To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The last chapter clarified how individuals differ in their management of anxiety and grief and linked it to the perception of genetic counselling and whether it was seen as stressful or not. In addition, individuals were shown to differ in their coping responses and to fall broadly into one of three groups: mature, defensive and symptomatic. This is particularly relevant to the counsellor as it explains different approaches and responses to genetic counselling. There are however individual differences in a number of other areas which have relevance for genetic counselling. These differences relate to the way a genetic family story is told, the thinking behind decision-making and the nature and pattern of relationship with the counsellor. All these differences of individual behaviour can be understood by referring to the concepts contained in attachment theory. The theory provides a framework which explains how these differences have arisen and how they are played out in genetics. Armed with these concepts, the counsellor will be equipped to recognise different patterns of behaviour and relating and to connect them to underlying attachment patterns. The counsellor can then adjust their personal response correspondingly so enhancing the professional relationship.
Attachment theory
Attachment theory is an up-to-date approach now being adopted and integrated into the different theoretical bases and thinking of the various schools of psychotherapy. It was conceived in the post-Freudian era and, in recent times, there has been a resurgence of interest from researchers, psychiatrists, psychotherapists and counsellors.
It is tempting to begin this book about the psychological aspects of the speciality of medical genetics by focusing on the individuals and families concerned and to explore the effect or the personal meaning of having a genetic consultation. However, good medical training and, in particular, training in psychological principles begin with a wider view. It uses a wide-angled lens, rather than a more detailed focus, to explore and define genetic counselling. This means beginning by addressing how genetic counselling has developed into its present shape and looking at the context of its evolution. This sets the scene which is the context of the question of the nature of genetic counselling and how is it defined. This can be followed by looking at the range of the speciality and the motivation for seeking genetic counselling. With that back-drop, it is then possible to analyse the component parts of a typical genetic counselling encounter, discuss the function of the interview and ask why it takes its present form.
The context
Genetic counselling has evolved in the context of three different areas: advances in medical knowledge, changes in society and the basic human desire to have knowledge, to understand and to learn.
Advances in medicine and the study of diseases have progressed by refinements in clinical diagnosis and special investigations. The richness of knowledge about the factors involved in the development of diseases has necessitated divisions into specialities, which all come under the umbrella of medicine.
In the first half of this book a framework has been presented which enables the genetic counsellor to think about genetic counselling in terms of stress theory, coping and the use of defences. It has also used attachment theory and ideas from psychotherapy to guide the counsellor'sunderstanding of the patient, the interview process and the appropriate therapeutic response. This chapter presents clinical examples to focus in more detail on extracts from clinical practice to give the reader a better feel for integrating these theoretical points.
Working with anxiety and grief
The next three examples demonstrate the importance of containing anxiety and processing grief to facilitate a different way of thinking as explained in the discussion of empathy and, in particular, Bion's work on facilitating thinking.
Working with anxiety and a changing state of mind
It is very common in genetic counselling for a patient to enter the consulting room in a highly charged emotional state and, as explained, that interferes with the ability to take in the whole picture and consider the issues comprehensively. Frequently, there will be a sense of urgency and agitation about a person whose mind cannot be still enough to process the complexities arising. As the woman in this example explains, successful genetic counselling creates a space for the patient to listen and take in information, express any relevant upset and be able to settle down to consider the issue in hand.
This chapter continues with the theme of working with families, but in particular, the nuclear family and addresses the variety of ways parents and children come into genetic counselling. The counsellor will have gained an understanding of child development from clinical experience in paediatrics, general medicine or from the experience of being clinically involved with a number of children who have conditions which are genetically determined. It is not considered appropriate to give detailed theoretical points of child development from a cognitive or emotional perspective. Rather, the chapter begins with a general awareness of children as part of the consultation system before discussing how worries about children are considered in genetic counselling. Case examples will be presented which will demonstrate the salient points of family functioning around child problems and includes requests for testing children for adult-onset disorders.
