Patients' information needs and decision-making processes: what can be learned from genetic counselees?

This field study investigated the information needs and decision-making strategies of 161 genetic counselees interviewed just prior to counseling. Patients were interested mostly in information about the outcomes and consequences of the alternative options at their disposal and about measures to defuse the risks. They wanted mainly information stated with certainty and were less interested in probability information. There was no difference in the search for information between the alternative eventually chosen and the one not chosen. There was a difference, however, among types of decisions and the interest in the various categories of information. These findings were interpreted within the theoretical model of decision making in natural risky situations (O. Huber, 1997). Practical implications for shared medical decision making are presented.     

Detection errors in a task with articulatory suppression: Phonological receding and reading

In two experiments, subjects read passages of text and circled instances of a target letter under normal conditions or while engaged in articulatory suppression. In Experiment 1, subjects searching for the letter e made a disproportionately large number of errors on the word “the” and more errors when e occurred in unstressed than in stressed syllables of three-syllable words. In Experiment 2, subjects searching for the letter f made an exceedingly large number of errors on the word “of.” Articulatory suppression significantly reduced the stress effect in the three-syllable words but did not reduce the tendency to make errors on “the” or “of,” suggesting that phonological recoding is responsible for this effect of stress but does not influence the unitization processes of reading.     

Behavioral effects of sucrose on preschool children

Despite speculation that sucrose consumption affects behavior, little empirical information is available. Accordingly, this study investigated the effect of sucrose consumption on the behavior of eight preschool children. Children were tested individually using a double-blind, crossover design. On separate mornings each child received 6 ounces of juice, sweetened on one morning with sucrose and on the other with an artificial sweetener. Children were observed for 90 minutes following the drinks, alternating between 15-minute sessions of work on structured tasks and 15-minute sessions of free play. Following the sucrose drink the children showed a decrement in performance in the structured testing situation, and they demonstrated more inappropriate behavior during free play. These differences in behavior were most pronounced approximately 45 to 60 minutes after the drinks. Thus, the study provides objective evidence in young children of a rather subtle, yet significant, time-dependent behavior effect of sucrose ingestion.This research was funded in part by grants from the General Research Grants Committee, University Hospital, Boston University Medical Center, and from the University of Connecticut Research Foundation. The project was conducted at the Clinical Research Center, Massachusetts Institute of Technology (National Institute of Health/General Clinical Research Center Grant 5M01-RR00088-20). We would like to express our appreciation to the many staff members of the Clinical Research Center for their extensive cooperation in helping us to plan and carry out this study, and to the director and staff of Technology Children's Center for their assistance in helping us to reach interested families. We also would like to thank the parents and children who participated in the study. Portions of this paper were presented at the annual meeting of the American Psychological Association, Toronto, August 1984.     

The effects of progressive relaxation on stress and diabetic control

Four insulin-requiring diabetic Ss were followed in single-S designs to measure the impact of progressive muscle relaxation training on blood glucose and stress levels. Measures of blood glucose, stress, activity and caloric intake were taken four times a day, along with a daily measure of anxiety. Two of the 4 Ss showed a significant decrease in blood glucose during treatment periods as compared to baseline measures. Similarly, 2 of the 4 Ss showed a significant decrease in stress levels during treatment. A multiple regression analysis revealed some significant relationships between blood glucose, stress, activity level and caloric intake. The results support previous studies that show relaxation techniques to be a viable aid in establishing greater diabetic control.     

Information and Counseling: A Dilemma

The revolutionary changes in data processing, and the resulting increases in the quantity and quality of information about counselees and their prospective environments, will make the work of the counselor more difficult in several ways. The one problem that is highlighted is the difficulty of maintaining a true counseling process and relationship while at the same time collecting necessary information about the client and about the environments regarding which he must make decisions. 2 solutions and their relative merits are discussed, one involving separation of the information and counseling functions, and the other requiring an integration of the functions by a single counselor.     

Mediating Effects of Perceived Personal Control in Coping With a Health Threat: The Case of Genetic Counseling1

The potential impact of perceived personal control on coping with a medical threat was investigated in genetic counseling, a clinical setting where issues of personal control are central. Data were collected from 72 counselees at a genetic clinic before, immediately after, and 1 month after initiating genetic counseling. Findings supported the hypothesized mediating model. Higher perceived control (cognitive-interpretive and decisional) and satisfaction with genetic counseling mediated between genetic counseling and the use of less emotion-focused coping strategies. Problem-focused coping was predicted only directly by counselees' knowledge of their problem after genetic counseling. Changes in emotion-focused coping were related to perceived increases in positive affect 1 month later, while changes in use of problem-focused coping were related to perceived decreases in both positive and negative affect.     

Factors Affecting the Career Aspirations of Asian Americans

The authors compared the career considerations of a group of Asian American college students (52 men and 72 women) with a comparison group of Caucasian students (95 men and 151 women) using an Occupations List. The results revealed that Asian American students were more likely to have considered Investigative occupations and less likely to have considered Enterprising and Conventional occupations than were the Caucasian students. There were also differences in the career considerations of the two racial groups in terms of the prestige level and gender traditionality of the occupations. The implications of the findings for theory and practice are discussed.     

Lifelong Mild Bad Feelings: A Review and Solution to a Psychotherapeutic Enigma

A review indicates that (a) comparatively little is known about the common phenomenon of lifelong mild bad feelings, and (b) psychotherapy has generally overlooked an effective focus on this enigmatic feeling state. As an invitation for clinicians to provide more attention to this feeling state, a proposal is suggested toward one way of freeing a patient of lifelong mild bad feelings in the course of a session.