Department of Psychiatry, The Ohio State University.
Department of Psychology, University of Southern California.
Health Psychol. 2014 Sep;33(9):1003-11. doi: 10.1037/a0032737. Epub 2013 Jun 17.
This study evaluated associations of cancer-related cognitive processing with BRCA1/2 mutation carrier status, personal cancer history, age, and election of prophylactic surgery in women at high risk for breast cancer.
In a 2 (BRCA1/2 mutation carrier status) × 2 (personal cancer history) matched-control design, with age as an additional predictor, participants (N = 115) completed a computerized cancer Stroop task. Dependent variables were response latency to cancer-related stimuli (reaction time [RT]) and cancer-related cognitive interference (cancer RT minus neutral RT). RT and interference were tested as predictors of prophylactic surgery in the subsequent four years.
RT for cancer-related words was significantly slower than other word groups, indicating biased processing specific to cancer-related stimuli. Participants with a cancer history evidenced longer RT to cancer-related words than those without a history; moreover, a significant Cancer History × Age interaction indicated that, among participants with a cancer history, the typical advantage associated with younger age on Stroop tasks was absent. BRCA mutation carriers demonstrated more cancer-related cognitive interference than noncarriers. Again, the typical Stroop age advantage was absent among carriers. Exploratory analyses indicated that BRCA+ status and greater cognitive interference predicted greater likelihood of undergoing prophylactic surgery. Post hoc tests suggest that cancer-related distress does not account for these relationships.
In the genetic testing context, younger women with a personal cancer history or who are BRCA1/2 mutation carriers might be particularly vulnerable to biases in cancer-related cognitive processing. Biased processing was associated marginally with greater likelihood of prophylactic surgery.
本研究评估了与癌症相关的认知处理与 BRCA1/2 基因突变携带者状态、个人癌症史、年龄以及选择预防性手术之间的关联，研究对象为乳腺癌高危女性。
在 2（BRCA1/2 基因突变携带者状态）×2（个人癌症史）匹配对照设计中，年龄作为附加预测因子，参与者（N=115）完成了计算机化癌症斯特鲁普任务。因变量为对癌症相关刺激的反应时（反应时 [RT]）和癌症相关认知干扰（癌症 RT 减去中性 RT）。在接下来的四年中，RT 和干扰被测试为预防性手术的预测因子。
癌症相关词汇的 RT 明显慢于其他词汇组，表明对癌症相关刺激存在有偏向的处理。有癌症病史的参与者对癌症相关词汇的 RT 比没有病史的参与者长；此外，癌症史×年龄的显著交互作用表明，在有癌症史的参与者中，与斯特鲁普任务相关的典型年龄优势不存在。BRCA 基因突变携带者表现出比非携带者更多的癌症相关认知干扰。同样，携带者中也不存在典型的斯特鲁普年龄优势。探索性分析表明，BRCA+状态和更大的认知干扰预测了更有可能进行预防性手术。事后检验表明，癌症相关的痛苦并不能解释这些关系。
在基因检测背景下，有个人癌症史或 BRCA1/2 基因突变携带者的年轻女性可能特别容易受到与癌症相关的认知处理偏见的影响。有偏向的处理与更大的预防性手术可能性相关。