When a child is the focus of a genetic consultation, he or she may be present in a consultation or, occasionally, parents may want to discuss their worries about their child in private. Alternatively there may be several children in a room as part of a consultation for a parent or a family. Young children can easily disrupt a consultation and some counsellors may prefer them to be looked after outside to ensure that the parents can concentrate and fully take part in the consultation. This may not be possible as a consultation is a potentially stressful encounter and children are often reluctant to leave a parent whom they sense is anxious.
Latitudinal variation of the polymorphic sn-glycerol-3-phosphate (α-Gpdh) locus in Drosophila melanogaster has been characterized on several continents; however, apparent clinal patterns are potentially confounded by linkage with an inversion, close associations with other genetic markers that vary clinally, and a tandem α-Gpdh pseudogene. Here we compare clinal patterns in α-Gpdh with those of other linked markers by testing field flies from eastern Australian locations collected in two separate years. The α-Gpdh variation exhibited a consistent non-linear cline reflecting an increase in the α-GpdhF allele at extreme latitudes. This pattern was not influenced by the In(2L)t inversion wherein this locus is located, nor was it influenced by the presence of the α-Gpdh pseudogene, whose presence was ubiquitous and highly variable among populations. The α-Gpdh pattern was also independent of a cline in allozyme frequencies at the alcohol dehydrogenase (Adh) locus, and two length polymorphisms in the Adh gene. These results suggest clinal selection at the α-Gpdh locus that is partially or wholly unrelated to linear climatic gradients along the eastern coast of Australia.
The Transforming growth factor-β (TGF-β) family control diverse cellular processes and specify cell-fate/differentiation during embryogenesis in vertebrates and invertebrates. Mutations disrupting TGF-β signalling lead to developmental abnormalities and a range of diseases such as cancer. Nodal is a major TGF-β signal, responsible for gastrulation in embryogenesis. Arkadia (Akd) was discovered by mouse gene-trap mutagenesis and encodes a nuclear E3 ubiquitin ligase. Akd allows the Nodal signal to reach its maximum level and Akd-null mice lack mammalian organiser (MO) and mesendodermal tissues. Although Akd RNA is ubiquitously expressed, Akd-null mice lose a subset of Nodal-dependent functions. The specificity of Akd function is therefore most likely to be regulated post-transcriptionally or by co-factors. Akd possesses differentially spliced 5′ untranslated regions (UTRs) and large 3′ UTR. We have employed bioinformatics and developed a reporter system to address Akd post-transcriptional regulation. Akd RNA may initiate from different promoters and 5′ UTR differential splicing, upstream AUGs (uAUGs) and open-reading frames upstream (uORFs) may regulate protein translation. 5′ and 3′ UTRs can interact to either destabilise or decrease translational efficiency of RNA. The nature of this interaction is cell-type and signal level dependent. These data may represent mechanisms by which translational control of Arkadia is achieved and ultimately how TGF-β/Nodal signalling is regulated during embryogenesis.
The effect was investigated of the hypomorphic DNA double-strand break repair, notably synthesis-dependent strand annealing, deficient mutation mus309 on the third chromosome of Drosophila melanogaster on intergenic and intragenic meiotic recombination in the X chromosome. The results showed that the mutation significantly increases the frequency of intergenic crossing over in two of three gene intervals of the X chromosome studied. Interestingly the increase was most prevalent in the tip of the X chromosome where crossovers normally are least frequent per physical map unit length. In particular crossing over interference was also affected, indicating that the effect of the mus309 mutation involves preconditions of crossing over but not the event of crossing over itself. On the other hand, the results also show that most probably the mutation does not have any effect on intragenic recombination, i.e. gene conversion. These results are fully consistent with the present molecular models of meiotic crossing over initiated by double-strand breaks of DNA followed by formation of a single-end-invasion intermediate, or D-loop, which is subsequently processed to generate either crossover or non-crossover products involving formation of a double Holliday junction. In particular the results suggest that the mus309 gene is involved in resolution of the D-loop, thereby affecting the choice between double-strand-break repair (DSBR) and synthesis-dependent strand annealing (SDSA) pathways of meiotic recombination.
