Understudied Subgroup Research Articles

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

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. 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. 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. 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. 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.

Using Visual Methods to Uncover Context

The accurate assessment of physical activity and dietary intake is essential for assessing the relationships between physical activity, dietary intake, and health outcomes. However, the measurement of physical activity and dietary intake among women, particularly minority women, poses unique challenges related to gender, ethnicity, and social context. Measures that are not culturally relevant or sensitive to the experiences, traditions, or beliefs of ethnically diverse women might result in data that are unreliable, or which cannot be interpreted. Visual methods show promise for elucidating concepts that are important to refine established measures for assessing dietary intake and physical activity in diverse ethnic groups. Hispanic women, a largely understudied subgroup that experiences long-term health risks associated with dietary and physical activity behaviors, serves as the focal group for this discussion of the potential for visual methods to develop culturally and contextually relevant and valid approaches to outcome assessment.

Assessing Male Batterers With the Personality Assessment Inventory

Abstract In this study, we sought to provide empirical data on the utility of the Personality Assessment Inventory (Morey, 1991 Widiger, T. A., Williams, J., Spitzer, R. and Francis, A. 1985. The MCMI as a measure of DSM-III.. Journal of Personality Assessment, 49: 366–378. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) for the assessment of male batterers. The sample consisted of 93 men who were court mandated to treatment. In the study, we were able to replicate 2 of 3 clusters (borderline/dysphoric and nonelevated) commonly found in the literature on male batterers; however, we only partially replicated the 3rd cluster (antisocial/narcissistic). This new finding may reflect a difference in the assessment instrument used to assess male batterers (i.e., PAI). In this study, we also investigated a previously understudied subgroup of batterers, specifically, men who engage in positive impression management. In this study, we conclude that the PAI is a potentially useful instrument in assessing male batterers and provide suggestions for future research.

Assessing Male Batterers With the Personality Assessment Inventory

In this study, we sought to provide empirical data on the utility of the Personality Assessment Inventory (Morey, 1991) for the assessment of male batterers. The sample consisted of 93 men who were court mandated to treatment. In the study, we were able to replicate 2 of 3 clusters (borderline/dysphoric and nonelevated) commonly found in the literature on male batterers; however, we only partially replicated the 3rd cluster (antisocial/narcissistic). This new finding may reflect a difference in the assessment instrument used to assess male batterers (i.e., PAI). In this study, we also investigated a previously understudied subgroup of batterers, specifically, men who engage in positive impression management. In this study, we conclude that the PAI is a potentially useful instrument in assessing male batterers and provide suggestions for future research.

