Spanish adaptation of the Stress Manifestations Scale of the Student Stress Inventory (SSI-SM)

The aim of the present study was to translate into Spanish and to describe the psychometric properties of the Stress Manifestations Scale of the Student Stress Inventory (SSI-SM), developed by Fimian, Fastenau, Tashner and Cross to identify the main manifestations of stress in adolescents. The scale was applied to a sample of 1,002 pupils from years one and two of Secondary Education. The paper reports the factor structure, an item analysis, the internal consistency, differences by sex and academic year, external evidence of validity, and norms for scoring the scale. The results reveal a factor structure based on three first-order factors (emotional manifestations, physiological manifestations and behavioural manifestations) and one second-order factor (indicative of stress manifestations). In terms of external validity, there was a positive association with measures of perceived stress, aggressiveness, internalized/externalized symptoms, and a negative association with life satisfaction. The results show that the scale is an adequate tool for evaluating stress manifestations in adolescents.     

Internal attribution of outcome moderates the cortisol response to a cooperative task in women

Several ethological reports have indicated that cooperative behaviors play an adaptive role. However, research has focused on competition in men, and there have been few studies on cooperation. This study aims to analyze the cortisol and psychological responses in women to a cooperative situation compared with a competitive situation in a laboratory context. The sample was distributed into four groups depending on the task and the outcome obtained: Positive cooperation, negative cooperation, competition with victory, and competition with defeat. Our results show that, in comparison with competition, cooperation produces different effects in cortisol, but not in psychological states. Nevertheless, these effects occur only when the task outcome and its appraisal are considered. Only the participants who cooperated and obtained a positive outcome and those who competed and lost showed significant decrements of cortisol. Internal attribution was higher in groups with more stable cortisol levels, suggesting a possible modulator effect of controllability in the way the situation was experienced. These results could be generalized to situations in which negotiation, mediation, and cooperative strategies are relevant for making decisions and/or solving problems.     

Resisting and Conforming to the ‘Lesbian Look’: The Importance of Appearance Norms for Lesbian and Bisexual Women

Appearance is one way in which lesbian and bisexual identities and affiliation to lesbian, gay, bisexual (LGB) subculture can be demonstrated. ‘Butch’ and ‘androgynous’ styles have been used by lesbian women to communicate a non‐heterosexual identity. However, some LGB appearance researchers have argued that there has been a mainstreaming and diversification of lesbian style in the last couple of decades, which has resulted in less distinction between lesbian and straight looks. This research draws on the Social Identity approach to explore contemporary style in lesbian and bisexual communities. Fifteen lesbian and bisexual women took part in semi‐structured interviews which were analysed using thematic analysis. Although some participants reported a diversification of lesbian style, most used the term ‘butch’ to describe lesbian style, and a ‘boyish’ look was viewed as the most common contemporary lesbian style. By contrast, most participants could not identify distinct bisexual appearance norms. The data provide evidence of conflicting desires (and expectations) to visibly project social identity by conforming to specific lesbian styles, and to be an authentic, unique individual by resisting these subcultural styles. Copyright © 2013 John Wiley & Sons, Ltd.     

Stakeholders’ Opinions on the Implementation of Pediatric Whole Exome Sequencing: Implications for Informed Consent

Advances in whole genome and whole exome sequencing (WGS/WES) technologies have led to increased availability in clinical settings. Currently, there are few guidelines relating to the process and content of informed consent for WGS/WES, nor to which results should be returned to families. To address this gap, we conducted focus groups to assess the views of professionals, parents, and adolescents for the future implementation of WES. The discussions assessed understanding of the risks and benefits of WES, preferences for the informed consent discussion, process for return of results, and the decision-making role of the pediatric patient. Professional focus group participants included bioethicists, physicians, laboratory directors, and genetic counselors. Parent focus groups included individuals with children who could be offered sequencing due to a potential genetic cause of the child’s condition. On-line discussion groups were conducted with adolescents aged 13–17 who had a possible genetic disorder. We identified discrepancies between professionals and patient groups regarding the process and content of informed consent, preference for return of results, and the role of the child in decision-making. Professional groups were concerned with the uncertainty regarding professional obligations, changing interpretation in genomic medicine, and practical concerns of returning results over time. Parent and adolescent groups focused on patient choice and personal utility of sequencing results. Each group expressed different views on the role of the child in decision-making and return of results. These discrepancies represent potential barriers to informed consent and a challenge for genetic counselors regarding the involvement of pediatric patients in decision-making and return of results discussions.     

