Uptake of Cardiac Screening and Genetic Testing Among Hypertrophic and Dilated Cardiomyopathy Families

Cardiomyopathy is a genetically and clinically heterogeneous, life threatening disease which affects people of all ages. Recent guidelines provide recommendations for cardiac screening and genetic testing in at-risk relatives, but the uptake and impact of these measures in the United States is unknown. This is a single institution retrospective study that characterizes the uptake of cardiac screening and genetic testing for relatives of a cohort of 57 probands with hypertrophic (HCM) and dilated cardiomyopathy (DCM) who underwent both clinical evaluation and genetic testing. Cardiac screening was indicated for 302 relatives. One hundred and seventy-three (57 %) completed cardiac screening. Forty of the 57 probands were mutation positive and genetic testing was indicated for 213 relatives. Eighty-four (39 %) completed genetic testing. The uptake of cardiac surveillance was greater than the uptake of genetic testing (p?<?0.0001) among relatives of mutation positive probands. Within the group of at-risk, asymptomatic relatives of probands, cardiac screening and genetic testing were positive in 25 % and 40 % of cases, respectively. These data demonstrate the important role and utility of cascade cardiac screening and genetic testing in the care of patients and families with HCM or DCM. The approach to cardiac screening and genetic testing should be family-specific and requires expertise in the genetics of cardiomyopathy.     

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key

ABSTRACT

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces.

Methods: Young adults (N?=?151; 79% female; M?=?19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions.

Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces.

Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.     

Sensory Processing Difficulties, Behavioral Problems, and Parental Stress in a Clinical Population of Young Children

This study examined the relationship between sensory processing difficulties, parental stress, and behavioral problems in a clinical sample of young children with developmental and behavioral difficulties. We hypothesized that a high rate of sensory processing difficulties would be found, that there would be a high rate of comorbidity between sensory processing difficulties and behavioral problems, and that children’s sensory processing difficulties and parental stress would be highly correlated. Parents of 59 children ages two to five who attended an out-patient clinic in a low income, urban community completed the Child Behavior Checklist, Parental Stress Inventory-Short Form and the Short Sensory Profile. Children in this clinical population showed a high prevalence (55.9 %) of sensory processing difficulties, a significantly higher rate than previously reported. Sensory processing deficits were correlated with behavioral difficulties and parental stress levels-suggesting that as sensory processing difficulties increase, so do behavioral difficulties and parental stress. Parents of children with sensory processing deficits had significantly higher levels of parental stress than parents of children without sensory deficits. Parenting stress levels were also clinically elevated for the cohort of children in which sensory processing difficulties and behavioral concerns co-existed. These findings suggest that treatment outcomes might improve and parental stress could be reduced if mental health clinicians were trained to identify and address sensory problems. This could result in more children being screened and treated for sensory processing difficulties and an eventual reduction in the rates of parental stress.     

Predictors of Response and Mechanisms of Change in an Organizational Skills Intervention for Students with ADHD

The purpose of the study was to evaluate predictors of response and mechanisms of change for the Homework, Organization, and Planning Skills (HOPS) intervention for middle school students with Attention-Deficit/Hyperactivity Disorder (ADHD). Twenty-three middle school students with ADHD (grades 6–8) received the HOPS intervention implemented by school mental health providers and made significant improvements in parent-rated materials organization and planning skills, impairment due to organizational skills problems, and homework problems. Predictors of response examined included demographic and child characteristics, such as gender, ethnicity, intelligence, ADHD and ODD symptom severity, and ADHD medication use. Mechanisms of change examined included the therapeutic alliance and adoption of the organization and planning skills taught during the HOPS intervention. Participant implementation of the HOPS binder materials organization system and the therapeutic alliance as rated by the student significantly predicted post-intervention outcomes after controlling for pre-intervention severity. Adoption of the binder materials organization system predicted parent-rated improvements in organization, planning, and homework problems above and beyond the impact of the therapeutic alliance. These findings demonstrate the importance of teaching students with ADHD to use a structured binder organization system for organizing and filing homework and classwork materials and for transferring work to and from school.     

Predictors of Relational Aggression and the Moderating Role of Religiousness

Predictors of relational aggression and the moderating role of religiousness on associations between relevant predictors and relational aggression were examined in a sample of 244 university students. Increased childhood relational aggression, increased adult relational victimization, lower agreeableness, and lower emotional stability significantly predicted increased adult relational aggression. Prayer moderated the relationship between agreeableness and adult relational aggression and the association between relational victimization and aggression, and religious service attendance moderated the relationship between emotional stability and relational aggression. Results are discussed in terms of the higher level latent personality constructs of self-regulation and communion, which suggest a potential protective function for religiousness in association with relational aggression.     

How people think “if only …” about reasons for actions

When people think about how a situation might have turned out differently, they tend to imagine counterfactual alternatives to their actions. We report the results of three experiments which show that people imagine alternatives to actions differently when they know about a reason for the action. The first experiment (n = 36) compared reason – action sequences to cause – effect sequences. It showed that people do not imagine alternatives to reasons in the way they imagine alternatives to causes: they imagine an alternative to an action more than an effect, and to a cause more than a reason. The second experiment (n = 214) and the third experiment (n = 190) both show that different sorts of reasons have different sorts of effects on how people imagine alternatives to actions. People imagine an alternative to an action (the protagonist went to a ball) less often when they know the reason for the action was an obligation (he had to participate in fundraising) compared to when they know about a weaker reason (he wanted to meet a famous violinist) or no reason. The second experiment shows the effect for a social obligation and the third experiment replicates and extends it to a health obligation. We interpret the results in terms of the possibilities that people keep in mind about actions and their reasons.     

Time: the back-door of perception

Fifty years ago the neurologist MacDonald Critchley observed that parietal cortex damage impaired temporal as well as spatial experience. Whereas the physiological understanding of space has since advanced, the same cannot be said of time. However, in a novel study, recording from single neurons in the macaque, Leon and Shadlen show that a region of the parietal cortex appears to encode time. The area in which these neurons reside also contains spatially selective neurons and overlaps with the area recently reported to contain number neurons.     

Gender differences in perceptions of normal body weights

The current study employed an alternative methodology to assess perceptions of normal range body weight. Male and female undergraduates were asked to give weight ranges for male and female targets, rather than use figure silhouettes. Male respondents felt that lighter weights in men and women were more normal. Female participants believed that heavier weight ranges were normal, both for themselves and for men. Despite this, women were no more likely than men to report being overweight and to be dieting. Future studies should utilize both figure silhouette drawings and acceptable weight range estimates to determine the influence of methodology on reported findings.