Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Adjustment to chronic low back pain--the relative influence of fear-avoidance beliefs, catastrophizing, and appraisals of control

The present study investigated the relative extent to which patients' adjustment to chronic low back pain (CLBP) was influenced by their fear-avoidance beliefs, their tendency to catastrophize, and their appraisals of control. Eighty-three CLBP patients completed a series of self-report measures before participating in a physical therapist-led intervention. Hierarchical multiple regression analyses revealed that patients' perceptions of their ability to decrease pain explained a small, but statistically significant, proportion of the variance in pain intensity. In addition, patients' levels of catastrophizing, as well as their fear-avoidance beliefs about both work and physical activity, were independently associated with levels of disability. Interestingly, however, when exploring the relative predictive utility of these three psychological factors, it became evident that fear-avoidance beliefs about physical activity (FABs-PA) were the only significant predictor of patients' disability. Specifically, those patients who exhibited higher levels of FABs-PA tended to report greater levels of disability, even after adjusting for age, sex and pain intensity.     

Estimates of emotional and psychometric intelligence: evidence for gender-based stereotypes

The authors examined participants' estimates of own and parental psychometric intelligence (IQ) and emotional intelligence (EI). The authors asked 224 participants (82 men, 138 women, 4 people who did not report their gender) to estimate their own and their parents' IQ and EI scores on a normal distribution ranging from 55 to 145 points. The authors hypothesized that men would give higher IQ but lower EI self-estimates than women and that participants, regardless of gender, would rate their fathers as higher on IQ but lower on EI than their mothers. The results confirmed the hypotheses, supporting the view that people perceive psychometric intelligence as a primarily masculine attribute in contrast with emotional intelligence, which they perceive as a primarily feminine attribute. The results also showed that the intensity of the stereotypical perception of EI as a feminine attribute diminished when the authors asked participants to estimate their scores on a range of specific EI facets instead of providing a direct overall self-estimate.     

Orientational manoeuvres in the dark: dissociating allocentric and egocentric influences on spatial memory

Subjects in a darkroom saw an array of five phosphorescent objects on a circular table and, after a short delay, indicated which object had been moved. During the delay the subject, the table or a phosphorescent landmark external to the array was moved (a rotation about the centre of the table) either alone or together. The subject then had to indicate which one of the five objects had been moved. A fully factorial design was used to detect the use of three types of representations of object location: (i) visual snapshots; (ii) egocentric representations updated by self-motion; and (iii) representations relative to the external cue. Improved performance was seen whenever the test array was oriented consistently with any of these stored representations. The influence of representations (i) and (ii) replicates previous work. The influence of representation (iii) is a novel finding which implies that allocentric representations play a role in spatial memory, even over short distances and times. The effect of the external cue was greater when initially experienced as stable. Females out-performed males except when the array was consistent with self-motion but not visual snapshots. These results enable a simple egocentric model of spatial memory to be extended to address large-scale navigation, including the effects of allocentric knowledge, landmark stability and gender.     

Inhibition and attention deficit hyperactivity disorder in adults

The inhibitory account of attention deficit hyperactivity disorder (ADHD) was tested by examining the performance of college-aged adults on a variety of inhibitory tasks. The poorer performance of adults with ADHD compared with controls on negative priming, stopping, and continuous performance tasks, combined with similar group performances on a test of working memory capacity, indicates a specific inhibitory deficit as opposed to a general limitation in attentional capacity. Overall results provide evidence for extending the inhibitory deficit hypothesis to adult ADHD, not only for mechanisms of response (or motor) inhibition but also for mechanisms of cognitive inhibition.     

Sex and cross-cultural differences in the estimated multi-faceted intelligence quotient score for self, parents and siblings

Over four hundred young people from Britain, Hawaii and Singapore estimated their own, their parents and their siblings IQ score on each of Gardner (1983) fundamental human intelligences: verbal (linguistic), logical (mathematical), spatial, musical, body-kinesthetic, interpersonal and intrapersonal. They also answered six simple questions concerning intelligence tests. There were both cultural and sex differences in the estimation of overall own intelligence score. Males gave higher scores than females (109 vs 107) while the British gave the highest score (109) compared with the Singaporeans (106) and Hawaiians (104). Factor analysis of the seven dimensions yielded either a two or three factor solution, the latter being verbal (verbal, inter-intrapersonal), mathematical (mathematical and spatial), and musical (musical, body-kinesthetic). There were consistent sex differences in the estimations of the three factors for self, but not of parents, and only marginally of sisters. Males more than females, and the British more than the other groups, were more likely to believe in sex and race difference in intelligence.     

Developing a model for online support group use, empowering processes and psychosocial outcomes for individuals living with HIV/AIDS

This study examined the mechanism through which online support group (OSG) participation may promote patient empowerment among 340 individuals living with HIV/AIDS. Results from structural equation modelling revealed that greater use of OSGs was associated with more frequent occurrence of the empowering processes as measured by receiving useful information, receiving social support, finding positive meaning and helping others. Receiving useful information and finding positive meaning were related to higher levels of adaptive coping and lower levels of maladaptive coping, while receiving social support and helping others were related to higher levels of self-care self-efficacy, which in turn was related to higher levels of adaptive coping, and lower levels of maladaptive coping. Finally, higher levels of maladaptive coping were related to poorer quality of life, while higher levels of adaptive coping were related to better quality of life. Results suggest that OSG participation may offer some benefits for those living with HIV/AIDS.     

Patterns of theorizing about chess skill – Commentary on Linhares and Freitas (2010) and Lane and Gobet (2011)

Although Linhares and Freitas (2010) have failed to characterize earlier experimental work in chess skill accurately, their conceptual approach of “experience-recognition”-driven problem solving points to the need to incorporate analogical reasoning mechanisms into explanations of how chess players choose the best move in chess. The Lane and Gobet (2011) commentary and the cognitive simulation models that they espouse consist of plausible mechanisms to support choosing a good move, but need additional development to incorporate abstract/semantic information. One possible avenue for future exploration will be to produce hybrid models that use both “piece-on-square” chunk and template representations and abstract high-level representations to guide search in chess.