Correlates of Psychologic Distress in Colorectal Cancer Patients Undergoing Genetic Testing for Hereditary Colon Cancer

University of Texas Health Science Center at Houston School of Public Health 77225, USA.
Health Psychology (Impact Factor: 3.59). 02/1997; 16(1):73-86. DOI: 10.1037//0278-6133.16.1.73
Source: PubMed


In this article the authors describe the demographic and psychosocial correlates of 2 measures of psychologic distress among 200 colorectal cancer patients undergoing genetic testing for hereditary nonpolyposis colon cancer. The prevalence of symptoms of depression on the Center for Epidemiologic Studies Depression (CES-D) Scale was 24%. In multivariate analysis, female sex, less formal education, fewer sources of social contacts, and less satisfaction with them were associated with high scores on the CES-D Scale. Characteristics associated with high scores on the State-Trait Anxiety Inventory were younger age, less formal education, non-White race, local-regional stage of disease, fewer social contacts, and less satisfaction with them. Information on psychosocial correlates of psychologic distress may prove useful in guiding genetic counseling sessions, in identifying subgroups that need more intensive follow-up, and in developing interventions to facilitate adjustment to genetic test results.

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    • "Data were collected as part of a cross-sectional, qualitative study to evaluate family communication regarding Lynch Syndrome (Koehly et al. 2003; Pentz et al. 2005; Peterson et al. 2003). The qualitative study was part of a multi-phase longitudinal study of psychosocial aspects of genetic counseling and testing for Lynch Syndrome (Gritz et al. 2005; Vernon et al. 1999, 1997). Both studies were conducted concurrently with a research protocol offering free genetic counseling and testing for Lynch Syndrome. "
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    ABSTRACT: This study explores the social context of hereditary cancer risk perception in three families, an African-American family, a Mexican-American family, and a Caucasian family, each with Lynch Syndrome documented by a mismatch repair gene mutation. Communication network assessments measured family communication about cancer experiences and genetic testing information among a total of 26 participants. Participant narratives were evaluated to gain insight into how family cancer experiences and genetic testing information have shaped perceptions of cancer risk. Analysis of communication networks indicated that some families discussed cancer experiences to a greater extent than genetic testing information, and vice-versa. Interviews elucidated that sharing both types of health information led participants to conceptualize linkages among a strong family history of cancer, genetic testing information, and cancer prevention strategies. Understanding how different types of family communication influence the formation of perceived hereditary disease risk may enhance efforts to tailor genetic counseling services for families.
    Full-text · Article · Oct 2010 · Journal of Genetic Counseling
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    • "However, despite the fact that mean levels of distress are not increased, it has been reported that 3% to 24% of individuals experience heightened levels of distress after genetic counselling and/or testing for colorectal cancer [16-18]. Factors that are reported to be associated with heightened levels of distress during or after counselling or testing include: high perceived cancer risk [23], younger age [23], education level [18,23] (with conflicting findings with regard to the direction of the association), female gender [18], baseline mood disturbance [19], genetic test result (carriers and those awaiting test results) [16], fewer sources of social contacts [18,19], and less satisfaction with those contacts [18]. "
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    ABSTRACT: This study examined: (1) levels of cancer-specific distress more than one year after genetic counselling for hereditary nonpolyposis colorectal cancer (HNPCC); (2) associations between sociodemographic, clinical and psychosocial factors and levels of distress; (3) the impact of genetic counselling on family relationships, and (4) social consequences of genetic counselling. In this cross-sectional study, individuals who had received genetic counselling for HNPCC during 1986-1998 completed a self-report questionnaire by mail. 116 individuals (81% response rate) completed the questionnaire, on average 4 years after the last counselling session. Of all respondents, 6% had clinically significant levels of cancer-specific distress (Impact of Event Scale, IES). Having had contact with a professional psychosocial worker for cancer risk in the past 10 years was significantly associated with higher levels of current cancer specific distress. Only a minority of the counselees reported any adverse effects of genetic counselling on: communication about genetic counselling with their children (9%), family relationships (5%), obtaining life insurance (8%), choice or change of jobs (2%), and obtaining a mortgage (2%). On average, four years after genetic counselling for HNPCC, only a small minority of counselled individuals reports clinically significant levels of distress, or significant family or social problems.
    Full-text · Article · Feb 2007 · Hereditary Cancer in Clinical Practice
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    • "Consistent with the predictions of Baum et al. (1997), individuals receiving positive genetic testing results for Huntington's disease (Tibben, Timman, Bannick, & Duivenvoorden, 1997), hereditary breast/ovarian cancer risk (Croyle, Smith, Botkin, Baty, & Nash, 1997; Lodder et al., 2002) and colorectal cancer risk (Gritz et al., 2005) have been more distressed than those receiving negative testing results in the immediate post-testing period. Those feeling a residual sense of uncertainty about their risk (Decruyenaere et al., 2003) and those with less social support (Vernon et al., 1997) have also demonstrated greater post-testing anxiety. However , long-term follow-up of individuals after genetic testing for Huntington's disease (Decruyenaere et al., 2003; Tibben et al., 1997), breast/ ovarian cancer (van Oostrom et al., 2003), and colorectal cancer (Gritz et al., 2005) has revealed no significant differences amongst mutation carriers and noncarriers on several measures of psychological distress. "
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    ABSTRACT: Four theories of health behavior and of stress and coping are reviewed for their ability to illuminate interest in uptake and outcomes of genetic testing for adult-onset diseases. These theories are the Health Belief Model, the Theory of Planned Behavior (TPB), the Common Sense Model of Self-regulation (CSM), and the Transactional Model of Stress and Coping (TMSC). Basic concepts of each theory are discussed, followed by evidence from the literature supporting the relevance of these concepts to the understanding of genetic testing for four adult-onset diseases: Huntington's disease, Alzheimer's disease, hereditary breast/ovarian cancer, and hereditary colorectal cancer. Emphasis is placed on the finding that a decision to undergo genetic testing may be considered as a way to cope with both the cognitive and affective concerns that arise from living at increased risk of developing a disease in the future. The potential value of genetic testing for reducing uncertainty about and gaining a sense of control over one's risk of developing a chronic disease is highlighted. We argue that theories which focus on stress and coping provide a useful framework for future studies of genetic testing decisions for adult-onset disease risk.
    Full-text · Article · May 2006 · Social Science & Medicine
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