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.     

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.     

Interaction of cognitive and sensorimotor maps of visual space

Studies of saccadic suppression and induced motion have suggested separate representations of visual space for perception and visually guided behavior. Because these methods required stimulus motion, subjects might have confounded motion and position. We separated cognitive and sensorimotor maps without motion of target, background, or eye, with an “induced Roelofs effect”: a target inside an off-center frame appears biased opposite the direction of the frame. A frame displayed to the left of a subject’s center line, for example, will make a target inside the frame appear farther to the right than its actual position. The effect always influences perception, but in half of our subjects it did not influence pointing. Cognitive and sensorimotor maps interacted when the motor response was delayed; all subjects now showed a Roelofs effect for pointing, suggesting that the motor system was being fed from the biased cognitive map. A second experiment showed similar results when subjects made an open-ended cognitive response instead of a five-alternative forced choice. Experiment 3 showed that the results were not due to shifts in subjects’ perception of the felt straight-ahead position. In Experiment 4, subjects pointed to the target and judged its location on the same trial. Both measures showed a Roelofs effect, indicating that each trial was treated as a single event and that the cognitive representation was accessed to localize this event in both response modes.     

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.     

Counselling the HIV ‘affected’ individual: A case study

The literature on HIV disease has largely centred on the virus' biological, psychological and social impact on the infected individual. There is, however, an increasing recognition of the impact of this virus and the extent to which it reaches beyond the infected person and affects partners, families, fiend and carers. This focus, from a family systems perspective, on the impact of illness (Rolland, 1994) and death (Walsh & McGoldrick, 1991), attempts to give attention to both the immediate and long tern effects on nuclear and extended family members, whilst the work of Bor, Miller & Goldman (1992) specifically offers a family systems approach to psychotherapy for people affected by HIV. The following case is an illustration of the complex and challenging issues encountered in working with an affected family member and the way in which “a range of feelings depending on the unique meaning of the releationship and its loss for each member and the implications of the death for the family unit” is experienced (Walsh & McGoldrick, 1991).     

Sensation seeking, augmenting-reducing, and absolute auditory threshold: a strength-of-the-nervous-system perspective

The following measures were obtained from 42 student volunteers: the General and the Disinhibition subscales of the Sensation Seeking Scale (Form IV), the Reducer-Augmenter Scale, and the Absolute Auditory Threshold. General sensation seeking correlated significantly with the Reducer-Augmenter Scale, r(40) = .59, p less than .001, and the Absolute Auditory Threshold, r(40) = .45, p less than .005. Both results proved general across sex. These findings, that high-sensation seekers tend to be reducers and to lack sensitivity to weak stimulation, were interpreted as supporting strength-of-the-nervous-system theory more than the formulation of Zuckerman and his associates.