title: Distress among women receiving uninformative BRCA1/2 results: 12-month outcomes.
abstract: OBJECTIVE
  Few data are available regarding the long-term psychological impact of uninformative BRCA1/2 test results. This study examines change in distress from pretesting to 12-months post-disclosure, with medical, family history, and psychological variables, such as pretesting perceived risk of carrying a deleterious mutation prior to testing and primary and secondary appraisals, as predictors.
  
  
  METHODS
  Two hundred and nine women with uninformative BRCA1/2 test results completed questionnaires at pretesting and 1-, 6-, and 12-month post-disclosure, including measures of anxiety and depression, cancer-specific and genetic testing distress. We used a mixed models approach to predict change in post-disclosure distress.
  
  
  RESULTS
  Distress declined from pretesting to 1-month post-disclosure, but remained stable thereafter. Primary appraisals predicted all types of distress at 1-month post-disclosure. Primary and secondary appraisals predicted genetic testing distress at 1-month as well as change over time. Receiving a variant of uncertain clinical significance and entering testing with a high expectation for carrying a deleterious mutation predicted genetic testing distress that persisted through the year after testing.
  
  
  CONCLUSIONS
  As a whole, women receiving uninformative BRCA1/2 test results are a resilient group. For some women, distress experienced in the month after testing does not dissipate. Variables, such as heightened pretesting perceived risk and cognitive appraisals, predict greater likelihood for sustained distress in this group and could be amenable to intervention.
authors.affiliation: Lombardi Comprehensive Cancer Center, Jess and Mildred Fisher Center for Familial Cancer Research, Georgetown University, Georgetown, Washington, DC 20007, USA. sco4@georgetown.edu
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: O'Neill
authors.forename: Christine
authors.initials: C
authors.lastname: Rini
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Goldsmith
authors.forename: Heiddis
authors.initials: H
authors.lastname: Valdimarsdottir
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Cohen
authors.forename: Marc D
authors.initials: MD
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005820:Genetic Testing / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D055500:Resilience, Psychological; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome