Psychological aspects of genetic testing: Introduction to the special issue.

Research in molecular genetics has led to the identification of a growing number of disease-predisposing genes. With increasing commercial pressures and public interest in genetic testing, genetic tests are likely to become an integral part of routine medical care. Awareness of genetic risk can facilitate informed medical decision making and, in some cases, can promote risk reduction behaviors that have the potential to reduce morbidity and mortality. Despite these potential medical benefits, there are serious concerns about the psychosocial sequelae of an individual learning that he or she carries an elevated risk for disease. This special issue of Health Psychology is devoted to research that seeks to provide an empirical foundation for the understanding of the psychosocial aspects of genetic testing for disease predisposition. The introduction to the special issue provides a brief overview of patterns of inheritance and genetic testing. This overview is followed by a consideration of the unique features of genetic information that make it different from other types of health threats studied by health psychologists. Finally, this author summarizes the organization of the issue, highlighting key study findings and suggesting future directions for this new field of research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological testing and psychological assessment: A closer examination.

Comments on the G. J. Meyer et al (see record 2001-00159-003) summary of evidence and issues associated with psychological assessment. J. Hunsley states that Meyer et al failed to address two major issues at the very heart of psychological assessment practices in a consistent and sufficient manner: the crucial distinction between testing and assessment and the critical importance of incremental validity in both testing and assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological testing and the analytically trained child psychologist.

The author reviews some of the unique contributions that psychoanalytic theory brings to the testing of children and adolescents. Although demand for child evaluations has burgeoned in recent decades, the trend is toward atheoretical assessment; test findings are rarely linked to a coherent theory of personality and a developmental framework. The author delineates skills that analytically trained child psychologists bring to the testing situation, allowing them to place clinical observations and results within the context of the child's ongoing development and emerging sense of self. These include recognizing characteristic modes of thinking, relating, and fantasizing during different developmental phases; making meaningful use of transference and countertransference reactions; examining the quality of children's play and narratives; and using the feedback process to help parents contemplate their child's inner life. In conclusion, the author suggests that the testing tradition of Rappaport, Gil, and Schafer is highly relevant for contemporary child evaluation. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The real numbers: Psychological testing in custody evaluations.

A reanalysis of M. J. Ackerman and M. C. Ackerman's (1997) figures on the frequency of use of psychological tests with adults and children in custody evaluations was undertaken. The analysis revealed that, contrary to widely held opinion, nothing approaching a standard of practice for test use in custody evaluations exists other than an estimated 84% frequency of use of the Minnesota Multiphasic Personality Inventory in the assessment of adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic testing and psychology: New roles, new responsibilities.

Advances in genetics and genetic testing promise to catalyze a fundamental change in the practice of medicine. Psychologists have much to offer as psychotherapists, researchers, educators, and policymakers to a society heavily influenced by the genetic revolution. To make the most of new opportunities available to mental health professionals in genetics, psychologists must know basic genetic principles and learn what is new about 21st-century genetics. The core competencies for all health professionals developed by the National Coalition for Health Professional Education in Genetics are related in this article to the significant roles psychologists can play in helping individuals with genetic concerns to cope with vulnerability, optimize family interaction, and improve health behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological testing and the public service.

The author, Chairman of the Untied States Civil Service Commission, argues that the necessity to measure characteristics of people that are related to job performance is at the very root of the merit system, which is the basis for entry into the career services of the Federal Government. Thus, over the years, the public service has had a vital interest in the development and application of psychological testing methods. He has no doubt that the widespread public confidence in the objectivity of hiring procedures has in large part been nurtured by the public's perception of the fairness, the practicality, and the integrity of the appraisal methods they must submit to. Sound testing methods are absolutely essential if there is to be real meaning to the concept of equal opportunity. He is concerned, therefore, that the current outcry against the use of personality tests should not endanger this hard-won confidence, nor inhibit our use of tests in carrying out the vital personnel management programs of the President. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological testing and analyzability: Breathing new life into an old issue.

The construct of analyzability (i.e., selecting for psychoanalysis) has been with us for 101 years. It has been extensively discussed and extensively debated. Most recently, it has been proposed that the construct has expired, due to the shrinking pool of people interested in undergoing psychoanalysis and the expanding meaning of what psychoanalysis is. The present authors briefly summarize the life and near-death of the construct, and suggest resuscitation, but only with revamping. More specifically, we insist that thoughtful treatment planning is always essential for focus, safety, and effectiveness of any treatment, including psychoanalysis. If we transition to a paradigm of "mapping" the patient's structural strengths and weaknesses, via a particular approach to psychological testing outlined in this article, we pay respect to the unpredictable and complex array of shiftings, moment-to-moment, within the psychoanalytic relational encounter, and thereby offer the analyst a chance at foresight that is relevant, intelligent, and attuned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of coping style and BRCA1 and BRCA2 test results on anxiety among women participating in genetic counseling and testing for breast and ovarian cancer risk.

Using the monitoring process model (MPM), the authors examined the immediate effects of coping style and test results on the psychological distress of women at increased risk for breast and/or ovarian cancers. Cases selected for analysis were 107 probands and relatives of positive probands participating in genetic counseling and testing for heritable cancer risk. Specifically, the authors explored the relationships among coping style (high and low monitoring), test results (BRCA1 and BRCA2 mutation carrier and noncarrier status), and psychological distress (state anxiety). Consistent with the MPM, higher monitoring was associated with greater psychological distress while anticipating genetic test results. After test results were disclosed, greater distress was associated with testing positive for a mutation. The implications of the findings for breast and ovarian cancer patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Amplifying issues related to psychological testing and assessment.

Responds to comments by D. A. Smith (see record 2002-10716-011), H. N. Garb et al (see record 2002-10716-012), R. Fernández-Ballesteros (see record 2002-10716-013), J. Hunsley (see record 2002-10716-014) regarding the G. J. Meyer et al (see record 2001-00159-003) summary of evidence and issues associated with psychological assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The practice of psychological testing in clinical services in the United States.

Questionnaire responses were obtained from 185 (61% of 304 agencies including VA stations, state mental hospitals, institutions for mental defectives, outpatient clinics, and counseling centers. The median number of different tests was used 26; the range was from 5 to 8. The most frequently used tests are the Rorschach, Draw-A-Person (Machover), Thematic Apperception Test, Visual Motor Gestalt Test (Bender), Stanford-Binet, WAIS, and MMPI in that order. Comparisons are made of the 20 most used psychological tests in each of 3 decades. From Psyc Abstracts 36:02:2HA79S. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work of the APA Committee on Psychological Assessment in relation to public concern about testing.

Scientific and professional aspects of psychological assessment have both been recognized in the committee work of the American Psychological Association for many years. Ethical standards for the distribution and use of test devices were first published in the early 19SOs (APA, 19SO), and the original edition of "Technical Recommendations for Psychological Tests and Diagnostic Techniques" appeared in 19S4 (APA, 1954). In large measure, organizational concern with these issues was self-generated in response to an accurate perception on the part of psychologists that the rapidly growing application of tests would involve problems of standards and control. External pressures came later. An interesting literary tradition of anti-testing tracts has been developed over the past several years, but the writers involved have often been less interested in discussing ideas than in selling them. The really significant discussions of the role of psychological assessment in American society is, for the most part, very recent and has increasingly involved APA with the democratic process in its formal executive, legislative, and judicial aspects. The roles played by the Committee on Psychological Assessment, which was charged with responsibility for gathering information and making recommendations concerning the very broad area of practices and social consequences of psychological assessment, are detailed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving HIV rapid testing rates among STD clinic patients: A randomized controlled trial.

Objective: The Centers for Disease Control and Prevention recommends that HIV testing be a standard part of medical care; however, testing is voluntary and some patients decline. We evaluated 2 brief interventions to promote rapid HIV testing among STD clinic patients who initially declined testing. Method: Using a randomized controlled trial, patients either viewed an educational digital video disc (DVD) or participated in stage-based behavioral counseling (SBC) provided by a nurse. Sixty clients presenting for care at a STD clinic who initially declined HIV testing at registration and during risk behavior screening participated in the study. Results: The primary outcome was whether patients agreed to be tested for HIV. The secondary outcomes included attitudes, knowledge, and stage-of-change regarding HIV testing. Patients receiving both interventions improved their attitudes and knowledge about testing (ps     

Emotional distress following genetic testing for hereditary breast and ovarian cancer: A meta-analytic review.

Objective: Meta-analysis was used to synthesize results of studies on emotional consequences of predictive genetic testing for BRCA1/2 mutations conferring increased risk of breast and ovarian cancer. Design: Studies assessing anxiety or cancer-specific distress before and after provision of test results (k = 20) were analyzed using a random-effects model. Moderator variables included country of data collection and personal cancer history of study participants. Main Outcome Measures: Standardized mean gain effect sizes were calculated for mutation carriers, noncarriers, and those with inconclusive results over short (0–4 weeks), moderate (5–24 weeks), or long (25–52 weeks) periods of time after testing. Results: Distress among carriers increased shortly after receiving results and returned to pretesting levels over time. Distress among noncarriers and those with inconclusive results decreased over time. Some distress patterns differed in studies conducted outside the United States and for individuals with varying cancer histories. Conclusion: Results underscore the importance of time; changes in distress observed shortly after test-result disclosure frequently differed from the pattern of distress seen subsequently. Although emotional consequences of this testing appear minimal, it remains possible that testing may affect cognitive and behavioral outcomes, which have rarely been examined through meta-analysis. Testing may also affect understudied subgroups differently. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the teaching of psychological tests and testing.

