Genetic counselor as a member of an outreach education team

As part of a program to improve maternal and infant health in New Jersey, the Robert Wood Johnson Foundation has funded seven regional consortia throughout the State. One of the goals of the Northern New Jersey Regional Consortium is to provide a comprehensive educational program for ambulatory care staff. An outreach education team was established that includes a perinatal nurse educator, a neonatal nurse educator, a nutritional counselor and a genetic counselor. Many issues in genetics can be initially addressed by the ambulatory care provider. A good understanding and awareness of the impact of genetic issues in patient care is needed to enhance the ability to recognize patients needing special services. Early assessment of possible risk for developmental disabilities can lead to appropriate comprehensive care and improved pregnancy outcome. Regular in-service programs, addressing the way heredity contributes to developmental disorders, the latest techniques used in genetics and the available management programs, can be provided. The present study is an evaluation of the effectiveness of the program.     

Parent attributions of emotion to their children and the cues children use in perceiving their own emotions

A number of studies have demonstrated stable individual differences in the cues that generate emotions and other feeling states. These differences are assumed to arise from the cues parents use to identify their children's emotional states. As children learn about their own emotional states, they come to rely on these same cues. To test one implication of their view, the facial expressions of children (N=41) were manipulated and their feelings assessed. Some children reported emotions consistent with their expressions, while others reported emotions appropriate to the situation. In a separate procedure, their mothers were asked to identify the emotional states of children whose expressions were inconsistent with an account of their circumstances. Mothers who paid more attention to their children's expressive behavior had children who were more responsive to their own expressive behavior. In contrast, the mothers who were more responsive to situational cues had children whose emotions arose from the situational cues as well.The authors would like to thank numerous teachers and administrators of the Worcester Public School system in Worcester, Massachusetts, for their assistance.     

Evoked potentials and the study of sentence comprehension

Evoked brain potentials were used to monitor moment-by-moment decisions during language comprehension. Subjects read sentences containing temporary syntactic ambiguities for which one of the possible interpretations was semantically implausible. The N400 component of the evoked potential, which is sensitive to implausibility, was used to discover when during a sentence subjects made a decision about the ambiguity. The results demonstrate that readers try to interpret a syntactic ambiguity early in a sentence rather than waiting for disambiguating information. This introduces a new way to use brain activity to study sentence comprehension processes.     

Insight without awareness: On the interaction of verbalization, instruction and practice in a simulated process control task

Four experiments in which subjects learned to control two versions of a complex simulated process control task show that verbalizable knowledge of procedures used to perform these tasks is very limited and is acquired late in learning. Individual learning curves associated with these tasks showed sudden improvements in performance, which were not accompanied by a similar increase in verbalizable knowledge. It was also found that verbal instructions consisting of exemplar memorization, strategies for rule induction, simple heuristics, and experts' instructions were all effective in enhancing novice subjects' performance. A theoretical framework is proposed in which subjects draw on two separate but interacting knowledge structures to perform these tasks. One knowledge structure is based on memory for past experiences (close analogies), and the other is based on one's current mental model of the task. Implicit sets of competing rules that control response selection are derived from both sources of knowledge. It is suggested that dissociations between task performance and verbalizing occur because memory-based processing tends to have more control over response selection because of its greater specificity, whereas a mental model tends to be the preferred mode for verbal reporting because of its greater accessibility.     

Serendipity? Are there gender differences in the adoption of computers? A case study

In a study of the effect of learning styles of patent examiners on adoption of computers, there was an important serendipitous finding: women showed a greater propensity to adopt than did men. Moreover, within the sample of women covered in the study, adoption of the computer related to a preference for abstract thinking, scientific education, and effective use of training. No such relationships were found within the group of men. Women were more encouraging to others than men but less assertive in assisting others to learn how to use the computer, implying that the socialization of men and women affects their behavior. The data also suggest that there are important implications of these findings for programs intended to train men and women to use the computer. This paper speculates on the reasons for and implications of these findings.     