A Bayesian model and variable dimensional parameter estimation based on Markov chain Monte Carlo was applied to map quantitative trait loci (QTLs) in a doubled haploid mapping population of rainbow trout. To increase power, the analysis was performed using the multiple-QTL model, which simultaneously accounted for all the environmental and genetic main effects that influence the expression of early development life history traits. By doing so we obtained the posterior estimated effects for the environmental factors as well as the number, positions, and the effects for the QTLs. The analyses revealed QTLs for time at hatching, embryonic length and weight at swim-up stage. The posterior expectation of the number of QTLs in different linkage groups shows that at least four QTLs are needed to explain the observed differences in early development between the clonal lines. The Bayesian method effectively combined all the information available to accurately position these QTLs in the rainbow trout genome.
To comprehensively investigate the genetic architecture of growth and obesity, we performed Bayesian analyses of multiple epistatic quantitative trait locus (QTL) models for body weights at five ages (12 days, 3, 6, 9 and 12 weeks) and body composition traits (weights of two fat pads and five organs) in mice produced from a cross of the F1 between M16i (selected for rapid growth rate) and CAST/Ei (wild-derived strain of small and lean mice) back to M16i. Bayesian model selection revealed a temporally regulated network of multiple QTL for body weight, involving both strong main effects and epistatic effects. No QTL had strong support for both early and late growth, although overlapping combinations of main and epistatic effects were observed at adjacent ages. Most main effects and epistatic interactions had an opposite effect on early and late growth. The contribution of epistasis was more pronounced for body weights at older ages. Body composition traits were also influenced by an interacting network of multiple QTLs. Several main and epistatic effects were shared by the body composition and body weight traits, suggesting that pleiotropy plays an important role in growth and obesity.
Two growth-selected lines in chickens have been developed from a single founder population by divergent selection for body weight at 56 days of age. After more than 40 generations of selection they show a nine-fold difference in body weight at selection age and large differences in growth rate, appetite, fat deposition and metabolic characteristics. We have generated a large intercross between these lines comprising more than 800 F2 birds. QTL mapping revealed 13 loci affecting growth. The most striking observation was that the allele in the high weight line in all cases was associated with enhanced growth, but each locus explained only a small proportion of the phenotypic variance using a standard QTL model (1·3–3·1%). This result is in sharp contrast to our previous study where we reported that the two-fold difference in adult body size between the red junglefowl and White Leghorn domestic chickens is explained by a small number of QTLs with large additive effects. Furthermore, no QTLs for anorexia or antibody response were detected despite large differences for these traits between the founder lines. The result is an excellent example where a large phenotypic difference between populations occurs in the apparent absence of any single locus with large phenotypic effects. The study underscores the need for powerful experimental designs in genetic studies of multifactorial traits. No QTL at all would have reached genome-wide significance using a less powerful design (e.g. approx. 200 F2 individuals) regardless of the nine-fold phenotypic difference between the founder lines for the selected trait.
W. G. Hill and X.-S. Zhang (2004). Effects on phenotypic variability of directional selection arising through genetic differences in residual variability. Genetical Research83, 121–132.
We thank Herman Mulder for noting errors in the published equations. The correct formulae were used in calculations.
The extent to which epistasis contributes to adaptation and speciation has been a controversial topic in evolutionary genetics. One experimental approach to study epistasis is based on quantitative trait locus (QTL) mapping using molecular markers. Comparisons can be made among all possible pair-wise combinations of the markers, irrespective of whether an additive QTL is associated with a marker; several software packages have been developed that facilitate this. We review several examples of using this approach to identify epistatic QTLs for traits of evolutionary or ecological interest. While there is variability in the results, the number of epistatic QTL interactions is often greater than or equal to the number of additive QTLs. The magnitude of epistatic effects can be larger than the additive effects. Thus, epistatic interactions seem to be an important part of natural genetic variation. Future studies of epistatic QTLs could lead to descriptions of the genetic networks underlying variation for fitness-related traits.
Mammalian mitochondrial genomes are organized in a conserved and extremely compact manner, encoding molecules that play a vital role in oxidative phosphorylation (OXPHOS) and carry out a number of other important biological functions. A large-scale screening of the normalized mitochondrial gene expression profiles generated from publicly available mammalian serial analysis of gene expression (SAGE) datasets (over 17·7 millions of tags) was performed in this study. Acquired SAGE libraries represent an extensive range of human, mouse, rat, bovine and swine cell and tissue samples (normal and pathological) in a variety of conditions. Using a straightforward in silico algorithm, variations in total mitochondrial gene expression, as well as in the expression of individual genes encoded by mitochondrial genomes are addressed, and common patterns in the species- and tissue-specific mitochondrial gene expression profiles are discussed.
