An Assessment of Time Involved in Pre-test Case Review and Counseling for a Whole Genome Sequencing Clinical Research Program

Whole genome sequencing (WGS) is being used for evaluation of individuals with undiagnosed disease of suspected genetic origin. Implementing WGS into clinical practice will place an increased burden upon care teams with regard to pre-test patient education and counseling about results. To quantitate the time needed for appropriate pre-test evaluation of participants in WGS testing, we documented the time spent by our clinical research group on various activities related to program preparation, participant screening, and consent prior to WGS. Participants were children or young adults with autism, intellectual or developmental disability, and/or congenital anomalies, who have remained undiagnosed despite previous evaluation, and their biologic parents. Results showed that significant time was spent in securing allocation of clinical research space to counsel participants and families, and in acquisition and review of participant’s medical records. Pre-enrollment chart review identified two individuals with existing diagnoses resulting in savings of $30,000 for the genome sequencing alone, as well as saving hours of personnel time for genome interpretation and communication of WGS results. New WGS programs should plan for costs associated with additional pre-test administrative planning and patient evaluation time that will be required to provide high quality care.     

Driving it Home: How Workplace Emotional Labor Harms Employee Home Life

To date, the majority of research on emotional labor has focused on outcomes that occur in the workplace. However, research has yet to consider the possibility that the daily effects of emotional labor spill over to life outside of work, even though a large body of literature examining the spillover from work life to home life indicates that work experiences influence employees after they leave the workplace. Accordingly, we examined the influence of day‐to‐day surface acting on 3 types of theoretically derived stress outcomes experienced at home: emotional exhaustion, work‐to‐family conflict, and insomnia. In an experience sampling field study of 78 bus drivers, we found that daily surface acting was connected to increases in each of the outcomes noted above. Moreover, surface acting had an indirect effect on emotional exhaustion and insomnia via state anxiety.     

Measuring Callous Unemotional Behaviors in Early Childhood: Factor Structure and the Prediction of Stable Aggression in Middle Childhood

This study sought to replicate the results of our earlier study, which were published in this Journal (Willoughby et. al 2011), that used mother-reported items from the Achenbach System of Empirically Based Assessment to develop a screening measure of callous unemotional (CU) behaviors for use with preschool-aged children. We further sought to extend those results by exploring the predictive validity of the CU measure with aggression trajectories in early-/mid- childhood. The current study involved secondary data analysis of the NICHD Study of Early Childhood and Youth Development (NICHD-SECCYD) dataset. Factor analyses included N?=?1,176 children who participated in the age 3 year assessment of the NICHD-SECCYD. Predictive models included N?=?1,081 children for whom four of the six possible teacher ratings of aggressive behavior were available from annual assessments spanning 1st–6th grades. Consistent with prior work, a three-factor confirmatory factor model, which differentiated CU from oppositional defiant (ODD) and attention deficit/hyperactive-impulsive (ADHD) behaviors, provided the best fit to the data. Among children with disorganized attachment status, the combination of high levels of mother-rated ODD behaviors and CU behaviors, was predictive of stable elevated levels of teacher-rated aggression from 1st–6th grade (predicted probability?=?0.38, compared with a base rate of 0.07). These results demonstrate that CU behaviors can be reliably measured by parent report in young children and are dissociable from more commonly assessed dimensions of disruptive behavior. Three-year-old children who exhibit elevated levels of ODD and CU behaviors, and who have disorganized attachments, are at increased risk for exhibiting elevated levels of aggression across middle childhood. Results are discussed from the perspective of early assessment and intervention.     

