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.     

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.     

Autonomous work group selection

The history of selecting office employees and autonomous work group employees is discussed. This study demonstrates the implementation of autonomous work group procedures with office/clerical employees. A selection model is developed advocating the use of skill, personality, and cognitive-based tests.     

Team effectiveness: beyond skills and cognitive ability.

On the basis of job analysis results, the validity of using measures of general cognitive ability, job-specific skills, and personality traits jointly at both the individual level and the group level to predict the performance of 79 four-person, human resource work teams was evaluated. Team member trait and job skill scores were aggregated with a conjunctive model of task performance. At the individual level of analysis, measures of personality (i.e., Agreeableness and Conscientiousness) predicted peer ratings of team member performance beyond measures of job-specific skills and general cognitive ability. Similarly, at the group level of analysis, both Agreeableness and Conscientiousness predicted supervisor ratings of work team performance, objective measures of work team accuracy, and work completed. At both the individual and group levels, the trait of Agreeableness predicted Interpersonal Skills.     

Modelling decisions to undergo genetic testing for susceptibility to common health conditions: an ancillary study of the Multiplex Initiative

New genetic tests reveal risks for multiple conditions simultaneously, although little is understood about the psychological factors that affect testing uptake. We assessed a conceptual model called the multiplex genetic testing model (MGTM) using structural equation modelling. The MGTM delineates worry, perceived severity, perceived risk, response efficacy and attitudes towards testing as predictors of intentions and behaviour. Participants were 270 healthy insured adults aged 25-40 from the Multiplex Initiative conducted within a health care system in Detroit, MI, USA. Participants were offered a genetic test that assessed risk for eight common health conditions. Confirmatory factor analysis revealed that worry, perceived risk and severity clustered into two disease domains: cancer or metabolic conditions. Only perceived severity of metabolic conditions was correlated with general response efficacy (β?=?0.13, p<0.05), which predicted general attitudes towards testing (β?=?0.24, p<0.01). Consistent with our hypothesised model, attitudes towards testing were the strongest predictors of intentions to undergo testing (β?=?0.49, p<0.01), which in turn predicted testing uptake (OR 17.7, β?=?0.97, p<0.01). The MGTM explained a striking 48% of the variance in intentions and 94% of the variation in uptake. These findings support use of the MGTM to explain psychological predictors of testing for multiple health conditions.     

The Role of Spiritual Experiences and Activities in the Relationship Between Chronic Illness and Psychological Well-Being

Our research explores the correlates of spiritual experiences over a 2-year period in a sample of older adults (N = 164; mean age 81.9 years) living in a continuing care retirement community. Utilizing responses to the Daily Spiritual Experiences Scale, scores were analyzed for changes over time and for their hypothesized moderating effect in the relationship between chronic illness impact and markers of psychological well-being (as measured by the Geriatric Depression and Life Satisfaction scales). Repeated measures ANOVA indicated a significant decline (P < .01) in the reported spiritual experiences over a 2-year period of time, and t tests showed a significant difference by gender (P < .01) in years 1 and 2, with women reporting higher levels of spiritual experiences than men. Analyses found low spirituality scores associated with low life satisfaction in all years (baseline: r = ?.288, P < .01; year 1: r = ?.209, P < .05; year 2: r = ?.330, P < .001). Only weak associations were detected between low spirituality and the presence of depressive symptoms at baseline (r = .186, P < .05) and year 2 (r = .254, P < .01). Moderation effects of spirituality on the relationship between chronic illness impact and markers of psychological well-being were explored in all years, with a statistically significant effect found only for the presence of depressive symptoms in year 2. Higher impact of chronic illnesses is associated with more depressive symptoms under conditions of low spirituality. Future research may center upon longer-duration evaluation of reliance upon spiritual practices and their impact in care management models.     

Personality,socio-economic status and education: factors that contribute to the degree of structure in homeschooling

Homeschooling has been expanding in many countries in the western world, especially in the United States and in England. Studies have shown that there are different types of homeschooling, with different influences on the outcome of the educational process. However, the research to date has ignored the effects of parents’ personality and background on the practice of homeschooling, despite extensive evidence of the important role of these factors in shaping the educational orientation of parents. The present study focused on the impact of different aspects of parents’ personality and socioeconomic status on the type of homeschooling they chose. The findings indicated, among other things, that mother’s education correlated positively with more structured homeschooling, and family income and conscientiousness both correlated positively with more structure in daily routine and in homeschooling.     

Pre-existing Background Knowledge Influences Socioeconomic Differences in Preschoolers’ Word Learning and Comprehension

The goal of the current study is to explore the influence of knowledge on socioeconomic discrepancies in word learning and comprehension. After establishing socioeconomic differences in background knowledge (Study 1), the authors presented children with a storybook that incorporates this knowledge (Study 2). Results indicated that middle-income children learned significantly more words and comprehended the story better than lower-income children. By contrast, Study 3 presented children with a novel category and found that children performed equally in their word learning and comprehension. This suggests that socioeconomic differences in vocabulary and comprehension skills may be partially explained by differences in extant knowledge.     

Parenting of 7‐month‐old infants at familial risk for attention deficit/hyperactivity disorder

Patterns of interaction between parents and 7‐month‐old boys at familial risk for attention deficit/hyperactivity disorder (ADHD) and a comparison group were studied during a warm‐up and two play episodes. The sample included 78 (47 at‐risk, 31 comparison) mother–child and 45 (27 at‐risk, 18 comparison) father–child dyads. A coding system developed by G. Kochanska (1997, 1998) was used. Infants in the risk group did not differ from the comparison group in the rate of emission of infant‐related events. However, they received less adequate responsivity from both their fathers and their mothers to these events, and specifically to negative emotions or distress, than did the comparison group. Maternal psychopathology did not account for these findings. Mothers were more adequately responsive than were fathers, especially for physiological needs. The association between nonoptimal interaction in infancy and the development of ADHD is discussed.