Genetic Counseling Assistants: an Integral Piece of the Evolving Genetic Counseling Service Delivery Model

This study explores the potential impact of the genetic counseling assistant (GCA) position on the efficiency of the genetic counseling field, evaluates attitudes regarding expansion of the genetic counseling field to include the GCA, and presents data on GCA endeavors and GCA job tasks as reported by GCAs, certified genetic counselors (CGCs), and program directors (PDs). Data on GCA roles and attitudes toward different aspects of the GCA position were collected via surveys of CGCs who have worked with GCAs, PDs who have and have not had experience with GCAs in their programs, and GCAs. We analyzed responses from 63 individuals: 27 PDs, 22 CGCs, and 14 GCAs. GCAs’ impact on efficiency was calculated via internal analysis of genetic patient volume per genetic counselor within the University of Texas Southwestern (UTSW) patient database prior to, and since the addition of, a GCA to the practice. The response rates for PDs, CGCs, and GCAs were 27 %, 79 %, and 61 %, respectively. Every CGC stated the GCA increased their efficiency. CGCs with a GCA reported a 60 % average increase in patient volume. This figure was congruent with internal data from the UTSW cancer genetics program (58.5 % increase). Appropriate responsibilities for GCAs as reported by CGCs and PDs (>90 %) include: data entry, shipping tests, administrative tasks, research, and ordering supplies. Regarding GCAs delivering test results, there was response variation whether this should be a job duty: 42 % of CGCs agreed to GCAs delivering negative results to patients, compared to 22 % of program directors. Twenty-two percent of PDs expressed concern about the job title “Genetic Counseling Assistant.” Ninety percent of CGCs felt that GCA was a career path to becoming a CGC, compared to 42 % of PDs. Eighty-three percent of GCAs who decided to apply to CGC graduate programs were accepted. We conclude the addition of a GCA to a genetic counseling practice contributes to increased efficiency and is one way to expand the reach of the profession.     

Narrative Therapy to Prevent Illness‐Related Stress Disorder

More than 94% of cancer patients described the experience as the most traumatic event they have ever faced and 13% have posttraumatic stress disorder (PTSD) in the aftermath. Empirical evidence demonstrates that certain behaviors lead to more positive health outcomes. Although many patients automatically engage in these behaviors, many others do not. Treatments typically focus on short‐term, symptom‐focused strategies. Narrative‐Expressive Therapy is an intervention designed to address the long‐term, underlying stress and to prevent PTSD in patients with serious illness.     

Age-related trends in Stroop and conflicting motor response task findings.

Inhibition problems are reportedly at the heart of several childhood pathologies and learning disorders, but few instruments are available for their in-depth investigation. The main aim of the present study was to investigate the development of a capacity to inhibit automatic responses in young and middle childhood. For this purpose, 100 children between 6 and 11 years old were administered two tests that measure executive inhibition: an animal Stroop task (in a paper-and-pencil version of the computerized original proposed by Wright and colleagues in 2003) and a conflicting motor response task. Our results indicate that performance clearly improves in both tests during the course of a child's development and the data obtained with the paper-and-pencil animal Stroop task overlap with those obtained with the computerized version. When the task calls for a stronger inhibitory control (the incongruent situation in the Stroop task and in the opposite condition in the conflicting motor response test) the trend of the response times is less homogeneous, peaking in the youngest and oldest age brackets considered. The positivity and significance of the correlation coefficients between the two tests also suggest that the two measures are tapping cognitive abilities that are developing in a parallel fashion.     

Predicting Sexual Satisfaction in Women: Implications for Counselor Education and Training

The authors examined how physical affection in the family of origin, partner initiation and communication, and masturbatory practices predicted 4 measures of sexual satisfaction. Participants in this national study were 2,632 women who volunteered to complete a survey on women's sexuality. Results showed that partner initiation and communication most strongly predicted female sexual satisfaction regardless of how it was measured. Implications for counselor education and training are discussed, and directions for further study are suggested.     

Adolescent Violence: The Protective Effects of Youth Assets

The authors explored adolescent physical fighting and weapon carrying, using in‐home interviews with 1,098 middle/high school students and their parents. Logistic regression analyses examined the relationship between youth assets and the risk behaviors while controlling for demographic information. Both demographic factors and assets were associated with no physical fighting, and 6 of 9 assets were linked to not carrying a weapon. These findings indicate that certain assets may protect youth from physical fighting and carrying a weapon.     