The physiology of the tunnel

Several theories to account for the origin of tunnel hallucinations and tunnel experiences near death are considered: (1) the idea of a real tunnel; (2) representations of transition; (3) reliving birth memories; (4) imagination; and (5) physiological origins. Three different physiological theories are considered that related the tunnel form to the structure of the visual cortex. All can account for much of the phenomenology of the tunnel experience, and all lead to testable predictions. It is argued that the tunnel experience involves a change in the mental model of the self in the world. Because of this, an experience of purely physiological origin, with no implications for other worlds or for survival, can nevertheless produce lasting changes in the sense of self and reduce the fear of death.     

Self-labeling by educably mentally retarded high school students in their mainstream and special education classes

Educably mentally retarded (EMR) students and nonhandicapped students from their mainstream classes completed semantic differential ratings of a stereotypic popular teen-ager, juvenile delinquent, and special education student. Subjects also rated their global self-concepts and situation-specific self-concepts within the mainstream and the special class settings. Ratings were done at the beginning (Time 1) and the end (Time 2) of a semester. Results showed that mainstream classes did not "de-label" EMR students. Within the mainstream class, the number of EMR students who saw themselves as similar to a special education student significantly increased over time. Moreover, at Time 2, EMR students were more likely to think of themselves as similar to a special education student in their mainstream class than in their special education class. However, EMR subjects' global self-concepts did not change. Implications for mainstreaming are discussed.     

The Social Psychology of Caregiving: Physical and Psychological Costs of Providing Support to the Disabled1

The emphasis of much of the existing research on social support-health relationships has been on the availability and impact of support on the recipient, but social psychologists have paid little attention to the costs to the caregiver of providing that support. In an earlier study (Schulz & Decker, 1985), we found that the long-term coping of individuals experiencing chronic disability as a result of spinal-cord injury was facilitated by the availability of a primary support person, or caregiver. In this study we examined the determinants of well-being of the primary caregiver of the middle-aged and elderly spinal-cord-injured persons. Psychological well-being, life satisfaction, and depression were the dependent measures. The availability of social support, social contact, and feelings of control over one's life were important determinants of caregiver well-being, even after controlling for health and income. In addition, the amount of time spent each day assisting the disabled person was a strong independent correlate of depression, and the extent to which the caregiver felt burdened by the victim was significantly and negatively related to life satisfaction. These results are discussed in the context of a comprehensive stress-coping model. Since data were available from both disabled individuals and their primary support persons, we had the unique opportunity to compare the perspectives of both those giving and receiving daily care. We found no relationship in levels of psychological well-being and depression reported by the disabled person and caregiver; however, caregivers attributed to the victims affective levels similar to their own.     

Stability and Change in Type A Components and Cardiovascular Reactivity in Medical Students During Periods of Academic Stress1

This study examined the effects of academic stress upon components of Type A behavior and cardiovascular reactivity. In a longitudinal design, heart rate and blood pressure responses to the Type A Structured Interview (SI) and additional laboratory challenges were measured in medical students at three points during an academic semester. Sessions 1 and 3 were scheduled during vacation periods; Session 2 took place during an intensive examination week. Results indicated that three “stylistic” components of Pattern A derived from the SI—loud and explosive speech, short response latency, and potential for hostility—increased significantly during the exam period. Similar increases achieved marginal significance for another stylistic component, rapid and accelerated speech. By contrast, global Type A assessments did not increase with academic demands. Cardiovascular reactivity was significantly but only moderately stable across the three sessions, showing less consistency than has been reported in previous research. In addition, there was little evidence in this study that cardiovascular reactivity was potentiated by academic stress or by Type A behavior. These results demonstrate the influence of naturalistic environmental factors on overt behavioral components that have recently been suggested as coronary risk factors. Therefore, it is advisable for future experimental and epidemiological research to examine the social and environmental context in which these behaviors occur.