STRESS AND GENETIC TESTING FOR DISEASE RISK

Healthy people who believe they are at risk for a life-threatening dis ease appear to carry a substantial stress burden because of threat of disease and uncertainty of risk, Testing for risk factors may be helpf ul by reducing this uncertainty, but diseases with multiple causes, li ke breast cancer, appear to be determined by generic factors and by ag e, reproductive behavior, exposure to environmental toxins, or unknown antecedents. For diseases caused by inherited generic defects, testin g brings different benefits and stressors. A model is proposed that pr edicts long-term distress when risk analysis suggests a very high risk , when uncertainty is not reduced, when results of testing are at odds with preventive actions already taken, and when people who receive a positive, risk-increasing result lack strong social support, coping sk ills, other psychosocial resources, or all of these.