Abstract
Mediators and moderators of anxiety following predictive genetic testing were investigated in a cross-sectional study of 208 individuals at risk for familial adenomatous polyposis (FAP). Receiving a positive test result was associated with increased anxiety. The relationship between test result and anxiety was mediated by how threatened individuals felt by their test results. The impact of a positive test result was greater for those who felt distressed about FAP in their families, perceived FAP to be more serious, and perceived the genetic test to be more accurate. The results suggest that assessing, and possibly modifying, people’s appraisals of the condition and of its impact on the family and of the threat of the genetic test may help to reduce subsequent anxiety. This has implications for the practice of genetic counseling.
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Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinctioninsocial psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.
Broadstock, M., Michie, S., & Marteau, T. M. (2000). The psychological consequences of predictive genetic testing: A systematic review. European Journal of Human Genetics, 8, 731–738.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159.
Croyle, R. T., Achilles, J. S., & Lerman, C. (1997). Psychological aspects of cancer genetic testing: Are-search update for clinicians. Cancer Supplement, 80, 569–575.
Croyle, R. T., & Lerman, C. (1995). Psychological impact of genetic testing. In Robert T. Croyle et al. (Ed.), Psychosocial effects of screening for disease prevention and detection (pp. 11–38). New York: Oxford University Press.
Croyle, R. T., & Sande, G. N. (1988). Denial and confirmatory search: Paradoxical consequences of medical diagnosis. Journal of Applied Social Psychology, 18, 473–490.
Croyle, R. T., Sun, Y.-C., & Louie, D. H. (1993). Psychological minimisation of cholesterol test results: moderators of appraisal in college students and community residents. Health Psychology, 12, 503–507.
Ditto, P. H., & Lopez, D. F. (1992). Motivated skepticism: The use of differential decision criteria for preferred and nonpreferred conclusions. Journal of Personality and Social Psychology, 63, 568–584.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.
Jaccard, J., Turrisi, R., & Wal, C. K. (1990). Interaction effects in multiple regression. Newbury Park, CA: Sage.
Johnston M., Wright, S., & Weinman, J. (1995). Individual and demographic differences. In Measures in health psychology: A user’s portfolio. Windsor, Berkshire: NFER-Nelson.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.
Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick-Miller, P., & Robitaille, C. (1997). Illness representations: Theoretical foundations. In K. J. Petrie & J. Weinman (Eds.), Perceptions of health and illness (pp. 19–46) London: Harwood.
Marteau, T. M., & Bekker, H. (1992). The development of a six-item short-form of the state scale of the Spielberger state-trait anxiety inventory (STAI). British Journal of Clinical Psychology, 31, 301–306.
Michie, S., Bobrow, M., & Marteau, T. M. (2001). Predictive genetic testing in children and adults: A study of emotional impact. Journal of Medical Genetics, 38, 519–526.
Michie, S., McDonald, V., & Marteau, T. M. (1996). Understanding responsestopredictive genetic testing: A grounded theory approach. Psychology and Health, 11, 455–470.
Michie, S., Weinman, J., Miller, J., Collins, V., Halliday, J., & Marteau, T. M. (2002). Predictive genetic testing: High risk expectations in the face of low risk information. Journal of Behavioral Medicine, 25, 33–50.
Petrie, K. J., Weinman, J., Sharpe, N., & Buckley, J. (1996). Role of patients view of their illness in predicting return towork and functioning after myocardial infarction: Longitudinal study. British Medical Journal, 312, 1191–1194.
Rosenberg, M. (1989). Society and the adolescent self-image. (reprint edition). Middletown, CT: Wesleyan University Press.
Scheier, M. F., & Carver, C. S. (1985). Optimism, coping and health: Assessment and implications of generalised outcome expectancies. Health Psychology, 4, 219–247.
Schwarzer, R. (1994). Optimism, vulnerability, and self-beliefs as health-related cognitions: A systematic overview. Psychology and Health, 9, 161–180.
Segerstrom, S. C., Taylor, S. E., Kemeny, M. E., & Fahey, J. L. (1998). Optimism is associated with mood, coping and immune change in response to stress. Journal of Personality and Social Psychology, 74, 1646–1655.
Spielberger, C. D. (1973). STAIC preliminary manual for the state-trait inventory for children. Palo Alto, CA: Consulting Psychologists Press.
Timman, R., Zoeteweij, M. W., Tibben, A., Breuning, M. H., & Passchier, J. (2000). Long-term (7-10 years) psychological follow up after predictive testing for Huntington’s Disease in the Netherlands. Journal Medical Genetics., 37, Suppl. 11.
Wooldridge, E. Q., & Murray, R. F. (1998). The Health Orientation scale: A measure of feelings about sickle cell trait. Social Biology, 35, 123–136.
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Michie, S., French, D.P. & Marteau, T.M. Predictive genetic testing: Mediators and moderators of anxiety. Int. J. Behav. Med. 9, 309–321 (2002). https://doi.org/10.1207/S15327558IJBM0904_02
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DOI: https://doi.org/10.1207/S15327558IJBM0904_02