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Hamilton JG, Waters EA. How are multifactorial beliefs about the role of genetics and behavior in cancer causation associated with cancer risk cognitions and emotions in the US population? Psychooncology 2017; 27:640-647. [PMID: 29024169 DOI: 10.1002/pon.4563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/13/2017] [Accepted: 09/29/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE People who believe that cancer has both genetic and behavioral risk factors have more accurate mental models of cancer causation and may be more likely to engage in cancer screening behaviors than people who do not hold such multifactorial causal beliefs. This research explored possible health cognitions and emotions that might produce such differences. METHODS Using nationally representative cross-sectional data from the US Health Information National Trends Survey (N = 2719), we examined whether endorsing a multifactorial model of cancer causation was associated with perceptions of risk and other cancer-related cognitions and affect. Data were analyzed using linear regression with jackknife variance estimation and procedures to account for the complex survey design and weightings. RESULTS Bivariate and multivariable analyses indicated that people who endorsed multifactorial beliefs about cancer had higher absolute risk perceptions, lower pessimism about cancer prevention, and higher worry about harm from environmental toxins that could be ingested or that emanate from consumer products (Ps < .05). Bivariate analyses indicated that multifactorial beliefs were also associated with higher feelings of risk, but multivariable analyses suggested that this effect was accounted for by the negative affect associated with reporting a family history of cancer. Multifactorial beliefs were not associated with believing that everything causes cancer or that there are too many cancer recommendations to follow (Ps > .05). CONCLUSION Holding multifactorial causal beliefs about cancer are associated with a constellation of risk perceptions, health cognitions, and affect that may motivate cancer prevention and detection behavior.
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Affiliation(s)
- Jada G Hamilton
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erika A Waters
- Department of Surgery-Division of Public Health Sciences, Washington University in St. Louis, St Louis, MO, USA
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Abstract
PURPOSE OF REVIEW This review summarizes the experimental literature on behavioral outcomes and psychological effects of genetic testing for obesity. Such tests, although of dubious value, are increasingly marketed to the public, and there has been concern that while results may encourage some consumers to increase the healthfulness of their lifestyles, others may interpret feedback in maladaptive ways. RECENT FINDINGS Hypothetical vignettes have been used in artificial settings; few studies have investigated outcomes of actual test results. At present, the effects of genetic testing for obesity seem limited to improving consumers' weight control intentions and motivation rather than actual dietary behavior. Evidence for negative psychological consequences is scarce and seems of greater concern for normal weight persons than for those who are overweight. Better research designs carried out in the field rather than the laboratory with more diverse samples are needed.
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Affiliation(s)
- Mary Segal
- Research Center for Health Care Decision-making, Inc., 706 East Hartwell Lane, Wyndmoor, PA, 19038, USA.
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Muller C, Cameron LD. It's complicated - Factors predicting decisional conflict in prenatal diagnostic testing. Health Expect 2016; 19:388-402. [PMID: 25864420 PMCID: PMC5055274 DOI: 10.1111/hex.12363] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The technologies currently available to detect the presence of foetal genetic abnormalities are complex, and undergoing prenatal diagnostic testing can have wide-ranging repercussions. Before individuals can decide with certainty whether or not to take these tests, they first need to grasp the many psychosocial and clinical dimensions of prenatal genetic testing. OBJECTIVE To test a model integrating key psychosocial and clinical factors as predictors of decisional conflict in decisions about whether or not to undergo prenatal genetic testing. METHOD Adults (n = 457) read one of four hypothetical scenarios asking them to imagine expecting a child and considering the option of a prenatal test able to detect a genetic condition; age of condition onset (birth vs. adulthood) and its curability (no cure vs. curable) were manipulated. Participants completed measures of decisional conflict, perceived benefits from normal results, test response efficacy, condition coherence, child-related worry, perceived disagreement with the other parent's preference, motivation to comply with doctors' perceived preferences, and parity. RESULTS Prenatal testing decisional conflict was positively predicted by perceiving normal results as beneficial, doubting the test's reliability, lacking understanding of the genetic condition, worrying about the health of the foetus, perceiving differences of opinion from partner/spouse, wanting to follow doctors' preferences, and being childless. DISCUSSION These results, of growing relevance given the increasing availability of new technologies in pregnancy care, can inform communication strategies that facilitate couples' decision making. CONCLUSION This study provides insights into factors that might complicate prenatal testing decision making.