An Initial Investigation of the Factor-Analytic Structure of the Impact of Event Scale-Revised With a Volunteer Firefighter Sample

We provide an initial evaluation of the factor structure of the Impact of Event Scale-Revised (IES-R) when used with a volunteer firefighter and a similar community participant sample. A volunteer firefighter sample (n = 65) and a sample of similar community respondents (n = 103) completed a questionnaire study, including responses to the IES-R. The IES-R data from both groups were entered into a three-factor principal components analysis with direct oblimin rotation. We found further support for the validity of the IES-R when used with a community sample. However, our data suggested that when using the IES-R with a community sample, the choice between a two- and a three-factor model may depend on the composition of the participants. For volunteer firefighters, the factor-analytic structure of the IES-R appeared to be similar to that of the community sample, with more scatter in terms of item loadings. To our knowledge, there is no previous research considering the use of the IES-R with a strictly volunteer firefighter sample. In addition, despite adequate research on the factor-analytic structure of the original IES, little research has considered the factor-analytic structure of the more recent IES-R, even with community samples.     

In Vivo Hippocampal Acetylcholine Release During Exposure to Acute Stress

Hippocampal extracellular acetylcholine (ACh) and choline levels were evaluated using in vivo microdialysis in male Fischer 344 rats before, during, and following an 80-min exposure to two different stress conditions. Measurements were taken in rats restrained and immersed in a water bath containing either 37 degreesC (normothermic-restraint) or 20 degreesC (cold-restraint) water. Results were compared to normothermic-freely-moving rats. Cold-restrained rats displayed decreased ACh levels during cold exposure relative to both normothermic-restrained and normothermic-freely-moving rats. By the end of the cold exposure period and following removal from cold, ACh levels had returned to near-baseline values. Normothermic-restrained rats had levels similar to those of normothermic-freely-moving rats, except for a marked increase in ACh following removal from restraint. Cold-restrained rats displayed a gradual elevation in choline levels during cold stress, followed by a gradual decline after stress termination, whereas both normothermic-restrained and normothermic-freely-moving rats displayed gradual decreases during the microdialysis session. These findings demonstrate that central cholinergic neurotransmission can be altered by the application of, and removal from, acute stressors. In addition, the results suggest a possible relationship between the magnitudes of both the stressor and its cholinergic consequences.     

PTSD and the influence of context: The self as a social mirror

The principal accepted models of posttraumatic stress disorder (PTSD) are based on both memory processing and biological/brain changes occurring when one's life or well-being is threatened. It is our thesis that these models would be greatly informed by community studies indicating that PTSD is predicted to a greater extent by earlier life experience and experiences that occur distant from the threatening event. These findings suggest posttraumatic responding is best conceptualized through the lens of the self-in-context, as opposed to imprinting that results from a given event at a given time. Moreover, studies of non-Western populations often do not express trauma as PTSD, or at least not primarily as PTSD, which argues against specific neural or memory encoding processes, but rather for a more plastic neural process that is shaped by experience and how the self develops in its cultural context, as a product of a broad array of experiences. We posit that fear and emotional conditioning as well as the ways traumas are encoded in memory are only partial explanatory mechanisms for trauma responding, and that issues of safety and harm, which are long term and developmental, are the common and principal underpinnings of the occurrence of posttraumatic distress, including PTSD.     

Contributions of Observed Parent Socialization of Coping and Skin Conductance Level Reactivity to Childhood Adjustment

This research examined the longitudinal association between parent socialization of coping and child adjustment, as well as the moderating role of children's skin conductance level reactivity (SCLR). Participants were a community sample of children (n = 64, M age = 9.02, 54.5% females, 93.2% Caucasian) and their parent(s). Parent coping suggestions were observed while their child engaged in a stressful challenge task, during which the child's SCLR, a measure of children's physiological reactivity to stress, was also measured. Parent(s) completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) at baseline and a 6‐month follow‐up to assess internalizing and externalizing problems. Results revealed that secondary control engagement suggestions predicted fewer internalizing problems over time. In addition, disengagement suggestions predicted fewer externalizing problems over time among children with high SCLR. This study provides evidence that parent coping suggestions serve as a resource that protects youth from developing adjustment problems.