Public Attitudes, Interests, and Concerns Regarding Polygenic Embryo Screening.

Importance: Polygenic embryo screening (PES) is a novel technology that estimates the likelihood of developing future conditions (eg, diabetes or depression) and traits (eg, height or cognitive ability) in human embryos, with the goal of selecting which embryos to use. Given its commercial availability and concerns raised by researchers, clinicians, bioethicists, and professional organizations, it is essential to inform key stakeholders and relevant policymakers about the public's perspectives on this technology. Objective: To survey US adults to examine general attitudes, interests, and concerns regarding PES use. Design, Setting, and Participants: For this survey study, data were collected from 1 stratified sample and 1 nonprobability sample (samples 1 and 2, respectively) between March and July 2023. The surveys measured approval, interest, and concerns regarding various applications of PES. In the second sample, presentation of a list of potential concerns was randomized (presented at survey onset vs survey end). The survey was designed using Qualtrics and distributed to participants through Prolific, an online sampling firm. Sample 1 was nationally representative with respect to gender, age, and race and ethnicity; sample 2 was recruited without specific demographic criteria. Analyses were conducted between March 2023 and February 2024. Main Outcomes and Measures: Participants reported their approval, interest, and concerns regarding various applications of PES and outcomes screened (eg, traits and conditions). Statistical analysis was conducted using independent samples t tests and repeated-measures analyses of variance. Results: Of the 1435 respondents in sample 1, demographic data were available for 1427 (mean [SD] age, 45.8 [16.0] years; 724 women [50.7%]). Among these 1427 sample 1 respondents, 1027 (72.0%) expressed approval for PES and 1169 (81.9%) expressed some interest in using PES if already undergoing in vitro fertilization (IVF). Approval among these respondents for using PES for embryo selection was notably high for physical health conditions (1109 [77.7%]) and psychiatric health conditions (1028 [72.0%]). In contrast, there was minority approval for embryo selection based on PES for behavioral traits (514 [36.0%]) and physical traits (432 [30.3%]). Nevertheless, concerns about PES leading to false expectations and promoting eugenic practices were pronounced, with 787 of 1422 (55.3%) and 780 of 1423 (54.8%) respondents finding them very to extremely concerning, respectively. Sample 2 included 192 respondents (mean [SD] age 37.7 [12.2] years; 110 men [57.3%]). These respondents were presented concerns at survey onset (n = 95) vs survey end (n = 97), which was associated with less approval (28-percentage point decrease) and more uncertainty (24 percentage-point increase) but with only slightly higher disapproval (4 percentage-point increase). Conclusions and Relevance: These findings suggest that it is critical for health care professionals and medical societies to consider and understand the perspectives of diverse stakeholders (eg, patients undergoing IVF, clinicians, and the general public), given the absence of regulation and the recent commercial availability of PES.

Public Perceptions of Neurotechnologies Used to Target Mood, Memory, and Motor Symptoms.

Background: Advances in the development of neurotechnologies have the potential to revolutionize treatment of brain-based conditions. However, a critical concern revolves around the willingness of the public to embrace these technologies, especially considering the tumultuous histories of certain neurosurgical interventions. Therefore, examining public attitudes is paramount to uncovering potential barriers to adoption ensuring ethically sound innovation. Methods: In the present study, we investigate public attitudes towards the use of four neurotechnologies (within-subjects conditions): deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), pills, and MRI-guided focused ultrasound (MRgFUS) as potential treatments to a person experiencing either mood, memory, or motor symptoms (between-subjects conditions). US-based participants (N=1052; stratified to be nationally representative based on sex, race, age) were asked about their perceptions of risk, benefit, invasiveness, acceptability, perceived change to the person, and personal interest in using these neurotechnologies for symptom alleviation. Results: Descriptive results indicate variability between technologies that the U.S. public is willing to consider if experiencing severe mood, memory, or motor symptoms. The main effect of neurotechnology revealed DBS was viewed as the most invasive and risky treatment and was perceived to lead to the greatest change to who someone is as a person. DBS was also viewed as least likely to be personally used and least acceptable for use by others. When examining the main effects of symptomatology, we found that all forms of neuromodulation were perceived as significantly more beneficial, acceptable, and likely to be used by participants for motor symptoms, followed by memory symptoms, and lastly mood symptoms. Neuromodulation (averaging across neurotechnologies) was perceived as significantly riskier, more invasive, and leading to a greater change to person for mood versus motor symptoms; however, memory and motor symptoms were perceived similarly with respect to risk, invasiveness, and change to person. Conclusion: These results suggest that the public views neuromodulatory approaches that require surgery (i.e., DBS and MRgFUS) as riskier, more invasive, and less acceptable than those that do not. Further, findings suggest individuals may be more reluctant to alter or treat psychological symptoms with neuromodulation compared to physical symptoms.

Red and blue states: dichotomized maps mislead and reduce perceived voting influence.

