Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada.
J Genet Couns. 2023 Jun;32(3):698-705. doi: 10.1002/jgc4.1679. Epub 2023 Feb 3.
Direct-to-consumer (DTC) genetic tests have become an attractive product for those hoping to gain insight into their health, ancestry, and biological relatedness. In some cases, test results are unexpected, and lead to the revelation of previously undisclosed family secrets. A subset of individuals may pursue testing explicitly for this purpose; however, the psychosocial processes underlying this motivation remain unexamined. Grounded in the literature on family secrecy, trauma, and the development of self-concept, we tested a hypothesized mediation model to provide insight into this motivation among a sample of 433 individuals in pursuit of DTC genetic testing. In line with the documented association between maladaptive family communication patterns and trauma exposure in childhood, we found that exposure to adverse childhood experiences was associated with the motivation to pursue DTC genetic testing for the purpose of uncovering family secrets. We also found evidence of an indirect effect through reduced self-concept clarity. These findings suggest that impaired identity formation processes may have played a role in transmitting the effect. Furthermore, the findings highlight a novel way in which family histories may contribute to DTC genetic testing motivations. Future examination of these and other psychosocial phenomena that contribute to DTC genetic testing will be crucial to consider as the tests become increasingly accessible, and as the information they can provide becomes increasingly comprehensive. Findings from this line of research could help to identify for whom and under what conditions DTC genetic testing benefits well-being, and the conditions under which the act of testing and receipt of results could have adverse psychosocial effects. These insights will be of interest to genetic counselors working in the field of DTC genetic testing, and those working with individuals and families affected by unexpected test results.
直接面向消费者（DTC）的基因检测已经成为那些希望深入了解自身健康、祖先和生物学亲缘关系的人的有吸引力的产品。在某些情况下，测试结果出乎意料，揭示了以前未公开的家庭秘密。一部分人可能会出于这个目的专门进行测试；然而，这种动机背后的社会心理过程仍未得到检验。本研究以家庭秘密、创伤和自我概念发展的文献为基础，测试了一个假设的中介模型，以深入了解这一动机，该模型的样本来自 433 名正在进行 DTC 基因检测的个体。与儿童时期不良家庭沟通模式和创伤暴露之间的文献记录关联一致，我们发现，暴露于不良童年经历与为揭示家庭秘密而进行 DTC 基因检测的动机有关。我们还发现了通过自我概念清晰度降低的间接影响的证据。这些发现表明，受损的身份形成过程可能在传递这种影响方面发挥了作用。此外，这些发现强调了家庭史可能影响 DTC 基因检测动机的一种新方式。随着测试变得越来越容易获得，以及它们可以提供的信息变得越来越全面，未来对这些和其他有助于 DTC 基因检测的社会心理现象的研究将至关重要。这项研究的结果可能有助于确定哪些人在什么条件下从 DTC 基因检测中受益，以及在什么条件下测试和接受结果可能会产生不利的社会心理影响。这些见解将引起从事 DTC 基因检测领域的遗传咨询师以及那些与意外测试结果相关的个人和家庭的兴趣。
