Genetic Counseling for Personal Genomic Testing: Optimizing Client Uptake of Post-Test Telephonic Counseling Services

The field of genetic counseling faces a broad challenge: many potential clients may not be aware of the value and benefit of genetic counseling services, and therefore may not utilize those services. Navigenics is a personal genomic testing company that provides telephonic genetic counseling services for multifactorial diseases and pharmacogenetics. When first offered in 2008, utilization of the Navigenics genetic counseling service was less than expected. To explore the basis for under-utilization and potential mechanisms for increasing uptake, Navigenics initiated a quality improvement study, in which three different methods of engaging clients in the uptake of genetic counseling services were assessed over the course of 1 year. Outcomes showed significant differences in uptake rates between methodologies (7.5%, 24.6%, and 60.1%), yielding an 8-fold increase in service utilization when post-test telephonic outreach to all clients was performed. Further, utilization spanned all risk levels based on client results, evidence that not only clients with high-risk results were motivated to engage in the genetic counseling service. This research indicates that implementing strategies to educate clients about genetic counseling can positively impact client engagement and utilization of available services.     

Prior Trauma Exposure for Youth in Treatment Foster Care

Very little research has focused on rates of trauma exposure for youth in treatment foster care (TFC). Available research has utilized record review for assessing exposure, which presents limitations for the range of trauma types examined, as records are predominantly focused on abuse and neglect. The current study examines exposure rates and association with emotional and behavioral outcomes for 229 youth in 46 TFC agencies. The youth in this study had exceptionally high rates of trauma exposure by foster parent report, similar to youth in traditional foster care, with nearly half of the sample exposed to four or more types of traumatic events. A composite child abuse and neglect exposure variable was associated with child and adolescent emotional and behavioral outcomes. Implications for services provided as part of TFC are discussed.     

Utilizing Benchmarking to Study the Effectiveness of Parent–Child Interaction Therapy Implemented in a Community Setting

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of Parent–Child Interaction Therapy (CI-PCIT) utilized as a child maltreatment prevention effort. Data were collected from 83 parent–child dyads. Change scores were compared to treatment and control effect sizes aggregated from the PCIT literature. Pre-post results indicated significant positive changes in child behavior for CI-PCIT completers. Benchmarking analyses revealed that parents who completed CI-PCIT reported significantly greater positive child outcomes than the aggregate control group benchmark, and significantly less than observed in the treatment benchmark. A summary of decision points and implications for utilizing this methodology in the child maltreatment field are postulated.     

Mirror neurons are not evidence for the Simulation Theory

Recently, there as been a resurgence of interest in theories of mindreading. New discoveries in neuroscience have revitalized the languishing debate. The discovery of so-called mirror neurons has revived interest particularly in the Simulation Theory (ST) of mindreading. Both ST proponents and theorists studying mirror neurons have argued that mirror neurons are strong evidence in favor of ST over Theory Theory (TT). In this paper I argue against the prevailing view that mirror neurons are evidence for the ST of mindreading. My view is that on an appropriate construal of their function, mirror neurons do not operate like simulation theorists claim. In fact, mirror neurons are more appropriately understood as one element in an information-rich mindreading process. As such, mirror neurons fit in better with some sort of TT account of mindreading. I offer a positive account, the Model TT, which better explains the role of mirror neurons in social cognition.     

Does Complex or Simple Rhetoric Win Elections? An Integrative Complexity Analysis of U.S. Presidential Campaigns

Research suggests that the integrative complexity of political rhetoric tends to drop during election season, but little research to date directly addresses if this drop in complexity serves to increase or decrease electoral success. The two present studies help fill this gap. Study 1 demonstrates that, during the Democratic Party primary debates in 2003–2004, the eventual winners of the party nomination showed a steeper drop in integrative complexity as the election season progressed than nonwinning candidates. Study 2 presents laboratory evidence from the most recent presidential campaign demonstrating that, while the complexity of Obama's rhetoric had little impact on college students' subsequent intentions to vote for him, the complexity of McCain's rhetoric was significantly positively correlated with their likelihood of voting for him. Taken together, this research is inconsistent with an unqualified simple is effective view of the complexity‐success relationship. Rather, it is more consistent with a compensatory view: Effective use of complexity (or simplicity) may compensate for perceived weaknesses. Thus, appropriately timed shifts in complexity levels, and/or violations of negative expectations relevant to complexity, may be an effective means of winning elections. Surprisingly, mere simplicity as such seems largely ineffective.     

The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders

The present study aimed to understand the contributions of both the trait tendency to experience negative emotions and how one relates to such experience in predicting symptom change during participation in the Unified Protocol (UP), a transdiagnostic treatment for emotional disorders. Data were derived from a randomized controlled trial comparing the UP to a waitlist control/delayed-treatment condition. First, effect sizes of pre- to post-treatment change for frequency of negative emotions and several variables measuring reactivity to emotional experience (emotional awareness and acceptance, fear of emotions, and anxiety sensitivity) were examined. Second, the relative contributions of change in negative emotions and emotional reactivity in predicting symptom (clinician-rated anxiety, depression, and severity of principal diagnosis) reductions were investigated. Results suggested that decreases in the frequency of negative emotions and reactivity to emotions following participation in the UP were both large in magnitude. Further, two emotional reactivity variables (fear of emotions and anxiety sensitivity) remained significantly related to symptom outcomes when controlling for negative emotions, and accounted for significant incremental variance in their prediction. These findings lend support to the notion that psychological health depends less on the frequency of negative emotions and more on how one relates to these emotions when they occur.     

The Patient–Doctor Relationship Questionnaire (PDRQ-9) in Primary Care: A Validity Study

This study assessed the validity of the Patient–Doctor Relationship Questionnaire-9 (PDRQ-9) in a primary care sample (N = 180). Convergent validity was assessed through a correlation between the patient-rated PDRQ-9 and the physician-rated Difficult Doctor Patient Relationship Questionnaire-10 (DDPRQ-10). Discriminant validity was assessed through correlations between the PDRQ-9 and patient age, patient- and physician-reported health and psychological distress. To determine if the PDRQ-9 could discriminate between groups, patient PDRQ-9 ratings were compared between patients who were treated by faculty physicians versus those who were treated by residents. An exploratory factor analysis confirmed that the PDRQ-9 was made up of a single factor. The PDRQ-9 scale was internally consistent (α = .96) and significantly and negatively correlated with the DDPRQ-10 (r = ?.22, p = .003) and was not significantly correlated with patient age, health, or psychological distress. PDRQ-9 ratings were statistically greater in patients who were treated by faculty physicians than those who were treated by residents (p = .01). This study provides additional support for the reliability and validity of the PDRQ-9 as a measure of the doctor–patient relationship in a primary care sample.     

Is It OK If Mommy Dates? The Influence of Mother’s Post-Divorce Dating Transitions for Children’s Behaviors

Journal of Child and Family Studies - Despite many mothers’ interest in establishing romantic relationships following divorce, some worry about the impacts of dating transitions, such as...     

Advancing Our Understanding of the Risk Factors Associated with Crossover Youth in the Child Welfare and Juvenile Justice Systems: A Trauma-Informed Research Agenda

Clinical Child and Family Psychology Review - Previous research has provided robust evidence demonstrating that a notable proportion of youth become involved in both the child welfare (CW) system...