Bias in the Reporting of Family History: Implications for Clinical Care

Family history of cancer is critical for identifying and managing patients at risk for cancer. However, the quality of family history data is dependent on the accuracy of patient self reporting. Therefore, the validity of family history reporting is crucial to the quality of clinical care. A retrospective review of family history data collected at a community hospital between 2005 and 2009 was performed in 43,257 women presenting for screening mammography. Reported numbers of breast, colon, prostate, lung, and ovarian cancer were compared in maternal relatives vs. paternal relatives and in first vs. second degree relatives. Significant reporting differences were found between maternal and paternal family history of cancer, in addition to degree of relative. The number of paternal family histories of cancer was significantly lower than that of maternal family histories of cancer. Similarly, the percentage of grandparents' family histories of cancer was significantly lower than the percentage of parents' family histories of cancer. This trend was found in all cancers except prostate cancer. Self-reported family history in the community setting is often influenced by both bloodline of the cancer history and the degree of relative affected. This is evident by the underreporting of paternal family histories of cancer, and also, though to a lesser extent, by degree. These discrepancies in reporting family history of cancer imply we need to take more care in collecting accurate family histories and also in the clinical management of individuals in relation to hereditary risk.     

Rule-based and exemplar-based classification in artificial grammar learning

In this study, we examined the induction of syntactic rules, given the presentation of letter strings generated from a finite-state grammar. Our primary interest was whether application of abstracted syntax or analogy to remembered exemplars could serve as a basis for judgments of grammaticality of novel stimuli. The grammatical status of test items and their objective similarity to studied exemplars were manipulated independently to investigate whether rule-based or instance-based information was a more important determinant of classification performance. When group data were examined, the results indicated that both factors were equally important in influencing grammaticality judgments about novel letter strings. There were, however, large individual differences in the magnitude of grammatical status effects, with a subgroup of subjects clearly using a classification strategy other than analogy to remembered exemplars. The results offer qualified support for the hypothesis (Reber & Allen, 1978) that rule-based information can be implicitly abstracted given limited experience with richly structured stimulus domains, and these results are inconsistent with a strong version of the instance-based model of categorization.     

Assessing teaching opportunities in a residential treatment facility

Seventeen living units in a residential treatment facility for developmentally disabled persons were assessed to determine the availability of teaching opportunities during the course of a normal day's routine. Teaching opportunities exist when the environment is arranged so that residents can participate in the ongoing activities. The teaching opportunities are identified within components that are recognizable activities that occur routinely and have a functional purpose. An assessment form was constructed as a means for documenting teachng opportunities. Assessments were conducted continuously from early morning through evening activities. The results of the assessments suggested that two approaches to resident care were in operation at the facility: one was characterized by a traditional care/custodial model, the other was characterized by a teaching model. On units where the number of teaching opportunities available was high, there was a smaller percentage of unstructured time, i.e., blocks of time when opportunities to engage in structured activities were not available to the residents.     

The importance of ‘mass’ in line drawings of faces

Previous research (Davies, Ellis and Shepherd, 1978; Rhodes, Brennan and Carey, 1987) has shown that accurate line drawings of familiar faces are identified rather poorly. However, artists can produce lifelike portraits with pen and ink, and Pearson and Robinson (1985) described an automatic method for producing computer-drawn sketches (‘cartoons’) of faces which appear very similar to those produced by a human artist. In this paper we show that subjects can identify famous faces depicted in such computer-drawn ‘cartoons’ almost as well as full grey-scale images. The cartoon algorithm comprises two components. One component draws lines at the locations of intensity changes corresponding to luminance valleys and edges (the ‘valledge’ detector). The other component applies a ‘threshold’ to the original intensity distribution, and replaces any area darker than threshold with black. Thus the full cartoon contains both ‘line’ and ‘mass’. Neither the valledges nor the threshold components alone were as well identified as full cartoons containing both components. The results suggest that the addition of the threshold component adds significantly to the identifiability of line drawings of faces.     

Facial identity and facial expression matching in 5–12‐year‐old children and adults

Facial identity and facial expression matching tasks were completed by 5–12‐year‐old children and adults using stimuli extracted from the same set of normalized faces. Configural and feature processing were examined using speed and accuracy of responding and facial feature selection, respectively. Facial identity matching was slower than face expression matching for all age groups. Large age effects were found on both speed and accuracy of responding and feature use in both identity and expression matching tasks. Eye region preference was found on the facial identity task and mouth region preference on the facial expression task. Use of mouth region information for facial expression matching increased with age, whereas use of eye region information for facial identity matching peaked early. The feature use information suggests that the specific use of primary facial features to arrive at identity and emotion matching judgments matures across middle childhood. Copyright © 2009 John Wiley & Sons, Ltd.     

Exemplary Counseling Strategies for Developmental Transitions of Young Women With Attention Deficit/Hyperactivity Disorder

This article is intended to provide rehabilitation, career, and mental health counselors with an understanding of how attentional impairments are manifested in young women and how professional counselors may help them most effectively. Treatment guidelines and recommendations are presented for working with these young women through the developmental transition years of adolescence and young adulthood.     

Autism and 15q11-q13 disorders: behavioral, genetic, and pathophysiological issues

New insights into biological factors that underlie autism may be gained by comparing autism to other neurodevelopmental disorders that have autistic features and relatively well-delineated genetic etiologies or neurobiological findings. This review moves beyond global diagnoses of autism and instead uses an endophenotypic approach to compare specific clusters of autistic symptomatology to features of chromosome 15q11-q13 disorders. Paternally or maternally derived deficiencies of 15q11-q13 result in Prader-Willi or Angelman syndromes, and we first use a global approach to review potential autism susceptibility genes in the 15q11-q13 region. We then use a more trait-based approach to suggest possible ties between specific phenotypic characteristics of autism and Prader-Willi syndrome, namely savant-like skills. We conclude with insights from pathophysiological studies that implicate altered development of specific neuron types and circuits in the cerebral cortex as part of the pathophysiological processes associated with autism and mental retardation.     

Effects of Anxiety on Novice Genetic Counseling Students’ Experience of Supervised Clinical Rotations

Supervised clinical experiences with patients comprise a critical component of genetic counseling student education. Previous research has found genetic counseling students tend to be more anxiety prone than the general population, and anxiety related to supervision has been found in genetic counseling and related fields. The present study investigated how anxiety affects the experience of supervision for genetic counseling students. Second year genetic counseling students were invited to participate through email invitations distributed via training directors of the 33 programs accredited at the time of the study by the American Board of Genetic Counseling. An initial online survey contained the trait scale of the State-Trait Anxiety Inventory to estimate anxiety proneness in this population and an invitation to participate in a 45-minute semi-structured phone interview focusing on students’ experiences of supervision during their clinical rotations. High and low trait anxiety groups were created using STAI scores, and the groups’ interview responses were compared using consensual qualitative research methodology (CQR; Hill 2012). The high anxiety group was more likely to describe problematic supervisory relationships, appreciate the supervisor’s ability to help them when they get stuck in sessions, and feel their anxiety had a negative effect on their performance in general and in supervision. Common themes included supervisors’ balancing support and guidance, the importance of feedback, ego-centric responses, and supervisors as focal points. The results of the present study are largely consistent with current literature. Further research findings and research, practice, and training recommendations are provided.