The anxiety course during predictive genetic testing protocol for HBOC or HNPCC in pre-symptomatic persons

Abstract

Background : To study the evolution of anxiety and the use of emotional suppression strategies during the course of a predictive genetic testing protocol for breast / ovarian cancer (HBOC) or Lynch syndrome (HNPCC) in pre-symptomatic persons belonging to a family in which an hereditary mutation has been identified. Method : Thirty three mutation-positive individuals and 48 mutation-negative individuals participated in this study. They completed questionnaires to measure anxiety-state (Stai-YA Scale), emotion regulation processes (ERQ Scale), and coping strategies (WCC Scale) at 3 times: just before the first oncogenetic counseling (Baseline, T0), 15 days after the test disclosure session (T1) and 6 months after the test disclosure (T2). Findings : The generalized estimating equation (GEE) revealed an interaction effect time * gene status. Non-carriers had their level of anxiety declined between T0 and T1 while it increased in carriers. The level of anxiety returned at baseline level for both groups between T1 and T2. The emotional suppression course evidenced an interaction between time and mutation status. Indeed, a decreasing of the suppression between T0-T1 was associated with the decline of the anxiety course at T1 for non mutation career while the suppression remain stable for carrier and associated with the anxiety level. Discussion : The predictive genetic testing for HBOC and HNPCC does not seem to induce major psychological problems at short and medium term. Moreover, generally, expressive suppression was associated with higher stress and anxiety, which leads us to consider clinical implications for modifying this emotional regulation strategy.