The Development of a Methodology for Examining the Process of Family Communication of Genetic Test Results

It is important to study communication processes in families where members are undergoing testing for genetic conditions because the information received from such testing is crucial not just to the individual concerned but also to other members of the biological family. This topic has received little research attention, in part because of the complexities of methodology required. In this paper we present the development of a method specifically designed for the examination of the content and process of communication of genetic information in families. The method aims to maximize ecological validity as far as is possible. We describe how participants and other family members are recruited and how data were collected. We outline three main data analytic strategies: a graphic to show how genetic information changes as it flows from clinic and through the family, an intensive qualitative analysis of the meaning and impact of the genetic information to different family members, and an informative genogram which plots key family dynamics. This method will be illustrated in relation to a study of ten family-groups where one individual has been found to carry a genetic mutation predisposing them to hereditary breast and ovarian cancer.     

Reducing probabilistic weather forecasts to the worst-case scenario: anchoring effects

Many weather forecast providers believe that forecast uncertainty in the form of the worst-case scenario would be useful for general public end users. We tested this suggestion in 4 studies using realistic weather-related decision tasks involving high winds and low temperatures. College undergraduates, given the statistical equivalent of the worst-case scenario (1 boundary of the 80% predictive interval), demonstrated biased understanding of future weather conditions compared with those given both bounds or no uncertainty information. We argue that this was due to an anchoring effect on numeric estimates, which were closer to the worst-case scenario than was warranted and increased linearly as the anchor became more extreme. In many situations tested here, anchoring in numeric estimates also extended to subsequent binary decisions, leading participants with the worst-case scenario to take action more often than did other participants. These results suggest that worst-case scenario forecasts can mislead the user. They appear to convince people that wind speeds will be higher and temperatures will be lower than what are indicated by the forecast. In addition, participants systematically "corrected" the forecast they were given. This effect was most prominent in the condition in which no uncertainty was provided, suggesting that people feel compelled to take uncertainty into account, even when it is not acknowledged by the forecast. Both the anchoring and correction biases were least evident when both bounds were provided, suggesting that balanced uncertainty leads to the best understanding of future weather conditions.     

A Protection Motivation Theory application to date rape education

Date rape risk communication is a key component of education-based Date Rape Prevention Programs, common across colleges. In such programs, risk assessment in date rape is approached cautiously in order to avoid a tone of "victim blaming." Since it is important in the assessment of any risk to understand the surrounding social context of the risky situation and the individual's unique relationship with that social context, this study examines Protection Motivation Theory as it applies to handling the risk of date rape without victim blaming. The paper links individual personality and social contexts with risk communication. The study sample comprised 367 undergraduate women enrolled in a large Southern Public University. The study examines the relationships between dating activity, social competency, and type of information provided with the dependents variables of date rape related protection behavior (intent), belief, and knowledge. A factorial multiple analysis of covariance analysis found that the dependent variables had a significant relationship with aspects of social competency and dating activity. The exposure to varying information about date rape was not significantly related to the dependent variables of date rape-related protection behavior (intent), belief, and knowledge. The identification of social competency and dating activity status as protective factors in this study makes a significant contribution to the practice and research efforts in date rape education.     

Design of the Steps to Health Study of Physical Activity in Survivors of Endometrial Cancer: Testing a Social Cognitive Theory Model

Physical activity has been shown to benefit cancer survivors' physical functioning, emotional well-being, and symptoms. Physical activity may be of particular benefit to survivors of endometrial cancer because they are more likely to be obese and sedentary than the general population, as these are risk factors for the disease, and thus experience a number of related co-morbid health problems. However, there is little research systematically studying mechanisms of physical activity adherence in cancer survivor populations. This paper describes the design of the Steps to Health study, which applies a Social Cognitive Theory-based model of endometrial cancer survivors' adoption and maintenance of exercise in the context of an intervention to increase walking or other moderate intensity cardiovascular activity. In Steps to Health we will test the influence of self-efficacy and outcome expectations on adherence to exercise recommendations, as well as studying the determinants of self-efficacy. Endometrial cancer survivors who are at least 6 months post-treatment are provided with an intervention involving print materials and telephone counseling, and complete assessments of fitness, activity, self-efficacy and outcome expectations, and determinants of self-efficacy every two months for a six month period. In addition to testing an innovative model, the Steps to Health study employs multiple assessment methods, including ecological momentary assessment, implicit tests of cognitive variables, and ambulatory monitoring of physical activity. The study results can be used to develop more effective interventions for increasing physical activity in sedentary cancer survivors by taking into account the full complement of sources of self-efficacy information and outcome expectations.     

