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1.
Behav Neurosci ; 131(4): 348-58, 2017 08.
Article in English | MEDLINE | ID: mdl-28714720

ABSTRACT

Caffeine is a psychostimulant frequently consumed by adults and children, often in combination with high levels of sugar. Chronic pretreatment with either substance can amplify both amphetamine and cocaine-induced hyperactivity in rodents. The present study sought to elucidate whether age at the time of exposure to sugar and/or caffeine alters sensitivity to an acute illicit psychostimulant (methamphetamine, [METH]) challenge in adulthood. Adult and adolescent (Postnatal Day 35 on first day of treatment) male Sprague-Dawley rats were treated for 26 days with water, caffeine (0.6 g/L), 10% sucrose or their combination. Locomotor behavior was measured on the first and last day of treatment. Following 9-days treatment free, animals were challenged with saline (1 ml/kg, i.p.) or METH (1 mg/kg, i.p.) and locomotor activity was measured. During the treatment period, adolescent rats maintained a higher caffeine (mg/kg) dose than their adult counterparts. Adding sugar to caffeine increased adolescent consumption and the highest caffeine dose consumed was measured in these animals. Drinking sugar-sweetened caffeinated water or combination did not produce cross-sensitization to METH administration in either age group. Nevertheless, the finding that regular exposure through adolescence to caffeinated sugar-sweetened beverages could increase consumption of caffeine and sugar later in life is important, as there is a large body of evidence that has linked excess consumption of sugar-sweetened beverages to a broad range of other negative physical and mental health outcomes. (PsycINFO Database Record


Subject(s)
Caffeine/adverse effects , Sugars/adverse effects , Age Factors , Animals , Caffeine/metabolism , Central Nervous System Stimulants/pharmacology , Dietary Sucrose/pharmacology , Locomotion/drug effects , Male , Methamphetamine/metabolism , Methamphetamine/pharmacology , Rats , Rats, Sprague-Dawley , Sugars/metabolism , Sweetening Agents/pharmacology
2.
Proteomics ; 16(22): 2894-2910, 2016 11.
Article in English | MEDLINE | ID: mdl-27588558

ABSTRACT

Caffeine is a psychostimulant commonly consumed with high levels of sugar. The increased availability of highly caffeinated, high sugar energy drinks could put some consumers at risk of being exposed to high doses of caffeine and sugar. Notably, research that has examined the consequences of this combination is limited. Here, we explored the effect of chronic exposure to caffeine and/or sugar on behavior and protein levels in the orbitofrontal cortex (OFC) of rats. The OFC brain region has been implicated in neuropsychiatric conditions, including obesity and addiction behaviors. Adult male Sprague-Dawley rats were treated for 26 days with control, caffeine (0.6 g/L), 10% sugar, or combination of both. Locomotor behavior was measured on the first and last day of treatment, then 1 week after treatment. Two hours following final behavioral testing, brains were rapidly removed and prepared for proteomic analysis of the OFC. Label-free quantitative shotgun analysis revealed that 21, 12, and 23% of proteins identified in the OFC were differentially expressed by sugar and/or caffeine. The results demonstrate that the intake of high levels of sugar and/or low to moderate levels of caffeine has different behavioral consequences. Moreover, each treatment results in a unique proteomic profile with different implications for neural health.


Subject(s)
Caffeine/pharmacology , Central Nervous System Stimulants/pharmacology , Dietary Carbohydrates/pharmacology , Prefrontal Cortex/drug effects , Proteome/metabolism , Animals , Behavior, Animal/drug effects , Beverages/adverse effects , Caffeine/adverse effects , Central Nervous System Stimulants/adverse effects , Dietary Carbohydrates/adverse effects , Locomotion/drug effects , Male , Prefrontal Cortex/physiology , Proteome/analysis , Proteomics , Rats, Sprague-Dawley , Signal Transduction/drug effects , Weight Gain/drug effects
3.
J Proteome Res ; 15(5): 1455-71, 2016 05 06.
Article in English | MEDLINE | ID: mdl-26941107

