A Systematic Review of Randomized Controlled Trials to Assess Outcomes of Genetic Counseling

With the advancements in precision medicine and health care reform, it is critical that genetic counseling practice respond to emerging evidence to maximize client benefit. The objective of this review was to synthesize evidence on outcomes from randomized controlled trials (RCTs) of genetic counseling to inform clinical practice. Seven databases were searched in conducting this review. Studies were selected for inclusion if they were: (a) RCTs published from 1990 to 2015, and (b) assessed a direct outcome of genetic counseling. Extracted data included study population, aims, and outcomes. Risk of bias was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions guidelines. A review of 1654 abstracts identified 58 publications of 54 unique RCTs that met inclusion criteria, the vast majority of which were conducted in cancer genetic counseling setting. Twenty-seven publications assessed ‘enhancements’ to genetic counseling, and 31 publications compared delivery modes. The methodological rigor varied considerably, highlighting the need for attention to quality criteria in RCT design. While most studies assessed several client outcomes hypothesized to be affected by genetic counseling (e.g., psychological wellbeing, knowledge, perceived risk, patient satisfaction), disparate validated and reliable scales and other assessments were often used to evaluate the same outcome(s). This limits opportunity to compare findings across studies. While RCTs of genetic counseling demonstrate enhanced client outcomes in a number of studies and pave the way to evidence-based practice, the heterogeneity of the research questions suggest an important need for more complementary studies with consistent outcome assessments.     

A Psycho-Educational Intervention for People with a Family History of Depression: Pilot Results

We developed and pilot-tested the first online psycho-educational intervention that specifically targets people with a family history of depression (‘LINKS’). LINKS provides genetic risk information and evidence-rated information on preventive strategies for depression and incorporates a risk assessment tool and several videos using professional actors. LINKS was pilot-tested in the general practitioner (GP) setting. The patient sample included people with a family history of at least one first-degree relative (FDR) with major depressive disorder (MDD) or bipolar disorder (BD). Patients attending participating GP practices were invited to enroll in the study by letter from their GP. Patients who self-identified as having at least one first-degree relative (FDR) with MDD or BD were eligible. Patients completed questionnaires, pre-post viewing LINKS, with measures assessing satisfaction, relevance, emotional impact and perceived improvement of understanding. Six GP practices participated, and 24 patients completed both questionnaires. Of these, all reported that they were satisfied or very satisfied with LINKS, and 74 % reported that LINKS met their expectations, and 21 % that it exceeded their expectations. LINKS was judged highly acceptable by this sample of GP attendees, and results indicate that an assessment of its effectiveness in a larger controlled trial is warranted.     

The Politics of Language: A Discussion of Andrew Samuels’s “The ‘Activist Client’”

This commentary offers three suggestions or potential additions to Samuels’s fine and important article “The ‘Activist Client’” (this issue). First, it is suggested that hermeneutic theory would set a solid philosophical foundation for his political project, a foundation that could add to the article’s persuasiveness and assist the ability of others to apply his perspective to their own therapeutic practices. Two, certain linguistic terms Samuels uses are discussed as counterproductive to his goals, and alternative terms are suggested. Finally, Gadamer’s argument against the concept of empathy is offered as a supplement to Samuels’s intriguing use of Brecht’s approach.     

‘Needed not wanted’: An interdisciplinary examination of the work-related challenges faced by irregular migrants

Using an integrative perspective drawn from vocational psychology and migration studies, this article explores the lives of irregular migrants, which represents a unique aspect of work-based migration. Irregular migrants are those individuals who travel from regions without much work to states that offer some means of employment, without formal immigration documentation. The relational and social contexts of migration of working people to states that offer employment (albeit limited and with many attendant risks) are presented. Using the broad framework provided by the psychology of working coupled with the relational perspectives of working, prominent resources and barriers in the working lives of irregular migrants are described, including social capital, social support, culture as a source of support, and social oppression. Future directions for research that can inform public policy are provided at the conclusion of the article.     

Intelligent management of intelligence agencies: beyond accountability ping-pong

The intelligence community (IC) is asked to predict outcomes that may often be inherently unpredictable-and is blamed for the inevitable forecasting failures, be they false positives or false negatives. To move beyond blame games of accountability ping-pong that incentivize bureaucratic symbolism over substantive reform, it is necessary to reach bipartisan agreements on performance indicators that are transparent enough to reassure clashing elites (to whom the IC must answer) that estimates have not been politicized. Establishing such transideological credibility requires (a) developing accuracy metrics for decoupling probability and value judgments; (b) using the resulting metrics as criterion variables in validity tests of the IC's selection, training, and incentive systems; and (c) institutionalizing adversarial collaborations that conduct level-playing-field tests of clashing perspectives.     

