Johnson Suzanne Bennett, Lynch Kristian F, Roth Roswith, Schatz Desmond
Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL
Health Informatics Institute, University of South Florida, Tampa, FL.
Diabetes Care. 2017 Sep;40(9):1167-1172. doi: 10.2337/dc17-0166. Epub 2017 Jun 29.
To assess parent anxiety in response to genetic and islet autoantibody (IA) testing in children at increased genetic risk for type 1 diabetes followed from birth in The Environmental Determinants of Diabetes in the Young (TEDDY) study.
Parent anxiety about TEDDY children's risk was assessed with the State Anxiety Inventory (SAI). Parents completed the SAI when the child was 3, 6, and 15 months old and annually thereafter. Children were tested for IA every 3 months for 4 years and every 6 months thereafter. Parent SAI scores of 6,799 children followed with IA testing for at least 1 and up to 6 years were examined.
At study inception, parents showed high levels of anxiety in response to their child's increased genetic type 1 diabetes risk; mothers were more anxious than fathers, and parents with diabetes in the family were more anxious than parents with no family history. In response to repeated IA-negative (IA-) test results, parent anxiety declined to normal levels. Anxiety increased in parents faced with an IA-positive (IA+) test result. Parents faced with two or more types of IA+ test results showed particularly high levels of anxiety (all < 0.001).
Infant genetic screening for type 1 diabetes raises parent anxiety when the child is at increased risk, but anxiety dissipates over time in cases of repeated IA- results. IA+ results heighten parent anxiety, and parents faced with two or more types of IA+ results may experience considerable anxiety for longer periods.
在“青少年糖尿病环境决定因素（TEDDY）”研究中，评估从出生就开始随访的1型糖尿病遗传风险增加的儿童进行基因和胰岛自身抗体（IA）检测后家长的焦虑情况。
采用状态焦虑量表（SAI）评估家长对TEDDY儿童患病风险的焦虑程度。孩子3个月、6个月和15个月大时，以及之后每年，家长都要完成SAI测评。儿童每3个月进行一次IA检测，持续4年，之后每6个月检测一次。对6799名接受IA检测至少1年至6年的儿童的家长SAI评分进行了研究。
在研究开始时，家长对孩子1型糖尿病遗传风险增加表现出高度焦虑；母亲比父亲更焦虑，有糖尿病家族史的家长比无家族史的家长更焦虑。面对IA检测反复呈阴性（IA-）的结果，家长焦虑程度降至正常水平。面对IA检测呈阳性（IA+）结果的家长焦虑程度增加。面对两种或更多类型IA+检测结果的家长焦虑程度尤其高（均P<0.001）。
对1型糖尿病进行婴儿基因筛查，当孩子患病风险增加时会引起家长焦虑，但如果IA检测结果反复为阴性，焦虑会随着时间消散。IA+结果会加剧家长焦虑，面对两种或更多类型IA+结果的家长可能会长时间经历相当程度的焦虑。
