Psychological Interventions and Genetic Testing: Facilitating Informed Decisions About BRCA1/2 Cancer Susceptibility

Genetic testing for inherited cancer susceptibility, based on the recently identified. BRCA1 and BRCA2 genes, will soon be available on a large scale. However, at present, genetic test results do not lead to clearly indicated diagnostic or preventive measures, and the nature of the psychological impact of BRCA1/2 testing is still largely unknown. This uncertainty, combined with preliminary evidence suggesting significant individual differences in reactions to genetic susceptibility feedback, constitutes a unique challenge for any individual contemplating such testing. We outline the nature of this challenge and then propose an intervention strategy designed to help individuals make deeply processed and psychologically well-informed decisions with regard to their genetic susceptibility. The intervention is guided by recent research findings and theory on the cognitive–emotional processing of cancer-risk information. Specifically, the goal is to prepare the individual for genetic testing by (1) cognitively and emotionally activating, or preliving, the individual's potential reactions to testing feedback; (2) facilitating accurate appraisal of the individual's cognitive–emotional reactions; and (3) enabling the individual to process these reactions through the use of well-established clinical techniques.     

A matching-to-sample procedure for the study of visual perception and concept formation in infrahumans: A test in the pigeon

An apparatus suitable for conducting simultaneous or delayed matching-to-sample experiments with as many as eight comparison stimuli is described. Data are presented which indicate that pigeons are capable of performing such a task. It is concluded that the simultaneous matching-to-sample procedure with more than two comparison stimuli is an efficient means of obtaining information about discrimination capacity and that this procedure may be suitable for studying visual perception in infrahuman Ss.     

Children's component selection with varying degrees of training

With the component selection measure developed by Hale and Morgan (1973), children's use of selective attention was assessed at six levels of learning, ranging from undertraining to overtraining, and this function was examined at each of ages 4, 8, and 12. It was found that, as the children learned the task, they maintained a relatively wide focus of attention, acquiring information about both features of the stimuli, color and shape. Thus, contrary to the model under investigation, the children did not exercise a high degree of selectivity as they approached mastery of the task; nor did overtraining produce the expected “broadening” of attention, as the children acquired little stimulus information beyond the point at which criterion had been reached. The data were interpreted to be more consistent with a model that assumes the bulk of stimulus learning to occur prior to task mastery.     

Child‐directed teaching and social learning at 18 months of age: evidence from Yucatec Mayan and US infants

In several previous studies, 18‐month‐old infants who were directly addressed demonstrated more robust imitative behaviors than infants who simply observed another's actions, leading theorists to suggest that child‐directed interactions carried unique informational value. However, these data came exclusively from cultural communities where direct teaching is commonplace, raising the possibility that the findings reflect regularities in infants' social experiences rather than responses to innate or a priori learning mechanisms. The current studies consider infants' imitative learning from child‐directed teaching and observed interaction in two cultural communities, a Yucatec Mayan village where infants have been described as experiencing relatively limited direct instruction (Study 1) and a US city where infants are regularly directly engaged (Study 2). Eighteen‐month‐old infants from each community participated in a within‐subjects study design where they were directly taught to use novel objects on one day and observed actors using different objects on another day. Mayan infants showed relative increases in imitative behaviors on their second visit to the lab as compared to their first visit, but there was no effect of condition. US infants showed no difference in imitative behavior in the child‐directed vs. observed conditions; however, infants who were directly addressed on their first visit showed significantly higher overall imitation rates than infants who observed on their first visit. Together, these findings call into question the idea that child‐directed teaching holds automatic or universal informational value.     

Source Monitoring and Executive Function in 2.5- to 3-Year-Olds

Hala, Brown, McKay, and San Juan (2013) found that children as young as 2.5 years of age demonstrated high levels of accuracy when asked to recall whether they or the experimenter had carried out a particular action. In the research reported here, we examined the relation of early-emerging source monitoring to executive function abilities. Participants were children aged 2.5- to 3-years old. For the source-monitoring procedure, we used the Hala et al. (2013) task in which children and the experimenter took turns placing a total of 20 items on a model farm (encoding phase). For the source memory test, children were asked who had placed each item (retrieval phase). Executive function measures included assessments of working memory, delay-inhibitory control, and conflict-inhibitory control. The main finding was that inhibitory control measures were significantly related to performance on the source-monitoring task. This relation held for the conflict-inhibitory control measures even when controlling for age and vocabulary. The findings of this research suggest that even at the early age of 2.5 years, development of executive control is linked to the emergence of source-monitoring ability.     

The Munroe-Meyer Approach: Continuous Integration of Didactic Instruction,Research, and Clinical Practice

Increased demand for applied behavior analysis (ABA) services has increased the need for additional masters-level practitioners and doctoral-level academicians and clinical directors. Based on these needs, the University of Nebraska Medical Center’s (UNMC) Munroe-Meyer Institute has developed a PhD program. The academic structure at UNMC allowed us to create our PhD program in a relatively quick and efficient manner. Our PhD program has many unique features, including (a) close integration of didactic instruction with clinical and research training provided by leading experts in ABA in which students immediately apply concepts introduced in the classroom during coordinated clinical and research practica; (b) structured grant writing training in which students learn to write and submit an NIH-level grant; (c) financial support in the form of a stipend of $23,400 per year, free health benefits, and a full-tuition waiver for up to 12 credits per semester for UNMC courses (a benefits package worth approximately $50,000 per year for an out-of-state student); and (d) encouragement and financial support to present papers at local, regional, and national behavior analysis conferences.     

The Co-Development of Parenting Stress and Childhood Internalizing and Externalizing Problems

Although the detrimental influence of parenting stress on child problem behavior is well established, it remains unknown how these constructs affect each other over time. In accordance with a transactional model, this study investigates how the development of internalizing and externalizing problems is related to the development of parenting stress in children aged 4–9. Mothers of 1582 children participated in three one-year interval data waves. Internalizing and externalizing problems as well as parenting stress were assessed by maternal self-report. Interrelated development of parenting with internalizing and externalizing problems was examined using Latent Growth Modeling. Directionality of effects was further investigated by using cross-lagged models. Parenting stress and externalizing problems showed a decrease over time, whereas internalizing problems remained stable. Initial levels of parenting stress were related to initial levels of both internalizing and externalizing problems. Decreases in parenting stress were related to larger decreases in externalizing problems and to the (stable) course of internalizing problems. Some evidence for reciprocity was found such that externalizing problems were associated with parenting stress and vice versa over time, specifically for boys. Our findings support the transactional model in explaining psychopathology.     

Mental Health Services in Kentucky Nursing Homes: A Survey of Administrators

National surveys have shown that mental health problems are prevalent in long-term care and suggest that these settings are largely underserved by mental health services. Nursing home administrators are gatekeepers for mental health services in nursing homes. Administrators of Kentucky nursing homes were surveyed regarding their perceptions of mental health problems, current and future services use, satisfaction with services, and need for consultation. The response rate was 24%. Administrators appeared to underestimate mental health problems among residents. Most facilities were using at least one type of mental health service, but fewer residents received services than would be expected given the problem prevalence. Psychological services were underused, in spite of the fact that behavior management stood out as a major need. Psychiatry was more frequently used, but with less satisfaction. Results indicate significant financial and logistical barriers to mental health services. Future work is needed on developing, assessing, and disseminating models of effective service provision to long-term care.