PSYCHOLOGICAL INTERVENTIONS AND GENETIC TESTING - FACILITATING INFORMED DECISIONS ABOUT BRCA1 2 CANCER SUSCEPTIBILITY/

Genetic testing for inherited cancer susceptibility based on the recen tly identified BRCA1 and BRCA2 genes, will soon be available on a larg e scale. However at present, genetic test results do not lead to clear ly indicated diagnostic or preventive measures, and the nature of the psychological impact of BRCA1/2 resting is still largely unknown. This uncertainty, combined with preliminary evidence suggesting significan t individual differences in reactions to genetic susceptibility feedba ck, constitutes a unique challenge for any individual contemplating su ch testing. We outline the nature of this challenge and then propose a n intervention strategy designed to help individuals make deeply proce ssed and psychologically well-informed decisions with regard to their genetic susceptibility. The intervention is guided by recent research findings and theory on the cognitive-emotional processing of cancer-ri sk information. Specifically, the goal is to prepare the individual fo r genetic testing by (1) cognitively and emotionally activating, or '' preliving,'' the individual's potential reactions to testing feedback; (2) facilitating accurate appraisal of the individual's cognitive-emo tional reactions; and (3) Enabling the individual to process these rea ctions through the use of well-established clinical techniques.