Are Genetic Counselors and GLBT Patients “on the Same Page”? an Investigation of Attitudes, Practices, and Genetic Counseling Experiences

Gay, lesbian, bisexual, and transgender (GLBT) individuals comprise a growing patient population in genetic counseling, yet literature on working with this population is scarce. This study sought to investigate GLBT patient experiences in genetic counseling and genetic counselor attitudes and practices when counseling GLBT patients. Twenty-nine GLB individuals who had previously participated in genetic counseling, and 213 genetic counselors completed online surveys. No individuals identifying as transgender participated. The patient survey assessed disclosure of orientation, discrimination in genetic counseling, and quality of services received. The counselor survey assessed comfort with and attitudes about counseling GLBT patients, disclosure of counselor orientation, and whether they counsel differently with this population. Every patient denied experiencing discrimination during their session, but 17% reported their genetic counselor assumed they were heterosexual, and 45% indicated intake forms were not GLBT-inclusive. A majority of counselors (91%) reported having counseled GLBT patients and indicated they were comfortable doing so (86%), and 72% indicated no differences in their counseling approaches with GLBT patients. Few counselors (17%) received training in GLBT issues, and most (61%) desired such education. Additional findings and practice and research recommendations are presented.     

Taxometric analysis as a general strategy for distinguishing categorical from dimensional latent structure

Statistical analyses investigating latent structure can be divided into those that estimate structural model parameters and those that detect the structural model type. The most basic distinction among structure types is between categorical (discrete) and dimensional (continuous) models. It is a common, and potentially misleading, practice to apply some method for estimating a latent structural model such as factor analysis without first verifying that the latent structure type assumed by that method applies to the data. The taxometric method was developed specifically to distinguish between dimensional and 2-class models. This study evaluated the taxometric method as a means of identifying categorical structures in general. We assessed the ability of the taxometric method to distinguish between dimensional (1-class) and categorical (2-5 classes) latent structures and to estimate the number of classes in categorical datasets. Based on 50,000 Monte Carlo datasets (10,000 per structure type), and using the comparison curve fit index averaged across 3 taxometric procedures (Mean Above Minus Below A Cut, Maximum Covariance, and Latent Mode Factor Analysis) as the criterion for latent structure, the taxometric method was found superior to finite mixture modeling for distinguishing between dimensional and categorical models. A multistep iterative process of applying taxometric procedures to the data often failed to identify the number of classes in the categorical datasets accurately, however. It is concluded that the taxometric method may be an effective approach to distinguishing between dimensional and categorical structure but that other latent modeling procedures may be more effective for specifying the model.     

Contemplative/emotion training reduces negative emotional behavior and promotes prosocial responses

Contemplative practices are believed to alleviate psychological problems, cultivate prosocial behavior and promote self-awareness. In addition, psychological science has developed tools and models for understanding the mind and promoting well-being. Additional effort is needed to combine frameworks and techniques from these traditions to improve emotional experience and socioemotional behavior. An 8-week intensive (42 hr) meditation/emotion regulation training intervention was designed by experts in contemplative traditions and emotion science to reduce "destructive enactment of emotions" and enhance prosocial responses. Participants were 82 healthy female schoolteachers who were randomly assigned to a training group or a wait-list control group, and assessed preassessment, postassessment, and 5 months after training completion. Assessments included self-reports and experimental tasks to capture changes in emotional behavior. The training group reported reduced trait negative affect, rumination, depression, and anxiety, and increased trait positive affect and mindfulness compared to the control group. On a series of behavioral tasks, the training increased recognition of emotions in others (Micro-Expression Training Tool), protected trainees from some of the psychophysiological effects of an experimental threat to self (Trier Social Stress Test; TSST), appeared to activate cognitive networks associated with compassion (lexical decision procedure), and affected hostile behavior in the Marital Interaction Task. Most effects at postassessment that were examined at follow-up were maintained (excluding positive affect, TSST rumination, and respiratory sinus arrhythmia recovery). Findings suggest that increased awareness of mental processes can influence emotional behavior, and they support the benefit of integrating contemplative theories/practices with psychological models and methods of emotion regulation.     

