The hierarchical structure of self-reported impulsivity.

The hierarchical structure of 95 self-reported impulsivity items, along with delay-discount rates for money, was examined. A large sample of college students participated in the study (N = 407). Items represented every previously proposed dimension of self-reported impulsivity. Exploratory PCA yielded at least 7 interpretable components: Prepared/Careful, Impetuous, Divertible, Thrill and Risk Seeking, Happy-Go-Lucky, Impatiently Pleasure Seeking, and Reserved. Discount rates loaded on Impatiently Pleasure Seeking, and correlated with the impulsiveness and venturesomeness scales from the I(7) (Eysenck, Pearson, Easting, & Allsopp, 1985). The hierarchical emergence of the components was explored, and we show how this hierarchical structure may help organize conflicting dimensions found in previous analyses. Finally, we argue that the discounting model (Ainslie, 1975) provides a qualitative framework for understanding the dimensions of impulsivity.

Exploring professional issues: the psychosocial component of genetic counseling in genomic healthcare.

Aim: To determine UK genetic counselors' (UKGCs) opinion regarding 'the psychosocial component of the UKGC remit in the new genomics era'. Methods: Facilitated discussions at a national conference (2016) using interactive methodologies (58 participants). Results: UKGCs recognized the rapid rate of change emerging with advances in genomic science. Change will be required to the UKGC remit and the roles, rules, relationships and responsibilities that underpin it (29 topics identified). UKGCs supported their 'unique selling point'; integrating knowledge and the explicit focus on psychosocial aspects of genomic healthcare. By 2019, some of the aspirations have been achieved. Conclusion: UKGCs should proactively position themselves to capitalize on the challenges and opportunities of genomic healthcare to maximize patient benefit.

Perspectives of low-income chronically ill patients on complex care management.

INTRODUCTION: Low-income, chronically ill adults disproportionately experience poor health outcomes despite increased health care use and costs. Complex care management (CCM) programs are an innovative approach to improving outcomes for these patients, but little is known about the patients' experiences in CCM programs in safety net primary care settings. METHOD: The authors conducted semistructured interviews with 13 CCM participants in a safety net primary care clinic to explore their perceptions of their health and their experiences with CCM. Interviews were recorded, transcribed, independently coded, and analyzed through an iterative process using grounded theory methodology to identify themes in the participants' experiences. RESULTS: From our interviews, 3 themes emerged-(a) participants mourned the loss of physical function and social well-being as a result of poor health; (b) participants reported increased health-related motivation due to relationships with the care team; and (c) participants experienced a newfound sense of control as a result of improved care navigation and self-management. DISCUSSION: Complex care management improved health-related motivation and provided a renewed sense of control for study participants, who were experiencing the loss of physical function and social well-being due to their chronic diseases. These findings support the importance of relationship-centered care models in programs for low-income, chronically ill patients. Future research should focus on identifying and spreading best practices that effectively empower patients to feel more in control of their health. (PsycINFO Database Record