Group aversion by imaginal, vicarious and shared recipient-observer shocks

Sixty college students completed waiting control or alternative group aversion conditions, matched for severity and chronicity of nail-biting. Treatments spanned four sessions. Imaginai aversion (covert sensitization) clients visualized shocks to themselves. Vicarious aversion clients observed shocks to a trained model. A ‘hotseat’ format randomized a few actual shocks to each client with observing peers shocked on remaining trials. The predominant pattern of outcome and subjective impact results was as follows: Hotseat consistently best; vicarious typically second; imaginal usually third; controls worst. Clinical and conceptual issues are raised.     

Effects of availability of feature changes on behavior segmentation

Thirty-five subjects segmented one of two videotapes of an actor methodically assembling 20 five-page questionnaires. In one sequence, the completion of each questionnaire resulted in a highly visible change in the stimulus fields: The top page of the stack changed from black to white or from white to black with the completion of each questionnaire. In a second sequence the action was identical, but the changing feature was concealed from view. Results disclosed that subjects viewing the tape with the visible change segmented the action on the basis of that change. Subjects viewing the same action without the visible change segmented the behavior into its fine-unit components, despite the fact that the higher-level organization in the behavior was readily understood.     

Evidence for direct visual access to letter identities

Subjects were presented with two letters from the set BCDFGHLNPORTVZ, one in upper case and one in lower case. Subjects were required to decide, as quickly as possible, whether the two letters on each trial were the same (e.g., Bb) or different (e.g., Bd). Because letters were always physically different, subjects presumably must name the letters in order to respond. Reaction times were predicted by the visual similarity of the letters, and not by their phonemic distinctive feature similarity. Consistent with previous work showing that a word's meaning can be assessed directly from visual information, the findings suggest that visual analysis of a capital or small letter can result in knowing the latter name without further linguistic processing. These results were interpreted as an example of automatic detection as described by Schneider and Shiffrin (1977).     

The development of complex sentence processing strategies

Children aged 3, 4, and 5 years and adults heard sentences with clauses connected by after, and, or before, saw a picture, and indicated whether or not the picture matched one of the events of the sentence. Response times were taken as a measure of immediate accessibility to the meaning of the clause that the picture was about. Temporal organization of sentence meanings was dominant in 3-year-olds and adults, but not in 4- or 5-year-olds. The 3-year-olds and especially the adults processed and-sentences as implicitly temporal. The results for 4- and 5-year-olds are interpreted as indicating experimentation with alternate strategies for organizing sentences based on the structural/presuppositional properties of clauses.     

The Importance of Written Information Packages in Support of Case-Finding Within Families at Risk for Inherited High Cholesterol

Inherited High Cholesterol is treatable, but highly underdiagnosed. To detect undiagnosed blood relatives at a presymptomatic stage, in the Netherlands written information packages are available to facilitate family communication. To investigate the role of those packages in the detection of carriers, we conducted a qualitative evaluation (plus-minus method combined with semistructured interviews with index patients and relatives). Our data suggest that interviewees approved the family approach for finding carriers, although reluctantly. The packages aided family disclosure by reducing hesitation. However, index patients only informed first-degree relatives and generally communicated the risk only once. This may be due to the cultural context and a limited understanding of genetics. For relatives the packages served as a cue to action and as a legitimation to gain access to a diagnostic cholesterol test. Despite the value of these written materials, they should not be used as the only communication between index patient and relatives.     

Cystic Fibrosis Prenatal Screening in Genetic Counseling Practice: Recommendations of the National Society of Genetic Counselors

For over a decade, prenatal screening for cystic fibrosis (CF) has been considered a model for the integration of genetic testing into routine medical practice. Data from pilot studies and public policy discourse have led to recommendations by some professional organizations that CF screening should be offered or made available to pregnant women and their partners, and to couples planning a pregnancy. It is crucial that genetic counselors gain thorough understanding of the complexities of CF and the implications of positive test results, so that they may serve as a reliable, educated referral base and resource for health care providers and their patients. While not all pregnant women will be referred for genetic counseling prior to CF carrier testing, genetic counselors often will be asked to counsel clients after they have a positive test result, or who are found to be at increased risk. Genetic counselors can play an important role in providing accurate and current information as well as support for patients informed decisions. These recommendations were created by a multicenter working group of genetic counselors with expertise in CF and are based on personal clinical experience, review of pertinent English language medical articles, and reports of expert committees. The recommendations should not be construed as dictating an exclusive course of management, nor does the use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care providers professional judgment based on the clinical circumstances of a particular client.     

Sequential Down Syndrome Screening: The Importance of First and Second Trimester Test Correlations when Calculating Risk

Down syndrome screening can be particularly effective when both first and second trimester tests are performed. However, the counseling of women who have received sequential first and second trimester screening can be problematic. We evaluated an approximation where the post-test risk from the first trimester screening is used as the new a priori risk for the second trimester screening. The approximation disregards between-trimester test correlations. The Down syndrome detection rate based on the approximation (90.2%) would be close to that obtained when all correlations were considered (90.8%) but the false positive rate would be 26% higher (3.9% versus 3.1%, respectively). For any particular woman, the use of the approximation could result in highly inaccurate risks. We conclude that the correlations that exist between first and second trimester screening tests preclude the use of second trimester risks derived from the direct product of separate first and second trimester screening. Counseling issues in the delivery of sequential screening are discussed.     

Women’s Attitudes Toward Testing for Fragile X Carrier Status: A Qualitative Analysis

Fragile X syndrome (FXS) is primarily due to a repeat expansion mutation found in the FMR1 X-linked gene. We have conducted a qualitative analysis of responses from women concerning their attitudes toward testing for carrier status of the fragile X mutation among reproductive-age women. We obtained responses from focus groups including women with and without FXS in their families. We found the following themes: (1) mothers of children with FXS have difficulty formulating their opinions on population screening because of their unique experiences surrounding their own carrier diagnosis and their relationship with their children with FXS, (2) the motivation for carrier testing and need for information differ by family history of FXS and parental status, and (3) the timing of carrier testing with respect to a woman’s life stage dictates whether carrier information will be viewed as beneficial or detrimental. There was evidence that non-carrier women from the general population would be wholly unprepared for positive carrier results. These findings have significant implications for genetic counseling as well as for population screening.