Pathways to vocational services: factors affecting entry by veterans enrolled in Veterans Health Administration mental health services

The current study provides naturalistic data documenting the pathways-to-care to vocational services for 155 veterans who were receiving some form of mental health care from the Veterans Health Administration and had a vocational need but were not currently enrolled in vocational services. Of the participants, 94.2% had recognized their vocational need, 80.6% reported that they or someone else had sought help to alleviate the need, and 77.4% had previously received some form of vocational services. The median length of the participants' vocational need was more than 4.2 years. Delays associated with recognition, help-seeking, and treatment entry all contributed to the overall delay in entering appropriate care. Filtering factors associated with quicker recognition, seeking help, and receiving services included diagnosis, level of disability, type of vocational need, and support from primary providers, family, and friends. The results provide information for designing interventions to improve service entry by adults with mental health problems and vocational needs.     

Within-person relationships between mood and creativity

State mood has been proposed as a facilitator of creative behavior. Whereas positive mood compared to neutral mood generally facilitates creative performance, mood effects are weaker and less consistent when positive mood is compared to negative mood. These inconsistent results may be due to focusing only on mood valence, while neglecting or confounding mood activation. The current study is based on the dual-pathway model, which describes separate roles for mood valence and mood activation in facilitating creativity. We used experience sampling methodology to investigate the concurrent and lagged effects of mood valence and activation on creative process engagement (CPE) within-person over time among individuals working on a long-term project requiring creativity. We also investigated the moderating effects of individual differences in goal orientation and supervisory support on within-person mood-creativity relationships. As expected, we found that activating positive and activating negative moods were positively associated with concurrent CPE, whereas deactivating moods of both valences were negatively related to CPE. Activating negative mood had a significant lagged effect on CPE, whereas activating positive mood did not. We also found that activating positive mood was more strongly related to concurrent CPE among individuals with high rather than low learning goal orientation. Further, activating positive mood interacted with prove goal orientation and supervisory support for creativity, such that activating positive mood had the strongest association with CPE when both prove goal orientation and supervisory support were high.     

Youth Group Cliques: How Religious Goals Can Disguise Discriminatory Group Dynamics

This paper provides an in-depth, qualitative analysis of two Christian youth groups. Researchers conducted personal interviews with participating youth and their youth ministers and collected extensive field notes on participant observations of youth group events. Findings indicate the presence of youth group cliques with clear delineations about which participants are youth group insiders and which are outsiders. Results show that insider participants are typically socioeconomically-advantaged youth, while outsiders are typically youth from disadvantaged backgrounds. Despite the existence of these exclusionary practices within both groups, leaders in the two cases demonstrate differing levels of awareness of and response to these dynamics. This paper explores the specifics of both cases, illuminating who is targeted for exclusion within these groups and how this targeting varies across the two congregational contexts. Implications of these findings are that religious youth groups may perpetuate broader socioeconomic divisions. Specifically, the analysis reveals that rather than forming benign cliques, youth group members may be discriminating against others based on their relative socioeconomic advantage.     

Supporting Implementation: The Role of Community Development Teams to Build Infrastructure

Evidence-based methods for assisting consumers, such as counties, in successfully implementing practices are lacking in the field of implementation science. To fill this gap, the Community Development Teams (CDT) approach was developed to assist counties in developing peer networks focused on problem-solving and resource sharing to enhance their possibility of successful implementation. The CDT is an interactive, solution-focused approach that shares many elements of the Interactive Systems Framework (ISF) for Dissemination and Implementation. An ongoing randomized implementation trial of Multidimensional Treatment Foster Care (MTFC) was designed to test the hypothesis that such interactive implementation methods are more successful at helping counties achieve successful and sustainable MTFC programs than standard individualized implementation methods. Using the Stages of Implementation Completion measure, developed for this study, the potential benefit of these interactive methods is examined at different stages of the implementation process ranging from initial engagement to program competency.