Reducing Psychological Distress in a Genetic Counseling Consultation for Breast Cancer

High levels of cancer specific distress have been found before and after genetic counseling for breast cancer. This study investigated the process of reducing distress during 111 genetic counseling consultations for familial breast cancer. Consultations were audiotaped, transcribed, and a detailed coding system developed to measure cues of emotional distress from the patient, and consultant (clinical geneticist or genetic counselor) behaviors before and after the cues. At least 1 emotional cue was given in 64 consultations, with a median of 1 cue per consultation. More emotional cues of distress occurred when the consultant responded empathetically to the first cue of distress. Satisfaction outcomes were largely positive regardless of the consultant's attentiveness to distress. Postconsultation depression scores were significantly reduced if more empathic responses were given, but anxiety remained the same. These results are discussed and recommendations are made for improving patient care.     

The Teacher's Career and Life

Abstract. Participants in a Wabash Center consultation on vocation discussed the variety of expectations, opportunities, and challenges that create contexts for teaching as they move through careers. These essays emerge from the experiences and reflections of four participants about different stages of careers in diverse contexts. Tom Massaro writes from the perspective of one who recently navigated the challenges leading up to the tenure review in a Jesuit theological school and notes common patterns amidst the diversity of challenges. Phyllis Airhart ponders vocational fidelity in the transitions to new roles and responsibilities at mid‐career in a Canadian university. Barbara Brown Zikmund deals with what she calls the ‘mature years’ and traces a major shift in her career from administration in an American school to teaching in Japan. Raymond Williams reflects on vocation during the process of preparing for retirement from teaching in a liberal arts college, attempting to respond faithfully to the inevitable question, ‘What are you going to do when you retire?’ Vocation is a thread that runs through each essay as reflection on the integrity and continuity of careers. The authors raise issues and make suggestions that may help others reflect on their vocation as teacher.     

Reducing the tendency to self-handicap: The effect of self-affirmation

Self-handicapping, the creating or claiming of obstacles to one’s performance to influence explanations given for subsequent outcomes, has been shown to have a host of attitudinal and behavioral consequences. Given the wide ranging impact of self-handicapping, it is important to understand the conditions under which self-handicapping is more or less likely to occur. Accordingly, the present study tested the hypothesis that people will be less likely to engage in self-handicapping if they have previously engaged in self-affirmation. The results of this study found that self-affirmation was more effective in reducing self-handicapping behavior when individuals experienced non-contingent success than when they experience contingent success. Theoretical contributions to the self-handicapping and self-affirmation literatures are discussed, as are practical implications.     

The moderating influence of procedural fairness on the relationship between work-life conflict and organizational commitment

To help employees better manage work-life conflict, organizations have introduced various initiatives, which have met with mixed results. The present studies examined the utility of a procedurally based approach to understanding employees' reactions to work-life conflict. The authors examined whether the fairness of procedures used by organizational authorities to plan and implement decisions moderates the (inverse) relationship between work-life conflict and employees' organizational commitment. Three studies using different methodologies showed support for the moderating role played by procedural fairness. That is, the tendency for greater work-life conflict to lead to lower commitment was significantly less pronounced when procedural fairness was high rather than low. Theoretical contributions to the work-life conflict and organizational justice literatures are discussed, as are practical implications.     

Better the Devil You Know? High-Risk Individuals’ Anticipated Psychological Responses to Genetic Testing for Melanoma Susceptibility

Purpose: The psychological consequences of genetic testing for mutations among individuals at increased risk of developing melanoma remain unexamined. The present study aimed to explore anticipated emotional, behavioral, cognitive, and familial responses to hypothetical genetic testing for melanoma susceptibility. Methods: Forty semi-structured interviews were undertaken with affected (n=20) and unaffected (n=20) individuals at either high or average risk of developing melanoma due to family history. Results: In-depth thematic analysis revealed that, in response to being identified as a mutation carrier, most participants with a family history anticipated calmly accepting their increased risk; either increasing precaution adoption or maintaining already vigilant behavioral practices; perceiving such information as important and valuable; and communicating genetic test results to family members, despite the acknowledgement of potential difficulties. In response to being identified as a non-carrier, the majority of participants expected to feel relieved; to maintain current precautionary health practices; to still perceive themselves at some risk of developing melanoma; and to be wary of the potential negative behavioral consequences of disclosing such information to family members. Women appeared more likely than men to acknowledge the potential for depression and worry following genetic testing. In contrast, more males than females expected to carry a gene mutation, and viewed their current preventive practices as optimum. Conclusion: Genetic testing for melanoma risk is likely to elicit a complex array of emotional, behavioral, cognitive, and familial responses for both testees and their family members, and these responses are likely to bear subtle differences for males and females.     

Racists or tolerant multiculturalists? How do they begin?

The author discusses how negative racial attitudes originate. First, she looks globally at how various theories have attempted to explain the origins of racism. Second, she reviews some research on this topic that she and her colleagues have completed with very young children. Both the theories and the studies have ramifications for how psychologists might reduce the possibility of children becoming racist.     

Code of fair testing practices in education

Although the code was not developed to cover employment tests, its guidelines appear useful for both developers and users of tests for the purposes of employee training, counseling, and development.     

Longitudinal scalogram analysis: A methodology and microcomputer program for Guttman scale analysis of longitudinal data

Guttman scalogram analysis has been limited to cross-sectional analysis. Longitudinal scalogram analysis (LSA), a direct extension of cross-sectional scalogram analysis to longitudinal-data, is proposed as an alternative methodology. The benefits of LSA relative to cross-sectional methods of analysis are discussed.     

Gender roles and adjustment in elementary-school children: A multidimensional approach

The present study of fourth through sixth graders examined the relationships between their school adjustment and the extent to which their self-concepts conformed to stereotypic gender roles. Several dimensions of gender roles were assessed. Adjustments was assessed by teacher ratings of externalizing and of internalizing symptoms. Among boys, more stereotypic self-concepts were associated with high levels of externalizing symptoms. Among girls, stereotypy was associated with high levels of internalizing. Discussion emphasized the practical importance of these relationships between gender-role stereotypy and poor adjustment, since externalizing and internalizing symptoms constitute the most frequent reasons for clinical referral among boys and among girls, respectively. Further findings, however, indicated that conclusions about the unfavorable adjustment correlates of stereotypy should not be extended to the less gender-typical symptoms (i.e., neither to boys' internalizing nor to girls' externalizing symptoms). Implications of the findings were also discussed with regard to earlier results obtained with adults that suggest mental health advantages associated with higher levels of masculinity. It was suggested that the contradiction between adult and child results partially reflects an emphasis upon externalizing symptoms with children, while studies employing adults have emphasized internalizing ones.The authors acknowledge the assistance of the Jefferson County School District, and especially Ms. Diane Hill, Director of Research, for their assistance in this study. The following persons are thanked for their assistance in interviewing children and collecting data: Heidi Hauge, Carol Hathaway-Clark, Judith King, and Ed Priddy. The authors also wish to thank Drs. Ann Boggiano and William Hodges for commenting on earlier drafts of this paper.