Modelling decisions to undergo genetic testing for susceptibility to common health conditions: an ancillary study of the Multiplex Initiative

New genetic tests reveal risks for multiple conditions simultaneously, although little is understood about the psychological factors that affect testing uptake. We assessed a conceptual model called the multiplex genetic testing model (MGTM) using structural equation modelling. The MGTM delineates worry, perceived severity, perceived risk, response efficacy and attitudes towards testing as predictors of intentions and behaviour. Participants were 270 healthy insured adults aged 25-40 from the Multiplex Initiative conducted within a health care system in Detroit, MI, USA. Participants were offered a genetic test that assessed risk for eight common health conditions. Confirmatory factor analysis revealed that worry, perceived risk and severity clustered into two disease domains: cancer or metabolic conditions. Only perceived severity of metabolic conditions was correlated with general response efficacy (β?=?0.13, p<0.05), which predicted general attitudes towards testing (β?=?0.24, p<0.01). Consistent with our hypothesised model, attitudes towards testing were the strongest predictors of intentions to undergo testing (β?=?0.49, p<0.01), which in turn predicted testing uptake (OR 17.7, β?=?0.97, p<0.01). The MGTM explained a striking 48% of the variance in intentions and 94% of the variation in uptake. These findings support use of the MGTM to explain psychological predictors of testing for multiple health conditions.     

One size does not fit all: face emotion processing impairments in semantic dementia, behavioural-variant frontotemporal dementia and Alzheimer's disease are mediated by distinct cognitive deficits

Patients with frontotemporal dementia (both behavioural variant [bvFTD] and semantic dementia [SD]) as well as those with Alzheimer's disease (AD) show deficits on tests of face emotion processing, yet the mechanisms underlying these deficits have rarely been explored. We compared groups of patients with bvFTD (n = 17), SD (n = 12) or AD (n = 20) to an age- and education-matched group of healthy control subjects (n = 36) on three face emotion processing tasks (Ekman 60, Emotion Matching and Emotion Selection) and found that all three patient groups were similarly impaired. Analyses of covariance employed to partial out the influences of language and perceptual impairments, which frequently co-occur in these patients, provided evidence of different underlying cognitive mechanisms. These analyses revealed that language impairments explained the original poor scores obtained by the SD patients on the Ekman 60 and Emotion Selection tasks, which involve verbal labels. Perceptual deficits contributed to Emotion Matching performance in the bvFTD and AD patients. Importantly, all groups remained impaired on one task or more following these analyses, denoting a primary emotion processing disturbance in these dementia syndromes. These findings highlight the multifactorial nature of emotion processing deficits in patients with dementia.     

Colorless green ideas (can) prime furiously

That similar words can prime one another is not news. However, this phenomenon can be exploited to make inferences about the organization of conceptual representations. What types of similarity matter? Although there is evidence that similarity of function, shape, and even manner of manipulation is reflected in semantic memory, evidence for organization on the basis of color similarity is sparse. This lack of evidence is surprising: Intuition suggests that color is a prominent feature of many object concepts. The research reported here clarifies this puzzle and illustrates the dynamic nature of conceptual representations. Our research demonstrates color-based priming (e.g., "emerald" primes "cucumber") in participants who completed a Stroop color-naming task before a priming task. Notably, the size of the Stroop effect predicted the size of the priming effect. When the order of tasks was reversed, priming effects were eliminated. By demonstrating that both extrinsic and intrinsic factors can influence conceptual activation, our findings have implications for theories of semantic memory.     

Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders

Eating disorders are serious mental illnesses affecting a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no recommended treatments for EDNOS. This article provides an overview of enhanced cognitive behavior therapy, a validated treatment for all forms of EDs.     

Job burnout and depression: unraveling their temporal relationship and considering the role of physical activity

Job burnout and depression have been generally found to be correlated with one another. However, evidence regarding the job burnout-depression association is limited in that most studies are cross-sectional in nature. Moreover, little is known about factors that may influence the job burnout-depression association, other than individual or organizational factors (e.g., gender, supervisor support). The current study seeks to address these gaps by (a) unraveling the temporal relationship between job burnout and depression and (b) examining whether the job burnout-depression association may be contingent upon the degree to which employees engage in physical activity. On the basis of a full-panel 3-wave longitudinal design with a large sample of employees (N = 1,632), latent difference score modeling indicated that an increase in depression from Time 1 to Time 2 predicts an increase in job burnout from Time 2 to Time 3, and vice versa. In addition, physical activity attenuated these effects in a dose-response manner, so that the increase in job burnout and depression was strongest among employees who did not engage in physical activity and weakest to the point of nonsignificance among those engaging in high physical activity.     

Effects of three types of noncontingent auditory stimulation on vocal stereotypy in children with autism

We evaluated the effects of 3 types of noncontingent auditory stimulation (music, white noise, recordings of vocal stereotypy) on 2 children with autism who engaged in high rates of vocal stereotypy. For both participants, the music condition was the most effective in decreasing vocal stereotypy to near-zero levels, resulted in the highest parent social validity ratings, and was selected as most preferred in treatment preference evaluations.     

Using the Interactive Systems Framework in Understanding the Relation Between General Program Capacity and Implementation in Afterschool Settings

The present study uses the Interactive Systems Framework (ISF) to understand how general capacity influences the implementation of prevention programs in afterschool settings. Eight afterschool sites received the Good Behavior Game (GBG) intervention, a program designed to foster supportive behavioral management and positive youth behavior. In line with the Prevention Support System component of ISF, the intervention afterschool staff were trained and received weekly on-site support from coaches in implementing the GBG. It was found that GBG implementation scores were greatest in afterschool programs that rated high on both organizational- and community-levels of general capacity; high scores on only one level of general capacity resulted in lower implementation scores. Thus, afterschool sites that were more organized, maintained adequate facilities, and developed strong linkages to individuals or organizations in the community scored highest in implementation fidelity and quality. This study highlights the importance of considering interactions among multiple levels of general capacity in efforts to promote evidence-based practices in afterschool settings. Caution should be taken in generalizing findings due to the small sample in this study.     

Stress, Cortisol, and Externalizing Behavior in Adolescent Males: An Examination in the Context of Multisystemic Therapy

Stress and hypothalamic-pituitary-adrenal (HPA) axis dysregulation have been associated with externalizing behavior in adolescence, but few studies have examined these factors in a treatment context. This study investigated the relationship between stress, cortisol, and externalizing behavior among 120 adolescent males (mean age?=?15) receiving Multisystemic Therapy (MST). To examine the differential relationship of cortisol with various types of stressors, self-report measures assessed lifetime stress, current episodic stress, and daily hassles. Morning and afternoon cortisol samples were collected to examine whether the relationship between stress and treatment outcome depended on the youth's biological stress levels. Regression analyses indicated that awakening cortisol levels moderated the relationship between daily hassles and externalizing behaviors at post-treatment. More specifically, higher levels of daily hassles predicted worse outcomes only among adolescents with high levels of morning cortisol. In addition, lifetime stressors and afternoon measures of cortisol interacted to predict changes in caretaker reports of externalizing problems and youth arrests following treatment; lifetime stressors were positively associated with externalizing behavior when adolescents had low levels of afternoon cortisol. Implications for theory and future directions for evidence-based treatment are discussed.