Department of Medicine, Columbia University, New York, New York, USA,
Department of Medical Humanities and Ethics, Columbia University, New York, New York, USA,
Public Health Genomics. 2021;24(1-2):14-25. doi: 10.1159/000512475. Epub 2021 Jan 27.
Precision medicine raises hope for translating genetic-based knowledge about psychiatric risks into mental health benefits by motivating health-related, risk-reducing behaviors. Teenagers (ages 14-17) are an important age-group to engage in preventive efforts but, their views about psychiatric genetics are understudied.
An online survey with a nationally representative sample of teenagers (n = 417) was conducted. Participants were randomly assigned to receive 1 of 2 handouts, 1 emphasizing the genetic underpinnings of psychiatric conditions; the other agency-oriented and focusing on gene-environment interactions. Survey questions queried their views about behavioral changes in response to psychiatric genetic risk information and expressed willingness to undertake them. Participants' decision-making characteristics (i.e., self-efficacy, empowerment, intolerance of uncertainty, and sensation-seeking) were assessed at baseline.
Teenagers strongly valued the information provided and its potential usefulness for their mental health. Information about psychiatric genetics alone impacted views about the causes of mental illness. Contrary to our hypothesis, the type of handout did not impact participants' expressed willingness to make behavioral changes to reduce their risk of developing a psychiatric condition, but their sense of empowerment played a key role in their responses.
Educating teenagers about gene-environment interactions may help facilitate the translational efforts of precision psychiatry. Research with teenagers across racial/ethnic groups, especially those with family histories, is needed to better understand the factors that impact teenagers' empowerment in psychiatric genomic settings and to identify measures, including the best enablers of empowerment (e.g., educators, parents), which would allow them to reap the benefits of precision psychiatry.
精准医学通过激励与健康相关的、降低风险的行为，使基于遗传学的精神疾病风险知识转化为精神健康益处，从而带来了希望。青少年（14-17 岁）是参与预防工作的重要年龄群体，但他们对精神遗传学的看法还没有得到充分研究。
对一个具有全国代表性的青少年样本（n=417）进行了一项在线调查。参与者被随机分配阅读 2 份传单中的 1 份，1 份强调精神疾病的遗传基础，另 1 份以机构为导向，侧重于基因-环境相互作用。调查问题询问了他们对根据精神遗传学风险信息做出行为改变的看法以及表达了他们愿意做出改变的意愿。在基线时评估了参与者的决策特征（即自我效能感、赋权感、不确定性容忍度和寻求刺激）。
青少年非常重视所提供的信息及其对他们心理健康的潜在有用性。关于精神遗传学的信息单独影响了他们对精神疾病病因的看法。与我们的假设相反，传单的类型并没有影响参与者表达愿意做出行为改变以降低患上精神疾病风险的意愿，但他们的赋权感在他们的反应中起着关键作用。
向青少年传授基因-环境相互作用的知识可能有助于促进精准精神病学的转化努力。需要对跨种族/族裔群体的青少年进行研究，尤其是那些有家族病史的青少年，以更好地了解影响青少年在精神基因组学环境中赋权的因素，并确定措施，包括赋权的最佳促进者（例如，教育工作者、家长），使他们能够从精准精神病学中获益。
