title: Intrusion and avoidance in subjects undergoing genetic investigation and counseling for hereditary cancer.
abstract: OBJECTIVE
  Genetic counseling for hereditary cancer is expected to involve a growing number of individuals in the near future since an increasing number of genetic tests are offered. This study was designed to identify psychosocial variables predicting distress after genetic investigation and genetic counseling (GC) in order to develop new counseling strategies.
  
  
  METHODS
  A prospective multi-site study was undertaken on 214 patients undergoing GC for hereditary cancer to explore the relationships between socio-demographic variables, medical variables, social support, self-efficacy, physical functioning, satisfaction with GC, the level of worry after GC, results of genetic testing, and the course and outcomes of distress. Distress was measured with the Impact of Event Scale, which includes subscales of intrusion and avoidance. Patients completed questionnaires mailed to them before and after GC.
  
  
  RESULTS
  The mean level of intrusion and avoidance was moderate, even though one quarter of participants reported a severe level of intrusion at baseline. Subjects with a low level of self-efficacy at baseline and high level of worry immediately after GC seemed to be vulnerable to both intrusion and avoidance. Lower level of intrusion was also associated with having a first-degree relative with cancer, while a lower avoidance level was associated with a higher level of education, having cancer, more social support, and higher satisfaction with GC.
  
  
  CONCLUSIONS
  In this study, subjects who had lower level of self-efficacy at baseline and a high level of worry immediately after GC seemed to be vulnerable to both intrusion and avoidance in this study.
authors.affiliation: Department of Public Health and Primary Health Care, University of Bergen, 5018 Bergen, Norway. cathrine.bjorvatn@isf.uib.no
authors.forename: Cathrine
authors.initials: C
authors.lastname: Bjorvatn
authors.forename: Geir Egil
authors.initials: GE
authors.lastname: Eide
authors.forename: Berit R
authors.initials: BR
authors.lastname: Hanestad
authors.forename: Anniken
authors.initials: A
authors.lastname: Hamang
authors.forename: Odd E
authors.initials: OE
authors.lastname: Havik
mesh_terms: D000328:Adult; D005260:Female; D005817:Genetic Counseling / Q000379:methods / Q000523:psychology*; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000235:genetics / Q000523:psychology; D017060:Patient Satisfaction; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D020377:Self Efficacy; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires