Racial and Ethnic Differences in Direct-to-Consumer Genetic Tests Awareness in HINTS 2007: Sociodemographic and Numeracy Correlates

To examine the association of 1) race/ethnicity and 2) numeracy with awareness of DTC genetic tests. Secondary analysis of 6,754 Hispanic, black, and white adult respondents to the National Cancer Institute’s 2007 Health Information National Trends Survey (HINTS). Logistic regression was used to examine sociodemographic predictors of DTC genetic tests awareness including race/ethnicity, income, education, and gender. Next, two numeracy variables were added to the model. After controlling for sociodemographic variables, black respondents were significantly less likely to have heard of DTC genetic tests compared to white respondents (OR = 0.79; CI: 0.65–0.97). When numeracy variables were added to the model, the effect of black race was no longer significant (OR = 0.84; CI: 0.69–1.04). Hispanic respondents did not significantly differ from white respondents in awareness of DTC genetic tests. Other significant correlates of DTC genetic tests awareness in the full model included education, income, age, and numeracy variables including degree to which people use medical statistics and numbers to make health decisions, and preference for words or numbers when discussing “the chance of something happening.” Although black respondents were generally less aware of DTC genetic tests than white respondents, this relationship appears to be partially mediated by numeracy.     

A Unified Empirical Account of Responsibility Judgments*

Skeptical worries about moral responsibility seem to be widely appreciated and deeply felt. To address these worries—if nothing else to show that they are mistaken—theories of moral responsibility need to relate to whatever concept of responsibility underlies the worries. Unfortunately, the nature of that concept has proved hard to pin down. Not only do philosophers have conflicting intuitions; numerous recent empirical studies have suggested that both prosaic responsibility judgments and incompatibilist intuitions among the folk are influenced by a number of surprising factors, sometimes prompting apparently contradictory judgments. In this paper, we show how an independently motivated hypothesis about responsibility judgments provides a unified explanation of the more important results from these studies. According to this ‘Explanation Hypothesis’, to take an agent to be morally responsible for an event is to take a relevant motivational structure of the agent to be part of a significant explanation of the event. We argue that because of how explanatory interests and perspectives affect what we take as significant explanations, this analysis accounts for the puzzling variety of empirical results. If this is correct, the Explanation Hypothesis also provides a new way of understanding debates about moral responsibility.     

Is there an optimal factor structure of the Positive and Negative Syndrome Scale in patients with first‐episode psychosis?

The Positive and Negative Syndrome Scale (PANSS) is the most widely used scale to assess a variety of symptoms in patients with schizophrenia and other psychoses. The factor structure of the PANSS has been examined with confirmatory factor analyses in several studies, but not in a well‐defined first‐episode psychosis sample. The aim of this paper is to examine the statistical fit of five different PANSS models in a first‐episode, non‐affective psychosis sample. Confirmatory factor analyses were performed on PANSS data (n = 588). A main criterion for best fit was defined as the Expected Cross Validation Index (ECVI). No tested model revealed an optimally satisfactory model fit index. The Wallwork/Fortgang five‐factor model demonstrated the most optimal psychometric properties. The corresponding subscales of all evaluated five‐factor models were strongly intercorrelated. The Wallwork/Fortgang five‐factor model was found to be statistically and clinically ideal among patients with first‐episode psychosis. Therefore, we recommend this model in forthcoming studies among patients with first‐episode psychosis. However, to prevent the loss of clinically valuable information on an item level, we do not recommend removing any items from the original form. Our study also implies that the specific choice of model will not have a substantial effect on outcome results in studies on the course and outcome in first‐episode psychosis.     

Gender differences on the Five to Fifteen questionnaire in a non‐referred sample with inattention and hyperactivity‐impulsivity and a clinic‐referred sample with hyperkinetic disorder

Lambek, R., Trillingsgaard, A., Kadesjö, B., Damm, D. & Thomsen, P. H. (2010). Gender differences on the Five to Fifteen questionnaire in a non‐referred sample with inattention and hyperactivity‐impulsivity and a clinic‐referred sample with hyperkinetic disorder. Scandinavian Journal of Psychology 51, 540–447. The aim of the present study was to examine gender differences in children with inattention, hyperactivity, and impulsivity on the Five to Fifteen (FTF) parent questionnaire. First, non‐referred girls (n = 43) and boys (n = 51) with problems of attention and hyperactivity‐impulsivity and then clinic‐referred girls (n = 35) and boys (n = 66) with hyperkinetic disorder (HKD) were compared on the FTF. Results suggested that non‐referred boys were more hyperactive‐impulsive than non‐referred girls, whereas clinic‐referred boys and girl with HKD were more similar than dissimilar on the FTF questionnaire. Secondly, it was examined whether the application of gender mixed norms versus gender specific norms would result in varying proportions of clinic‐referred children with HKD being identified as impaired on the subdomains of the FTF questionnaire. Based on results it was concluded that the use of a gender mixed normative sample may lead to overestimation of impairment in boys with HKD, but the type of sample applied to define impairment on the FTF should depend on the purpose for applying the questionnaire.     