Another dragon in the kitchen: Psychological experiences of hepatitis C treatment among HIV‐hepatitis C co‐infected gay men

Background: Increasing numbers of HIV‐infected gay men acquire hepatitis C virus (HCV) co‐infection, which causes serious medical consequences. Treatment for HCV is associated with many severe side effects, in some cases psychological, and many patients subsequently fail to adhere, even when psychological services are utilised, to improve treatment adherence. Objective: This qualitative study aimed to explore the experiences of HIV‐infected gay men undergoing treatment for HCV in order to inform psychological services to better meet specific treatment needs of this population. Methods: Thirteen HIV‐infected gay men who had undergone HCV treatment were interviewed and a qualitative analysis was conducted. Participants described HCV and its treatments in the context of their relationships and lifestyles. Findings: Four domains emerged: HCV diagnosis and treatment; HCV treatment education; change in sense of self; and sexual risk‐taking. Adhering to treatment was a significant challenge for all participants and emerged across all domains. Discussion: Psychological services for this population of co‐infected gay men should assist this clinical population not only with adherence to hepatitis C treatment but should also be available at an earlier stage in the process to help patients make informed choices about whether or not to begin a course of treatment. Assessing factors such as coping strategies, treatment readiness and knowledge, self‐awareness, and level of risk‐taking, can guide clinicians in tailoring treatment and adherence planning for HIV/HCV‐co‐infected gay men.     

Left-handedness and male-male competition: Insights from fighting and hormonal data

Male-male competition can shape some behavioral or morphological traits of males. Here we investigate if this competition could play a role in the persistence of the polymorphism of handedness in human populations. A negative frequency-dependent selection mechanism has been hypothesized, based on the fact that left-handed men may benefit from a "surprise" advantage during fighting interactions because they are rare in human populations. This advantage may thereby enhance the probability of survival of left- handed men and/or their reproductive success through an increase in social status. In this study, we first explored the association between hand preference and lifetime fighting behavior in a population of 1,161 French men. No effect of hand preference on the probability of fighting was detected, suggesting that the innate propensity to fight does not differ between left- and right-handers. However, among men who had been involved in at least one fight during their lifetime, left-handers reported significantly more fights than right-handers. To explore the biological basis of this behavior, we also investigated the testosterone concentration in saliva samples from 64 French university students. Consistent with frequencies of fights, we found a significantly higher average testosterone concentration in left-handers than in right-handers. We suggest that these behavioral and hormonal differences may be acquired throughout life due to previous experiences in a social context and may favor the persistence of left-handers in humans.     

Spiritual well-being and spiritual practices in elderly depressed psychiatric inpatients

This study's aims were to describe the spirituality of depressed elderly psychiatric inpatients and to examine associations among spirituality, depression, and quality of life (QOL). Forty-five persons participated. Most reported frequent, stable spiritual practices and experiencing spiritual comfort and guidance. Some reported spiritual distress and changes in spirituality. During hospitalization, participants demonstrated increased spiritual well-being (SWB) and peacefulness, and reduced hopelessness, worthlessness, and guilt. Positive associations were found between SWB and QOL and negative associations between SWB and depression.     

Effects of vision and haptics on categorizing common objects

Most research on object recognition and categorization centers on vision. However, these phenomena are likely influenced by the commonly used modality of touch. The present study tested this notion by having participants explore three-dimensional objects using vision and haptics in naming and sorting tasks. Results showed greater difficulty naming (recognizing) and sorting (categorizing) objects haptically. For both conditions, error increased from the concrete attribute of size to the more abstract quality of predation, providing behavioral evidence for shared object representation in vision and haptics.     

Telling stories: The structure of adults' narratives

Abstract

Adults' narratives were analysed to study life-span changes in their structure. The narratives were collected from a group of adults in their 60s, 70s, and 80s. Four separate analyses were performed on the narratives' (1) hierarchical structure, (2) syntactic structure, (3) propositional content, and (4) cohesion. Age-group differences were obtained for the measures of hierarchical structure, syntactic structure, and cohesion. Further analyses revealed that the structural complexity of the narratives influenced their syntactic structure and cohesion. Interactions between the effects of age group and structural complexity suggest that elderly adults minimise the syntactic complexity of their narratives, reducing their cohesion, when producing structurally complex narratives. Finally, ratings of the quality of the narratives were strongly correlated with their structural complexity, suggesting that telling a “good” story involves constructing complex plots.     

Combined Individual/Marital Therapy: A Conflict Resolution Framework and Ethical Considerations

This paper illustrates how couple and individual treatment formats can be intertwined. A conflict resolution theoretical framework structures treatment around three goals: (1) relieving symptoms (anger, depression, and marital distress), (2) facilitating resolution of the couple's conflicts, and (3) building communication and conflict resolution skills. The literature review focuses on why combining individual and couple therapy is often important for married clients. Two Bicycles, an illustrative case incorporating both conjoint and individual interventions, is presented and analyzed with regard to when each format seems beneficial. Ethical and practical issues raised by dual format treatment include potential harm, informed consent, dual roles, confidentiality, and time and financial costs.