GBM. Controlling for demographics and childhood sexual and physical abuse, CEA was associated with self-report and clinician-administered measures of psychological distress. Concern about stigma of being gay mediated the relationship between CEA and psychological distress. Internalized antigay attitudes might be important in the relationship between CEA and adult psychological distress. Clinicians might address negative beliefs about the self as a GBM that could be exacerbated due to CEA.     

Implicit Coping Responses to Racism Predict African Americans' Level of Psychological Distress

African Americans report experiencing discrimination on a frequent basis, and these experiences have been linked to psychological distress. Coping responses to racism have been suggested to mediate the relationship between discrimination and distress. This study introduces the first measure of African Americans' implicit emotional and coping responses to racism and examines the measure's ability to predict psychological distress. The Go/No-Go Association Task (Nosek &; Banaji, 2001 Nosek , B. A. , &; Banaji , M R. ( 2001 ). The go/no-go association task . Social Cognition , 19 , 625 – 664 .[Crossref], [Web of Science ®] , [Google Scholar]) was adapted to assess African Americans' implicit association of racial prejudice with each of four coping and two emotional responses. Anxiety and general psychological distress were assessed with the Brief Symptom Inventory. Greater implicit association between prejudice and “seeking support” was found to predict lower anxiety and general distress, demonstrating the potential utility of implicit measures in assessing coping responses to racism and their consequences.     

The effects of violent video games on aggression.

Violent content video games such as Mortal Kombat and Doom have become very popular among children and adolescents, causing great concern for parents, teachers, and policy makers. This study cumulates findings across existing empirical research on the effects of violent video games to estimate overall effect size and discern important trends and moderating variables. Results suggest there is a smaller effect of violent video games on aggression than has been found with television violence on aggression. This effect is positively associated with type of game violence and negatively related to time spent playing the games. Directions for future programmatic research on video games are outlined.     

A Factor Structure of Wellness: Theory,Assessment, Analysis,and Practice

The Wheel of Wellness, a theoretical model of well‐being, incorporates 16 dimensions of healthy functioning that can be assessed using the Wellness Evaluation of Lifestyle (WEL; J. E. Myers, T. J. Sweeney, & J. M. Witmer, 1998). A series of studies are reported concerning the development and validation of the WEL based on a large database. In the current study, exploratory and confirmatory factor analyses of the items and scales revealed 5 primary factors of well‐being (Creative, Coping, Social, Essential, and Physical) and 1 superordinate factor identified as “Wellness.”     

Advocacy for the Counseling Profession: Results of a National Survey

Seventy‐one leaders in state, regional, and national professional and credentialing associations in counseling responded to a survey concerning professional advocacy efforts, resources, obstacles, and needs. The results indicate a variety of ongoing advocacy initiatives, specific needs for resources and interprofessional collaboration, and agreement on the importance of advocacy for the future of the profession.