The Complexity and Challenges of Genetic Counseling and Testing for Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is an umbrella term referring to two chronic idiopathic intestinal diseases: ulcerative colitis (UC) and Crohn’s disease (CD). Both UC and CD are characterized by immune activation that leads to symptoms, but the location, severity and behavior of the inflammation varies among individuals and in characteristic ways between UC and CD. A majority of patients with IBD are diagnosed in young adulthood, but the response to therapy is variable and difficult to predict, with some patients demonstrating a prompt and effective remission while others have continuous symptoms that do not respond to existing medical options. Surgery remains a frequent and necessary occurrence among patients with IBD, but in UC it is considered curative, while in CD only temporizing. Clinical observations, epidemiological studies, and molecular genetics have provided strong evidence that both genetic and environmental factors are important determinants for disease susceptibility. In recent years, a number of genes have been identified that associate with CD and UC, although the clinical utility of these discoveries in patients or in susceptible family members has not been determined. Nonetheless, it is hoped that these fundamental advances in our understanding of IBD will lead to better therapies for patients and prevention strategies for those who are susceptible. Effective incorporation of clinical genetic testing for IBD into practice will require appropriate education and counseling.     

The centrality of event scale: a measure of integrating a trauma into one's identity and its relation to post-traumatic stress disorder symptoms

We introduce a new scale that measures how central an event is to a person's identity and life story. For the most stressful or traumatic event in a person's life, the full 20-item Centrality of Event Scale (CES) and the short 7-item scale are reliable (alpha's of .94 and .88, respectively) in a sample of 707 undergraduates. The scale correlates .38 with PTSD symptom severity and .23 with depression. The present findings are discussed in relation to previous work on individual differences related to PTSD symptoms. Possible connections between the CES and measures of maladaptive attributions and rumination are considered along with suggestions for future research.     

Exogenous influences on task set activation in task switching

To explore the effect of exogenous processes on cognitive control, we used a cueing task-switching paradigm with two spatial judgement tasks and added an irrelevant colour attribute to the task-relevant spatial attribute of the target. The colour was not related to any specific Stimulus-Response relation in the tasks. A correlation was created between stimulus colour and task identity. This correlation was strong but imperfect in Experiment 1 and perfect in Experiment 2. As a result of the colour-task correlation, stimuli contained redundant information about task identity. By changing the correlation pattern every few blocks we caused this information to be sometimes invalid. In both experiments, performance was worse when the information carried by the target was invalid than when it was valid. However, this effect was exclusive to conditions with short task preparation time. By comparing performance with a control group, which had no colour-task correlation (in Experiment 2) we established that the colour manipulation did not cause a qualitative change in preparation strategy, and that the exogenous effect was stronger in switch trials than in repetition trials. We conclude that exogenous processes that are related to task set affect performance primarily if they are presented before endogenous processes of task set preparation have been launched.     

Confidence,not consistency,characterizes flashbulb memories

On September 12, 2001, 54 Duke students recorded their memory of first hearing about the terrorist attacks of September 11 and of a recent everyday event. They were tested again either 1, 6, or 32 weeks later. Consistency for the flashbulb and everyday memories did not differ, in both cases declining over time. However, ratings of vividness, recollection, and belief in the accuracy of memory declined only for everyday memories. Initial visceral emotion ratings correlated with later belief in accuracy, but not consistency, for flashbulb memories. Initial visceral emotion ratings predicted later posttraumatic stress disorder symptoms. Flashbulb memories are not special in their accuracy, as previously claimed, but only in their perceived accuracy.     

Finding the "genuine" schizotype: a model and method for resolving heterogeneity in performance on laboratory measures in experimental psychopathology research

Heterogeneity in the performance of persons affected with schizophrenia or schizotypic psychopathology on various laboratory tasks has long been recognized, both for its consistency across tasks and studies and for the massive methodological and substantive challenges it poses for experimental psychopathology, genetic, and other investigations. Traditional multivariate techniques, such as factor analysis, discriminant function analysis, and cluster analysis, have all been deemed inadequate for resolving heterogeneity, because of one or another statistical limitation. Here, an objective statistical approach based on a formal statistical model that uses the ubiquitous and well-developed expectation-maximization (EM) algorithm (A. P. Dempster, N. M. Laird, & D. B. Rubin, 1977) is presented, which enables one effectively to partition a group of experimental subjects, in this case identified initially using the well-known Perceptual Aberration Scale (L. J. Chapman, J. P. Chapman, & M. L. Raulin, 1978), in a manner that reduces heterogeneity and allows for the separation of what are termed genuine and false-positive schizotypes. The validity of the parsing strategy was supported by reference to other laboratory indexes of relevance to schizophrenia and schizotypy that were not included in the initial EM-based analyses. The potential utility of this approach is discussed with reference to future schizophrenia and schizotypy research.     

Factor analysis of the 122 item fear survey schedule

The 122 item fear survey schedule was factor analyzed in an attempt to discover whether various stimuli cluster together in their capacity to evoke anxiety. The method of factor analysis involved a rotation to an oblique structure with the result that 5 conceptually pure factors emerged accounting for at least 90 per cent of the variance. The factors were named as follows: (1) fears related to small animals, (2) fears of the precipitators and manifestations of hostility, (3) moralistically related fears and sexual fears, (4) fears of isolation and loneliness, and (5) fears of anatomical destruction and physical pain. Using the items that correlated 0.35 or better with factors, a 40 item fear survey schedule emerged. Suggestions for clinical use of this fear survey schedule were made.     

The distribution of early childhood memories

The quantitative distribution of autobiographical memories for the first decade of life is described. The distribution, based on over 11,000 autobiographical memories from age 10 and younger from published studies, is nearly identical for males and females, for participants of different ages, and for different methods of collecting data, including using words to cue memories from anywhere in the lifespan or from just the childhood years, exhaustive listing of all early memories, and interviews.     

Close Encounters of a New Kind: Toward an Integration of Psychoanalysis and Buddhism

The American Journal of Psychoanalysis -     

Binaural and temporal integration of the loudness of tones and noises

Subjects judged the loudness of tones (Experiment 1) and of bursts of noise (Experiment 2) that varied in intensity and duration as well as in mode of presentation (monaural vs. binaural). Both monaural and binaural loudness, for both types of signals, obeyed the bilinear-interaction prediction of the classic temporal integration model. The loudness of short tones grows as a power function of both intensity and duration with different exponents for the two factors (.2 and .3, respectively). The loudness of wide-band noises grows as a power function of duration (with an exponent of approximately .6) but not of sound pressure. For tones, binaural summation was constant but fell short of full additivity. For noises, summation changed across level and duration. Temporal summation followed the same course for monaural and binaural tonal stimuli but not for noise stimuli. Notwithstanding these differences between tone and noise, we concluded that binaural and temporal summation are independently operating integrative networks within the auditory system. The usefulness of establishing the underlying metric structure for temporal summation is emphasized.