Effect of low dose ionizing radiation exposure in utero on cognitive function in adolescence

Heiervang, K. S., Mednick, S., Sundet, K. & Rund, B. R. (2010). Effect of low dose ionizing radiation exposure in utero on cognitive function in adolescence. Scandinavian Journal of Psychology, 51, 210–215. Radiation from the Chernobyl nuclear power plant meltdown greatly affected several Norwegian counties. The cognitive consequences of in utero exposure to radiation from the Chernobyl accident have been intensely debated. This study examines the cognitive outcomes for those Norwegians who were exposed as fetuses to the fallout from Chernobyl. The participants, 84 adolescents who were exposed in utero to radiation from the most contaminated areas in Norway and 94 adolescents from areas not contaminated by the radiation, were tested on verbal and nonverbal IQ. Two data analyses were conducted. First, using a control‐group design, the IQ scores of exposed and unexposed adolescents were compared. Second, in a timing‐of‐exposure design, those exposed during the most sensitive period were contrasted with those exposed later in gestation. Adolescents exposed to low‐dose ionizing radiation in utero scored significantly lower in full‐scale IQ than unexposed adolescents. The difference was restricted to verbal IQ and was not evident for nonverbal IQ. The effect was not observed in exposed adolescents who had passed the most sensitive gestational period prior to the accident and thus were exposed to the radiation from Chernobyl exclusively after gestational week 16. These participants performed as well as the controls. Although the results should be interpreted cautiously due to the study’s nonrandomized design, the data add new and important support to the hypothesis that the Chernobyl accident may have had a subtle effect on the cognitive functioning of those exposed to low‐dose ionizing radiation in utero during the most sensitive gestational period.     

Attributions for ambiguity in a treatment-decision context can create ambiguity aversion or seeking

The phenomenon of ambiguity aversion suggests that people prefer options that offer precisely rather than imprecisely known chances of success. However, past work on people's responses to ambiguity in health treatment contexts found ambiguity seeking rather than aversion. The present work addressed whether such findings reflected a broad tendency for ambiguity seeking in health treatment contexts or whether specific attributions for ambiguity play a substantial role. In three studies, people choose between two treatment options that involved similar underlying probabilities, except that the probabilities for one option involved ambiguity. The attributions offered for the ambiguity played an important role in the results. For example, when the range of probabilities associated with an ambiguous treatment was attributed to the fact that different studies yield different results, participants tended to show ambiguity aversion or indifference. However, when the range was attributed to something that participants could control (e.g., regular application of a cream) or something about which they were overoptimistic (e.g., their immune system function), participants tended to show ambiguity seeking. Health professionals should be mindful of how people will interpret and use information about ambiguity when choosing among treatments.     

The neural basis of updating: Distinguishing substitution processes from other concurrent processes

Sörqvist, P. & Sætrevik, B. (2010). The neural basis of updating: Distinguishing substitution processes from other concurrent processes. Scandinavian Journal of Psychology, 51, 357–362. Most previous studies of updating processes have not been able to contrast processes of substituting items in memory with other concurrent processes. In the present investigation, we used a new task called “number updating” and an fMRI protocol to contrast the activation of trials that require item substitution (adding a new item to the working memory representation and suppressing an old item) with trials that involve no substitution (discarding the new item). Trials that require item substitution activated the dorsolateral prefrontal cortex, the posterior medial frontal cortex and the parietal lobes, areas typically seen activated for working memory tasks in general. Trials that do not require substitution activated the anterior medial frontal cortex. Studies examining executive functions have associated this area with cognitive conflict, and may represent suppression of the substitution processes.     

The role of the affect heuristic and cancer anxiety in responding to negative information about medical tests

Objective: Little is known about the affective implications of communicating negative information about medical tests. This research explored how affective processes – particularly the Affect Heuristic and cancer anxiety – influence the way in which people respond to such information.

Design: Participants received different types of information about PSA screening for prostate cancer and magnetic resonance imaging (MRI) scans for migraine headaches. This was a 2 (Test harm information: present vs. absent) × 2 (Test benefit information: present vs. absent) × 2 (Test recommendation: present vs. absent) between-participants design.

Outcome Measures: Perceived risk, perceived benefit and general attitudes towards PSA and MRI testing, cancer anxiety, preferences to receive the tests vs. not.

Results: As predicted by the Affect Heuristic, test harm information reduced perceived test benefits. However, information about uncertain test benefit did not increase perceived test risks. Information about the test reduced cancer anxiety, indicating defensive coping. These variables – affect, anxiety, perceived risks and benefits – all uniquely predicted test preferences.

Conclusion: Affective processes play an important role in how people respond to and interpret negative information about medical tests. Information about harms and information about the lack of benefit can both make a test seem less beneficial, and will reduce cancer anxiety as a result.     

Considering adaptation in preference elicitations

OBJECTIVE: Patients with chronic health conditions usually place higher utility on their condition than the public does. One explanation for this discrepancy is that healthy people focus on the negative aspects of the condition without considering their own ability to emotionally adapt to the condition over time. The aim of this randomized experimental study was to test whether people would give higher utility ratings for chronic health conditions when they were encouraged to consider their own ability to adapt to difficult situations before giving their ratings. MAIN OUTCOME MEASURE: Utility ratings for four chronic health conditions. RESULTS: The authors presented scenarios describing 4 chronic health conditions to 1,117 respondents drawn from a demographically balanced U.S. Internet panel. The adaptation exercise did not influence respondents' valuations. However, utility values increasingly improved with decreasing ratings of how upsetting it would be to live with the condition over time. CONCLUSION: The authors speculate that asking people to think about adaptation changes their evaluations of what it would feel like to live with chronic illness, but doing so does not change how much they are willing to trade off to avoid that chronic illness.