Development of an Interactive Decision Aid for Female BRCA1/BRCA2 Carriers

Shared decision making between patients and providers is becoming increasingly common, particularly when there is no clear preferred course of action. As a result, decision aids are being adopted with growing frequency and have been applied to many medical decision-making issues. One such issue where there is uncertainty is breast cancer risk management among BRCA1/BRCA2 carriers. We present the development of a CD-ROM decision aid to facilitate risk management decision making in this population. Our decision aid was developed with the intention of providing it through a randomized clinical trial. The CD-ROM is a multimedia, interactive intervention which provides information about breast cancer, risks associated with BRCA1 and BRCA2 mutations, risk management options for hereditary breast cancer, and a breast cancer risk management decision aid. The goal of this CD-ROM, offered as an adjunctive intervention, is to reduce decisional conflict and psychological distress and improve comprehension of risk information, decisional satisfaction, medical adherence, and quality of life for this population of women at increased risk for breast cancer.     

Broadening the Study of the Self: Integrating the Study of Personal Identity and Cultural Identity

This article reviews what is known and what remains to be studied, regarding the association between personal identity and cultural identity. Although these two conceptions of identity have inspired separate literatures and have developed independently of one another, globalization and mass immigration have increased the need to study these two conceptions of identity together. The article puts forth recommendations for integrating the literatures on personal identity and cultural identity. These recommendations include using multidimensional constructs to represent both personal identity and cultural identity, refining the measurement of personal identity and of cultural identity, and of studying these conceptions of identity across various ethnic, cultural, and national groups.     

Working memory load differentially affects tip-of-the-tongue states and feeling-of-knowing judgments

Tip-of-the-tongue states (TOTs) are judgments of the likelihood of imminent retrieval for items currently not recalled, whereas feeling-of-knowing judgments (FOKs) are predictions of successful recognition for items not recalled. The assumption has been that similar metacognitive processes dictate these similar judgments. In Experiment 1, TOTs and FOKs were compared for general information questions. Participants remembered four digits (working memory load) during target retrieval for half of the questions, and there was no memory load for the other questions. Working memory did not affect recall but decreased the number of TOTs and increased FOKs. In Experiment 2, participants maintained six digits during retrieval. TOTs decreased in the working memory condition, but FOKs remained constant. Experiment 3 replicated the results of Experiment 2 while asking for FOKs for recall. In each of the first three experiments, positive metacognitive judgments also affected working memory performance, supporting the idea that working memory and metamemory use similar monitoring processes. In Experiment 4, visual working memory did not affect TOTs or FOKs. The data support a view that TOTs and FOKs are separable metacognitive entities.     

Capturing ruminative exploration: Extending the four-dimensional model of identity formation in late adolescence

Identity exploration has been associated with openness and curiosity but also with anxiety and depression. To explain these mixed findings, the four-dimensional identity formation model [Luyckx, K., Goossens, L., Soenens, B., & Beyers, W. (2006b). Unpacking commitment and exploration: Validation of an integrative model of adolescent identity formation. Journal of Adolescence, 29, 361–378.] was extended using data from two late adolescent samples (total N = 703). A fifth dimension, labeled ruminative (or maladaptive) exploration, was added as a complement to two forms of reflective (or adaptive) exploration already included in the model (i.e., exploration in breadth and exploration in depth). Results indicated that ruminative exploration was positively related to distress and to self-rumination. The two forms of reflective exploration, by contrast, were unrelated to well-being and positively to self-reflection. Ruminative and reflective exploration also helped to distinguish between two types of less adaptive identities (i.e., Ruminative Moratorium and Diffused Diffusion) in a six-cluster solution that also contained adaptive types of identity. Implications for current research on identity formation are discussed.     

Hormonal sensitivity of preterm versus full-term infants to the effects of maternal depression

Comparisons were made of differences in the hormonal sensitivity of preterm versus full-term infants to maternal depression, as reflected in children's cortisol levels. In Study 1 (N=25), a comparison was made between preterm versus healthy full-term children. In Study 2 (N=80), a comparison was made between preterm infants and full-term infants with mild or moderate medical problems. Preterm infants were found to be highly reactive to maternal depression (as measured by the Beck Depression Inventory). That is, they demonstrated higher cortisol levels when paired with depressed mothers and lower cortisol levels when paired with non-depressed mothers. No equivalent effects were found for children who were full-term, even when they had experienced other medical problems at birth. It was concluded that premature infants are exceptionally sensitive to the "emotional climate" in their home environment. As a result, they may manifest very different hormonal outcomes--with implications for their later development.     

Toward a unifying model of identification with groups: integrating theoretical perspectives.

Building on the contributions of diverse theoretical approaches, the authors present a multidimensional model of group identification. Integrating conceptions from the social identity perspective with those from research on individualism-collectivism, nationalism- patriotism, and identification with organizations, we propose four conceptually distinct modes of identification: importance (how much I view the group as part of who I am), commitment (how much I want to benefit the group), superiority (how much I view my group as superior to other groups), and deference (how much I honor, revere, and submit to the group's norms, symbols, and leaders). We present an instrument for assessing the four modes of identification and review initial empirical findings that validate the proposed model and show its utility in understanding antecedents and consequences of identification.     

Accuracy in judgments of aggressiveness

Perceivers are both accurate and biased in their understanding of others. Past research has distinguished between three types of accuracy: generalized accuracy, a perceiver's accuracy about how a target interacts with others in general; perceiver accuracy, a perceiver's view of others corresponding with how the perceiver is treated by others in general; and dyadic accuracy, a perceiver's accuracy about a target when interacting with that target. Researchers have proposed that there should be more dyadic than other forms of accuracy among well-acquainted individuals because of the pragmatic utility of forecasting the behavior of interaction partners. We examined behavioral aggression among well-acquainted peers. A total of 116 9-year-old boys rated how aggressive their classmates were toward other classmates. Subsequently, 11 groups of 6 boys each interacted in play groups, during which observations of aggression were made. Analyses indicated strong generalized accuracy yet little dyadic and perceiver accuracy.