ABSTRACT

Caffeine is a plant-derived psychostimulant and a common additive found in a wide range of foods and pharmaceuticals. The orbitofrontal cortex (OFC) is rapidly activated by flavours, integrates gustatory and olfactory information, and plays a critical role in decision-making, with dysfunction contributing to psychopathologies and neurodegenerative conditions. This study investigated whether long-term consumption of caffeine causes changes to behavior and protein expression in the OFC. Male adult Sprague-Dawley rats (n = 8 per group) were treated for 26 days with either water or a 0.6 g/L caffeine solution. Locomotor behavior was measured on the first and last day of treatment, then again after 9 days treatment free following exposure to a mild stressor. When tested drug free, caffeine-treated animals were hyperactive compared to controls. Two hours following final behavioral testing, brains were rapidly removed and prepared for proteomic analysis of the OFC. Label free shotgun proteomics found 157 proteins differentially expressed in the caffeine-drinking rats compared to control. Major proteomic effects were seen for cell-to-cell communication, cytoskeletal regulation, and mitochondrial function. Similar changes have been observed in neurological disorders including Alzheimer's disease, Parkinson's disease, and schizophrenia.


Subject(s)
Caffeine/pharmacology , Gene Expression Regulation/drug effects , Prefrontal Cortex/chemistry , Proteomics/methods , Animals , Cell Communication/drug effects , Cytoskeleton/drug effects , Gene Expression Profiling , Male , Mitochondria/drug effects , Motor Activity/drug effects , Nervous System Diseases/metabolism , Rats , Rats, Sprague-Dawley
4.
Proteomics ; 16(4): 657-73, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26621205

ABSTRACT

In most Westernized societies, there has been an alarming increase in the consumption of sugar-sweetened drinks. For many adults these drinks represent a substantial proportion of their total daily caloric intake. Here we investigated whether extended exposure to sugar changes behavior and protein expression in the orbitofrontal cortex (OFC). Male adult Sprague-Dawley rats (n = 8 per group) were treated for 26 days with either water or a 10% sucrose solution. Locomotor behavior was measured on the first and last day of treatment, then 1 week after treatment. Following the 1-week period free from treatment, sucrose treated rats were significantly more active than the control. Two hours following final behavioral testing, brains were rapidly removed and prepared for proteomic analysis of the OFC. Label free quantitative shotgun proteomic analyses of three rats from each group found 290 proteins were differentially expressed in the sucrose treated group when compared to the control group. Major changes in the proteome were seen in proteins related to energy metabolism, mitochondrial function and the cellular response to stress. This research does not seek to suggest that sugar will cause specific neurological disorders, however similar changes in proteins have been seen in neurological disorders such as Alzheimer's disease, Parkinson's disease and schizophrenia.


Subject(s)
Prefrontal Cortex/metabolism , Proteome/metabolism , Sucrose/metabolism , Animals , Carbohydrate Metabolism , Carbonated Beverages/adverse effects , Energy Intake , Energy Metabolism , Glucose/metabolism , Male , Mitochondria/metabolism , Motor Activity , Oxidative Stress , Prefrontal Cortex/physiology , Proteome/analysis , Proteomics , Rats , Rats, Sprague-Dawley , Sucrose/adverse effects , Weight Gain
5.
J Nerv Ment Dis ; 203(8): 591-5, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26230647

ABSTRACT

As part of a larger, mixed-methods study, we posted an invitation to participate in a study on the effects of reading eating disorder memoirs on the website of an organization that provides support for people with eating disorders. Twenty-four women completed the questionnaire. Qualitative analysis of their responses indicated a recovery continuum, whereby the direction of memoir influence seemed to depend on an individual's recovery stage and motivation to recover. Individuals who reported that they were exposed to memoirs before, or during, their illness reported experiencing negative consequences including making unfavorable social comparisons, along with emulation and triggering of disordered behaviors, whereas those who reported being exposed when in recovery reported more positive outcomes including hope, validation, and social support. Findings have implications for the use of personal accounts as a means of facilitating patient recovery in eating disorder treatment settings. Future research should test the influence of memoirs using a larger eating disorder sample, and across different recovery stages.


Subject(s)
Feeding and Eating Disorders/psychology , Feeding and Eating Disorders/therapy , Narrative Therapy/methods , Reading , Self Report , Social Support , Adolescent , Adult , Female , Humans , Internet , Middle Aged , Surveys and Questionnaires , Treatment Outcome , Young Adult
6.
Epilepsy Behav ; 44: 136-42, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25703620

ABSTRACT

We examined the relationship between baseline neuropsychological functioning and 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in intractable mesial temporal lobe epilepsy (MTLE). We hypothesized relationships between dominant temporal lobe hypometabolism and verbal memory and between nondominant temporal lobe hypometabolism and nonverbal memory in line with the lateralized material-specific model of memory deficits in MTLE. We also hypothesized an association between performance on frontal lobe neuropsychological tests and prefrontal hypometabolism. Thirty-two patients who had undergone temporal lobectomy for treatment of MTLE and who completed both presurgical FDG-PET and comprehensive neuropsychological investigations with widely used standardized measures were included. Age-adjusted composite measures were calculated for verbal memory, nonverbal memory, relative material-specific memory, IQ, executive function, attention/working memory, and psychomotor speed. Fluorodeoxyglucose positron emission tomography was analyzed with statistical parametric mapping (SPM) to identify hypometabolism relative to healthy controls. Pearson's correlation was used to determine the relationship between regions of hypometabolism and neuropsychological functioning. Dominant temporal lobe hypometabolism was associated with relatively inferior verbal memory, while nondominant temporal lobe hypometabolism was associated with inferior nonverbal memory. No relationship was found between performance on any frontal lobe measures and prefrontal hypometabolism. Statistical parametric mapping-quantified lateralized temporal lobe hypometabolism correlates with material-specific episodic memory impairment in MTLE. In contrast, prefrontal hypometabolism is not associated with performance on frontal lobe measures. We suggest that this is because frontal lobe neuropsychology tests may not be good measures of isolated frontal lobe functioning.


Subject(s)
Epilepsy, Temporal Lobe/diagnostic imaging , Fluorodeoxyglucose F18/metabolism , Glucose Metabolism Disorders/etiology , Memory/physiology , Positron-Emission Tomography/methods , Temporal Lobe/metabolism , Adolescent , Adult , Anterior Temporal Lobectomy/methods , Attention , Epilepsy, Temporal Lobe/surgery , Female , Frontal Lobe/physiopathology , Glucose Metabolism Disorders/diagnosis , Humans , Male , Memory Disorders/diagnosis , Middle Aged , Neuropsychological Tests , Temporal Lobe/diagnostic imaging , Temporal Lobe/physiopathology , Temporal Lobe/surgery , Treatment Outcome
7.
Epilepsia ; 55(8): e80-4, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24725141

ABSTRACT

We investigated the cognitive profile of structural occipital lobe epilepsy (OLE) and whether verbal memory impairment is selectively associated with left temporal lobe hypometabolism on [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET). Nine patients with OLE, ages 8-29 years, completed presurgical neuropsychological assessment. Composite measures were calculated for intelligence quotient (IQ), speed, attention, verbal memory, nonverbal memory, and executive functioning. In addition, the Wisconsin Card Sorting Test (WCST) was used as a specific measure of frontal lobe functioning. Presurgical FDG-PET was analyzed with statistical parametric mapping in 8 patients relative to 16 healthy volunteers. Mild impairments were evident for IQ, speed, attention, and executive functioning. Four patients demonstrated moderate or severe verbal memory impairment. Temporal lobe hypometabolism was found in seven of eight patients. Poorer verbal memory was associated with left temporal lobe hypometabolism (p = 0.002), which was stronger (p = 0.03 and p = 0.005, respectively) than the association of left temporal lobe hypometabolism with executive functioning or with performance on the WCST. OLE is associated with widespread cognitive comorbidity, suggesting cortical dysfunction beyond the occipital lobe. Verbal memory impairment is selectively associated with left temporal lobe hypometabolism in OLE, supporting a link between neuropsychological dysfunction and remote hypometabolism in focal epilepsy.


Subject(s)
Cognition Disorders/metabolism , Epilepsies, Partial/metabolism , Memory Disorders/metabolism , Temporal Lobe/metabolism , Adult , Child , Cognition/physiology , Cognition Disorders/diagnostic imaging , Cognition Disorders/psychology , Epilepsies, Partial/diagnostic imaging , Epilepsies, Partial/psychology , Humans , Memory Disorders/diagnostic imaging , Memory Disorders/psychology , Positron-Emission Tomography/methods , Temporal Lobe/diagnostic imaging
8.
Brain Sci ; 2(3): 375-404, 2012 Sep 12.
Article in English | MEDLINE | ID: mdl-24961199

ABSTRACT

The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) often results in chronic treatment with psychostimulants such as methylphenidate (MPH, Ritalin®). With increases in misdiagnosis of ADHD, children may be inappropriately exposed to chronic psychostimulant treatment during development. The aim of this study was to assess the effect of chronic Ritalin treatment on cognitive and neural development in misdiagnosed "normal" (Wistar Kyoto, WKY) rats and in Spontaneously Hypertensive Rats (SHR), a model of ADHD. Adolescent male animals were treated for four weeks with oral Ritalin® (2 × 2 mg/kg/day) or distilled water (dH2O). The effect of chronic treatment on delayed reinforcement tasks (DRT) and tyrosine hydroxylase immunoreactivity (TH-ir) in the prefrontal cortex was assessed. Two weeks following chronic treatment, WKY rats previously exposed to MPH chose the delayed reinforcer significantly less than the dH2O treated controls in both the DRT and extinction task. MPH treatment did not significantly alter cognitive performance in the SHR. TH-ir in the infralimbic cortex was significantly altered by age and behavioural experience in WKY and SHR, however this effect was not evident in WKY rats treated with MPH. These results suggest that chronic treatment with MPH throughout adolescence in "normal" WKY rats increased impulsive choice and altered catecholamine development when compared to vehicle controls.

9.
Res Dev Disabil ; 33(2): 583-93, 2012.
Article in English | MEDLINE | ID: mdl-22138497

ABSTRACT

This study examined differences in implicit and explicit memory performance between people with Down syndrome (DS), their siblings, children matched on mental age, and university undergraduates, using olfactory stimuli. The DS and mental-age matched participants were also compared on two tasks of executive function. The data revealed implicit memory for olfactory stimuli. Further, people with DS performed similarly to each control group on the implicit memory task, but performed significantly poorer than all control groups on the explicit memory task. Impairment to executive functioning was identified as a possible cause of this deficit in explicit memory as people with DS performed more poorly than the mental-age matched controls on both tasks of executive function.


Subject(s)
Down Syndrome/physiopathology , Executive Function/physiology , Memory Disorders/physiopathology , Memory/physiology , Olfactory Perception/physiology , Adolescent , Child , Female , Humans , Male , Neuropsychological Tests , Odorants , Predictive Value of Tests , Smell/physiology , Young Adult
10.
Prog Transplant ; 21(2): 161-8, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21736247

ABSTRACT

CONTEXT: Globally, the demand for donated organs outstrips supply, meaning that there are both practical and theoretical reasons for examining factors that are predictive of individuals' willingness to donate their organs upon their death. OBJECTIVES: To determine whether individuals of different religious denominations living in Australia have different views on organ donation, whether donation attitudes differ significantly across ethnic groups, and whether factors identified in international research are predictors of willingness to donate and actual donor behavior in this population. PARTICIPANTS: Data for this study were collected from students at an Australian university from a range of religious and ethnic backgrounds, and their friends and relatives (N = 509). Intervention-Participants were administered the Organ Donation Attitude Scale, as well as additional attitudes and knowledge measures. MAIN OUTCOME MEASURES: Self-reported "willingness to donate" and "donor behavior". RESULTS: Our findings complemented those reported in comparable countries, with females, younger Australians, and those with high knowledge levels being more willing to donate than males, older persons, and those with low knowledge. Persons who described themselves as having stronger religious beliefs (particularly Buddhist and Islamic) held less favorable attitudes toward donation, had lower knowledge levels, and were more likely to oppose donation. CONCLUSIONS: Although this study established that attitudes toward, knowledge about, and predictors of organ donation in Australia are similar to those reported elsewhere, donation rates remain low. Further in-depth research examining the impact of religion and culture on attitudes, beliefs, and behavior is essential when exploring strategies to improve organ donation rates in highly multicultural societies such as Australia.


Subject(s)
Attitude to Health/ethnology , Cross-Cultural Comparison , Religion , Tissue Donors , Tissue and Organ Procurement , Adolescent , Adult , Aged , Buddhism , Christianity , Ethnicity , Female , Health Knowledge, Attitudes, Practice , Humans , Islam , Linear Models , Male , Middle Aged , New South Wales
11.
Autism ; 15(6): 728-45, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21690210

ABSTRACT

Cerebellar dysfunction and impaired cognitive flexibility are key features of autism spectrum disorders (ASD). However, despite the increasing interest in subclinical autism, no research has yet examined the relationship between these signs and autistic traits in the wider population. This study used the Autism-Spectrum Quotient (AQ) questionnaire to assess autistic traits in university students enrolled in either systems-oriented or humanities degree programmes. Participants also completed a battery of motor tasks designed to assess cerebellar function, and subscales from the Delis-Kaplan Executive Function System (D-KEFS) battery. Students enrolled in systems-oriented degrees had on average higher AQ scores than students enrolled in humanities degrees. The data showed a significant correlation between autistic traits and motor function scores, as well as between autistic traits and verbal set-shifting ability, as assessed on the D-KEFS. These data provide support for the autistic spectrum hypothesis, in indicating that key cognitive, neurological and behavioural features of autism carry over into non-clinical populations.


Subject(s)
Cerebellar Diseases/complications , Child Development Disorders, Pervasive/complications , Cognition Disorders/complications , Executive Function , Adult , Child , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Students , Universities
12.
Psychol Assess ; 23(3): 670-8, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21517188

ABSTRACT

Currently, there is no standard self-report measure of psychopathy in community-dwelling samples that parallels the most commonly used measure of psychopathy in forensic and clinical samples, the Psychopathy Checklist. A promising instrument is the Self-Report Psychopathy scale (SRP), which was derived from the original version the Psychopathy Checklist. The most recent version of the SRP (SRP-III; D. L. Paulhus, C. S. Neumann, & R. D. Hare, in press) has shown good convergent and discriminate validity and a factor structure similar to the current version of the Psychopathy Checklist (PCL-R; R. D. Hare, 1991, 2003). The analyses in the current study further investigated the viability of the SRP-III as a PCL-R-analogous measure of psychopathy in nonforensic and nonclinical samples by extending the validation process to a community sample. Using confirmatory factor analyses and logistic regressions, the results revealed that a four-factor oblique model for the SRP-III was most tenable, congruent with the PCL-R factor structure of psychopathy and previous research in which the SRP-III was administered to a student sample.


Subject(s)
Antisocial Personality Disorder/diagnosis , Psychiatric Status Rating Scales/standards , Adult , Antisocial Personality Disorder/psychology , Crime/psychology , Factor Analysis, Statistical , Female , Humans , Male , Personality Inventory/standards , Reproducibility of Results , Self Report/standards
13.
Genet Test Mol Biomarkers ; 14(5): 617-27, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20722497

ABSTRACT

AIMS: We aimed to assess the psychometric properties of a 25-item short form of the Zimbardo Time Perspective Inventory in a community sample (N = 276) and in individuals with a strong family history of cancer, considering genetic testing for cancer risk (N = 338). RESULTS: In the community sample, individuals with high past-negative or present-fatalistic scores had higher levels of distress, as measured by depression, anxiety, and aggression. Similarly, in the patient sample, past-negative time perspective was positively correlated with distress, uncertainty, and postdecision regret when making a decision about genetic testing. Past-negative-oriented individuals were also more likely to be undecided about, or against, genetic testing. Hedonism was associated with being less likely to read the educational materials they received at their clinic, and fatalism was associated with having lower knowledge levels about genetic testing. CONCLUSIONS: The assessment of time perspective in individuals at increased risk of cancer can provide valuable clinical insights. However, further investigation of the psychometric properties of the short form of this scale is warranted, as it did not meet the currently accepted criteria for psychometric validation studies.


Subject(s)
Attitude , Neoplastic Syndromes, Hereditary/psychology , Time , Adult , Anxiety/etiology , Anxiety/psychology , Depression/etiology , Depression/psychology , Female , Genetic Testing/psychology , Health Behavior , Humans , Male , Middle Aged , Philosophy , Psychometrics , Risk , Self-Assessment , Socioeconomic Factors , Stress, Psychological/etiology , Stress, Psychological/psychology , Surveys and Questionnaires , Young Adult
14.
Prog Transplant ; 20(4): 380-91, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21265292

ABSTRACT

OBJECTIVE: To conduct a systematic review of published research that assessed the predictors of attitudes toward deceased organ donation, willingness to donate, and donor behavior. DATA SOURCES: MEDLINE, PreMEDLINE, PsycInfo, and the Cumulative Index to Nursing and Allied Health Literature were searched for the period from 1988 to 2009. STUDY SELECTION: Eligible studies included members of the general public (i.e., not transplant recipients, donor families, or health professionals) and used multivariate analyses for quantitative assessment of predictors. Data Extraction-The search identified 33 relevant studies. Owing to heterogeneity in populations and measures, results were summarized rather than subjected to meta-analysis. DATA SYNTHESIS: Research suggests that individuals who are younger, female, have higher education levels and socioeconomic status, hold fewer religious beliefs, have high knowledge levels, know others with positive attitudes, are more altruistic, and have fewer concerns about manipulation of the body of the deceased donor are more likely to have positive attitudes toward donation and are more willing to donate their organs. CONCLUSIONS: The review revealed the complexity of individuals' attitudes toward donation and the need for more sophisticated future studies of the interactions between the broader factors influencing donation (such as social norms and existing legislation in each country) and individual factors, such as attitudes and beliefs. (Progress in Transplantation.


Subject(s)
Attitude to Health , Health Knowledge, Attitudes, Practice , Tissue and Organ Procurement/organization & administration , Adolescent , Adult , Aged , Altruism , Educational Status , Female , Humans , Male , Middle Aged , Motivation , Multivariate Analysis , Religion and Psychology , Research Design , Socioeconomic Factors
15.
J Neurosci Methods ; 176(2): 166-71, 2009 Jan 30.
Article in English | MEDLINE | ID: mdl-18835408

ABSTRACT

Previous research using free-operant procedures have reported that the Spontaneously Hypertensive Rat (SHR) is more impulsive and inattentive than the Wistar-Kyoto (WKY) rat. Recently these behavioural differences have been suggested to be a consequence of differences in the overall activity of these strains. This study compared SHRs to WKYs on locomotor activity and delay sensitivity using a delayed reinforcement (DR) and extinction (EXT) task. SHRs maintained higher locomotor activity than WKYs, however no significant group differences were found on the total lever presses in the DR or EXT tasks. During the DR task, SHRs shifted to selecting the immediate small reinforcer significantly faster than WKYs as the delay increased. WKYs predominantly selected the lever previously associated with the delayed large reinforcer throughout the EXT task, while the SHRs showed no such preference. The significant group differences found on lever selection during the DR and EXT tasks suggests that SHRs are more sensitive to delays, therefore providing further support for the face validity of the SHR as an animal model of ADHD.


Subject(s)
Attention Deficit Disorder with Hyperactivity/physiopathology , Choice Behavior/physiology , Conditioning, Operant/physiology , Disease Models, Animal , Analysis of Variance , Animals , Evaluation Studies as Topic , Extinction, Psychological , Male , Motor Activity/physiology , Neuropsychological Tests , Rats , Rats, Inbred SHR , Rats, Inbred WKY , Reinforcement, Psychology , Time Factors
16.
Cancer ; 113(5): 956-65, 2008 Sep 01.
Article in English | MEDLINE | ID: mdl-18618513

