Genetic counseling for the next 25 years: Models for the future

Currently, two trends pose particular challenges for genetic counseling: (1) spin offs from the Human Genome Project leading to new diagnostic genetic tests far in advance of any cures; and (2) an increasing and diversified client population. These trends will lead to changes in both genetic service delivery systems and the development of alternative models of the genetic counseling process itself. Two models that could be adapted for genetic counseling are: the mutual participation model and the life history narrative model. Technological advances present ethical dilemmas and raise many questions. Already, improved detection of genes for predisposing conditions has entered clinical medicine requiring renewed ethical appraisals of genetic testing. Integration of genetic counseling (and required pre-screening education) into primary care settings involves time constraints and the involvement of health care personnel with less training in genetics. Alternative approaches are beginning to be discussed. Innovative genetic counselors with expanded visions of counseling goals and practices will play an increasingly important role in the future of genetic counseling.     

The relations of generative concern and generative action to personality traits,satisfaction/happiness with life,and ego development

This research examined the relations that generative concern and generative action have to personality traits, satisfaction/happiness with life, and ego development. Generative concern is a general personality tendency or interest in caring for younger and anticipated individuals, while generative action addresses actual physical behaviors that promote the well-being of future generations. Two samples (79 and 152 adults) were employed. Generative concern scores were significantly related to scores for extraversion, openness, emotional stability (non-neuroticism), and agreeableness as well as to two agentic traits (achievement, dominance) and two communal traits (affiliation, nurturance). Generative action was significantly related to extraversion and openness. Generative concern but not generative action was found, as predicted, to be positively related to one's life satisfaction/happiness. Further, one's level of ego development determined, in part, the relation that generative concern had to satisfaction/happiness with life. Given that a subject scored high in ego development, his or her level of satisfaction/happiness varied as a function of generative concern such that those who scored low on generative concern were significantly less satisfied/happy than those that scored high on generative concern. The results are discussed within the context of the recently proposed theory of generativity.     

Development of a diary for use with ambulatory monitoring of mood,activities, and physiological function

This paper describes three studies developed and providing preliminary validation for a pocket-size, self-monitoring diary suitable for use infield research on relationships among psychological states, activities, and physiological events. In the first study, a principal-components analysis of the diary's mood and cognition scales yielded three factors—negative affect, engagement, and predictability. These showed moderate concordance across two samples. In the second study, diary self-ratings of events, moods, and cognitions were shown to be meaningfully correlated with ratings made by spouse observers, providing evidence of concurrent validity of the diary. In the third study, diary ratings made by the same subjects at home, at work, and in other locations differed from each other in expected ways, providing evidence for discriminative validity. Modifications to the diary are suggested, and possible uses and limitations of the instrument are discussed.This research was supported by USUHS protocol RO7233 and a grant from the John D. and Catherine T. MacArthur Foundation. The opinions and assertions expressed herein are those of the authors and should not be construed as reflecting those of the USUHS or the Department of Defense.     

The impact of variability and prechoice experience on taking safety measures: The case of security updates

The goal of this research is to clarify the conditions that trigger reluctance to take cost-effective safety measures. We present three experiments. In two of the experiments, the participants were asked to operate a simulated system for 20 periods, each with 10 trials. They could “update the system” to eliminate the risk of a “security failure” that led to a loss of 100 points. The updating cost was either fixed (at 10 points) or variable (initially 10 points, and some probability of free—0 points—updates). The optimal strategy prescribed updating at the first opportunity. Another experiment focused on one-shot decision under risk. The results highlight two factors that reduce the tendency to update and impair performance: cost variability and prechoice experience. Importantly, we show that the negative impact of cost variability is the product of two tendencies. First, experiencing periods with free updates slowed learning to select the optimal policy. Second, in many cases, the participants behaved as if they plan to update when the cost of updating is low but forget to do so. The results suggest that security can be enhanced by asking users to select a default updating policy before gaining experience and by replacing “free updates” with automatic updates. Information concerning the existence of automatic updates reduced manual updating, but this effect was eliminated by experience.     

