Audrain J, Schwartz M D, Lerman C, Hughes C, Peshkin B N, Biesecker B
Georgetown University Medical Center, Washington, DC 20007, USA.
Ann Behav Med. 1997 Fall;19(4):370-7. doi: 10.1007/BF02895156.
The purpose of the present study was two-fold: (a) to characterize the psychological status of women with a family history of breast or ovarian cancer who self-refer for genetic counseling and BRCA1 testing; and (b) to identify specific demographic, personality, and appraisal factors that contribute to cancer-specific distress and general distress in this group of women. Participants were 256 women ages 18 and older who had at least one first-degree relative (FDR) with breast and/or ovarian cancer. Participants were recruited through breast cancer clinics and obstetrics/gynecology departments at two medical centers by responding to program information described in a brochure. The results revealed moderate distress levels in this population. The results of a hierarchical regression of general distress indicated that women with higher levels of general distress were less likely to be married, less optimistic, and had heightened breast cancer risk perceptions accompanied by feelings of low perceptions of control over the development of breast cancer (R2 = .44, p = .0001). Women with higher levels of cancer-specific distress tended to be younger and non-White and had low perceptions of control over developing breast cancer (R2 = .15, p = .0002). These findings suggest that self-referred genetic counseling participants may be psychologically vulnerable and may benefit from interventions designed to decrease distress and the perceived absence of control over developing breast cancer.
（a）描述那些因自我推荐前来进行遗传咨询和BRCA1检测、且有乳腺癌或卵巢癌家族史的女性的心理状况；（b）确定导致该组女性特定癌症困扰和一般困扰的具体人口统计学、人格和评估因素。研究对象为256名18岁及以上的女性，她们至少有一位患有乳腺癌和/或卵巢癌的一级亲属（FDR）。通过回应一本小册子中描述的项目信息，在两个医疗中心通过乳腺癌诊所和妇产科招募了参与者。结果显示该人群存在中度困扰水平。一般困扰的分层回归结果表明，一般困扰水平较高的女性结婚的可能性较小，不太乐观，对乳腺癌风险的认知较高，同时伴有对乳腺癌发展控制感较低的感觉（R2 = 0.44，p = 0.0001）。特定癌症困扰水平较高的女性往往更年轻且非白人，对患乳腺癌的控制感较低（R2 = 0.15，p = 0.0002）。这些发现表明，自我推荐进行遗传咨询的参与者可能在心理上较为脆弱，可能会从旨在减少困扰以及对患乳腺癌缺乏控制感的干预措施中受益。
