Acceptance of Genetic Counseling and Testing in a Hospital-Based Series of Patients with Gynecological Cancer

Referral of patients with endometrial (EC) and/or ovarian cancer (OC) for genetic counseling is based on age at diagnosis and family history. Many patients with hereditary cancers are missed by following this strategy. We determined acceptance and mutation detection rate of offering genetic counseling and testing to unselected EC and OC patients. Therefore, in 2007, EC and OC patients were invited for genetic counseling and testing. Patients were asked for their reasons to accept or decline. Nineteen out of fifty-two EC patients (36 %) and twenty-two out of thirty-five OC patients (63 %) accepted genetic counseling, mainly to receive risk assessment for themselves and relatives. Counseling was declined mainly because patients did not want more tests or had no relatives for whom it was relevant. Eighteen out of nineteen EC patients (95 %) and twenty out of twenty-two OC patients (91 %) underwent genetic testing. One EC patient carried an MSH6 mutation (mutation detection rate: 6 %). BRCA1/2 mutations were found in two out of twenty OC patients (10 %). Eleven patients (29 %) received surveillance recommendations for themselves and their relatives. Finally, family history recorded by the gynecologist was compared to that taken by the clinical geneticist. Gynecologists reported family history in ten out of forty-one participants (24 %). In conclusion, genetic counseling and testing are acceptable to patients with OC and/or EC. The 10 % BRCA1/2 mutation detection rate and underreporting of family history by gynecologists warrant referral for genetic counseling for all OC patients, followed by BRCA1/2 testing if indicated. We recommend that microsatellite instability and immunohistochemical analysis be performed in all EC patients, followed by genetic counseling if appropriate. These strategies will lead to better cancer prevention in gynecological cancer patients and their relatives.     

Counselees’ Expressed Level of Understanding of the Risk Estimate and Surveillance Recommendation are Not Associated with Breast Cancer Surveillance Adherence

We studied counselees’ expressed understanding of the risk estimate and surveillance recommendation in the final consultation for breast cancer genetic counseling in relation with their risk perception, worry and cancer surveillance adherence 1 year post-counseling. Consecutive counselees were included from 2008 to 2010. Counselees with an indication for diagnostic DNA-testing for themselves or a breast cancer affected relative were requested to complete online questionnaires before and after counseling and one year after counseling (N?=?152–124). Self-reported surveillance was compared to surveillance recommendations. Consultations were videotaped. Counselees’ reactions to the risks and recommendations were coded. Statements about the risk perception and surveillance intentions of breast cancer unaffected counselees were transcribed. Associations with outcomes were explored. Almost all breast cancer unaffected counselees (>90 %) reacted to their risk estimate with an utterance indicating understanding and this reaction was not significantly associated with their post-visit risk perception alignment. Over one-third (38.6 %) overestimated their risk post-counseling. Few counselees (5.8 %) expressed surveillance intentions. One year after counseling, about three-quarters (74.0 %) of the breast cancer unaffected counselees had adhered to the surveillance recommendation. Almost one-quarter (23.3 %) had performed more mammograms/MRI scans than recommended, which was associated with prior mammography uptake (n?=?47; X ² ?=?5.2; p?=?.02). Counselees’ post-counseling overestimation of their risk, high levels of worry and high surveillance uptake were not reflected in their reactions to the counselor’s information during the final visit.     

The effect of linguistic abstraction on interpersonal distance

It is well known that people describe positive behaviors of others close to them (e.g., in‐group member, friend) in abstract terms, but with concrete terms in the case of people who they are not close to (e.g., out‐group member, enemy). In contrast, negative behaviors of people who we are close to are described in concrete terms, but in abstract terms for people who are distant. However, the communicative impact of such subtle differences in language use on a receiver who is also the actor of the behavior being described has never been addressed. We hypothesized and found that a positive abstract message compared to a positive concrete message leads to perceived proximity to the sender, while a negative abstract message compared to a negative concrete message leads to perceived distance. The implications of this study, which is the first to show the communicative impact of biased language use, are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

I’ll Never Forgive You: High Conflict Divorce,Social Network,and Co-Parenting Conflicts

The relation between divorce, co-parenting conflicts, and children’s adjustment problems has been well established. An unresolved question for research and clinical interventions, however, is how conflicts between parents are maintained and/or escalate. This cross-sectional research tested the hypothesis that co-parenting conflicts in divorced couples are associated with perceived social network disapproval and that this relation is mediated by parents’ tendency to forgive each other. In Study 1, a convenience sample of 136 divorced parents recruited via online forums, we showed that perceived social network disapproval was indeed positively related to co-parenting conflicts and that parents’ tendency to forgive the other parent—albeit partly—explained this relationship. Strength of our research is that in Study 2, 110 parents referred to children’s mental health care because the wellbeing of the children was severely compromised by the severity of the conflicts between parents, we replicated these results. In both studies perceived social network disapproval and co-parenting conflicts were positively related and this link was mediated by forgiveness: perceived social network disapproval was negatively related to forgiveness, which in turn was negatively related to more parental conflicts.     

