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To Test or Not To Test? Moderators of the Relationship Between Risk Perceptions and Interest in Predictive Genetic Testing

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The moderating effects of motivational factors (illness prevention vs. emotional reassurance), regulatory focus (health vs. illness orientations), and cancer anxiety on the relationship between risk perceptions and women's interest in predictive genetic testing for breast cancer were studied among 102 women with no history of breast cancer. Risk perceptions per se were unrelated to testing interests. Perceptions of higher personal risk for developing breast cancer were positively related to women's interest in testing only among women whose dominant motivation was not emotional reassurance, who were not oriented towards ruling-out disease, and who were not highly anxious about breast cancer. These findings pointed to conditions under which risk perceptions may enhance screening behaviors, and other conditions under which they may not.

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REFERENCES

  • Aiken, L. S., Fenaughty, A. M., West, S. G., Johnsons, J. J., and Luckett, T. L. (1995). Perceived determinants of risk for breast cancer and the relations among objective risk, perceived risk, and screening behavior over time. Women Health Res. Gender Behav. Policy 1: 27–50.

    CAS  Google Scholar 

  • Aiken, L. S., West, S. G., Woodward, C. K., and Reno, R. R. (1994). Health beliefs and compliance with mammography-screening recommendations in asymptomatic women. Health Psychol. 13: 122–129.

    Article  PubMed  CAS  Google Scholar 

  • American Cancer Society. (1995). Cancer facts and figures. American Cancer Society, Atlanta.

    Google Scholar 

  • Audrain, J., Rimer, B., Cella, D., Garber, J., Peshkin, B. N., Ellis, J., Schildkraut, J., Stefanek, M., Vogel, V., and Lerman, C. (1998). Genetic counseling and testing for breast-ovarian cancer susceptibility: what do women want? Clin. Oncol. 16: 133–138.

    CAS  Google Scholar 

  • Baum, A., Friedman, A. L., and Zakowski, S. G. (1997). Stress and genetic testing for disease risk. Health Psychol. 16: 8–19.

    Article  PubMed  CAS  Google Scholar 

  • Becker, M. H. (1974). The health belief model and personal health behavior. Health Educ. Monogr. 2: 324–508.

    Google Scholar 

  • Blackwood, M. A., and Weber, B. L. (1998). BRCA1 and BRCA2: from molecular genetics to clinical medicine. J. Clin. Oncol. 16: 1969–1977.

    PubMed  CAS  Google Scholar 

  • Bowen, D. J., Helmes, A., Powers, D., Andersen, M. R., Burke, W., McTiernan, A., and Durfy, S. (2003). Predicting breast cancer screening intentions and behavior with emotion and cognitions. J. Soc. Clin. Psychol. 22: 213–232.

    Article  Google Scholar 

  • Brain, K., Gray, J., Norman, P., Parsons, E., Clarke, A., Rogers, C., Mansel, R., and Harper, P. (2000). Why do women attend familial breast cancer clinics? J. Med. Genet. 37: 197–202.

    Article  PubMed  CAS  Google Scholar 

  • Braithwaite, D., Sutton, S., and Steggles, N. (2002). Intention to participate in predictive genetic testing for hereditary cancer: the role of attitude toward uncertainty. Psychol. Health 17: 761–772.

    Article  Google Scholar 

  • Cameron, L. D., and Diefenbach, M. A. (2001). Responses to information about psychosocial consequences of genetic testing for breast cancer susceptibility: influences of cancer worry and risk perceptions. J. Health Psychol. 6: 47–59.

    Google Scholar 

  • Cameron, L. D., and Leventhal, H. (1995). Vulnerability beliefs, symptom experiences, and the processing of health threat information: A self-regulatory perspective. J. Appl. Soc. Psychol. 25: 1859–1883.

    Article  Google Scholar 

  • Crisp, B. R., and Barber, J. G. (1995). The effect of locus of control on the association between risk perception and sexual risk-taking. Pers. Individual Diff. 19: 841–845.

    Article  Google Scholar 

  • Croyle, R. T., Dutson, D. S., Tran, V. T., and Sun, Y. C. (1995). Need for certainty and interest in genetic testing. Women Health 1: 329–339.

    CAS  Google Scholar 

  • Croyle, R. T., and Lerman, C. (1993). Interest in genetic testing for colon cancer susceptibility: cognitive and emotional correlates. Prev. Med. 22: 284–292.