Change detection in complex scenes: hemispheric contribution and the role of perceptual and semantic factors

The perceptual salience and semantic relevance of objects for the meaning of a scene were evaluated with multiple criteria and then manipulated in a change-detection experiment that used an original combination of one-shot and tachistoscopic divided-visual-field paradigms to study behavioural hemispheric asymmetry. Coloured drawings that depicted meaningful situations were presented centrally and very briefly (120 ms) and only the changes were lateralised by adding an object in the right or in the left visual hemifield. High salience and high relevance improved both response times (RTs) and accuracy, although the overall contribution of salience was greater than that of relevance. Moreover, only for low-salience changes did relevance affect speed. RTs were shorter when a change occurred in the left visual hemifield, suggesting a right-hemisphere advantage for detection of visual change. Also, men responded faster than women. The theoretical and methodological implications are discussed.     

Children's activities and their meanings for parents: a mixed-methods study in six Western cultures

Theoretical perspectives and research in sociology, anthropology, sociolinguistics, and cultural psychology converge in recognizing the significance of children's time spent in various activities, especially in the family context. Knowing how children's time is deployed, however, only gives us a partial answer to how children acquire competence; the other part must take into account the culturally constructed meanings of activities, from the perspective of those who organize and direct children's daily lives. In this article, we report on a study of children's routine daily activities and on the meanings that parents attribute to them in six Western middle-class cultural communities located in Italy, The Netherlands, Poland, Spain, Sweden, and the United States (N = 183). Using week-long time diaries kept by parents, we first demonstrate similarities as well as significant differences in children's daily routines across the cultural samples. We then present brief vignettes--"a day in the life" --of children from each sample. Parent interviews were coded for themes in the meanings attributed to various activities. Excerpts from parent interviews, focusing on four major activities (meals, family time, play, school- or developmentally related activities), are presented to illustrate how cultural meanings and themes are woven into parents' organization and understanding of their children's daily lives. The results of this mixed-method approach provide a more reliable and nuanced picture of children's and families' daily lives than could be derived from either method alone.     

Women accused of sex offenses: a gender-based comparison

Sexual offenses committed by women are likely underestimated and under-reported. This exploratory study compares and contrasts women accused of sexual offenses and their male counterparts. Data were retrospectively compiled on all alleged female and age-matched male sex offenders who were referred for psychiatric evaluation to a large Midwestern city's court psychiatric clinic over a six-year period. Data were abstracted regarding their crimes, charges, demographics, social history, medical history, legal history, violence history, substance use, sexual history, psychiatric history and their victims. Like the men, women were most frequently referred for sexual predator classification evaluations. Ages ranged from 19 to 62 years, and the majority had children. Most had prior arrests. One-third had a past history of psychiatric hospitalization, and most were given a non-paraphilic psychiatric diagnosis. The majority of the women reported past histories of sexual or physical victimization. While there were many similarities between female and male sex offenders in this psychiatric sample, women more frequently had victims of both genders.     

Sticky thoughts: depression and rumination are associated with difficulties manipulating emotional material in working memory

Cognitive inflexibility may play an important role in rumination, a risk factor for the onset and maintenance of depressive episodes. In the study reported here, we assessed participants' ability to either reverse or maintain in working memory the order of three emotion or three neutral words. Differences (or sorting costs) between response latencies in backward trials, on which participants were asked to reverse the order of the words, and forward trials, on which participants were asked to remember the words in the order in which they were presented, were calculated. Compared with control participants, depressed participants had higher sorting costs, particularly when presented with negative words. It is important to note that rumination predicted sorting costs for negative words but not for positive or neutral words in the depressed group. These findings indicate that depression and rumination are associated with deficits in cognitive control.     

The Relationship Quality Interview: evidence of reliability, convergent and divergent validity, and incremental utility

Relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention has been paid to the assessment of relationship quality. The present study introduces the Relationship Quality Interview (RQI), a semistructured, behaviorally anchored individual interview. The RQI was designed to provide a more objective assessment of relationship quality as a dynamic, dyadic construct across 5 dimensions: (a) quality of emotional intimacy in the relationship, (b) quality of the couple's sexual relationship, (c) quality of support transactions in the relationship, (d) quality of the couple's ability to share power in the relationship, and (e) quality of conflict/problem-solving interactions in the relationship. Psychometric properties of RQI ratings were examined through scores obtained from self-report questionnaires and behavioral observation data collected cross-sectionally from a sample of 91 dating participants and longitudinally from a sample of 101 married couples. RQI ratings demonstrated strong reliability (internal consistency, interrater agreement, interpartner agreement, and correlations among scales), convergent validity (correlations between RQI scale ratings and questionnaire scores assessing similar domains of relationship quality), and divergent validity (correlations between RQI scale ratings and (a) behavioral observation codes assessing related constructs, (b) global relationship satisfaction scores, and (c) scores on individual difference measures of related constructs). Clinical implications of the RQI for improving couple assessment and interventions are discussed.