title: Psychological impact of genetic counseling for hereditary nonpolyposis colorectal cancer: the role of cancer history, gender, age, and psychological distress.
abstract: OBJECTIVE
  We prospectively examined the impact of an initial interdisciplinary genetic counseling (human geneticist, oncologist, and psycho-oncologist) on feelings of anxiety with a special focus on subgroups related to personal cancer history, gender, age, and education.
  
  
  RESULTS
  At baseline, cancer-affected men revealed a significantly higher level of anxiety than unaffected men (p<0.05), whereas history of cancer did not play a role in women. Furthermore, a significant interaction between time, gender, and age was identified for change of anxiety. While women in general and men above 50 years revealed a significant reduction in anxiety, younger men did not show any change over time. A logistic regression indicated that clinical Hospital Anxiety and Depression Scale-A cases can be predicted by general distress (Brief Symptom Inventory) as well as by hereditary nonpolyposis colorectal cancer-related cognitions of intrusion and avoidance (impact of event scale) with a correct classification of 86%.
  
  
  CONCLUSIONS
  Although initial hereditary nonpolyposis colorectal cancer counseling leads to an overall reduction of anxiety, differential effects of cancer history, gender, and age focus on subgroups of cancer-affected men, who may display unexpectedly high anxiety scores at baseline. Especially younger men do not seem to reduce this high anxiety level. Baseline anxiety was mainly determined by maladaptive situation-specific cognitions. Therefore, consulters should be more aware of anxiety-related cognitions in cancer-affected younger men.
authors.affiliation: Department of Medical Psychology and Medical Sociology, Medical Faculty, Ruhr-University of Bochum, Bochum, Germany. monika.hasenbring@ruhr-uni-bochum.de
authors.forename: Monika I
authors.initials: MI
authors.lastname: Hasenbring
authors.forename: Nina
authors.initials: N
authors.lastname: Kreddig
authors.forename: Gabriele
authors.initials: G
authors.lastname: Deges
authors.forename: Joerg T
authors.initials: JT
authors.lastname: Epplen
authors.forename: Erdmute
authors.initials: E
authors.lastname: Kunstmann
authors.forename: Susanne
authors.initials: S
authors.lastname: Stemmler
authors.forename: Karsten
authors.initials: K
authors.lastname: Schulmann
authors.forename: Joerg
authors.initials: J
authors.lastname: Willert
authors.forename: Wolf
authors.initials: W
authors.lastname: Schmiegel
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000175:diagnosis / Q000503:physiopathology; D001294:Attitude to Health; D003123:Colorectal Neoplasms, Hereditary Nonpolyposis / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology*; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D020022:Genetic Predisposition to Disease / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013315:Stress, Psychological