    Article  PubMed  CAS  Google Scholar 

  • Croyle, R. T., and Lerman, C. (1995). Psychological impact of genetic testing. In Croyle, R. T. (Ed.), Psychological effects of screening for disease prevention and detection. Oxford University Press, New York, pp. 11–38.

    Google Scholar 

  • Cull, A. (1998). Psychological implications of progress in breast cancer genetics: Uncertainties and challenges. Clin. Psychol. Psychother. 5: 109–123.

    Article  Google Scholar 

  • Daly, M. B., Lerman, C. L., Ross, E., Schwartz, M. D., Sands, C. B., and Masny, A. (1996). Gail model breast cancer risk components are poor predictors of risk perception and screening behaviour. Breast Cancer Res. Treat. 41: 59–70.

    Article  PubMed  CAS  Google Scholar 

  • Decruynaere, M., Evers-Kiebooms, G., and Van den Berghe, H. (1993). Perception of predictive testing for Huntington's disease by young women: preferring uncertainty to certainty? J. Med. Genet. 30: 557–561.

    Article  Google Scholar 

  • Ditto, P. H., and Croyle, R. T. (1995). Understanding the impact of risk factor test results: Insights from a basic research program. In Croyle, R. T. (Ed.), Psychological effects of screening for disease prevention and detection. Oxford University Press, New York, pp. 144–181.

    Google Scholar 

  • Durfy, S. J., Bowen, D. J., McTiernan, A., Sporleder, J., and Burke, W. (1999). Attitudes and interest in genetic testing for breast and ovarian cancer susceptibility in diverse groups of women in western Washington. Cancer Epidemiol. Biomark. Prev. 8: 369–375.

    CAS  Google Scholar 

  • Eiser, J. R., and Cole, N. (2002). Participation in cervical screening as a function of perceived risk, barriers and need for cognitive closure. J. Health Psychol. 7: 99–105.

    Article  Google Scholar 

  • Ellisen, L. W., and Haber, D. A. (1998). Hereditary breast cancer. Annu. Rev. Med. 49: 425–436.

    Article  PubMed  CAS  Google Scholar 

  • Evers-Kiebooms, G., Welkenhuysen, M., Claes, E., Decruyenaere, M., and Denayer, L. (2000). The psychological complexity of predictive testing for late onset neurogenetic diseases and hereditary cancers: Implications for multidisciplinary counseling and for genetic education. Soc. Sci. Med. 51: 831–841.

    Article  PubMed  CAS  Google Scholar 

  • Floyd, D. L., Prentice-Dunn, S., and Rogers, R. W. (2000). A meta-analysis of research on protection motivation theory. J. Appl. Soc. Psychol. 30: 407–429.

    Article  Google Scholar 

  • Gerend, M. A., Aiken, L. S., West, S. G., and Erchull, M. J. (2004). Beyond medical risk: Investigating the psychological factors underlying women's perceptions of susceptibility to breast cancer, heart disease, and osteoporosis. Health Psychol. 23: 247–258.

    Article  PubMed  Google Scholar 

  • Green, J., Murton, F., and Statham, H. (1993). Psychological issues raised by a familial ovarian cancer register. J. Med. Genet. 30: 575–579.

    PubMed  CAS  Google Scholar 

  • Higgins, E. T. (1998). Promotion and prevention: Regulatory focus as a motivational principle. Adv. Exp. Soc. Psychol. 30: 1–46.

    Google Scholar 

  • Holtzman, N. A. (1999). Are genetic tests adequately regulated? Science 286: 409.

    Article  PubMed  CAS  Google Scholar 

  • Kash, K. M., Holland, J. C., Halper, M. S., and Miller, G. (1992). Psychological distress and suveillance behaviors of women with a family history of breast cancer. J. Nat. Cancer Inst. 84: 24–30.

    Article  PubMed  CAS  Google Scholar 

  • Katapodi, M. C., Lee, K. A., Facione, N. C., and Dodd, M. J. (2004). Predictors of perceived breast cancer risk and the relation between perceived risk and breast cancer screening: A meta-analytic review. Prev. Med. 38: 388–402.

    Article  PubMed  Google Scholar 

  • Kent, G., Howie, H., Fletcher, M., Newbury-Ecob, R., and Hosie, K. (2000). The relationship between perceived risk, thought intrusiveness and emotional well-being in women receiving counseling for breast cancer risk in a family history clinic. Br. J. Health Psychol. 5: 15–26.