Markers with segregation ratio distortion are commonly observed in data sets used for quantitative trait locus (QTL) mapping. In this study, a multipoint method of maximum likelihood (ML) was newly developed to estimate the positions and effects of the segregation distortion loci (SDLs) in two F2 populations of rice (Oryza sativa L.), i.e. Taichung65/Bhadua (TB; japonica–indica cross) and CPSLO17/W207-2 (CW; japonica–japonica). Of the four parents, W207-2 and Bhadua were found to be spikelet semi-sterile and stably inherited through selfing, and spikelet fertility segregated in the two populations. Therefore, recombination frequencies were recalculated after mapping the SDLs by using the multipoint method, and the molecular linkage maps of the two F2 populations were constructed to detect QTLs underlying spikelet fertility. As a result, five SDLs in the TB population were mapped on chromosomes 1, 3, 8 and 9, respectively. Two major QTLs underlying spikelet fertility, namely qSS-6a and qSS-8a, were detected on chromosomes 6 and 8, respectively. In the CW population, a total of 12 SDLs were detected on all 12 chromosomes except 1, 5, 7 and 11. Three QTLs underlying spikelet sterility, namely qSS-2, qSS-6b and qSS-8b on chromosomes 2, 6 and 8, were determined on the whole genome scale. Interestingly, both qSS-6a and qSS-6b, detected in the two F2 populations respectively, were located on a similar position as the S5 gene on chromosome 6; while qSS-8a and qSS-8b were also simultaneously detected on similar positions of the short arm of chromosome 8 in the two populations, which should be a new sterility gene showing the same type of zygotic selection.
Sperm competition is an important fitness component in many animal groups. Drosophila melanogaster males exhibit substantial genetic variation for sperm competitive ability and females show considerable genetic variation for first versus second male sperm use. Currently, the forces responsible for maintaining genetic variation in sperm competition related phenotypes are receiving much attention. While several candidate genes contributing to the variation seen in male competitive ability are known, genes involved in female sperm use remain largely undiscovered. Without knowledge of the underlying genes, it will be difficult to distinguish between different models of sexual selection such as cryptic female choice and sexual conflict. We used quantitative trait locus (QTL) mapping to identify regions of the genome contributing to female propensity to use first or second male sperm, female refractoriness to re-mating, and early-life fertility. The most well supported markers influencing the phenotypes include 33F/34A (P2), 57B (refractoriness) and 23F/24A (fertility). Between 10% and 15% of the phenotypic variance observed in these recombinant inbred lines was explained by these individual QTLs. More detailed investigation of the regions detected in this experiment may lead to the identification of genes responsible for the QTLs identified here.
Cluster analyses of gene expression data are usually conducted based on their associations with the phenotype of a particular disease. Many disease traits have a clearly defined binary phenotype (presence or absence), so that genes can be clustered based on the differences of expression levels between the two contrasting phenotypic groups. For example, cluster analysis based on binary phenotype has been successfully used in tumour research. Some complex diseases have phenotypes that vary in a continuous manner and the method developed for a binary trait is not immediately applicable to a continuous trait. However, understanding the role of gene expression in these complex traits is of fundamental importance. Therefore, it is necessary to develop a new statistical method to cluster expressed genes based on their association with a quantitative trait phenotype. We developed a model-based clustering method to classify genes based on their association with a continuous phenotype. We used a linear model to describe the relationship between gene expression and the phenotypic value. The model effects of the linear model (linear regression coefficients) represent the strength of the association. We assumed that the model effects of each gene follow a mixture of several multivariate Gaussian distributions. Parameter estimation and cluster assignment were accomplished via an Expectation-Maximization (EM) algorithm. The method was verified by analysing two simulated datasets, and further demonstrated using real data generated in a microarray experiment for the study of gene expression associated with Alzheimer's disease.