Supportive Care in Cancer

, Volume 17, Issue 11, pp 1371–1381 | Cite as

Intrusion and avoidance in subjects undergoing genetic investigation and counseling for hereditary cancer

  • Cathrine Bjorvatn
  • Geir Egil Eide
  • Berit R. Hanestad
  • Anniken Hamang
  • Odd E. Havik
Original Article


Goals of work

Genetic counseling for hereditary cancer is expected to involve a growing number of individuals in the near future since an increasing number of genetic tests are offered. This study was designed to identify psychosocial variables predicting distress after genetic investigation and genetic counseling (GC) in order to develop new counseling strategies.

Materials and methods

A prospective multi-site study was undertaken on 214 patients undergoing GC for hereditary cancer to explore the relationships between socio-demographic variables, medical variables, social support, self-efficacy, physical functioning, satisfaction with GC, the level of worry after GC, results of genetic testing, and the course and outcomes of distress. Distress was measured with the Impact of Event Scale, which includes subscales of intrusion and avoidance. Patients completed questionnaires mailed to them before and after GC.

Main results

The mean level of intrusion and avoidance was moderate, even though one quarter of participants reported a severe level of intrusion at baseline. Subjects with a low level of self-efficacy at baseline and high level of worry immediately after GC seemed to be vulnerable to both intrusion and avoidance. Lower level of intrusion was also associated with having a first-degree relative with cancer, while a lower avoidance level was associated with a higher level of education, having cancer, more social support, and higher satisfaction with GC.


In this study, subjects who had lower level of self-efficacy at baseline and a high level of worry immediately after GC seemed to be vulnerable to both intrusion and avoidance in this study.


Intrusion Avoidance Genetic counseling Hereditary cancer Subjective distress 



The authors are grateful for the assistance with data collection provided by the Centre of Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway, and the Centre of Medical Genetics, St. Olav Hospital, Trondheim, Norway. We are also grateful to Professor Cathrine Himberg, California State University, for linguistic advice. This project was funded by the Norwegian Research Council, Functional Genome Project (FUGE) no. 155757/510.


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Cathrine Bjorvatn
    • 1
    • 2
  • Geir Egil Eide
    • 1
    • 3
  • Berit R. Hanestad
    • 1
    • 4
  • Anniken Hamang
    • 1
    • 4
  • Odd E. Havik
    • 1
    • 4
  1. 1.Department of Public Health and Primary Health CareUniversity of BergenBergenNorway
  2. 2.Center of Medical Genetics and Molecular MedicineHaukeland University HospitalBergenNorway
  3. 3.Centre for Clinical ResearchHaukeland University HospitalBergenNorway
  4. 4.Department of Clinical PsychologyUniversity of BergenBergenNorway

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