, Volume 19, Issue 4, pp 362-369

Predictors of intrusive thoughts and avoidance in women with family histories of breast cancer

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Having a family history of cancer is an important predictor of lifetime cancer risk. Individuals with family histories of cancer have been reported to experience symptoms of general distress and to have frequent intrusive thoughts and avoidance regarding cancer. To date, little is known about predictors of such distress. A relation between perception of cancer risk and distress has been suggested, but the possibility that prior cancer-related events may contribute to distress in these women has received little attention. The major aim of the study was to examine the contribution of the past experience of the death of a parent from cancer to distress in women at familiar risk for breast cancer.

Women with family histories of breast cancer (Risk Group, N=46) were assessed on the day of their yearly mammography screening and four to eight weeks after normal result notification in order to confirm the generalizability of their distress. Their levels of intrusive thoughts, avoidance, and perceived lifetime risk for breast cancer were significantly higher than those of women with no family histories of cancer who were not undergoing mammography (Comparison Group, N=43), and this was true on both assessment days. Among the women in the Risk Group, those whose parent (s) had died of cancer had the highest levels of intrusive thoughts, avoidance, and perceived risk. Results suggested that perceived risk mediated the effect of this event on intrusive thoughts and avoidance regarding breast cancer. The findings are discussed in terms of theories of cognitive responses to traumatic and stressful life events. Implications for future research and interventions are discussed.

Preparation of this manuscript was supported in part by research grants from the American Cancer Society (PBR-92) and the Martell Foundation, as well as a Career Development Award (Valdimarsdottir; J-4139) and a Postdoctoral Fellowship Award (Zakowski; J-4164) from the United States Department of Defense. We are required to indicate that the content of the information contained in this report does not necessarily reflect the position or policy of the United States Government.
The authors want to thank Ms. Jennifer Keats and Julie Fasano for their help in conducting the study, as well as Dr. William Redd and the anonymous reviewers for their comments on an earlier draft of this manuscript.