ABSTRACT

BACKGROUND: Despite the potential benefits of genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) risk, individuals can find the genetic testing decision-making process complicated and challenging. The goal of the current study was to measure the effectiveness of a tailored decision aid designed specifically to assist individuals to make informed decisions regarding genetic testing for HNPCC risk. METHODS: In all, 153 individuals were randomized to receive the decision aid or a control pamphlet at the end of their first genetic counseling consultation. Of these, 109 (71.2%) completed the first questionnaire 1 week after consultation, whereas 95 (62.1%) completed the 6-month follow-up questionnaire. RESULTS: Although the decision aid had no significant effect on postdecisional regret or actual genetic testing decision, the trial results demonstrated that participants who received the decision aid had significantly lower levels of decisional conflict (ie, uncertainty) regarding genetic testing (chi-square(1) = 8.97; P = .003) and were more likely to be classified as having made an informed choice concerning genetic testing (chi-square(1) = 4.37; P = .037) than participants who received a control pamphlet. Also, men who received the decision aid had significantly higher knowledge levels regarding genetic testing compared with men who received the control pamphlet, whereas no such differences were found for women (chi-square(2) = 6.76; P = .034). CONCLUSIONS: A decision aid for individuals considering genetic testing for HNPCC is an effective intervention to reduce uncertainty and assist individuals to make an informed choice regarding genetic testing for HNPCC after genetic counseling.


Subject(s)
Colorectal Neoplasms, Hereditary Nonpolyposis/psychology , Decision Support Techniques , Genetic Testing , Adult , Aged , Colorectal Neoplasms, Hereditary Nonpolyposis/genetics , Female , Genetic Counseling , Genetic Predisposition to Disease , Health Education , Humans , Male , Middle Aged , Risk
17.
Psychooncology ; 17(8): 844-54, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18613319

ABSTRACT

OBJECTIVES: To evaluate the impact of a decision aid for women considering genetic testing for breast/ovarian cancer risk given during genetic counseling. METHODS: One hundred and forty-eight women were randomized to receive the decision aid or a control pamphlet at the beginning of their first consultation with a genetic counselor. When the patient received the decision aid, it was used to complement consultation discussions about genetic testing. One hundred and ten (74.3%) women completed the first questionnaire designed to elicit information about women's levels of decisional conflict and knowledge about genetic testing. Of these, 105 (70.9%) completed a second questionnaire to assess longer-term outcomes, 6 months postconsultation. RESULTS: Results showed that women who received the decision aid felt more informed about genetic testing (chi(2)(1)=8.69; P=0.003), had clearer values (chi(2)(1)=6.90; P=0.009) and had higher knowledge levels (chi(2)(2)=6.49; P=0.039) than women who received the control pamphlet. CONCLUSIONS: The developed decision aid improved patient outcomes better than a control pamphlet when implemented during genetic counseling and given to the patient to take home.


Subject(s)
Breast Neoplasms/epidemiology , Breast Neoplasms/genetics , Communication , Genetic Counseling/statistics & numerical data , Genetic Testing/methods , Ovarian Neoplasms/epidemiology , Ovarian Neoplasms/genetics , Adult , Aged , Female , Genes, BRCA1 , Genes, BRCA2 , Helping Behavior , Humans , Middle Aged , Point Mutation/genetics , Surveys and Questionnaires , Young Adult
18.
Breast Cancer Res Treat ; 107(2): 289-301, 2008 Jan.
Article in English | MEDLINE | ID: mdl-17333332

ABSTRACT

PURPOSE: To measure the effectiveness of a tailored decision aid (DA) designed to help women make informed decisions about genetic testing for breast/ovarian cancer risk. METHODS: A total of 145 women were randomized to receive the DA or a control pamphlet at the end of their first genetic counseling consultation. Of these, 120 (82.8%) completed two questionnaires, 1 week and 6 months post-consultation. RESULTS: While the DA had no effect on informed choice, post-decisional regret or actual genetic testing decision, the trial showed that women who received the DA had higher knowledge levels and felt more informed about genetic testing than women who received the control pamphlet (chi(2)(2) = 6.82; P = 0.033; chi(2)(1) = 4.86; P = 0.028 respectively). The DA also helped women who did not have blood drawn at their first consultation to clarify their values with regards to genetic testing (chi(2)(1) = 5.27; P = 0.022). Women who received the DA were less likely to share the information with other family members than women in the control condition (chi(2)(1) = 8.78; P = 0.003). CONCLUSIONS: Decision aids are an effective decision-support strategy for women considering genetic testing for breast/ovarian cancer risk, and are most effective before the patient has made a decision, which is generally at the point of having blood drawn.