Traditional Roles in a Non-Traditional Setting: Genetic Counseling in Precision Oncology

Next generation sequencing technology is increasingly utilized in oncology with the goal of targeting therapeutics to improve response and reduce side effects. Interpretation of tumor mutations requires sequencing of paired germline DNA, raising questions about incidental germline findings. We describe our experiences as part of a research team implementing a protocol for whole genome sequencing (WGS) of tumors and paired germline DNA known as the Michigan Oncology Sequencing project (MI-ONCOSEQ) that includes options for receiving incidental germline findings. Genetic counselors (GCs) discuss options for return of results with patients during the informed consent process and document family histories. GCs also review germline findings and actively participate in the multi-disciplinary Precision Medicine Tumor Board (PMTB), providing clinical context for interpretation of germline results and making recommendations about disclosure of germline findings. GCs have encountered ethical and counseling challenges with participants, described here. Although GCs have not been traditionally involved in molecular testing of tumors, our experiences with MI-ONCOSEQ demonstrate that GCs have important applicable skills to contribute to multi-disciplinary care teams implementing precision oncology. Broader use of WGS in oncology treatment decision making and American College of Medical Genetics and Genomics (ACMG) recommendations for active interrogation of germline tissue in tumor-normal dyads suggests that GCs will have future opportunities in this area outside of research settings.     

The Role of Parental Distress in Moderating the Influence of Child Neglect on Maladjustment

Despite pervasive evidence of the harmful impact of neglect on children’s adjustment, individual differences in adaptation persist. This study examines parental distress as a contextual factor that may moderate the relation between neglect and child adjustment, while considering the specificity of the relation between neglect and internalizing versus externalizing problems. In a sample of 66 children (33 with a documented child protective services history of neglect prior to age six), neglect predicted internalizing, and to a lesser extent externalizing, problems as rated by teachers at age seven. Parental distress moderated the relation between neglect and internalizing, but not externalizing, problems. Specifically, higher levels of neglect predicted more internalizing problems only among children of distressed parents. These findings indicate that parent-level variables are important to consider in evaluating the consequences of neglect, and point to the importance of considering contextual factors when identifying those children most at risk following neglect.     

Relationship of Youth Involvement in Diabetes-Related Decisions to Treatment Adherence

The aim of this study was to examine the relationship of youth’s involvement in diabetes-related decisions to adherence. Children and adolescents (8–19 years) and their parents (N = 89) completed the Decision Making Involvement Scale and the Self Care Inventory, a self-report measure of adherence. After controlling for youth age, the degree to which youth expressed an opinion and information to parents was associated with better parent- and youth-reported adherence. The degree to which parents expressed an opinion and information to youth was associated with worse parent-reported adherence. Joint decision-making behaviors (e.g., negotiation; provision of options) also were associated with better youth-reported adherence. Encouraging youth to express opinions and share illness-related information with parents during illness management discussions may improve adherence. Additional research is needed to identify mechanisms of effect and determine associations between decision making involvement and health behaviors and outcomes over time.     

Babies Born Dying: Just Bad Karma? A Discussion Paper

The paper examines the notion of being born dying and karma. Karma is a belief upheld by Buddhists and non-Buddhists: That is, karma follows people from their previous lives into their current lives. This raises a difficult question: Does karma mean that a baby’s death is its own fault? While great peace can be found from a belief in karma, the notion of a baby’s karma returning in some sort of retributive, universal justice can be de-emphasized and is considered “un-Buddhist.” Having an understanding of karma is intrinsic to the spiritual care for the dying baby, not only from the perspective of parents and families who have these beliefs, but also for reconciling one’s own beliefs as a healthcare practitioner.     

Belief-based action prediction in preverbal infants

Successful mindreading entails both the ability to think about what others know or believe, and to use this knowledge to generate predictions about how mental states will influence behavior. While previous studies have demonstrated that young infants are sensitive to others’ mental states, there continues to be much debate concerning how to characterize early theory of mind abilities. In the current study, we asked whether 6-month-old infants appreciate the causal role that beliefs play in action. Specifically, we tested whether infants generate action predictions that are appropriate given an agent’s current belief. We exploited a novel, neural indication of action prediction: motor cortex activation as measured by sensorimotor alpha suppression, to ask whether infants would generate differential predictions depending on an agent’s belief. After first verifying our paradigm and measure with a group of adult participants, we found that when an agent had a false belief that a ball was in the box, motor activity indicated that infants predicted she would reach for the box, but when the agent had a false belief that a ball was not in the box, infants did not predict that she would act. In both cases, infants based their predictions on what the agent, rather than the infant, believed to be the case, suggesting that by 6 months of age, infants can exploit their sensitivity to other minds for action prediction.