Baum A, Friedman A L, Zakowski S G
University of Pittsburgh Cancer Institute, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Health Psychol. 1997 Jan;16(1):8-19. doi: 10.1037//0278-6133.16.1.8.
Healthy people who believe they are at risk for a life-threatening disease appear to carry a substantial stress burden because of threat of disease and uncertainty of risk. Testing for risk factors may be helpful by reducing this uncertainty, but diseases with multiple causes, like breast cancer, appear to be determined by genetic factors and by age, reproductive behavior, exposure to environmental toxins, or unknown antecedents. For diseases caused by inherited genetic defects, testing brings different benefits and stressors. A model is proposed that predicts long-term distress when risk analysis suggests a very high risk, when uncertainty is not reduced, when results of testing are at odds with preventive actions already taken, and when people who receive a positive, risk-increasing result lack strong social support, coping skills, other psychosocial resources, or all of these.
那些认为自己有患危及生命疾病风险的健康人，似乎因疾病威胁和风险不确定性而承受着巨大的压力负担。检测风险因素可能有助于降低这种不确定性，但像乳腺癌这类由多种原因引起的疾病，似乎由遗传因素、年龄、生殖行为、接触环境毒素或未知的先前因素所决定。对于由遗传性基因缺陷引起的疾病，检测会带来不同的益处和压力源。本文提出了一个模型，该模型预测，当风险分析表明风险非常高、不确定性未降低、检测结果与已采取的预防措施不一致，以及当得到阳性的、增加风险结果的人缺乏强大的社会支持、应对技能、其他心理社会资源或所有这些时，会出现长期痛苦。