In the United States the color red has come to represent the Republican party, and blue the Democratic party, in maps of voting patterns. Here we test the hypothesis that voting maps dichotomized into red and blue states leads people to overestimate political polarization compared to maps in which states are represented with continuous gradations of color. We also tested whether any polarizing effect is due to partisan semantic associations with red and blue, or if alternative hues produce similar effects. In Study 1, participants estimated the hypothetical voting patterns of eight swing states on maps with dichotomous or continuous red/blue or orange/green color schemes. A continuous gradient mitigated the polarizing effects of red/blue maps on voting predictions. We also found that a novel hue pair, green/orange, decreased perceived polarization. Whether this effect was due to the novelty of the hues or the fact that the hues were not explicitly labeled "Democrat" and "Republican" was unclear. In Study 2, we explicitly assigned green/orange hues to the two parties. Participants viewed electoral maps depicting results from the 2020 presidential election and estimated the voting margins for a subset of states. We replicated the finding that continuous red/blue gradient reduced perceived polarization, but the novel hues did not reduce perceived polarization. Participants also expected their hypothetical vote to matter more when viewing maps with continuous color gradations. We conclude that the dichotomization of electoral maps (not the particular hues) increases perceived voting polarization and reduces a voter's expected influence on election outcomes.

Divergence Between Clinician and Patient Perspectives on Polygenic Embryo Screening: A Qualitative Study.

Objective: To explore and compare the perspectives of clinicians and patients on polygenic embryo screening. Design: Qualitative. Subjects: Fifty-three participants: 27 reproductive endocrinology and infertility specialists and 26 patients currently undergoing in vitro fertilization or had done so within the last five years. Main Outcome Measures: Qualitative thematic analysis of interview transcripts. Results: Both clinicians and patients often held favorable views of screening embryos for physical or psychiatric conditions, though clinicians tended to temper their positive attitudes with specific caveats. Clinicians also expressed negative views about screening embryos for traits more often than patients, who generally held more positive views. Most clinicians were either unwilling to discuss or offer polygenic embryo screening to patients or were willing to do so only under certain circumstances, while many patients expressed interest in polygenic embryo screening. Both sets of stakeholders envisioned multiple potential benefits or uses of polygenic embryo screening; the most common included selection and/or prioritization of embryos, receipt of more information about embryos, and preparation for the birth of a predisposed or "affected" child. Both sets of stakeholders also raised multiple potential, interrelated concerns about polygenic embryo screening. The most common concerns among both sets of stakeholders included the potential for different types of "biases" - most often in relation to selection of embryos with preferred genetic chances of traits -, the probabilistic nature of polygenic embryo screening that can complicate patient counseling and/or lead to excessive cycles of in vitro fertilization, and a lack of data from long-term prospective studies supporting the clinical use of polygenic embryo screening. Conclusion: Despite patients' interest in polygenic embryo screening, clinicians feel such screening is premature for clinical application. Though now embryos can be screened for their genetic chances of developing polygenic conditions and traits, many clinicians and patients maintain different attitudes depending on what is specifically screened, despite the blurry distinction between conditions and traits. Considerations raised by these stakeholders may help guide professional societies as they consider developing guidelines to navigate the uncertain terrain of polygenic embryo screening, which is already commercially available.

A trade-off model of intentional thinking for pleasure.

We investigated intentional thinking for pleasure, defined as the deliberate attempt to have pleasant thoughts while disengaged from the external world. We propose a Trade-Off model that explains when and why thinking for pleasure is enjoyable: People focus on personally meaningful thoughts when thinking for pleasure (especially when prompted to do so), which increases their enjoyment, but they find it difficult to concentrate on their thoughts, which decreases their enjoyment. Thus, the net enjoyment of thinking for pleasure is a trade-off between its benefits (personal meaningfulness) and costs (difficulty concentrating). To test the model, we compared intentional thinking for pleasure to four alternate activities in three studies. Thinking for pleasure was more enjoyable than undirected thinking (Study 1) and planning (Study 3), because it was more meaningful than these activities while requiring a similar level of concentration. Thinking for pleasure was just as enjoyable as playing a video game (Study 2) or unprompted idle time activities (Study 3), but for different reasons: It was more meaningful than these activities, but required more concentration. We discuss the implications of these findings for what people might choose to do during idle times. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

What makes thinking for pleasure pleasurable?

When left to their own devices, people could choose to enjoy their own thoughts. But recent work suggests they do not. When given the freedom, people do not spontaneously choose to think for pleasure, and when directed to do so, struggle to concentrate successfully. Moreover, people find it somewhat boring and much less enjoyable than other solitary activities. One reason for this is that people may not know how to think for pleasure. Specifically, they may not know what to think about to make this both a meaningful and pleasant experience. We tested this prediction in two preregistered studies, by providing specific examples of meaningful topics (Study 1) or instructing participants to think "meaningful" thoughts (Study 2). Although providing specific examples of meaningful topics boosted how meaningful and enjoyable people found thinking for pleasure (Study 1), asking people to think "meaningful" thoughts (as compared with pleasurable ones) did not, because some of the meaningful topics people thought about were negative (Study 2). In order for thinking for pleasure to be pleasurable, people need to focus on topics that are both meaningful and positive. (PsycInfo Database Record (c) 2021 APA, all rights reserved).