Department of Medical Humanities and Social Science, Florida State University College of Medicine, Tallahassee, FL 32306-4300, USA.
Curr Diab Rep. 2011 Oct;11(5):454-9. doi: 10.1007/s11892-011-0208-9.
Screening programs designed to identify persons at risk for type 1 diabetes via genetic and antibody testing are controversial because they typically target children, provide only a crude estimate of type 1 diabetes risk, and offer no means of preventing the disease. For this reason, genetic and antibody testing for type 1 diabetes risk is usually limited to carefully conducted research studies. The psychological impact of such screening programs include cognitive, emotional, and behavioral sequelae; the available literature has focused primarily on parents, and usually mothers, since the target of screening is usually infants or young children. Diabetes risk is a difficult construct to effectively communicate. Many individuals fail to accurately understand risk; inaccurate risk perceptions may increase over time and have been associated with early study withdrawal. Simply asking study participants if they understand the risk information provided is insufficient. Anxiety and worry are common reactions to learning that you or a loved one is at increased risk for type 1 diabetes. For most people, anxiety and worry dissipate with time but some individuals may be particularly vulnerable to prolonged anxiety or depression. Although there is no known means to prevent type 1 diabetes in at-risk individuals, families often report increased surveillance of those at risk and behavior changes to prevent the disease, potentially threatening the internal validity of the study.
旨在通过基因和抗体检测来识别 1 型糖尿病高危人群的筛查项目存在争议，因为它们通常针对儿童，仅提供 1 型糖尿病风险的粗略估计，并且没有预防疾病的方法。出于这个原因，1 型糖尿病风险的基因和抗体检测通常仅限于精心进行的研究。此类筛查项目的心理影响包括认知、情感和行为后果；现有文献主要集中在父母身上，通常是母亲，因为筛查的目标通常是婴儿或幼儿。糖尿病风险是一个难以有效沟通的概念。许多人无法准确理解风险；不准确的风险感知可能会随着时间的推移而增加，并与早期研究退出有关。仅仅询问研究参与者是否理解提供的风险信息是不够的。得知自己或亲人患 1 型糖尿病的风险增加，焦虑和担忧是常见的反应。对于大多数人来说，随着时间的推移，焦虑和担忧会逐渐消散，但有些人可能特别容易长期焦虑或抑郁。虽然目前尚无已知方法可以预防高危人群患 1 型糖尿病，但许多家庭会增加对高危人群的监测，并改变行为以预防疾病，这可能会威胁到研究的内部有效性。