Effects of a ‘Learn to Think’ intervention programme on primary school students

Background. Methods for teaching thinking may be described as out‐of‐context or infusion. Both approaches have potential to raise students’ general cognitive processing ability and so raise academic achievement, but each has disadvantages. Aims. To describe and evaluate a theory‐based learn to think (LTT) curriculum for primary school students, which draws on the strengths of both out‐of‐context and infusion approaches. Sample. One‐hundred and sixty‐six students in three classes of Grade 1 (6+ years old), Grade 2 (7+ years old), and Grade 3 (8+ years old) in a primary school in Shanxi province, China, randomly ascribed to experimental (90) and control (76) groups. Methods. All students were pre‐tested for non‐verbal intelligence and academic achievement. Experimental students followed the LTT curriculum (one activity every 2 weeks) for 4 school years. All were post‐tested on three occasions for thinking ability and four times for academic achievement. Results. Grade 1 and Grade 2 students showed effects of LTT from 1 year after their start and increasing: on thinking ability d= .78–1.45; on Chinese d= .68–1.07; on maths .58–.87. Grade 3 students showed effects from 6 months after their start: on thinking ability .90–1.37; Chinese .77–1.32; maths .65–1.29. The effects were concentrated in students in the middle band of initial ability. Conclusions. A curriculum for teaching thinking based on a structured theoretical model that combines elements of out‐of‐context and infusion methods has been shown to have long‐term far transfer effects on students’ thinking ability and academic achievement. More work is needed to meet the needs of a wider range of abilities.     

Development of hot and cool executive function during the transition to adolescence

This study examined the development of executive function (EF) in a typically developing sample from middle childhood to adolescence using a range of tasks varying in affective significance. A total of 102 participants between 8 and 15 years of age completed the Iowa Gambling Task, the Color Word Stroop, a Delay Discounting task, and a Digit Span task. Age-related improvements were found on all tasks, but improvements on relatively cool tasks (Color Word Stroop and Backward Digit Span) occurred earlier in this age range, whereas improvements on relatively hot tasks (Iowa Gambling Task and Delay Discounting) were more gradual and occurred later. Exploratory factor analysis indicated that performance on all tasks could be accounted for by a single-factor model. Together, these findings indicate that although similar abilities may underlie both hot and cool EF, hot EF develops relatively slowly, which may have implications for the risky behavior often observed during adolescence. Future work should include additional measures to characterize more intensively the development of both hot and cool EF during the transition to adolescence.     

Studying cognitive adaptations in the field of sport: broad or narrow transfer? A comment on Allen, Fioratou, and McGeorge (2011)

This commentary addresses Allen, Fioratou, and McGeorge (2011), drawing attention to the important topic of how humans cognitively adapt to activities they engage in on a daily basis. We elaborate on the critique and suggestions made by Allen, et al. by reviewing research on the relationship of sport and cognition and argue that publication bias may be an issue when studying cognitive adaptations as a function of sport engagement. Implications for future research on the sport-cognition relationship are discussed.     

Love styles, shyness, and patterns of emotional self-disclosure

Previous research has shown a relationship between love styles and shyness. This study explored the possibility that this effect may be due to differences in patterns of self-disclosure associated with shyness. University student participants (N = 143) completed the Love Attitudes Scale, the Emotional Self-Disclosure Scale, and the Revised Cheek and Buss Shyness Scale. Correlations between the measures were calculated and significant results ranged from r = .18 to .30. Findings supported previous research in showing significant relationships between shyness and love styles; self-disclosure showed no relationship with shyness but did show some direct associations with love style scores. Results are discussed in relation to the importance of self-disclosure in relationship development.     

A biopsychosocial formulation of pain communication

We present a detailed framework for understanding the numerous and complicated interactions among psychological and social determinants of pain through examination of the process of pain communication. The focus is on an improved understanding of immediate dyadic transactions during painful events in the context of broader social phenomena. Fine-grain consideration of social transactions during pain leads to an appreciation of sociobehavioral events affecting both suffering persons as well as caregivers. Our examination considers knowledge from a variety of perspectives, including clinical health psychology, social and developmental processes, evolutionary psychology, communication studies, and behavioral neuroscience.