Habituation in high‐risk infants: reliability and patterns of responding

We examined both the reliability of infant‐controlled habituation and patterns of responding in a group of high‐risk infants (mean age 16 mos). Good test–retest reliability was found for mean, total, and baseline looking time for one of the stimuli. Classification of infants' pattern of performance yielded two groups: linear (57%) and non‐linear (29%) responders; 14% of cases could not be classified because of cross‐session inconsistencies in performance. Linear responders had shorter total looking times, fewer trials to criterion, and showed more habituation than non‐linear responders, thus validating the linear/non‐linear distinction. Our findings indicate that the infant‐controlled habituation task can be used reliably with infants who are at high risk for developmental disorders. Indeed, we provide evidence that this task is not only reliable, but may also provide meaningful distinctions between infants within the high‐risk population. Discussion focuses on the role of attention in distinguishing between short (linear) and long (non‐linear) lookers. Copyright © 2003 John Wiley & Sons, Ltd.     

A genetic two-factor model of the covariation among a subset of Multidimensional Aptitude Battery and Wechsler Adult Intelligence Scale—Revised subtests

The phenotypic and genetic factor structure of performance on five Multidimensional Aptitude Battery (MAB) subtests and one Wechsler Adult Intelligence Scale—Revised (WAIS-R) subtest was explored in 390 adolescent twin pairs (184 monozygotic [MZ]; 206 dizygotic (DZ)). The temporal stability of these measures was derived from a subsample of 49 twin pairs, with test–retest correlations ranging from .67 to .85. A phenotypic factor model, in which performance and verbal factors were correlated, provided a good fit to the data. Genetic modeling was based on the phenotypic factor structure, but also took into account the additive genetic (A), common environmental (C), and unique environmental (E) parameters derived from a fully saturated ACE model. The best fitting model was characterized by a genetic correlated two-factor structure with specific effects, a general common environmental factor, and overlapping unique environmental effects. Results are compared to multivariate genetic models reported in children and adults, with the most notable difference being the growing importance of common genes influencing diverse abilities in adolescence.     

Intergenerational studies of parenting and the transfer of risk from parent to child

This review describes a recent approach to studying the intergenerational processes that place families and children at risk for a broad variety of social, behavioral, and health problems. Intergenerational studies typically involve two (or more) generations of participants, observed over time. These projects are utilized to study the origins and early determinants of parenting behavior and of other environmental, health, and social conditions that place young offspring at risk for continuing behavioral, cognitive, and health problems. Convergent findings, across a broad range of research populations in several countries, suggest that problematic parenting develops in part through learning the behavior modeled by one's own parents. In addition, problematic parenting seems to be an extension of an individual's early style of aggressive and problematic social behavior. Parents with a history of childhood aggression, in particular, tend to have continuing social, behavioral, and health difficulties, as do their offspring. Conversely, parental involvement, cognitive stimulation, warmth, and nurturance appear to have important protective effects for offspring. Finally, educational achievement appears to be a powerful buffer against problematic parenting and a wide variety of difficult family circumstances, protecting families against the transfer of risk between generations.     

医疗风险防范与化解新趋向

新的《医疗事故处理条例》实施以后,患者的自我保护意识不断增强、高精尖医疗器械的应用、新技术的不断开展等均增加了医疗行为的风险,医疗风险管理显示出日益重要的作用。新形势下医疗风险管理的新趋向是建立自愿的医疗责任保险、组织患者参加医疗风险保险、建立强制性医疗责任保险制度、卫生行政部门代理保险业务、建立医疗援助基金等方式,提出了在风险控制的基础上,加强风险融资的措施。     

Erna and Melanie Klein

Erna was one of the child patients treated by Melanie Klein in Berlin, employing her recently discovered play technique. Since Erna died in Chile, the authors considered the IPA Congress in Santiago an opportunity to present a paper as a homage both to Erna and, especially, to Klein. She learned much from that very disturbed child, which she later used to sustain the ongoing development of her theories. The paper explores biographic data relevant to understanding both the case and the theories. It analyses the case material to follow Klein in the discovery and the handling of the child's transference and the harsh expressions of hate, jealousy and envy, which are brought in, with sad consequences, by strong persecutory feelings. Klein's comparison of this case with that of Freud's Wolf-man is also considered, mostly to show that the similarities were less than originally claimed, and that Klein, perhaps, was introducing a theoretic shift which led her technique to gradually change from ' Nachträglichkeit ' to the 'signification-resignification' pair, akin to Strachey's concept of the mutative interpretation. Lastly, the comprehension of Erna's strong psychotic traits and the links with later developments of the theory on psychosis are studied.     

