Stress and Genetic Testing for Disease Risk

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Stress and Genetic Testing for Disease Risk

• Baum, A, Friedman, A.L. Zakowski, S.G. (1997) .
  Health Psychology,16(1), 8-19.

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Benefits and costs

• Genetic testing heritable risk for breast cancer
  and Huntingtons Disease

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Benefits of risk evaluation

• Vigilant for emergence of disease
• Active surveillance for early signs
• Maybe prevent onset
• Resolve personal issues
• Reduce risk and cope with illness

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but..

• With prediction can come
• Fear
• Worry
• distress

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• Unfortunately, the psychosocial impact of this
  knowledge is not well understood. As is often
  the case, societys technological capabilities
  have outpaced its understanding of the
  psychological consequences

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etiology

• Breast cancer multiple determinants
• Interactions of heredity, mutagens, age,
  behaviors that impact hormonal patterns
• Testing cant rule out risk
• New evidence of genetic marker (mutation)
• Huntingtons Disease
• Genetic factors alone
• No prevention or treatment

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Stress theory

• Coping and distress
• Test results
• Disease characteristics
• Uncertainty reduction
• Coping options
• Social support, optimism, perceived risks and
  beliefs about illness disability

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Uncertainty and Uncertainty Reduction

• Uncertainty seen as aversive
• Uncertainty can reduce distress
• Question When does uncertainty reduction
  outweigh stress of increase threat?

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Positive result and enhanced risk Decrease
stress depends on

• Extent of uncertainty reduction
• Previous decisions that impacted risk
• Treatment and surveillance options
• Magnitude of threat
• Coping and resources
• Intrusive thoughts memories that affect stress
  and well-being

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Some research findings..

• 80 of general public 90 of women w. close
  relative having had cancer would elect to have
  genetic testing
• Huntington's Disease moderate/severe depression
  with positive uncertainty reduction

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Potential problem?

• Surveillance may suffer after relief of negative
  testing (avoidance)