Chaillet Katharine S, Sleiman Marcelo M, Yockel Mary Rose, Peshkin Beth N, Chiang Jessica J, Isaacs Claudine, Tercyak Kenneth P
Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
Department of Psychology, Georgetown University, Washington, DC, USA.
Psychol Health Med. 2025 Feb;30(2):297-308. doi: 10.1080/13548506.2024.2417311. Epub 2024 Oct 21.
This study aimed to understand long-term coping responses of mothers ( = 287) receiving genetic counseling and testing (GCT) for hereditary breast/ovarian cancer (HBOC) syndrome. Psychological characteristics, including cancer-specific distress (Impact of Events Scale-Revised, α = .85) and coping (Brief COPE, α = .93) were assessed via structured personal communication, along with epidemiologic items assessing personal and family history of cancer. Genetic risk was determined by carriage. A principal component analysis was conducted on the coping measure to reduce its summary score to active coping (α = .91) with nine approach-oriented strategies responsive to stress. A multivariable regression model examined the main and interacting effects of clinical and psychological characteristics on maternal coping. Personal cancer history (F = 4.99, df = 1, = .026), test result (F = 22.20, df = 1, < .001), and cancer-specific distress (F = 17.80, df = 1, < .001) were associated with greater engagement in active coping strategies. When controlling for cancer-specific distress, the interaction between personal cancer history and genetic test results was significant, such that women previously unaffected by cancer who received positive results reported the greatest levels of active coping (F = 7.92, < .001). These findings indicate that previous cancer history, genetic risk, and psychological distress independently and jointly impact how women adapt to the threat of cancer over time.
本研究旨在了解接受遗传性乳腺癌/卵巢癌(HBOC)综合征遗传咨询与检测(GCT)的母亲(n = 287)的长期应对反应。通过结构化的个人交流评估心理特征,包括癌症特异性困扰(事件影响量表修订版,α = 0.85)和应对方式(简易应对方式问卷,α = 0.93),同时评估流行病学项目以了解个人和家族癌症病史。通过基因携带情况确定遗传风险。对应对方式量表进行主成分分析,将其总分简化为积极应对(α = 0.91),该量表包含九种应对压力的积极导向策略。多变量回归模型检验了临床和心理特征对母亲应对方式的主要和交互作用。个人癌症病史(F = 4.99,自由度 = 1,P = 0.026)、基因检测结果(F = 22.20,自由度 = 1,P < 0.001)和癌症特异性困扰(F = 17.80,自由度 = 1,P < 0.001)与更多地采用积极应对策略相关。在控制癌症特异性困扰后,个人癌症病史与基因检测结果之间的交互作用显著,即先前未患癌症但基因检测结果为阳性的女性报告的积极应对水平最高(F = 7.92,P < 0.001)。这些发现表明,既往癌症病史、遗传风险和心理困扰独立且共同影响女性随着时间推移如何适应癌症威胁。