Ethnicity,Life Satisfaction,Stress, Familiarity,and Stigma Toward Mental Health Treatment

The authors examined the relative contribution of ethnicity, life satisfaction, level of stress, familiarity with mental health treatment, and self- and public stigma on attitudes toward mental health treatment among a diverse sample (N = 632) of adults. Results indicated that ethnicity, stress, familiarity, and self-stigma of mental illness were significant predictors of attitudes. Additionally, familiarity with mental health treatment moderated the relationship between public stigma and attitude.     

Satisfaction with life in individuals with a lower limb amputation: The importance of active coping and acceptance

The aim of this study was to analyze the relationship between sociodemographic/clinical characteristics, coping strategies and satisfaction with life in individuals with lower limb amputation. Sixty‐three individuals with a lower limb amputation due to Diabetes and Peripheral Vascular Disease participated in the study and answered measures of coping strategies and satisfaction with life. Findings revealed high dissatisfaction with life. Acceptance and active coping were the most used coping strategies. Satisfaction with life was positively associated with active and planning coping, religion, acceptance and humour. There were differences in coping strategies according to gender, age, marital status, presence of residual limb pain, prosthesis use and mobility level. Results emphasize the differential role of coping strategies, for each individual. Psychosocial interventions need to take into consideration coping strategies during the process of rehabilitation and be specific regarding individuals` sociodemographic and clinical characteristics. This study may help design interventions that answer individuals with lower limb amputations given that coping strategies are a valuable resource in the promotion of satisfaction with life.     

Anxiety after remembering stressful academic versus brush with death events: The moderating roles of future time perspective and personal intimacy

This study examines: (i) whether recalling stressful autobiographical events results in anxiety, (ii) the relation of memory qualities to anxiety, and (iii) the relation of future time perspective and personal intimacy to experiencing anxiety. Participants (N = 120) completed Future Time Perspective, Personal Intimacy and State Anxiety scales. They were randomly assigned to recall a brush with death, a stressful academic deadline, or a no-stress control. Memory qualities (vividness and significance) were assessed. As expected, recalling stressful events resulted in anxiety with more personally significant events related to higher anxiety. Having a more open-ended future time perspective related to lower anxiety after recalling a stressful academic deadline, whereas greater personal intimacy predicted lower anxiety after recalling a brush with death. Findings are discussed in terms of factors that may serve to moderate the link between stressful memories and the experience of anxiety.     

Distinguishing between level and impact of rumination as predictors of depressive symptoms: An experience sampling study

Rumination—repetitively thinking about one's emotional state, its causes and consequences—exacerbates negative mood and plays an important role in the aetiology and maintenance of depression. Yet, it is unclear whether increased vulnerability to depression is associated with simply how much a person ruminates, or the short-term impact rumination has on a person's negative mood. In the current study, we distinguish between the level versus the impact of rumination, and we examine how each uniquely predicts changes in depressive symptoms over time in an undergraduate sample. Using experience sampling, we assessed students’ (N = 101) subjective experiences of positive and negative affect and their use of rumination and distraction in daily life for seven days. Participants also reported their depressive symptoms before and after the experience sampling. Increases in depressive symptoms over the week were predicted by how much people ruminated, but not by its impact on negative mood.     

A THEORETICAL APPRECIATION OF THE ETHIC OF SOLIDARITY IN POLAND TWENTY-FIVE YEARS AFTER

The remarkable movement known as Solidarity recently celebrated its twenty‐fifth anniversary in Poland. This essay provides a theoretical appreciation of the values and principles that guided and undergirded the movement, which greatly contributed to the fall of communism in Central and Eastern Europe. This systematic overview of the ethic of the Solidarity movement fills a lacuna in the field of ethics because ethicists who are interested in the concept of solidarity have largely overlooked the Polish experience of the 1980s. This essay attempts to describe the key ingredients of the Polish ethic of solidarity by analyzing both Polish treatises on the subject and accounts of events on the ground. It elaborates conceptual categories and describes characteristic features of the movement in order to provide a phenomenological account of the nature of solidarity embodied in Poland during this era. These categories and characteristics include unity among differences, the foundation of hope at the movement's roots, self‐sacrifice and heroism, promoting the equality and dignity of all, the centrality of participation, the affirmation of “bread and freedom,” an option for the poor, and the insistence on life in truth. Although this essay does not attempt to demonstrate the relevance of this “thick” ethic of solidarity to capitalist, democratic societies today, by way of conclusion it raises questions pertaining to the contemporary significance of the Polish ethic of solidarity.