Spiritual Coping, Family History, and Perceived Risk for Breast Cancer—Can We Make Sense of it?

Differences in spiritual beliefs and practices could influence perceptions of the role of genetic risk factors on personal cancer risk. We explored spiritual coping and breast cancer risk perceptions among women with and without a reported family history of breast cancer. Analyses were conducted on data from 899 women in primary care clinics who did not have breast cancer. Structural equation modeling (SEM), linear, and logistic modeling tested an interaction of family history of breast cancer on the relationship between spiritual coping and risk perceptions. Overall analyses demonstrated an inverse relationship between spiritual coping and breast cancer risk perceptions and a modifying effect of family history. More frequent spiritual coping was associated with lower risk perceptions for women with positive family histories, but not for those with negative family histories. Results support further research in this area that could influence communication of risk information to cancer genetic counseling patients.     

How surprising is a simple pattern? Quantifying "Eureka!"

Simple patterns are compelling. When all the observed facts fit into a simple theory or "story," we are intuitively convinced that the pattern must be real rather than random. But how surprising is a simple pattern, really? That is, given a pattern of featural data, such as the properties of a set of objects, how unlikely would the pattern be if they were actually generated at random? In conventional statistics dealing with patterns of numbers, this type of question would be answered by reference to a null distribution such as the t distribution. This paper gives the analogous answer in the realm of concept learning, that is, the formation of generalizations from patterns of featural data. Using a formal but psychologically valid definition of complexity, I derive and exhibit the distribution of subjective complexity under the hypothesis of no pattern. This leads directly to a number of applications, including a statistical test indicating whether an observed pattern is sufficiently simple that it is not likely to have been an accident: literally, the "significance of simplicity."     

An Assessment of Risk Understanding in Hispanic Genetic Counseling Patients

This study sought to identify if differences existed in risk comprehension and risk format understanding between genetic counseling patients of Hispanic and Caucasian ethnicity. A total of 107 questionnaires were collected, 56 from Hispanic patients, and 51 from Caucasian controls. Of the total population 41.1% (44/107) could not demonstrate sufficient risk understanding, which was 71.4% (40/56) of Hispanics and 7.8% (4/51) of Caucasians. Fractions were the best-understood format for all participants. However, both Hispanics and Caucasians had difficulties with the percentage risk format. Discrepancies were also noted in qualitative word format understanding. Awareness of differences in risk comprehension may affect the selection of counseling techniques and strategies utilized by genetic counselors when educating patients about risk related information.     

Convergence of Sibling Risk Among Children of Parents with Serious Mental Disorders

We examined child psychiatric diagnoses, behavioral problems, overall symptom impairment, global psychological functioning, intellectual ability, and adaptive behavior in 83 sibling pairs whose mothers were diagnosed with a serious mental disorder. Sibling pairs were assessed for the extent to which they converged on the presence or absence of risk on each adverse outcome and then examined under conditions of high vs. low/moderate family stress. Consistent with the study hypotheses, we found that on each outcome assessed there was evidence for sibling convergence of risk. In addition, family stress was found to significantly moderate sibling risk convergence. The results are discussed in terms of their implications for understanding sibling convergence of risk in these families and for clinical and preventive intervention.     

Long-Term Unemployment Among Young People: The Risk of Social Exclusion

The European Union considers long-term unemployment among youth an impediment to their full integration into society. The Commission of the European Union has, therefore, supported research into the mechanisms by which youth unemployment leads to social exclusion. This paper provides a brief summary of the project's findings. These imply that theories and previous research concerning social exclusion and social support can help explain the effects of youth unemployment although the phenomena vary from country to country. Results also suggest that the construct of social exclusion leads to interventions that reduce the personal and societal costs of youth unemployment.     

