“I Wouldn’t Classify Myself as a Patient”: The Importance of a “Well-being” Environment for Individuals Receiving Counseling about Familial Cancer Risk

Many individuals receiving genetic counseling are healthy with no need for clinical cancer services. We have recently relocated our cancer genetic clinic to a small house on the outskirts of a hospital site which incorporates many elements proven to be important in creating a “well-being” environment. This study explored participants’ perceptions of such an environment. Eleven semi-structured telephone interviews were conducted with women who had attended the new cancer genetic clinic. All were at high risk of familial cancer, five were gene carriers and three had a personal diagnosis of cancer. The new clinic was perceived to be less medical and more relaxing than other clinics, encouraged other family members to attend in support of the attendee and did not appear to impede information comprehension. The importance of not being made to feel like an ill patient was apparent. A desire for a quiet area allowing time for reflection whilst waiting for, and following, counseling was identified. A poorly designed counseling area could reduce the quality of the interaction between patient and counselor. Consideration of specific environmental design features may promote individuals’ well-being and make those attending genetic counseling feel less like “patients.” Larger studies should seek to explore further the potential associations between factors such as environmental design, psychological well-being and comprehension of risk information.     

The role of medial temporal lobe in item recognition and source recollection of emotional stimuli

Recent neuroimaging results suggest that distinct regions within the medial temporal lobe (MTL) may differentially support the episodic encoding of item and relational information for nonemotional stimuli (for a review, see Davachi, 2006). The present study was designed to assess whether these findings generalize to emotional stimuli. Behaviorally, we found that emotion reduced item recognition accuracy but did not reliably affect relational memory. fMRI analyses revealed that neutral and emotional words elicited distinct activation patterns within MTL regions predictive of subsequent memory. Consistent with previous findings for neutral words, hippocampal activation predicted later relational memory, whereas activation in the perirhinal cortex predicted successful item recognition. However, for emotional words, activation in the amygdala, hippocampus, and posterior parahippocampal cortex predicted item recognition only. These data suggest that MTL regions differentially support encoding of neutral and emotional stimuli.     

Emotion enhances the subjective feeling of remembering, despite lower accuracy for contextual details

Emotion strengthens the subjective experience of recollection. However, these vivid and confidently remembered emotional memories may not necessarily be more accurate. We investigated whether the subjective sense of recollection for negative stimuli is coupled with enhanced memory accuracy for contextual details using the remember/know paradigm. Our results indicate a double-dissociation between the subjective feeling of remembering, and the objective memory accuracy for details of negative and neutral scenes. "Remember" judgments were boosted for negative relative to neutral scenes. In contrast, memory for contextual details and associative binding was worse for negative compared to neutral scenes given a "remember" response. These findings show that the enhanced subjective recollective experience for negative stimuli does not reliably indicate greater objective recollection, at least of the details tested, and thus may be driven by a different mechanism than the subjective recollective experience for neutral stimuli.     

Integrating immigrant minorities: developing a scale to measure majority members' attitudes toward their own proactive efforts

The present study is based on the premise that the integration of ethnic minorities may involve more than the majority's expression of tolerance. In order to promote inclusion, the majority may have to play a more active role in the integration process. We describe the development and validation of a new psychometric scale which assesses majority members' attitudes toward their own proactive contribution to the integration of immigrants within three domains: cultural and structural efforts, and openness to diversity. The scale is investigated by analyses of internal structure and exploration of construct validity in relation to relevant social psychological and personality constructs in a sample of 486 Norwegian university students (28% male, mean age = 26.5, SD = 6.08). Factor analyses supported a unidimensional structure and the estimated reliability of an additive scale was satisfactory (Cronbach's α = 0.91). The scale correlated negatively with measures of right-wing authoritarianism and social dominance orientation, and positively with global identity. It was weakly related to the personality traits agreeableness, intellect, extraversion, and conscientiousness. The potential utility of the scale in both applied and experimental social psychological studies are discussed.     

Recognition and recall in amnesics

Although there is considerable agreement that performance in direct memory tasks (e.g., recall, recognition) is more disrupted by amnesia than performance in indirect memory tasks (e.g., mirror reading, word completion), one may be able to further circumscribe the deficit within the domain of direct memory tasks. The present article explores whether recall is disproportionately disrupted by amnesia compared to recognition. If amnesia affects memory uniformly across different direct memory measures, recall of normal controls should not differ from the recall of amnesics when recognition scores of these two groups are equated. On the other hand, if recall is disproportionately disrupted, normal recall should be superior to amnesic recall even when recognition is equated. The present study equated amnesic recognition with that of controls by providing amnesics with 8 s of study time and normal subjects with 0.5 s. Amnesics with Korsakoff's syndrome, amnesics with other etiologies, and appropriate controls were examined. Normal recall was superior to amnesic recall even when no differences were found in recognition. The results further specify the selective nature of amnesia.     

Cuing effects of faces are dependent on handedness and visual field

Faces are unlike other visual objects we encounter, in that they alert us to potentially relevant social information. Both face processing and spatial attention are dominant in the right hemisphere of the human brain, with a stronger lateralization in right- than in left-handers. Here, we demonstrate behavioral evidence for an effect of handedness on performance in tasks using faces to direct attention. Nonpredictive, peripheral cues (faces or dots) directed exogenous attention to contrast-varying stimuli (Gabor patches)—a tilted target, a vertical distractor, or both; observers made orientation discriminations on the target stimuli. Whereas cuing with dots increased contrast sensitivity in both groups, cuing with faces increased contrast sensitivity in right- but not in left-handers, for whom opposite hemifield effects resulted in no net increase. Our results reveal that attention modulation by face cues critically depends on handedness and visual hemifield. These previously unreported interactions suggest that such lateralized systems may be functionally connected.     

Evidence for recovery of fear following immediate extinction in rats and humans

Fear responses can be eliminated through extinction, a procedure involving the presentation of fear-eliciting stimuli without aversive outcomes. Extinction is believed to be mediated by new inhibitory learning that acts to suppress fear expression without erasing the original memory trace. This hypothesis is supported mainly by behavioral data demonstrating that fear can recover following extinction. However, a recent report by Myers and coworkers suggests that extinction conducted immediately after fear learning may erase or prevent the consolidation of the fear memory trace. Since extinction is a major component of nearly all behavioral therapies for human fear disorders, this finding supports the notion that therapeutic intervention beginning very soon after a traumatic event will be more efficacious. Given the importance of this issue, and the controversy regarding immediate versus delayed therapeutic interventions, we examined two fear recovery phenomena in both rats and humans: spontaneous recovery (SR) and reinstatement. We found evidence for SR and reinstatement in both rats and humans even when extinction was conducted immediately after fear learning. Thus, our data do not support the hypothesis that immediate extinction erases the original memory trace, nor do they suggest that a close temporal proximity of therapeutic intervention to the traumatic event might be advantageous.