Development of E-Info Geneca: A Website Providing Computer-Tailored Information and Question Prompt Prior to Breast Cancer Genetic Counseling

This article describes the stepwise development of the website ‘E-info gene^ca’. The website provides counselees in breast cancer genetic counseling with computer-tailored information and a question prompt prior to their first consultation. Counselees generally do not know what to expect from genetic counseling and they tend to have a passive role, receiving large amounts of relatively standard information. Using the “intervention mapping approach,” we developed E-info gene^ca aiming to enhance counselees’ realistic expectations and participation during genetic counseling. The information on this website is tailored to counselees’ individual situation (e.g., the counselee’s age and cancer history). The website covers the topics of the genetic counseling process, breast cancer risk, meaning of being a carrier of a cancer gene mutation, emotional consequences and hereditary breast cancer. Finally, a question prompt encourages counselees to prepare questions for their genetic counseling visit.     

Interpersonal referential communication experiments with a small computer

A LINC-8 computer is used with a Tektronix 611 CRT for presenting verbal information, and a slide projector for displaying facial photographs in studies of interpersonal referential communication.     

Illness perceptions and coping explain well-being in patients with Huntington's disease

This study sought to investigate the contribution of illness perceptions and coping mechanisms to the explanation of well-being of patients with Huntington's disease (HD). We investigated the Leventhal et al. assumption of the Self-regulation Model that coping mediates the relationship between illness perceptions and patients’ well-being. Illness perceptions, coping, and well-being in 77 HD patients were assessed with validated questionnaires; motor performance and cognitive performance were assessed with Huntington's disease-specific measures. The assumption that illness perceptions influence HD patients’ well-being via coping was not supported. The results indicate that both coping and illness perceptions made a major contribution to the explanation of variance in HD patients’ psychosocial well-being. Variance in their physical well-being was explained by illness perceptions mainly. The need to conduct further research on the interrelationships between illness perceptions, coping, and well-being in this patient category is discussed.     

The dot-probe task to measure emotional attention: A suitable measure in comparative studies?

For social animals, attending to and recognizing the emotional expressions of other individuals is of crucial importance for their survival and likely has a deep evolutionary origin. Gaining insight into how emotional expressions evolved as adaptations over the course of evolution can be achieved by making direct cross-species comparisons. To that extent, experimental paradigms that are suitable for investigating emotional processing across species need to be developed and evaluated. The emotional dot-probe task, which measures attention allocation toward emotional stimuli, has this potential. The task is implicit, and subjects need minimal training to perform the task successfully. Findings in nonhuman primates, although scarce, show that they, like humans, have an attentional bias toward emotional stimuli. However, the wide literature on human studies has shown that different factors can have important moderating effects on the results. Due to the large heterogeneity of this literature, these moderating effects often remain unnoticed. We here review this literature and show that subject characteristics and differences in experimental designs affect the results of the dot-probe task. We conclude with specific recommendations regarding these issues that are particularly relevant to take into consideration when applying this paradigm to study animals.     

Do They Know How Happy They Are? On the Value of Self-Rated Happiness of People With a Mental Disorder

Quality of life is often measured using questions about happiness. This method presumes that respondents are able to judge their life. Research suggest that this is typically the case, but this is not to say that everybody can. In that context one may doubt whether people with a mental disorder can judge their life adequately. Happiness can be rejected as a indicator for quality of life for people with mental disorders, because of affective and cognitive distortions. We therefore checked the validity of happiness and satisfaction measures in the context of mental disorders. Psychiatric diagnoses were determined at baseline and at 12 and 36 months follow-up in a representative sample (N = 7,076) of the Dutch population, using a full Composite International Diagnostic Interview. Respondents indicated how often they had felt happy during the past month and how satisfied they were with their lives in general. The measurements have a satisfactory concurrent, ecological and predictive validity for people with mental disorders. Though the level of happiness is lower among the people with mental disorders, conditions for happiness and contentment appear to be similar.     

Relations of Neuroticism and Attentional Control with Symptoms of Anxiety and Aggression in Non-Clinical Children

The present study examined the associations between neuroticism and attentional control and the occurrence of symptoms of psychopathology in children. A large sample of non-clinical children aged 9 to 17 years (N = 409) completed questionnaires measuring neuroticism, attentional control, and symptoms of anxiety and aggression. Results demonstrated that neuroticism was positively associated with symptoms of anxiety and aggression, whereas attentional control was negatively linked to such symptoms. Regression analyses showed that both neuroticism and attentional control accounted for an independent and significant proportion of the variance in children’s anxiety and aggression symptoms. Further, tentative support was found for the notion that neuroticism and attentional control have an interactive effect on symptoms of anxiety and aggression. Results did not show that age had an influence on the emergence of this interaction.