Adolescent Runaway Episodes: Application of an Estrangement Model of Recidivism

Adolescents who run away represent a unique and understudied subgroup of the population, and estimates suggest that between 1.3 and 2.8 million youths in the United States run away or are forced out of parental homes each year (Greene, Ringwalt, & Iachan, 1997). These youths are at increased risk of a variety of problems, including drug and alcohol use, emotional and conduct disorders, school failure, criminal behavior, and victimization (Rotheram-Borus, 1993; Yoder, Hoyt, & Whitbeck, 1998). Although research of delinquency among adolescents has used theory to guide research (Thornberry, 1987), most studies of youths who run away have not drawn on a theoretical framework. Furthermore, limited research has addressed the issue of recidivism--specifically, youths who run away, return home, and run away again. In the few studies conducted to explore factors associated with recidivism to shelter services, results suggested significant differences between youths who run away once and those with repeated episodes (Baker, McKay, Hans, Schlange, & Auville, 2003; Thompson & Pillai, 2006). Youths who run away once appear to be responding to a specific incident, often parental maltreatment or intense conflict; youths who run away repeatedly experience prolonged and lingering problems that often originate from poor family relationships (Stefanidis, Pennbridge, & MacKenzie, 1992). Given the paucity of research concerning the characteristics and antecedents associated with runaway recidivism, research must address escalation of runaway behavior by developing conceptual models that identify factors contributing to runaway behaviors. CONCEPTUAL MODEL Research on adults has begun to focus on issues associated with the total duration of homelessness, referred to as the homeless career (Grigsby, Baumann, Gregorich, & Roberts-Gray, 1990; Piliavin, Sosin, Westerfelt, & Matsueda, 1993). Piliavin and colleagues hypothesized that adults who experience longer periods of homelessness differ systematically from those with shorter careers and in terms of estrangement from societal institutions. They also suggested a conceptual model of careers as a function of four sources of estrangement: (1) institutional disaffiliation, (2) psychological dysfunction, (3) identification with culture, and (4) human capital. This estrangement framework can be applied to understanding youth, family, and social systems pivotal in the progressive accumulation of behavioral problems leading to youths' running away. Using these four concepts is an exploratory and novel approach to developing a framework for identifying factors associated with multiple versus single runaway episodes. Institutional disaffiliation has been defined as the weakening of ties to societal institutions (Bahr & Caplow, 1973). Disaffiliation suggests that childhood antecedents of poor cohesion, adaptability, and family coping might be related to future difficulty with social support networks (Jackson-Wilson & Borger, 1993).Youths who run away are clearly vulnerable to weak interpersonal and family relationships (Whitbeck, Hoyt, & Ackley, 1997) and experience social disaffiliation and isolation (Malloy, Christ, & Hohloch, 1990). Educational detachment, criminal behavior, and other deviant behaviors represent this impoverishment and disaffiliation with societal institutions (Castel, 2000; Malloy et al.).Any one of these factors could complicate the developmental transitions normally associated with adolescence; collectively these factors constitute a condition of social marginalization that jeopardizes the course of normal development (Sullivan, 1996). Psychological dysfunction, or mental health difficulties, have long been linked to homelessness (Piliavin et al., 1993) and are disproportionately high among youths who run away (Yoder et al., 1998), particularly depression, low self-esteem, impulsivity, and suicidal thoughts and attempts. …

A Comparison of HIV-Related Factors Among Seropositive Brazilian, South American, and Puerto Rican Gay Men in the United States

Latino men who have sex with men are a group at high risk for HIV infection. Much of the research addressing attitudes and behaviors related to HIV among Latinos in the United States has overlooked differences based on nationality. Brazilian immigrants, in particular, are an understudied subgroup of Latinos. This study compared HIV-positive Brazilian gay men ( n = 75) with their Spanish-speaking counterparts from South America ( n = 103) and Puerto Rico ( n = 61) on a variety of HIV-related factors. Results failed to reveal any significant group differences in disclosure of serostatus or in behaviors relevant to sexual risk. Some differences in demographic characteristics, reasons for immigration, and acculturation, however, did emerge among the three groups. Implications for aggregation of Latino subgroups in HIV-related programs are discussed.

Clinical relevance of chronic catatonic schizophrenia in children and adolescents: Evidence from a prospective naturalistic study

The paper examines the phenomenology, diagnosis, and course of catatonia in children and adolescents. From 1993 to 2003, 21 boys and 9 girls, aged 12 to 18 years, were admitted for a catatonic syndrome (0.6% of the total inpatient population). Phenomenology and associated diagnoses were similar to those reported in the adult literature but relative frequency differed, with schizophrenia being the most frequent diagnosis. Comparison of patients with schizophrenia ( n=17) to those with other diagnoses ( n=13) showed that the two groups differed in terms of sex ratio, type of onset and phenomenology of catatonic symptoms, duration of hospitalization, and severity at discharge. Using discriminant function analysis, the combination of three clinical variables–male gender, duration of catatonic episode, and severity at discharge–correctly classified 100% of cases in the schizophrenia group. Catatonia is an infrequent but severe condition in young people, and is usually associated with schizophrenia. There is a need for research in the field of catatonic schizophrenia in adolescents as it appears to be a clinically relevant but understudied subgroup.