Evaluating the Impact of Genetic Counseling and Testing with Signal Detection Methods

One measure of the impact of genetic counseling and testing (GCT) is the extent to which it fosters behavioral change that is consistent with mutation status. We describe and illustrate how two different signal detection methods, receiver operating characteristic (ROC) analysis and recursive partitioning, can be used in this context to evaluate the impact of GCT. We analyzed real screening behavior data obtained in the 12 months following GCT for Hereditary Nonpolyposis Colon Cancer (HNPCC) using these two different signal detection approaches. Each approach demonstrated that GCT had an impact on behavioral outcomes, and was effective in fostering behavioral outcomes appropriate to mutation status. The ROC approach demonstrated that GCT was effective because mutation positive and mutation negative individuals could be distinguished on the basis of the number of recommended screening behaviors. The recursive partitioning approach demonstrated that GCT was effective because there were generally high rates of adherence to screening guidelines among subjects. The recursive partitioning technique also identified four subgroups of subjects, each with distinct characteristics, for which tailored interventions could be developed to increase rates of adherence to screening guidelines. Signal detection methods are easily implemented and are useful techniques for evaluating the impact of GCT.     

A matter of facts

We discuss the justification of Bickle's “ruthless” reductionism. Bickle intends to show that we know enough about neurons to draw conclusions about the “whole” brain and about the mind. However, his reductionism does not take into account the complexity of the nervous system and the fact that new properties emerge at each significant level of integration from the coupled functioning of elementary components. From a methodological point of view, we argue that neuronal and cognitive models have to exert a mutual constraint(MC) on each other. This approach would refuse to award any priority of cognitive approaches over neuroscience, and reciprocally, to refuse any priority of neuroscience over cognitive approaches. MC thus argues against radicalreductionism at the methodological level.     

Measurement Structure of the Turkish Translation of the Child Behavior Checklist Using Confirmatory Factor Analytic Approaches to Validation of Syndromal Constructs

The new correlated 8-factor measurement structure of the Child Behavior Checklist for ages 6-18 (CBCL/6-18; T. M. Achenbach & L. A. Rescorla, 2001) derived from an American sample was used as a benchmark to evaluate its generalizability to Turkish general population (N = 5,195) and clinical (N = 963) samples. Item-level confirmatory factor analysis (CFA) was used to evaluate the adequacy of the correlated 8-factor model across 3 sample conditions (general population, clinical, and combined sample whose Total Problems scores were above the Turkish national median). The results supported the generalizability of the overall measurement structure of the CBCL to the Turkish population.     

Linguistic Analysis of Written Narratives of Caregivers of Children and Adolescents with Chronic Illness: Cognitive and Emotional Processes and Physical and Psychological Health Outcomes

Used linguistic analysis of written narratives of caregivers of hospitalized youth with chronic illness to identify emotional and cognitive processes related to physical and psychological health outcomes following writing. Measures were administered at baseline and 4 months. Experimental group (n = 29) wrote about traumas whereas the control group (n = 24) wrote about summer activities for 20 min on three different days. Compared groups on negative emotion- and cognition-related word use. Tested change in negative emotion- and cognition-related word use as predictors of outcomes in experimental group. Consistent with hypotheses, experimental group used more negative emotion words [F(1, 53) = 77.55, p < .001] and cognition-related words than control group [F(1, 53) = 19.09, p < .001] and an increase in cognition words predicted Physical Health Summary Score on SF-36 (standardized = .37, p < .05). A decrease in negative emotion words was related to Physical Health Summary Score on SF-36 only when entered into regression with change in cognition words (standardized = –.31, p < .05). A decrease in negative emotion together with an increase in cognitive processing facilitated by written emotional disclosure has beneficial effects on physical health-related quality of life.     

Enhancing the effects of extinction on attention-maintained behavior through noncontingent delivery of attention or stimuli identified via a competing stimulus assessment

Recent research has shown that the noncontingent delivery of competing stimuli can effectively reduce rates of destructive behavior maintained by social-positive reinforcement, even when the contingency for destructive behavior remains intact. It may be useful, therefore, to have a systematic means for predicting which reinforcers do and do not compete successfully with the reinforcer that is maintaining destructive behavior. In the present study, we conducted a brief competing stimulus assessment in which noncontingent access to a variety of tangible stimuli (one toy per trial) was superimposed on a fixed-ratio 1 schedule of attention for destructive behavior for individuals whose behavior was found to be reinforced by attention during a functional analysis. Tangible stimuli that resulted in the lowest rates of destructive behavior and highest percentages of engagement during the competing stimulus assessment were subsequently used in a noncontingent tangible items plus extinction treatment package and were compared to noncontingent attention plus extinction and extinction alone. Results indicated that both treatments resulted in greater reductions in the target behavior than did extinction alone and suggested that the competing stimulus assessment may be helpful in predicting stimuli that can enhance the effects of extinction when noncontingent attention is unavailable. DESCRIPTORS: Attention-maintained problem behavior, competing stimuli, extinction, functional analysis, noncontingent reinforcement     

“Seeing Conversion Whole”: Testing a Model of Religious Conversion

Rambo (1993) theorized that religious conversion consists of a process involving seven dimensions, labeled context, crisis, quest, encounter, interaction, commitment, and consequences. To test the Rambo model, a new measure, the 97-item Adult Religious Conversion Experiences Questionnaire (ARCEQ), was developed, revised on the basis of feedback from a focus group, and administered by mail to 110 adult volunteers who self-identified as having experienced conversion. Reliability analysis of the subscales of the ARCEQ resulted in five (crisis, quest, encounter, commitment, and consequences) meeting the criterion ( > .80). A sixth (interaction) achieved a reliability of .76 and was retained, but the seventh (context) was dropped. Principal components factor analysis with Varimax rotation produced factors labeled Redemptive Love, Zealous Dedication, Dysphoric Need, Openness to Uncertainty, Extrinsic Crisis, and Experiential Learning, which could readily be interpreted in relation to Rambo's model. Subsidiary analyses showed a number of significant correlations between demographic characteristics of the sample and differences in religious conversion experience.     

Changes in values cognition after rating values-associated feelings

This study investigated values change as an outcome of assessing feelings elicited by contemplating the actualization of the same values. The subjects were divided into an experimental and a control group. They completed three tests in a single session. In the pretest, all subjects were asked to rate the importance of 20 values items on a 4-point scale. Subjects in the experimental group were then asked to rate the degree of pleasure they would feel in actualizing each of the values, while those in the control group rated the degree of inequality they considered women suffer in the actualization of each of the values. The post-test consisted of the same items as the pretest. The subjects in the experimental group completed a second post-test 3 months later. It was found that the experimental procedure produced significant change in the ratings of 15 values at the post-test, whereas the control procedure produced change in only five. The results suggest that rating one's emotional response to a value-related situation can change one's cognition of that value. At the post-test 3 months later, only 3-value ratings remained changed.