Decision Making with Uncertain Information: Learning from Women in a High Risk Breast Cancer Clinic

Patients and practitioners may believe that clinically validated laboratory tests provide definitive information. Genetic counselors know this is not always so, and the possibility of inconclusive genetic test results is often discussed in the pretest counseling session. This added discussion topic prolongs the process of genetic counseling, but if there is inadequate patient understanding, patient frustration may be high when receiving a result of uncertain significance, and patients may make decisions about subsequent medical management based on incorrect assumptions. For patients/participants in a research setting, where the clinical validity of testing may be unclear, some patients/participants may still want to use test results to influence their medical management. This paper presents findings from a qualitative study wherein 15 women from the High Risk Breast Cancer Clinic at Utah's Huntsman Cancer Institute discussed how uncertainty regarding results affected their decision making. The women were randomly selected from 3 categories--women with test results of uncertain significance; women without cancer who have a mutation; and women who are members of high-risk families, but for whom no mutation was found. Study findings will be used in future studies to better understand how to improve communication regarding uncertain results, especially in a research environment.     

Couple Therapy with Veterans: Early Improvements and Predictors of Early Dropout

Family services within Veterans Affairs Medical Centers fulfill an important role in addressing relationship distress among Veterans, which is highly prevalent and comorbid with psychopathology. However, even for evidence‐based couple therapies, effectiveness is weaker compared to controlled studies, maybe because many Veteran couples drop out early and do not reach the “active” treatment stage after the 3–4 session assessment. In order to improve outcomes, it is critical to identify couples at high risk for early dropout, and understand whether couples may benefit from the assessment as an intervention. The current study examined (a) demographics, treatment delivery mode, relationship satisfaction, and psychological symptoms as predictors of dropout during and immediately following the assessment phase, and (b) changes in relationship satisfaction during assessment. 174 couples completed questionnaires during routine intake procedures. The main analyses focused on 140 male Veterans and their female civilian partners; 36.43% dropped out during the assessment phase and 24.74% of the remaining couples immediately following the first treatment session. More severe depressive symptoms in non‐Veteran partners were associated with dropout during assessment. Relationship satisfaction improved significantly during the assessment phase for couples who did not drop out, with larger gains for non‐Veteran partners. No demographics or treatment delivery mode were associated with dropout. Although more research is needed on engaging couples at risk for early dropout and maximizing early benefits, the findings suggest that clinicians should attend to the civilian partner's and Veteran's depressive symptoms at intake and consider the assessment part of active treatment.     

Who Cares? The Role of Job Involvement in Psychological Contract Violation

This study examined survey data from full‐time employees employed in a variety of occupations. We empirically examined how psychological involvement with one's job affects reactions to psychological contract violation. Data for control variables (i.e., age, gender, organizational tenure), the independent variable (i.e., psychological contract violation), and the moderator (i.e., job involvement) were taken at Time 1; and dependent variables (i.e., depressed mood at work, turnover intention) were taken at Time 2. Results illustrated that job involvement was an important construct in understanding individuals' negative reactions to psychological contract violations. Implications and limitations are discussed, and suggestions for future research are offered.     

Bilingual Cancer Genetic Education Modules for the Deaf Community: Development and Evaluation of the Online Video Material

