PREDICTION OF PSYCHOLOGICAL FUNCTIONING ONE-YEAR AFTER THE PREDICTIVETEST FOR HUNTINGTONS-DISEASE AND IMPACT OF THE TEST RESULT ON REPRODUCTIVE DECISION-MAKING
M. Decruyenaere et al., PREDICTION OF PSYCHOLOGICAL FUNCTIONING ONE-YEAR AFTER THE PREDICTIVETEST FOR HUNTINGTONS-DISEASE AND IMPACT OF THE TEST RESULT ON REPRODUCTIVE DECISION-MAKING, Journal of Medical Genetics, 33(9), 1996, pp. 737-743
For people at risk for Huntington's disease, the anxiety and uncertain
ty about the future may be very burdensome and may be an obstacle to p
ersonal decision making about important Life issues, for example, proc
reation. For some at risk persons, this situation is the reason for re
questing predictive DNA testing. The aim of this paper is two-fold. Fi
rst, we want to evaluate whether knowing one's carrier status reduces
anxiety and uncertainty and whether it facilitates decision making abo
ut procreation. Second, we endeavour to identify pretest predictors of
psychological adaptation one year after the predictive test (psychome
tric evaluation of general anxiety, depression level, and ego strength
).The impact of the predictive test result was assessed in 53 subjects
tested, using pre- and post-test psychometric measurement and self-re
port data of follow up interviews. Mean anxiety and depression levels
were significantly decreased one year after a good test result; there
was no significant change in the case of a bad test result. The mean p
ersonality profile, including ego strength, remained unchanged one yea
r after the test. The study further shows that the test result had a d
efinite impact on reproductive decision making. Stepwise multiple regr
ession analyses were used to select the best predictors of the subject
's post-test reactions. The results indicate that a careful evaluation
of pretest ego strength, depression level, and coping strategies may
be helpful in predicting post-test reactions, independently of the car
rier status. Test result (carrier/non-carrier), gender, and age did no
t significantly contribute to the prediction. About one third of the v
ariance of posttest anxiety and depression level and more than half of
the variance of ego strength was explained, implying that other psych
ological or social aspects should also be taken into account when pred
icting individual post-test reactions.