Differential risks of covarying and pure components in mother and teacher reports of externalizing and internalizing behavior across ages 5 to 14

In a sample of 585 children assessed in kindergarten through 8th grade, we fit a confirmatory factor model to both mother- and teacher-reported symptoms on the Achenbach checklists (CBCL, TRF) and determined that a covariation factor of externalizing and internalizing behaviors existed, in addition to the pure-form factors of externalizing and internalizing for each reporter. In 3 structural equation models, between 8 and 67% of the variance in these 6 latent factors was accounted for by a set of antecedent child, sociocultural, parenting, and peer risk variables. Each of the 6 latent factors, taken 2 at a time, was predicted by a unique set of risk variables; however, there were some patterns that held for both mother- and teacher-report symptom factors: Child temperamental unadaptability and female gender were predictors of higher internalizing symptoms; child temperamental resistance to control, parental harsh punishment, male gender, low SES, and peer rejection were related to higher externalizing symptoms whereas child temperamental unadaptability was related to lower externalizing symptoms; and peer rejection and family stress were also related to the covarying, externalizing-plus-internalizing component of both mother and teacher reports.     

The Effects of Framing, Reflection, Probability, and Payoff on Risk Preference in Choice Tasks

A meta-analysis of Asian-disease-like studies is presented to identify the factors which determine risk preference. First the confoundings between probability levels, payoffs, and framing conditions are clarified in a task analysis. Then the role of framing, reflection, probability, type, and size of payoff is evaluated in a meta-analysis. It is shown that bidirectional framing effects exist for gains and for losses. Presenting outcomes as gains tends to induce risk aversion, while presenting outcomes as losses tends to induce risk seeking. Risk preference is also shown to depend on the size of the payoffs, on the probability levels, and on the type of good at stake (money/property vs human lives). In general, higher payoffs lead to increasing risk aversion. Higher probabilities lead to increasing risk aversion for gains and to increasing risk seeking for losses. These findings are confirmed by a subsequent empirical test. Shortcomings of existing formal theories, such as prospect theory, cumulative prospect theory, venture theory, and Markowitz's utility theory, are identified. It is shown that it is not probabilities or payoffs, but the framing condition, which explains most variance. These findings are interpreted as showing that no linear combination of formally relevant predictors is sufficient to capture the essence of the framing phenomenon.     

A Developmental Approach to Prevention Research: Configural Antecedents of Early Parenthood

A developmental framework emphasizing the combined impact of correlated constraints within and without the individual was applied to a prospective longitudinal study of early parenthood. The purpose was to use a person-approach to the analysis of longitudinal data to clarify risk for early parenthood and to generate hypotheses about potentially useful intervention strategies. Respondents were 475 youth who were assessed annually from seventh grade through the end of high school and, again, at ages 20 and 24. The risk patterns associated with parenthood were the same for both sexes. Individuals with a middle-school configuration of low socioeconomic status, high aggression, low academic skills, low popularity, and prior grade failure were most likely to become parents by early adulthood. Risk for early parenthood increased substantially for respondents who dropped out of school early, regardless of their initial risk status.     

A Longitudinal Study of Mothers' Overreactive Discipline and Toddlers' Externalizing Behavior

The association between children's externalizing behavior problems and mothers' overreactive discipline was examined in a longitudinally assessed sample of toddlers and their mothers. Path analyses indicated that mothers' overreactive discipline and children's externalizing behaviors were significantly and similarly stable over a 2 1/2-year period. No evidence of a cross-time influence of either variable on the other was observed. Mothers' overreactive discipline at Time 2 had a significant effect on Time 2 externalizing behavior. No significant effects of children's behavior on mothers' discipline were found. Mothers' depressive symptomatology and marital discord predicted initial overreactivity and were related to externalizing problems through their relations to overreactivity. The results support the appropriateness of implementing parenting interventions for externalizing problems before age 2 years.     

The Prophylactic Mastectomy Dilemma: A Support Group for Women at High Genetic Risk for Breast Cancer

The goal of this pilot study was to test the usefulness of a six session psychoeducational support group for women at high genetic risk for breast cancer who were considering prophylactic mastectomy. The themes of the group sessions included overestimation of and anxiety about risk; desire for hard data; the emotional impact of watching a mother die of breast cancer; concerns about spouse reactions; self- and body image; the decision-making process; and confusion over whom to trust in decision making. Both the participants and the multidisciplinary leaders concluded that as a supplement to individual counseling, a support group is a beneficial and cost-effective treatment modality. Recommendations for the optimal format for such a group are described.