If We Build It … Will They Come? – Establishing a Cancer Genetics Services Clinic for an Underserved Predominantly Latina Cohort

Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina⁶ (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used     

Smoking involvement during adolescence among African Americans and Puerto Ricans: risks to psychological and physical well-being in young adulthood

The major aim of this study was to examine the longitudinal association between adolescent smoking involvement and self-reported psychological and physical outcomes in young adulthood. Participants included 333 African Americans and 329 Puerto Ricans who were surveyed in 1990 in their New York City schools and interviewed in 1995 and 2000-2001, primarily in their homes. The psychological outcomes included ego integration, symptoms of depression, anxiety, and interpersonal difficulty. The physical health measures included a general health rating, number of illnesses, and symptoms of ill health. Also, three scales measured problems due to alcohol, marijuana, and other illicit drug use. Smoking involvement varied by age, sex, and ethnicity but not by socioeconomic status nor by late adolescent parental status. Analysis showed that the relationships between adolescent smoking involvement and psychological and physical health problems in young adulthood remained significant even with control on demographic factors, earlier levels of the outcome variables, and marijuana use. The relationships between smoking behavior and problems with alcohol, marijuana and other illicit drug use were particularly strong. Thus, adolescent smoking seems to have a wide range of clinical implications for young adulthood.     

More than just skin deep? Personality information influences men's ratings of the attractiveness of women's body sizes

This study examined the influence of personality information on perceptions of the physical attractiveness of a range of female body sizes. A sample of 2,157 male university students were randomly assigned to one of 10 groups in which they received personality information about women they were rating, or a control group in which they received no personality information. Controlling for participants' age and body mass index, results showed no significant between-group differences in the body size that participants found most attractive. However, participants provided with positive personality information perceived a wider range of body sizes as physically attractive compared with the control group, whereas participants provided with negative personality information perceived a narrower range of body sizes as attractive. Correlations showed that participants' own Extraversion was associated with their body size ratings. These results suggest that non-physical cues have an influence on the perception of physical beauty.     

Are True Scores and Construct Scores the Same? A critical examination of their substitutability and the implications for research results

Relations between constructs are estimated based on correlations between measures of constructs corrected for measurement error. This process assumes that the true scores on the measure are linearly related to construct scores, an assumption that may not hold. We examined the extent to which differences in distribution shape reduce the correlation between true scores on a measure and scores on the underlying construct they are intended to measure. We found, via a series of Monte Carlo simulations, that when the actual construct distribution is normal, nonnormal distributions of true scores caused this correlation to drop by an average of only .02 across 15 conditions. When both construct and true score distributions assumed different combinations of nonnormal distributions, the average correlation was reduced by .05 across 375 conditions. We conclude that theory‐based scales intended to measure constructs usually correlate highly with the constructs they are constructed to measure. We show that, as a result, in most cases true score correlations only modestly underestimate correlations between different constructs. However, in cases in which the two constructs are redundant, this underestimation can lead to the false conclusion that the constructs are ‘correlated but distinct constructs,’ resulting in construct proliferation.     

Lies and Body Cruelties in the Analytic Hour

Discussing an intensive case study of female sexual dysfunction, this paper studies mutual deregulation and disintegration as it unfolds in the transference–countertransference dyad. I propose that ethical transgressions are potentiated in analytic dyads in which the analyst's hope for either solitude or mutuality is foreclosed. This hope can be foreclosed by the particulars of the therapeutic interaction as well as by the theoretical and clinical aspects of analytic training. The deregulation that both precipitates and follows such transgression can be healed (in the analyst, in the analysis) only by the restitution of the therapist's agency, the reduction of paranoid-schizoid guilt and shame, and the location (in the analyst) of depressive, “I-Thou” remorse.     

Bill Clinton and John E Kennedy: The Dark Side of Charisma

In this review essay, I provide a summary of the basic tenets of Stuart A. Pizer's book, Building Bridges: The Negotiation of Paradox in Psychoanalysis. Focusing on the concepts of negotiation, paradox, and potential space, he privileges them as constituting the basic structure and process of the analytic relationship. Therapeutic action resides specifically in the analyst's optimizing of the potential space within which intrapsychic and interpersonal negotiation can occur. Negotiating paradox is a uniquely human capacity, difficult to sustain, but essential for a “distributed” self, one that is decentered and dynamic rather than disassociated. Pizer extends the reach of these concepts by developing them in relation to gender, evolution, species, and mediation. He also considers that which is nonnegotiable, a relational property between analyst and patient, at the brink of which deep analysis occurs. The book, with its elegant theoretical model and clinically useful tool, provides a rich potential space within which I was able to engage fruitfully.     

Effect of Age and Gender in the Control of Elbow Flexion Movements

In previous studies of rapid elbow movements in young healthy men, characteristic task-dependent changes in the patterns of muscle activation when movement speed or distance was varied have been reported. In the present study, the authors investigated whether age or gender is associated with changes in the patterns of muscle activity previously reported in young men. Arm movements of 10 healthy older and 10 healthy younger participants (5 men and 5 women in each group) were studied. Surface electromyograms (EMGs) from agonist (biceps) and antagonist (triceps) muscles, kinematic and kinetic parameters, as well as anthropometric and strength measures were recorded. All 4 groups of participants showed similar task- (distance or speed) dependent changes in biphasic EMG activity. Similar modulation of the initial rate of rise of the EMG, integrated agonist and antagonist EMG activity, as well as their relative timing were observed in all 4 groups. Those results suggest that older individuals of both genders retain the control strategies for elbow movements used by young individuals. Despite the qualitative similarities in the patterns of muscle activation, the men moved more quickly than the women, and younger participants moved more quickly than older participants. Those performance differences could not be explained in terms of differences in body size and strength alone.     

Cohort Differences in Hand Test Performance: A Time Lagged Analysis

In order to examine the impact of cultural differences (cohort and/or time of measurement) on the intrapsychic processes of older adults, two samples (1976, n = 102; 1986, n = 88) of older persons were compared with regard to their Hand Test (HT; Bricklin, Piotrowski, & Wagner, 1962; Wagner, 1983) performance. Relative to those studies investigating cultural effects in personality at the socioadaptational level (Neugarten, 1977), no research to date has examined this issue utilizing projective methods of assessment. Time-lagged analyses of HT scores of these two samples of elderly adults suggested that there appear to be clear age-related variance in HT performance for both content and derived HT variables. Age-related within-sample variability for most HT scores supported this interpretation. These findings are in contrast to those utilizing more standardized, nomothetic measures of personality functioning that suggest stability of personality in adulthood.     

Against libertarianism

The so-called Mind argument aims at the conclusion that agents act freely only if determinism is true. The soundness of this argument entails the falsity of libertarianism, the two-part thesis that agents act freely, and free action and determinism are incompatible. In this paper, I offer a new formulation of the Mind argument. I argue that it is true by definition that if an agent acts freely, either (i) nothing nomologically grounds an agent’s acting freely, or (ii) the consequence argument for incompatibilism is unsound. I define the notion of nomological grounding, and argue that unless an agent’s acting freely is nomologically grounded, unacceptable consequences follow. I then argue that if agents act freely and the consequence argument is sound, a vicious regress ensues. I conclude by considering the libertarian’s dialectical options.