Patients’ Views of Treatment-Focused Genetic Testing (TFGT): Some Lessons for the Mainstreaming of <Emphasis Type="Italic">BRCA1</Emphasis> and <Emphasis Type="Italic">BRCA2</Emphasis> Testing

This paper explores patients’ views and experiences of undergoing treatment-focused BRCA1 and BRCA2 genetic testing (TFGT), either offered following triaging to clinical genetics (breast cancer) or as part of a mainstreamed care pathway in oncology (ovarian cancer). Drawing on 26 in-depth interviews with patients with breast or ovarian cancer who had undergone TFGT, this retrospective study examines patients’ views of genetic testing at this point in their care pathway, focusing on issues, such as initial response to the offer of testing, motivations for undergoing testing, and views on care pathways. Patients were amenable to the incorporation of TFGT at an early stage in their cancer care irrespective of (any) prior anticipation of having a genetic test or family history. While patients were glad to have been offered TFGT as part of their care, some questioned the logic of the test’s timing in relation to their cancer treatment. Crucially, patients appeared unable to disentangle the treatment role of TFGT from its preventative function for self and other family members, suggesting that some may undergo TFGT to obtain information for others rather than for self.     

Development and Pilot Testing of a Decision Aid for Genomic Research Participants Notified of Clinically Actionable Research Findings for Cancer Risk

Germline genomic testing is increasingly used in research to identify genetic causes of disease, including cancer. However, there is evidence that individuals who are notified of clinically actionable research findings have difficulty making informed decisions regarding uptake of genetic counseling for these findings. This study aimed to produce and pilot test a decision aid to assist participants in genomic research studies who are notified of clinically actionable research findings to make informed choices regarding uptake of genetic counseling. Development was guided by published literature, the International Patient Decision Aid Standards, and the expertise of a steering committee of clinicians, researchers, and consumers. Decision aid acceptability was assessed by self-report questionnaire. All 19 participants stated that the decision aid was easy to read, clearly presented, increased their understanding of the implications of taking up research findings, and would be helpful in decision-making. While low to moderate levels of distress/worry were reported after reading the booklet, a majority of participants also reported feeling reassured. All participants would recommend the booklet to others considering uptake of clinically actionable research findings. Results indicate the decision aid is acceptable to the target audience, with potential as a useful decision support tool for genomic research participants.     

Discounting: A practical guide to multilevel analysis of choice data

Multilevel modeling provides the ability to simultaneously evaluate the discounting of individuals and groups by examining choices between smaller sooner and larger later rewards. A multilevel logistic regression approach is advocated in which sensitivity to relative reward magnitude and relative delay are considered as separate contributors to choice. Examples of how to fit choice data using multilevel logistic models are provided to help researchers in the adoption of these methods.     

“Inside out”: Appraisals for achievement emotions from constructive,positive, and negative feedback on writing

Even with the recent surge of research on achievement emotions, few studies have investigated emotions in feedback situations and the appraisals associated with such emotions. The purpose of this study was to examine emotion appraisals of constructive criticism, negative, and positive feedback, to aid us in determining whether these appraisals differed by feedback type. In a task asking them to provide open-ended responses as they imagined receiving feedback on a writing task, undergraduates (N?=?270) gave reasons for why they might experience unpleasant emotions from positive feedback and pleasant emotions from negative feedback along with reasons for both pleasant and unpleasant emotions emanating from constructive feedback. Open coding of responses yielded categories for each emotion-feedback pairing that, across all emotions, were collapsed into five appraisal categories: feedback suggests ways to improve, a mismatch between feedback and task exists, feedback targets the self or one’s ability, feedback says something about the relationship between feedback giver and receiver, and the task is judged for its value. Distributions of appraisal categories distinguished constructive feedback from positive and negative feedback. Implications are drawn for control-value theory and for classroom feedback practices.     

An Indecent Proposal: The Dual Functions of Indirect Speech

People often use indirect speech, for example, when trying to bribe a police officer by asking whether there might be “a way to take care of things without all the paperwork.” Recent game theoretic accounts suggest that a speaker uses indirect speech to reduce public accountability for socially risky behaviors. The present studies examine a secondary function of indirect speech use: increasing the perceived moral permissibility of an action. Participants report that indirect speech is associated with reduced accountability for unethical behavior, as well as increased moral permissibility and increased likelihood of unethical behavior. Importantly, moral permissibility was a stronger mediator of the effect of indirect speech on likelihood of action, for judgments of one's own versus others' unethical action. In sum, the motorist who bribes the police officer with winks and nudges may not only avoid public punishment but also maintain the sense that his actions are morally permissible.     

Counseling Multiple‐Heritage Couples

Multiple‐heritage couples are one of the fastest growing client populations in the United States. These partnerships are defined by intersecting ethnic, racial, linguistic, and religious differences. They are challenged by societal perceptions, stereotypes, and other pressures associated with being in a multiple‐heritage pairing. This article discusses strengths in the multiple‐heritage union brought about by the understanding of diverse viewpoints. Finally, the article identifies specific strategies, such as couples relationship education, to resolve and confront inherent differences. Las parejas multiculturales son uno de los grupos demográficos de clientes de mayor crecimiento en los Estados Unidos. Este tipo de parejas se define por la intersección de diferencias étnicas, raciales, lingüísticas y religiosas. Sus miembros enfrentan desafíos a causa de las percepciones sociales, los esterotipos y otras presiones asociadas con tener una pareja multicultural. Este artículo discute los puntos fuertes en una unión multicultural, facilitados por la comprensión de puntos de vista diversos. Finalmente, el artículo identifica estrategias específicas, como por ejemplo la educación en relaciones de pareja, para resolver y afrontar las diferencias intrínsecas.     

Relations between virtues and positive mental health in a Korean population: A Multiple Indicators Multiple Causes (MIMIC) model approach

A Multiple Indicators Multiple Causes (MIMIC) approach was applied to investigate the relationship between virtues and positive mental health as determined using the Character Strength Test and the Mental Health Continuum‐Short Form. The study participants were 876 college students (54% women; overall mean age [SD] 21.50 years [2.35]) recruited from introductory psychology courses at two universities in Seoul. Findings revealed that the intellectual virtues of college students predicted subjective well‐being according to all emotional, social and psychological measures. Results are discussed in the context of previous work using the Values in Action classification of virtues and character strengths. In addition, implications regarding understanding the nature and possible origins of positive mental health are outlined.