The nature of undergraduate courses involving psychological testing "deserve close study and scrutiny, with a view to self-imposed discipline and improved standards, with respect both to the teaching of psychology as part of a liberal education and to the development of psychology to a high professional level." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On preserving a legacy: Psychoanalysis and psychological testing.

With changes in the structure of the Menninger Foundation and its relocation from Topeka, Kansas, to Houston, Texas, and the greater opportunity for psychologists to obtain full psychoanalytic training, interest among psychologists/psychoanalysts in psychological testing has waned. This, in my judgment, is unfortunate, because it raises the possibility that fewer psychoanalytically oriented psychologists will be aware of the work of Rapaport and his contributions to testing. Based on the conviction that Rapaport's legacy is worth preserving, especially at a time when several are calling for a firming up of the scientific basis of psychoanalysis, in this article I review Rapaport's contributions to psychological testing, those of his students and colleagues, and discuss the work of current writers within this tradition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Incremental Validity of Psychological Testing and Assessment: Conceptual, Methodological, and Statistical Issues.

There has been insufficient effort in most areas of applied psychology to evaluate incremental validity. To further this kind of validity research, the authors examined applicable research designs, including those to assess the incremental validity of test instruments, of test-informed clinical inferences, and of newly developed measures. The authors also considered key statistical and measurement issues that can influence incremental validity findings, including the entry order of predictor variables, how to interpret the size of a validity increment, and possible artifactual effects in the criteria selected for incremental validity research. The authors concluded by suggesting steps for building a cumulative research base concerning incremental validity and by describing challenges associated with applying nomothetic research findings to individual clinical cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity and values: Monetary and otherwise.

Comments on the G. J. Meyer et al (see record 2001-00159-003) summary of evidence and issues associated with psychological assessment. D. A. Smith states that the force of their claim that medical and psychological tests are equally valid is undermined by a discrepancy with the data from which the claim purportedly derives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adverse Effects of Predictive Testing for Huntington Disease Underestimated: Long-Term Effects 7-10 Years After the Test.

The 7-10-year psychological effects of presymptomatic testing for Huntington disease are described in 142 individuals and 104 partners. Questionnaires included the Beck Hopelessness Scale (A. T. Beck, A. Weissman, D. Lester, & L. Trexler, 1974), the Impact of Event Scale (M. J. Horowitz, N. Wilner. & W. Alvarez. 1979). and the General Health Questionnaire (D. P. Goldberg. 1972). Carriers and their partners were more distressed immediately after the test result, although their outlooks improved somewhat in the 2-3-year posttest period. However, they became more pessimistic thereafter, when approaching the age of onset. Carriers, who were lost to follow-up after disclosure of test results, reported more distress pretest than did retained carriers. This demonstrates that studies that report few harmful effects may have underestimated the real impact. Moreover, follow-up studies need to investigate time effects for longer than a few years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A critical appraisal of intelligent testing with the WISC-III: Introduction to the series.

This special issue is intended to provide professionals and other members of the policy-shaping community with information from which judgments concerning the appropriate role of IQ testing in the delivery of school psychological services can be formed. In Kaufman's (1994) most recent rendition of his intelligent testing series, Intelligent testing with the WISC-III, he devotes a major section of the first chapter to his presumed defense of IQ testing against criticisms that have emerged within the school psychology literature. Are the inferences derived by Kaufman's methods of WISC-III test interpretation of sufficient quality to support their use in professional problem solving and decision making? Are they reliable? Are they accurate? Do they contribute to beneficial outcomes for children? These are guiding questions that represent underlying themes for this special issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic essentialism: On the deceptive determinism of DNA.

This article introduces the notion of genetic essentialist biases: cognitive biases associated with essentialist thinking that are elicited when people encounter arguments that genes are relevant for a behavior, condition, or social group. Learning about genetic attributions for various human conditions leads to a particular set of thoughts regarding those conditions: they are more likely to be perceived as (a) immutable and determined, (b) having a specific etiology, (c) homogeneous and discrete, and (d) natural, which can lead to the naturalistic fallacy. There are rare cases of “strong genetic explanation” when such responses to genetic attributions may be appropriate; however, people tend to overweigh genetic attributions compared with competing attributions even in cases of “weak genetic explanation,” which are far more common. The authors reviewed research on people's understanding of race, gender, sexual orientation, criminality, mental illness, and obesity through a genetic essentialism lens, highlighting attitudinal, cognitive, and behavioral changes that stem from consideration of genetic attributions as bases of these categories. Scientific and media portrayals of genetic discoveries are discussed with respect to genetic essentialism, as is the role that genetic essentialism has played (and continues to play) in various public policies, legislation, scientific endeavors, and ideological movements in recent history. Last, moderating factors and interventions to reduce the magnitude of genetic essentialism, which identify promising directions to explore in order to reduce these biases, are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)