Health information about inherited forms of cancer and the role of family history in cancer risk for the American Sign Language (ASL) Deaf community, a linguistic and cultural community, needs improvement. Cancer genetic education materials available in English print format are not accessible for many sign language users because English is not their native or primary language. Per Center for Disease Control and Prevention recommendations, the level of literacy for printed health education materials should not be higher than 6th grade level (~?11 to 12 years old), and even with this recommendation, printed materials are still not accessible to sign language users or other nonnative English speakers. Genetic counseling is becoming an integral part of healthcare, but often ASL users are not considered when health education materials are developed. As a result, there are few genetic counseling materials available in ASL. Online tools such as video and closed captioning offer opportunities for educators and genetic counselors to provide digital access to genetic information in ASL to the Deaf community. The Deaf Genetics Project team used a bilingual approach to develop a 37-min interactive Cancer Genetics Education Module (CGEM) video in ASL with closed captions and quizzes, and demonstrated that this approach resulted in greater cancer genetic knowledge and increased intentions to obtain counseling or testing, compared to standard English text information (Palmer et al., Disability and Health Journal, 10(1):23–32, 2017). Though visually enhanced educational materials have been developed for sign language users with multimodal/lingual approach, little is known about design features that can accommodate a diverse audience of sign language users so the material is engaging to a wide audience. The main objectives of this paper are to describe the development of the CGEM and to determine if viewer demographic characteristics are associated with two measurable aspects of CGEM viewing behavior: (1) length of time spent viewing and (2) number of pause, play, and seek events. These objectives are important to address, especially for Deaf individuals because the amount of simultaneous content (video, print) requires cross-modal cognitive processing of visual and textual materials. The use of technology and presentational strategies is needed that enhance and not interfere with health learning in this population.     

BRCA1 Testing: Genetic Counseling Protocol Development and Counseling Issues

This article discusses the genetic counseling protocols which were developed and counseling issues that have arisen in the first 2 years of evaluating a large kindred with a BRCA1 mutation. The rationale for the development of the genetic counseling protocols and specific genetic counseling visual aids are presented and discussed. The protocols and counseling aids can serve as models for other programs offering cancer susceptibility testing. The observations of study counselors about study subject concerns and responses to genetic testing at the time of the pretest and posttest counseling sessions are presented.     

Pointing gestures modulate domestic dogs’ search behavior for hidden objects in a spatial rotation problem

In the spatial domain, domestic dogs are highly inclined to search at the last location where they saw an object disappear and cannot infer that a hidden object has moved imperceptibly from one location to another. In the current study, we examined whether exposure to human social cues modulates dogs’ search behavior for hidden objects. In Experiment 1, twenty dogs were first trained to find an object they saw disappear inside a stationary container in the presence (social group) or absence (non-social group) of pointing gestures. In tests, the containers were rotated 180° around a central axis. The dogs in the non-social group systematically searched at the initial (now incorrect) hiding location, whereas the dogs in the social group chose correctly significantly above chance. In Experiment 2, we tested whether pre-exposure to human pointing has an impact on dogs’ use of gestures. No gestures were given during training and both the social and non-social conditions were administered to each of the ten dogs. In contrast to Experiment 1, the performance of dogs in the social condition dropped significantly and varied substantially from one dog to another. Overall, this study suggests that dogs’ tendency to use human signals is so strong that it even outweighs their spatial bias to search where they saw an object disappear; however, this penchant to use human gestures appears to be dependent on the degree of familiarity of the dog with these signals.     

How Perceptions Impact Recovery from Concussion in Childhood and Adolescence: a Systematic Review

Neuropsychology Review - Perceptions about the causes and consequences of concussion, and individual representations and interpretations of these factors, can influence the post-concussive recovery...     

The role of political skill in the stressor–outcome relationship: Differential predictions for self- and other-reports of political skill

The beneficial role of political skill in stress reactions and performance evaluations has been demonstrated in a substantial amount of empirical research. Most of the research, however, has focused on self-perceptions of political skill. This study examines the differential moderating effects of self- vs. other-rated political skill in the conflict – emotional burnout and performance relationships, using two samples including non-academic staff employees of a large university (N = 839) and a variety of office and retail employees from an automotive organization (N = 142). We argue that self-reported political skill moderates the relationship between conflict and a self-reported strain-related outcome that is important to the individual (i.e., emotional burnout), but that supervisor-rated political skill does not moderate this relationship. Further, we argue that supervisor-rated political skill moderates the relationship between conflict and an outcome important to the supervisor and the organization (i.e., job performance), but that self-reported political skill does not moderate this relationship. Findings partially support our hypotheses as both self and supervisor-rated political skill neutralized the negative effects of conflict on burnout, but only supervisor-rated political skill neutralized the negative effects of conflict on performance. Limitations and directions for future research are discussed.