The role of disease perceptions and results sharing in psychological adaptation after genetic susceptibility testing: the REVEAL Study.
The role of disease perceptions and results sharing in psychological adaptation after genetic susceptibility testing: the REVEAL Study.
复制标题
DOI：
10.1038/ejhg.2010.119
复制
发表时间：
2010-12
影响因子：
5.2
通讯作者：
Green, Robert C.
中科院分区：
文献类型：
--
作者：
Ashida, Sato;Koehly, Laura M.;Roberts, J. Scott;Chen, Clara A.;Hiraki, Susan;Green, Robert C.
这项研究评估了遗传易感性测试后心理适应（抑郁症状，焦虑和测试特定痛苦的有效措施）受到阿尔茨海默病（AD）信念变化和与他人分享测试结果的影响程度。AD患者的成年儿童（N=269）来自一项随机临床试验，涉及载脂蛋白E（APOE）的基因检测，提供了信息之前，以及6周和12个月后的结果披露。在12个月的评估中，参与者的适应水平差异很大。与那些知道自己是ε4阳性的人相比，那些知道自己是ε4阴性（风险较低）的参与者在感知风险和对发展AD的担忧方面有所减少。那些通过扩展教育方案（三次亲自访问）获得结果的人比那些在浓缩方案（教育手册和两次亲自访问）中的AD关注下降更大。在6周后AD关注的增加与抑郁评分（B=0.20，P<0.01）和焦虑水平（B=0.20，P<0.01）的增加相关，并且在测试1年后与AD基因测试相关的更高的痛苦（B=0.18，P=0.02）。感知风险的增加（B=0.16，P=0.04）也与较高的AD基因检测痛苦相关。与健康专家和朋友（但不是家人）分享测试结果与一年后抑郁（B=-0.11，P=0.05）和焦虑水平（B=-0.16，P<0.01）的下降有关。在测前咨询中加强对AD风险和担忧的讨论，并在测后通过分享结果获得支持，可能有助于促进受试者的长期心理适应。
This study evaluates the extent to which psychological adaptation (validated measures of depressive symptoms, anxiety, and test-specific distress) after genetic susceptibility testing is influenced by changes in beliefs about Alzheimer's disease (AD) and sharing of test results with others. Adult children of AD patients (N=269) from a randomized clinical trial involving genetic testing for apolipoprotein E (APOE) provided information before, as well as 6 weeks and 12 months after results disclosure. The levels of adaptation varied highly among participants at 12-month assessment. Participants who learned that they were ε4 negative (lower risk) had a reduction in perceived risk and concern about developing AD compared with those who learned that they were ε4 positive. Those who received results through an extended educational protocol (three in-person visits) had a larger decline in AD concern than those in a condensed protocol (educational brochure and two in-person visits). Increase in AD concern 6 weeks after disclosure was associated with increase in depression scores (b=0.20, P<0.01) and anxiety levels (b=0.20, P<0.01), and higher distress associated with AD genetic testing (b=0.18, P=0.02) 1 year after testing. Increase in perceived risk (b=0.16, P=0.04) was also associated with higher AD genetic testing distress. Sharing the test results with health professionals and friends (but not family) was associated with decrease in depression (b= −0.11, P=0.05) and anxiety levels (b= −0.16, P<0.01), respectively after a year. Enhancing discussion with regard to risks and concerns about AD during pretesting counseling and obtaining support through sharing the results after testing may help facilitate test recipients' long-term psychological adaptation.
登录
查看更多内容
DOI：
10.1002/ajmg.10110
发表时间：
2002-01-15
期刊：
AMERICAN JOURNAL OF MEDICAL GENETICS
影响因子：
--
作者：
Hughes, C;Lerman, C;Main, D
通讯作者：
Main, D
影响因子：
3.5
作者：
Hallowell, N;Ardern-Jones, A;Watson, M
通讯作者：
Watson, M
影响因子：
158.5
作者：
Green, Robert C.;Roberts, J. Scott;Farrer, Lindsay A.
通讯作者：
Farrer, Lindsay A.
DOI：
10.1097/gim.0b013e3181cef9e1
发表时间：
2010-04
期刊：
Genetics in medicine : official journal of the American College of Medical Genetics
影响因子：
--
作者：
Linnenbringer E;Roberts JS;Hiraki S;Cupples LA;Green RC
通讯作者：
Green RC
影响因子：
9.7
作者：
Neumann, PJ;Hammitt, JK;Kosik, KS
通讯作者：
Kosik, KS