Anticipated versus actual emotional reactions to disclosure of results of genetic tests for cancer susceptibility:: Findings from p53 and BRCA1 testing programs
Anticipated versus actual emotional reactions to disclosure of results of genetic tests for cancer susceptibility:: Findings from p53 and BRCA1 testing programs
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DOI：
10.1200/jco.2000.18.10.2135
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发表时间：
2000-05-01
影响因子：
45.3
通讯作者：
Garber, JE
中科院分区：
文献类型：
--
作者：
Dorval, M;Patenaude, AF;Garber, JE
目的：我们在两种结构化的研究方案中检验了接受癌症易感性基因检测的个体准确预测其检测结果披露后的情绪反应的能力。我们探讨了情绪预期的准确性是否与信息披露后的心理调整有关。方法：对65例患者资料进行分析；对24名Li-Fraumeni癌症综合征家族成员进行p53突变检测（24人均未受影响），对41名具有遗传性乳腺癌易感性的受试者进行BRCA1突变检测（34人未受影响，7人受影响）。受试者来自先前已发现种系突变的家庭。在测试前，受试者在得知自己携带或不携带家族突变基因后，对六种情绪状态（宽慰、快乐、悲伤、内疚、愤怒和担忧）的预期感受程度进行了评估。在收到测试结果后，他们根据相同的情绪等级对自己的感受进行了适当的评估。在6个月时，用标准化方法评估其准确性和与心理困扰的关联程度。结果：总体而言，收到测试结果后的平均情绪反应水平与结果披露前的预期水平没有差异。然而，受影响的BRCA1携带者经历了比他们预期更高水平的愤怒和担忧。低估与测试结果相关的后续痛苦情绪与6个月时一般心理痛苦的显著增加有关。结论：在癌症易感性测试项目中，未受影响的个体在预测测试结果的情绪反应方面通常是准确的。然而，癌症患者在得知阳性结果后可能会低估他们的痛苦，并可能从干预策略中受益。[J]中华临床杂志，18(2):535 - 542。(C) 2000年由美国临床肿瘤学会出版。
Purpose: We examined the ability of individuals undergoing genetic testing for cancer susceptibility in two structured research protocols to accurately anticipate emotional reactions to disclosure of their test result. We explored whether accuracy of emotional anticipation was associated with postdisclosure psychologic adjustment.Methods: Data from 65 individuals were analyzed; 24 members of Li-Fraumeni cancer syndrome families were tested for p53 mutations (all 24 were unaffected), and 41 subjects with hereditary breast-ovarian cancer susceptibility were tested for BRCA1 mutations (34 were unaffected and seven were affected). Subjects were from families in which a germline mutation had been previously identified. At the pretest session, subjects rated the extent to which they anticipated feeling each of six emotional states (relief, happiness, sadness, guilt, anger, and worry) after disclosure that they did or did not carry the familial mutation. After receiving their test result, they rated their feelings on the same scale of emotions for the appropriate condition. Extent of accuracy and association with psychologic distress at 6 months, as assessed with standardized measures, were evaluated.Results: Overall, mean levels of emotional reactions after receiving test results were not different from those anticipated before result disclosure. However, affected BRCA1 carriers experienced higher levels of anger and worry than they had anticipated. Underestimation of subsequent distress emotions related to test result was associated with a significant increase in general psychologic distress at 6 months.Conclusion: Unaffected individuals in cancer-predisposition testing programs are generally accurate in anticipating emotional reactions to test results. However, cancer patients may underestimate their distress after disclosure of positive results and could benefit from intervention strategies. J Clin Oncol 18:2135-2142. (C) 2000 by American Society of Clinical Oncology.