van Oostrom Iris, Meijers-Heijboer Hanne, Duivenvoorden Hugo J, Bröcker-Vriends Annette H J T, van Asperen Christi J, Sijmons Rolf H, Seynaeve Caroline, Van Gool Arthur R, Klijn Jan G M, Tibben Aad
Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
Psychooncology. 2007 Dec;16(12):1121-9. doi: 10.1002/pon.1178.
This prospective study explored the contribution of illness representations and coping to cancer-related distress in unaffected individuals undergoing predictive genetic testing for an identified mutation in BRCA1/2 (BReast CAncer) or an HNPCC (Hereditary Nonpolyposis Colorectal Cancer)-related gene, based on the common sense model of self-regulation. Coping with hereditary cancer (UCL), illness representations (IPQ-R) and risk perception were assessed in 235 unaffected applicants for genetic testing before test result disclosure. Hereditary cancer distress (IES) and cancer worry (CWS) were assessed before, 2 weeks after and 6 months after result disclosure. Timeline (r = 0.30), consequences (r = 0.25), illness coherence (r = 0.21) and risk perception (r = 0.20) were significantly correlated to passive coping. Passive coping predicted hereditary cancer distress and cancer worry from pre-test (beta = 0.46 and 0.42, respectively) up to 6 months after result disclosure (beta = 0.32 and 0.19, respectively). Illness coherence predicted hereditary cancer distress up to 6 months after result disclosure (beta = 0.24), too. The self-regulatory model may be useful to predict the cognitive and emotional reactions to genetic cancer susceptibility testing. Identifying unhelpful representations and cognitive restructuring may be appropriate interventions to help distressed individuals undergoing genetic susceptibility testing for a BRCA1/2 or a HNPCC-related mutation.
本前瞻性研究基于自我调节的常识模型,探讨了疾病表征和应对方式对接受BRCA1/2(乳腺癌)或HNPCC(遗传性非息肉病性结直肠癌)相关基因突变预测性基因检测的未患病个体中癌症相关困扰的影响。在235名未患病的基因检测申请者中,于检测结果披露前评估了应对遗传性癌症(UCL)、疾病表征(IPQ-R)和风险认知。在结果披露前、披露后2周和6个月评估遗传性癌症困扰(IES)和癌症担忧(CWS)。时间线(r = 0.30)、后果(r = 0.25)、疾病连贯性(r = 0.21)和风险认知(r = 0.20)与消极应对显著相关。消极应对预测了从检测前到结果披露后6个月的遗传性癌症困扰和癌症担忧(β分别为0.46和0.42,以及β分别为0.32和0.19)。疾病连贯性也预测了结果披露后6个月内的遗传性癌症困扰(β = 0.24)。自我调节模型可能有助于预测对遗传性癌症易感性检测的认知和情绪反应。识别无益的表征和认知重构可能是帮助接受BRCA1/2或HNPCC相关突变遗传性易感性检测的困扰个体的适当干预措施。