Distress in individuals facing predictive DNA testing for autosomal dominant late-onset disorders: comparing questionnaire results with in-depth interviews. Rotterdam/Leiden Genetics Workgroup

Am J Med Genet. 1998 Jan 6;75(1):62-74. doi: 10.1002/(sici)1096-8628(19980106)75:1<62::aid-ajmg14>3.0.co;2-q.

Abstract

In 50% risk carriers for Huntington disease (n = 41), hereditary cerebral hemorrhage with amyloidosis Dutch-type (n = 9) familial adenomatous polyposis coli (n = 45) and hereditary breast and ovarian cancer (n = 24), pretest intrusion and avoidance (Impact of Event Scale), anxiety and depression (Hospital Anxiety and Depression Scale), feelings of hopelessness (Beck Hopelessness Scale), and psychological complaints (Symptom Checklist) were assessed to determine their psychological well-being. The manner of discussing the genetic disorder, the test, and its implications during a semistructured interview (reflecting on one's emotions without getting carried away or dismissing or minimizing the subject) was judged in terms of coherence. Participants at risk for neurodegenerative disorders had higher anxiety and depression scores and more psychological complaints than did those at risk for cancer syndromes. Those reporting high intrusion/high avoidance had higher anxiety and depression scores and more psychological complaints than did those reporting low intrusion/low avoidance. However, the scoring of the interview showed that participants reporting high intrusion/high avoidance were more reflective about their emotions without getting carried away or dismissing the subject (e.g., more coherent) than those reporting low intrusion/low avoidance. This result suggests that participants with higher stress scores may be actively dealing with the emotional implications of the test, whereas those with low stress scores may (as yet) be unable to face these implications. It is important to identify the strategy of coping with threat to provide suitable counseling and necessary guidance. However, long-term follow-up is needed to learn the consequences of a denial coping strategy for those participating in a genetic testing program.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenomatous Polyposis Coli / epidemiology
  • Adenomatous Polyposis Coli / genetics
  • Adenomatous Polyposis Coli / psychology
  • Age of Onset
  • Anxiety / psychology
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / genetics
  • Breast Neoplasms / psychology
  • Cerebral Hemorrhage / epidemiology
  • Cerebral Hemorrhage / genetics
  • Cerebral Hemorrhage / psychology
  • Depression / psychology
  • Female
  • Genes, Dominant / genetics*
  • Genetic Counseling / methods
  • Genetic Counseling / psychology*
  • Genetic Diseases, Inborn / epidemiology
  • Genetic Diseases, Inborn / genetics
  • Genetic Diseases, Inborn / psychology*
  • Humans
  • Huntington Disease / epidemiology
  • Huntington Disease / genetics
  • Huntington Disease / psychology
  • Interview, Psychological* / methods
  • Male
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / psychology
  • Predictive Value of Tests
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires*