Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

Enhancement of auditory fear conditioning after housing in a complex environment is attenuated by prior treatment with amphetamine

Prior exposure to drugs of abuse has been shown to occlude the structural plasticity associated with living in a complex environment. Amphetamine treatment may also occlude some cognitive advantages normally associated with living in a complex environment. To test this hypothesis we examined the influence of prior exposure to amphetamine on fear conditioning in rats housed in either a standard or complex environment. Housing in a complex environment facilitated fear learning to an auditory conditioned stimulus (CS), but not to the training context, relative to animals housed singly or in a social group. Prior treatment with amphetamine eliminated this effect. These results indicate that living in a complex environment facilitates conditional freezing to an auditory CS, and that this effect is abolished by pretreatment with amphetamine.     

Processing demands in belief‐desire reasoning: inhibition or general difficulty?

Most 4-year-olds can predict the behavior of a person who wants an object but is mistaken about its location. More difficult is predicting behavior when the person is mistaken about location and wants to avoid the object. We tested between two explanations for children's difficulties with avoidance false belief: the Selection Processing model of inhibitory processing and a General Difficulty account. Children were presented with a false belief task and a control task, in which belief attribution was as difficult as in the false belief task. Predicting behavior in light of the character's desire to avoid the object added more difficulty in the false belief task. This finding is consistent with the Selection Processing model, but not with the General Difficulty account.     

Heart Follows Head: Influencing Violence-related Attitudes in the Classroom

We examined whether an undergraduate course on violence would influence students’ violence-related attitudes and beliefs. Students (N=145) completed the Violence-Related Attitudes and Beliefs Scale (V-RABS) at the beginning (Time 1) and end (Time 2) of the semester-long course. As expected, support for the death penalty, punishment, and catharsis decreased significantly, as did belief in an association between mental illness and violence. Acceptance of environmental influences on violent behavior increased significantly, although belief in biological influences did not change. Support for violence prevention efforts was high at both Times 1 and 2, and did not change significantly. Consistent with previous research, the results of this study confirm that college curricula may influence students’ attitudes and beliefs in addition to imparting knowledge.     

Playboy Playmate curves: changes in facial and body feature preferences across social and economic conditions

Past research has investigated ideals of beauty and how these ideals have changed across time. In the current study, facial and body characteristics of Playboy Playmates of the Year from 1960-2000 were identified and investigated to explore their relationships with U.S. social and economic factors. Playmate of the Year age, body feature measures, and facial feature measurements were correlated with a general measure of social and economic hard times. Consistent with Environmental Security Hypothesis predictions, when social and economic conditions were difficult, older, heavier, taller Playboy Playmates of the Year with larger waists, smaller eyes, larger waist-to-hip ratios, smaller bust-to-waist ratios, and smaller body mass index values were selected. These results suggest that environmental security may influence perceptions and preferences for women with certain body and facial features.     

Core mechanisms in "theory of mind"

Our ability to understand the thoughts and feelings of other people does not initially develop as a theory but as a mechanism. The "theory of mind" mechanism (ToMM) is part of the core architecture of the human brain, and is specialized for learning about mental states. Impaired development of this mechanism can have drastic effects on social learning, seen most strikingly in the autistic spectrum disorders. ToMM kick-starts belief-desire attribution but effective reasoning about belief contents depends on a process of selection by inhibition. This selection process (SP) develops slowly through the preschool period and well beyond. By modeling the ToMM-SP as mechanisms of selective attention, we have uncovered new empirical phenomena. We propose that early "theory of mind" is a modular-heuristic process of domain-specific learning.     

Analyzing the Process and Content of Genetic Counseling in Familial Breast Cancer Consultations

A detailed examination of the process of genetic counseling has been identified as a priority area for research by previous authors. This multicenter longitudinal study examined the process and content of genetic counseling in initial consultations with women from high-risk breast cancer families. One hundred and fifty-eight consultations with women unaffected and affected with breast cancer were audio taped and transcribed verbatim. A detailed coding system was developed. Clinical geneticists and genetic counselors demonstrated consistently good practice in giving detailed information on essential aspects related to familial breast cancer such as screening and management, genetic testing, breast cancer genetics, and prophylactic surgery. Eliciting emotional concerns and facilitating communication were found to be inconsistently present. As clinical practice guidelines and the general communication literature emphasize the importance of these factors, this is an area where training in or self-monitoring of such behaviors may assist consultants to further develop these skills.     

Pavlovian conditioning of Hermissenda: current cellular, molecular, and circuit perspectives

The less-complex central nervous system of many invertebrates make them attractive for not only the molecular analysis of the associative learning and memory, but also in determining how neural circuits are modified by learning to generate changes in behavior. The nudibranch mollusk Hermissenda crassicornis is a preparation that has contributed to an understanding of cellular and molecular mechanisms of Pavlovian conditioning. Identified neurons in the conditioned stimulus (CS) pathway have been studied in detail using biophysical, biochemical, and molecular techniques. These studies have resulted in the identification and characterization of specific membrane conductances contributing to enhanced excitability and synaptic facilitation in the CS pathway of conditioned animals. Second-messenger systems activated by the CS and US have been examined, and proteins that are regulated by one-trial and multi-trial Pavlovian conditioning have been identified in the CS pathway. The recent progress that has been made in the identification of the neural circuitry supporting the unconditioned response (UR) and conditioned response (CR) now provides for the opportunity to understand how Pavlovian conditioning is expressed in behavior.     

Potential noradrenergic targets for cognitive enhancement in schizophrenia

Substantial evidence suggests that alterations in noradrenergic function contribute to the cognitive impairments of schizophrenia. Activation of post-junctional alpha 2a-adrenergic receptors in the prefrontal cortex by the alpha 2a-selective agonist guanfacine has demonstrated some preliminary benefit in subjects with schizophrenia treated with atypical antipsychotics. alpha 1-adrenergic receptor activity may be less important in mediating the cognitive impairments of schizophrenia. beta-adrenergic receptors may serve as another potential target for cognitive remediation in schizophrenia. However, the potential increase in memory consolidation in schizophrenia patients produced by beta-adrenergic agonists may be outweighed by the impairment in cognitive flexibility and executive functioning produced by beta-adrenergic agonists. Finally, norepinephrine reuptake inhibitors, such as atomoxetine, hold promise as potential cognitive enhancers in schizophrenia because of their ability to indirectly but selectively increase extracellular dopamine concentrations in the prefrontal cortex.