Development and Validation of the Clutter Image Rating

Few instruments are available to assess compulsive hoarding and severity of clutter. Accuracy of assessment is important to understanding the clinical significance of the problem. To overcome problems associated with over- and under-reporting of hoarding symptoms, the clutter image rating (CIR) was developed. This pictorial scale contains nine equidistant photographs of severity of clutter representing each of three main rooms of most people’s homes: living room, kitchen, and bedroom. The psychometric properties of this measure were examined in two studies. Internal consistency, test–retest, and interobserver reliabilities were good and convergent validity with other questionnaire and interview measures was also good. The CIR correlated more strongly with measures of clutter than with other hoarding and psychopathology scales. The CIR’s very brief pictorial assessment method makes it useful in clinical and treatment contexts for measuring the clutter dimension of compulsive hoarding. The Clutter Image Rating (CIR) is available in conjunction with the following publication: Steketee, G., & Frost, R.O. (2007). Treatment of compulsive hoarding. New York: Oxford University Press at .     

Psychiatric Disorders in Clinical Genetics I: Addressing Family Histories of Psychiatric Illness

This is the first article of a two-part professional development series addressing genetic counseling for personal and family histories of psychiatric disorders. It is based on an Educational Breakout Session presented by the Psychiatric Special Interest Group of the National Society of Genetic Counselors at the 2006 Annual Education Conference. This article examines issues that arise in addressing family histories of psychiatric illness, while the second article in the series considers the generation and provision of individualized recurrence risks for psychiatric disorders. In this article we discuss the importance of managing uncertainty for affected individuals and their close family members who have been referred to genetics for a number of different indications. We then use four simulated cases to make recommendations about the scope and timing of discussions related to the psychiatric family history.     

Gene Concepts and Genethics: Beyond Exceptionalism

The discursive explosion that was provoked by the new genetics could support the impression that the ethical and social problems posed by the new genetics are somehow exceptional in their very nature. According to this view we are faced with special ethical and social problems that create a challenge so fundamental that the special label of genethics is needless to justify. The historical account regarding the evolution of the gene concepts could serve us to highlight the limits of what we know about genes and what we can do with genes. The widespread notion about the exceptionality of genetic knowledge and its applicative possibilities is hardly justifiable and leads to misunderstandings regarding the conceptualization of the ethical and social problems we might face. Following a more realistic interpretation of the role of genes in human life we might avoid a whole set of fictive dilemmas and counterproductive regulatory efforts in bioethics. Bioethical discourse should move from the gene-centered scientific discourse toward the more sophisticated and complex discourses where human development represented as a matter of complex interactions between genomes and environments, between genes, educational factors, nutritional regimes, and other different developmental resources. If a gene is seen as one among the different developmental resources that are shaping a given human trait then both genethics and genetic exceptionalism could hardly be represented as a justified approach in discussing the ethical and social problems of genetics.     

Code of Ethics of the National Society of Genetic Counselors: Explication of Revisions

The Code of Ethics (COE) of the National Society of Genetic Counselors (NSGC) was adopted in 1992. In 2004, the NSGC leadership appointed the Code of Ethics Work Group (COEWG) to consider revisions to the NSGC COE based on advice from the NSGC legal counsel, and to consider additional changes given growth in the scope of genetic counseling practice since the adoption of the original COE. After input from the NSGC membership, changes to the COE addressing the recommendations of the NSGC legal counsel were approved in December 2004. The COEWG then reviewed ethical codes and codes of professional conduct from 22 professional organizations, deemed to have similar goals and philosophies to the NSGC, searching for themes that encompassed genetic counseling practice that might not yet be addressed in the NSGC COE. Additional revisions to the COE were proposed, and after feedback from the NSGC membership, the revised COE was approved in January 2006 by majority vote of full members of the NSGC. The explications for the 2004 and 2006 revisions are presented.     

The Influence of Cancer-related Distress and Sense of Coherence on Anxiety and Depression in Patients with Hereditary Cancer

This study examines the association between Sense of Coherence and anxiety and depression amongst patients at risk of hereditary cancer receiving genetic counseling. When writing this article, 144 patients referred for genetic counseling due to a suspicion of hereditary cancer in the family were recruited for this multicentered longitudinal study on the psychosocial aspects of genetic counseling in Norway. A total of 96 (66%) patients responded to the follow-up survey distributed 6 months after genetic counseling. This survey included the Sense of Coherence-29 Scale, Impact of Event Scale, and Hospital Anxiety and Depression Scale. Multiple regression analyses were applied. Our results show association between cancer-related distress and symptoms of anxiety and depression. Sense of Coherence is significantly associated with both anxiety and depression. The hypothesis of Sense of Coherence buffering cancer-related distress and the possible impact of these findings for genetic counseling are discussed.     

Biotechnology,ethics and education

Fundamental differences between current and past knowledge in the field of biotechnology mean that we now have at our disposal the means to irreversibly change what is meant by ‘human nature’. This paper explores some of the ethical issues that accompany the (as yet tentative) attempt to increase scientific control over the human genetic code in what amounts to a diminishing of difference and the reduction of human life to scientific explanations at the expense of spiritual, cultural and communal considerations. Within such a limited view, the critical role of education is reduced in favour of promoting psychological efficiency, with the possibility of accelerating learning and increasing intellectual capacity through genetic manipulation. A major concern expressed in the paper is the fine line between corrective therapy and psychological enhancement: Who should be defining the normal range of human difference? And what degree of caution should be required in redesigning future generations? The unknown dangers inherent in the (perhaps irreversible) application of genetic technology to human life suggests that current precautions may not go far enough in recognising that education is a contestable field.     

Developmental trends in children's component selection

A new method is introduced for assessing children's component selection—i.e., the disposition to attend to a single feature of multifaceted stimuli. Eight-year-old children were found to exercise component selection to a lesser degree than 4-year-olds; while children at both age levels attended primarily to one stimulus component (shape), the older children showed a moderate amount of attention to a secondary redundant feature (color) as well. However, a comparable age difference in attention deployment was not observed when a single stimulus dimension (shape) was “relevant” in two variant tasks. These results imply a developmentally increasing ability to distinguish between conditions in which attending to redundant stimulus information can and cannot be useful. That this ability undergoes little further development beyond age 8 was suggested in a second experiment with 8- and 12-year-olds in which the three tasks produced relatively similar developmental trends in performance.     

Second-order dimensions of the Work Values Inventory (WVI)

An item factor analysis of the 45 items of the Work Values Inventory (WVI) for 445 physically disabled clients produced six second-order dimensions: Stimulating Work, Interpersonal Satisfaction, Economic Security, Responsible Autonomy, Comfortable Existence, and Esthetic Concerns. These second-order factors provide a summary of clients' work motivation at a higher level of generality that is consistent with the WVI primary structure. The six factors are virtually independent of age, education, and intelligence and can be hand-scored by a simple procedure.     

The genetic architecture of effortful control and its interplay with psychological adjustment in adolescence

The role of genes and environment in the relation between self-regulation and adjustment is unclear. We investigated, with the twin design, genetic and environmental components of the association between effortful control (EC) and indicators of psychological adjustment using adolescents’ and parents’ reports for 774 twins. Genetic factors explained a substantial proportion of variance in EC (58%) and the outcome variables of optimism (55%), general self-esteem (45%), happiness (48%), and self-derogation (29%). Perceived competence had no significant genetic component. Aside from perceived competence, uncorrelated with EC, phenotypic correlations of EC with measures of well-being/adjustment were moderate and predominantly explained by shared genetic effects. Results suggest a significant genetic contribution in adolescents’ EC and in its relation to various aspects of adjustment.