Subject(s)
Breast Neoplasms/metabolism , Decision Support Techniques , Genetic Counseling/methods , Genetic Testing/methods , Ovarian Neoplasms/metabolism , Adult , Aged , Female , Genetic Predisposition to Disease , Humans , Middle Aged , Models, Genetic , Patient Education as Topic , Risk , Surveys and Questionnaires
19.
Patient Educ Couns ; 69(1-3): 29-38, 2007 Dec.
Article in English | MEDLINE | ID: mdl-17706910

ABSTRACT

OBJECTIVE: To assess the psychometric properties of the Threatening Medical Situations Inventory (TMSI) in a community sample (Study 1), and to examine its usefulness in individuals with a strong family history of cancer (Study 2). METHODS: Study 1 participants (N=276) completed 2 online surveys, 14 days apart. Study 2 participants (N=311) completed 2 questionnaires, 6 months apart. RESULTS: Both studies revealed the inventory was psychometrically sound, although some concerns were raised about the factor structure. High monitors in Study 1 reported desiring more health-related information and an active role in medical decision-making. High monitors in Study 2 had the greatest knowledge increase when they received a detailed decision aid, compared to a brief pamphlet. CONCLUSION: The TMSI is appropriate for use in both community and clinical samples. High monitors in the general community are more likely to prefer receiving as much health-related information as possible and desire an active role in decision-making about their health. PRACTICE IMPLICATIONS: Familial cancer clinic patients may benefit from tailoring the amount of information they receive to their coping style, such that patients who are vigilant information-seekers may benefit most from receiving more detailed information about genetic testing.


Subject(s)
Genetic Predisposition to Disease/genetics , Genetic Testing/psychology , Neoplasms/genetics , Patient Acceptance of Health Care/psychology , Personality Inventory/standards , Adaptation, Psychological , Adolescent , Adult , Aged , Avoidance Learning , Decision Making , Discriminant Analysis , Factor Analysis, Statistical , Female , Follow-Up Studies , Humans , Male , Middle Aged , Needs Assessment , New South Wales , Psychometrics , Surveys and Questionnaires
20.
J Genet Couns ; 16(3): 325-39, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17318456

ABSTRACT

Current practice in genetic counseling may not allow a full deliberation of the consequences of decisions about genetic testing for cancer risk, despite increasing demand for these services. Thus, two decision aids for individuals considering genetic testing for hereditary breast/ovarian cancer and hereditary non-polyposis colorectal cancer (HNPCC) susceptibility were developed and pilot tested with 43 individuals who had previously considered genetic testing for these cancer syndromes. A description of the decision aid development process is provided, as well as results of the pilot testing, which assessed participants' perceptions of the decision aids. All participants reported that they would recommend the decision aid to others facing the same situation, and 93% reported that the decision aid would have been relevant during their decision-making. The perceived impact of the decision aids on participants' emotions and understanding of genetic testing were assessed. Limitations of the study and future directions are discussed.


Subject(s)
Breast Neoplasms/genetics , Colorectal Neoplasms, Hereditary Nonpolyposis/genetics , Colorectal Neoplasms/genetics , Decision Support Techniques , Genetic Counseling/psychology , Genetic Testing/psychology , Ovarian Neoplasms/genetics , Adaptation, Psychological , Breast Neoplasms/prevention & control , Breast Neoplasms/psychology , Colorectal Neoplasms/prevention & control , Colorectal Neoplasms/psychology , Colorectal Neoplasms, Hereditary Nonpolyposis/prevention & control , Colorectal Neoplasms, Hereditary Nonpolyposis/psychology , Female , Humans , Male , Ovarian Neoplasms/prevention & control , Ovarian Neoplasms/psychology , Patient Acceptance of Health Care/psychology , Pilot Projects
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