title: Subjective and Objective Risks of Carrying a BRCA1/2 Mutation in Individuals of Ashkenazi Jewish Descent.
abstract: This repeated measures study examines (1) the change in subjective risk of mutations pre- to postcounseling, (2) the accuracy of BRCAPRO estimates of mutations, and (3) the discrepancy between subjective risk and BRCAPRO estimates of mutations before and after genetic counseling. Ninety-nine Ashkenazi Jewish individuals pursued testing for BRCA1/2 mutations. Most had a personal cancer history (N = 51; family only: N = 48); and received uninformative negative results (N = 66; positives: N = 23; informative negative: N = 10). The coping strategy of defensive pessimism predicts that individuals will believe the worst case scenario to better cope with a potential negative outcome. Consistent with this, most felt they would have a mutation, if not mutations in both genes. The BRCAPRO model appeared to overestimate risk of having a mutation in this sample (p < .001). BRCAPRO overestimates notwithstanding, genetic counseling increased accuracy of subjective risk (p < .01). Individuals with a family-only cancer history had the least accurate estimates of risk (p < .05) and may need further intervention to either manage anxiety or improve knowledge.
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, kmkell2@uky.edu.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kelly
authors.forename: Howard
authors.initials: H
authors.lastname: Leventhal
authors.forename: Deborah
authors.initials: D
authors.lastname: Toppmeyer
authors.forename: Judy
authors.initials: J
authors.lastname: Much
authors.forename: James
authors.initials: J
authors.lastname: Dermody
authors.forename: Monica
authors.initials: M
authors.lastname: Marvin
authors.forename: Jill
authors.initials: J
authors.lastname: Baran
authors.forename: Marvin
authors.initials: M
authors.lastname: Schwalb