    Article  Google Scholar 

  • Kowalski, M. R., Henson, K. D., and Longshore, D. (1997). Rethinking perceived risk and health behavior: A critical review of HIV prevention research. Health Educ. Behav. 24: 313–325.

    Article  Google Scholar 

  • Lerman, C., Biesecker, B., Benkendorf, J. L., Kerne, J., Gomez-Caminero, A., Hughes, C., and Reed, M. M. (1997). Controlled trial of pretest education approaches to enhance informed decision making for BRCA1 gene testing. J. Nat. Cancer Inst. 89: 148–157.

    Article  PubMed  CAS  Google Scholar 

  • Lerman, C., Daly, C., Sands, C., Balshem, A., Lustbader, E., Heggan, T., Goldstein, L., James, J., and Engstrom, P. (1993). Mammography adherence and psychological distress among women at risk for breast cancer. J. Nat. Cancer Inst. 85: 1074–1080.

    Article  PubMed  CAS  Google Scholar 

  • Lerman, C., Lustbader, E., Rimer, B., Daly, M., Miller, S., Sands, C., and Balshem, A. (1995). Effects of individualized breast cancer risk counseling: A randomized trial. J. Nat. Cancer Inst. 87: 286–292.

    Article  PubMed  CAS  Google Scholar 

  • Lerman, C., and Schwartz, M. (1993). Adherence and psychological adjustment among women at high risk for breast cancer. Breast Cancer Res. Ther. 28: 144–155.

    Google Scholar 

  • Leventhal, H. (1970). Findings and theory in the study of fear communications. Adv. Exp. Soc. Psychol. 5: 119–186.

    Google Scholar 

  • Leventhal, H., Safer, M. A., and Panagis, D. M. (1983). The impact of communications on the self-regulation of health beliefs, decisions, and behavior. Health Educ. Q. 10: 3–29.

    PubMed  CAS  Google Scholar 

  • Marteau, T. M. (1993). Health-related screening: Psychological predictors of uptake and impact. In Maes, S., Leventhal, H., and Johnston, M. (Eds.), Int. Rev. Health Psychol., Vol. 2. Wiley, Chichester, UK, pp. 149–174.

    Google Scholar 

  • Marteau, T. M. (1995). Toward an understanding of the psychological consequences of screening. In Croyle, R. T. (Ed.), Psychological effects of screening for disease prevention and detection. Oxford University Press, New York, pp. 185–199.

    Google Scholar 

  • McCaul, K. D., Branstetter, A. D., Schroeder, D. M., and Glasgow, R. E. (1996a). What is the relationship between breast cancer risk and mammography screening? A meta-analytic review. Health Psychol. 15: 423–429.

    Article  PubMed  CAS  Google Scholar 

  • McCaul, K. D., and O’Donnell, S. M. (1998). Naïve beliefs about breast cancer risk. Women Health Res. Gender Behav. Policy 4: 93–101.

    CAS  Google Scholar 

  • Meiser, B., Butow, P., Schnieden, V., Gattas, M., Gaff, C., Harrop, K., Bankier, A., Young, M. A., and Tucker, K. (2000). Psychological adjustment of women at increased risk of developing hereditary breast cancer. Psychol. Health Med. 5: 378–388.

    Google Scholar 

  • Michie, S., Weinman, J., Miller, J., Collins, V., Halliday, J., and Marteau, T. M. (2002). Predictive genetic testing: High risk expectations in the face of low risk information. J. Behav. Med. 25: 33–50.

    Article  PubMed  Google Scholar 

  • Press, N. A., Yasui, Y., Reynolds, S., Durfy, S. J., and Burke, W. (2001). Women's interest in genetic testing for breast cancer susceptibility may be based on unrealistic expectations. Am. J. Med. Genet. 99: 99–110.

    Article  PubMed  CAS  Google Scholar 

  • Rogers, R. W. (1975). A protection motivation theory of fear appeals and attitude change. J. Psychol. 91: 93–114.

    Google Scholar 

  • Ronis, D. L. (1992). Conditional health threats: health beliefs, decisions and behaviors among adults. Health Psychol. 11: 127–134.

    Article  PubMed  CAS  Google Scholar 

  • Saidi, G., Sutton, S., and Bickler, G. (1998). A predictive study of reasons for attendance and non-attendance at a breast screening programme. Psychol. Health 13: 23–33.

    Article  Google Scholar 

  • Salkovskis, P. M., and Rimes, K. A. (1997). Predictive genetic testing: psychological factors. J. Psychosom. Res. 43: 477–487.

    Article  PubMed  CAS  Google Scholar 

  • Shaw, C., Abrams, K., and Marteau, T. M. (1999). Psychological impact of predicting individuals’ risks of illness: a systematic review. Soc. Sci. Med. 49: 1571–1598.

    Article  PubMed  CAS  Google Scholar 

  • Shiloh, S., Jaffe Eini, N., Ben-Neria, Z., and Sagi, M. (2001). Framing of prenatal screening test results and women's health-illness orientations as determinants of perceptions of fetal health and approval of amniocentesis. Psychol. Health 16: 313–325.

    Article  Google Scholar 

  • Shiloh, S., Petel, Y., Papa, M., and Goldman, B. (1998). Motivations, perceptions and interpersonal differences associated with interest in genetic testing for breast cancer susceptibility among women at high and average risk. Psychol. Health 13: 1071–1086.

    Article  Google Scholar 

  • Shiloh, S., Vinter, M., and Barak, A. (1997). Correlates of health screening utilization: The roles of health beliefs and self-regulation motivation. Psychol. Health 12: 301–317.

    Article  Google Scholar 

  • Smith, K. R., and Croyle, R. T. (1995). Attitudes toward genetic testing for colon cancer risk. Am. J. Pub. Health 85: 1435–1438.

    PubMed  CAS  Google Scholar 

  • Tambor, E. S., Rimer, B. K., and Strigo, T. S. (1997). Genetic testing for breast cancer susceptibility: awareness and interest among women in the general population. Am. J. Med. Genet. 68: 43–49.

    Article  PubMed  CAS  Google Scholar 

  • van der Pligt, J. (1994). Healthy thoughts about unhealthy behaviour. Psychol. Health 9: 187–190.

    Article  Google Scholar 

  • Van der Pligt, J. (1998). Perceived risk and vulnerability as predictors of precautionary behaviour. Br. J. Health Psychol. 3: 1–14.

    Google Scholar 

  • Van der Pligt, J., and Richard, R. (1994). Changing adolescents’ sexual behaviour: perceived risk, self-efficacy and anticipated regret. Patient Educ. Counsel. 23: 187–196.

    Article  CAS  Google Scholar 

  • Vernon, S. W., Vogel, V. G., Halabi, S., and Bondy, M. L. (1993). Factors associated with perceived risk of breast cancer among women attending a screening program. Breast Cancer Res. Ther. 28: 173–244.

    Google Scholar 

  • Weinstein, N. D. (1988). The precaution adaption process. Health Psychol. 7: 355–386.

    Article  PubMed  CAS  Google Scholar 

  • Weinstein, N. D. (1993). Testing four competing theories of health-protective behavior. Health Psychol. 12: 324–333.

    Article  PubMed  CAS  Google Scholar 

  • Weinstein, N. D. (2000). Perceived probability, perceived severity, and health-protective behavior. Health Psychol. 19: 65–74.

    Article  PubMed  CAS  Google Scholar 

  • Welkenhuysen, M., Evers-Kiebooms, G., Decruyenaere, M., Claes, E., and Denayer, L. (2001). A community based study on intentions regarding predictive testing for hereditary breast cancer. J. Med. Genet. 38: 540–547.

    Article  PubMed  CAS  Google Scholar 

  • Wroe, A. L., Salkovskis, P. M. (1999). Factors influencing anticipated decisions about genetic testing: Experimental studies. Br. J. Health Psychol. 4: 19–40.

    Article  Google Scholar 

  • Wroe, A. L., Salkovskis, P. M., and Rimes, K. A. (1998). The prospect of predictive testing for personal risk: attitudes and decision making. Behav. Res. Ther. 36: 599–619.

    Article  PubMed  CAS  Google Scholar 

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ACKNOWLEDGMENT

We thank Susan Michie for her valuable comments on an early version of this manuscript

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Correspondence to Shoshana Shiloh.

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This study was done in partial fulfillment of the M.A. thesis of the second author.

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Shiloh, S., Ilan, S. To Test or Not To Test? Moderators of the Relationship Between Risk Perceptions and Interest in Predictive Genetic Testing. J Behav Med 28, 467–479 (2005). https://doi.org/10.1007/s10865-005-9017-4

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