BIOMEDICAL ETHICS: MUSLIM PERSPECTIVES ON GENETIC MODIFICATION

Technology pertaining to genetically modified foods has created an abundance of food and various methods to protect new products and enhance productivity. However, many scientists, economists, and humanitarians have been critical of the application of these discoveries. They are apprehensive about a profit‐driven mentality that, to them, seems to propel the innovators rather than a poverty‐elimination mentality that should be behind such innovations. The objectives should be to afford the most benefit to those in need and to prevent hunger around the world. Another major concern is the safety of genetically modified food. Muslims, as well as those in other religious communities, have been reactive rather than proactive. Muslims must connect scientific knowledge and ethical behavior based on faith. In Islam, there is no divide between the two. God has commanded us to seek knowledge and make discoveries to better our lives and our environment. We are trustees of this world and everything in it. The poor, the sick, and the wayfarers have a right to be fed and cared for. God reminds Muslims continuously that the earth and all the heavens belong to God; therefore, no one should feel hunger, no one should suffer or be prevented from sharing this bounty.     

Sociobiology and Moral Discourse

In the intellectual lineage of sociobiology (understood as evolutionary social science), this article considers the place of moral discourse in the evolution of emergent systems for mediating behavior. Given that humans share molecular systems, reflex systems, drive systems, emotional systems, and cognitive systems with chimpanzees, why is it that human behavior is so radically different from chimpanzee behavior? The answer is that, unlike chimps, humans possess symbolic systems, empowering them to override chimplike default morality in favor of symbolically mediated moral codes. The article concludes with a brief discussion of the power of religious symbols to influence moral behavior by reprogramming emotional systems.     

An Assessment of Ethnocultural Beliefs Regarding the Causes of Birth Defects and Genetic Disorders

With the expansion of genetic services to various cultural groups, genetic counselors encounter clients who hold diverse beliefs inscribed by their culture about health conditions. Thus, clients may attribute the cause of a birth defect or genetic condition to a culturally-based health belief. This present study was conducted as a pilot study in order to assess the beliefs about the causes of birth defects and genetic disorders held by women of different ethnocultural backgrounds. This study proposed that women who do not have a family history of a disorder will differ in their knowledge about the cause of a birth defect or genetic disorder compared to women who have an affected child. In addition, this study determined to what extent culturally-based health beliefs are attributed to being the cause of a birth defect or genetic disorder in the 1990s.     

The Effect of Genetic Counseling on Knowledge and Perceptions Regarding Risks for Breast Cancer

In 1994, a clinic for cancer risk counseling was opened at Hadassah University Hospital in Jerusalem. Most of the counselees have been women who had breast cancer and/or a relative with breast cancer. In order to evaluate the effect of this counseling on women's knowledge and perceptions regarding the risks for breast cancer, a questionnaire was given before and after the counseling session to 60 healthy women who came to the clinic because they have relatives with breast cancer. According to the genetic counselors' estimations, most of these women had a significantly increased risk (compared to the general population) of developing cancer. Before counseling, the women overestimated the population risk for breast cancer, the contribution of heredity to morbidity of cancer, and their own risks to get cancer. After counseling session, they gave reduced estimates, closer to the real ones. The subjective perceptions regarding these risks were reduced after counseling, except for the perceptions regarding their relativerisks which have not changed after the counseling. About 90% of the women who came to the clinic wanted to be tested for genetic predisposition to cancer. For most of these women, the expectations that the test can rule out a genetic predisposition to cancer became more realistic after the counseling. The option to first test an affected relative was offered to all families, and a test was actually conducted in 75% of the families.     

Genetic Counselors' Judgments of Patient Concerns: Concordance and Consequences

The aims of this prospective study were to determine (a) the concordance between patient concerns and genetic counselors' judgments of these concerns, (b) the predictors of patient and counselor judgments, and (c) the relationship between concordance and patient outcomes. Patients' and counselors' views were sought before and after 131 routine genetic consultations. Before consultations, there was concordance about level of patient concern to within one point in 63% (82/131) of consultations and about type of patient concern in 60–84% of consultations. Lack of concordance in judging level and type of concern was associated with lower satisfaction with information and higher anxiety after the consultation. The biggest predictor of counselor judgment of concern was professional background: doctors judged patients to be more concerned than did nurses. Concordance of concern was predicted by counselors' experience in genetics: less experienced counselors overestimated patient concern. Future research needs to determine whether improving judgment of concern improves patient outcome.