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Affiliation(s)
- Cécile Muller
- Public Health Genetics, Genetic DisordersMurdoch Children's Research InstituteParkvilleVic.Australia
| | - Linda D. Cameron
- Psychological SciencesSchool of Social Science, Humanities, and the ArtsUniversity of CaliforniaMercedCAUSA
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Genetic causal attributions for weight status and weight loss during a behavioral weight gain prevention intervention. Genet Med 2015; 18:476-82. [PMID: 26291598 PMCID: PMC4761333 DOI: 10.1038/gim.2015.109] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/25/2015] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Emerging evidence suggests that attributing one's weight to genetics may contribute to the adoption of obesogenic behaviors. We investigated whether weight-related genetic attributions were associated with weight change during a weight gain prevention intervention. METHODS Participants (n = 185) were from a randomized clinical trial of a digital health weight gain prevention intervention for black women ages 25-44 years with body mass index 25.0-34.9 kg/m(2). Weight-related genetic attributions (weight status attribution and weight loss attributions) were measured at baseline and 12 months. RESULTS Among intervention participants, high genetic attribution for weight loss was associated with greater weight loss at 12 months (-2.7 vs. 0.5 kg) and 18 months (-3.0 vs. 0.9 kg). Among usual-care participants, high genetic attribution for weight status was associated with greater 18-month weight gain (2.9 vs. 0.3 kg). The intervention reduced the likelihood of high genetic attribution for weight loss at 12 months (P = 0.05). Change in the likelihood of genetic attribution was not associated with weight change over 12 months. CONCLUSION Impact of genetic attributions on weight differs for those enrolled and not enrolled in an intervention. However, weight gain prevention intervention may reduce genetic attribution for weight loss.Genet Med 18 5, 476-482.
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Cohen JN, Potter CM, Drabick DA, Blanco C, Schneier FR, Liebowitz MR, Heimberg RG. Clinical presentation and pharmacotherapy response in social anxiety disorder: The effect of etiological beliefs. Psychiatry Res 2015; 228:65-71. [PMID: 25920804 PMCID: PMC4416216 DOI: 10.1016/j.psychres.2015.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 03/13/2015] [Accepted: 04/08/2015] [Indexed: 11/27/2022]
Abstract
Therapies for social anxiety disorder (SAD) leave many patients symptomatic at the end of treatment and little is known about predictors of treatment response. This study investigated the predictive relationship of patients' etiological attributions to initial clinical features and response to pharmacotherapy. One hundred thirty-seven individuals seeking treatment for SAD received 12 weeks of open treatment with paroxetine. Participants completed the Attributions for the Etiology of Social Anxiety Scale at baseline in addition to measures of social anxiety and depression at baseline and over the course of treatment. A latent class analysis suggested four profiles of etiological beliefs about one's SAD that may be characterized as: Familial Factors, Need to be Liked, Bad Social Experiences, and Diffuse Beliefs. Patients in the more psychosocially-driven classes, Need to be Liked and Bad Social Experiences, had the most severe social anxiety and depression at baseline. Patients in the Familial Factors class, who attributed their SAD to genetic, biological, and early life experiences, had the most rapid response to paroxetine.These results highlight the effect of biological and genetically-oriented etiological beliefs on pharmacological intervention, have implications for person-specific treatment selection, and identify potential points of intervention to augment treatment response.
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Affiliation(s)
- Jonah N. Cohen
- Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, Pennsylvania, 19122, USA
| | - Carrie M. Potter
- Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, Pennsylvania, 19122, USA
| | - Deborah A.G. Drabick
- Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, Pennsylvania, 19122, USA
| | - Carlos Blanco
- Department of Psychiatry, Columbia University, Harness Pavilion, 180 Ft. Washington Avenue, New York, New York, 10032 USA,New York State Psychiatric Institute, 1051 Riverside Drive, New York, New York 10032 USA
| | - Franklin R. Schneier
- Department of Psychiatry, Columbia University, Harness Pavilion, 180 Ft. Washington Avenue, New York, New York, 10032 USA,New York State Psychiatric Institute, 1051 Riverside Drive, New York, New York 10032 USA
| | - Michael R. Liebowitz
- Department of Psychiatry, Columbia University, Harness Pavilion, 180 Ft. Washington Avenue, New York, New York, 10032 USA
| | - Richard G. Heimberg
- Department of Psychology, Weiss Hall, Temple University, 1701 North 13th Street, Philadelphia, Pennsylvania, 19122, USA,Corresponding author: Richard G. Heimberg, Adult Anxiety Clinic of Temple University, Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA 19122. ; Telephone: (215) 204-1575; Fax: (215) 204-5539
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Haukkala A, Konttinen H, Hankonen N, Perola M, Kääriäinen H, Salomaa V. Genetic causal beliefs about morbidity: associations with health behaviors and health outcome beliefs about behavior changes between 1982-2002 in the Finnish population. BMC Public Health 2015; 15:389. [PMID: 25884345 PMCID: PMC4405877 DOI: 10.1186/s12889-015-1657-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 03/18/2015] [Indexed: 11/25/2022] Open
Abstract
Background The role and meaning of genetic information has grown considerably in the recent decades. We examined changes in causal beliefs about morbidity as well as the associations between causal beliefs, health behaviors and obesity, and health outcome beliefs from 1982 to 2002. Methods In five population-based risk-factor surveys (the FINRISK Studies) of individuals aged 25 to 64 years conducted from 1982 to 2002 (n = 37,503), respondents chose the most important cause of morbidity from a list of ten alternatives. Health outcome beliefs were assessed with two items. Physical inactivity and smoking status were based on self-reports and obesity was based on measured height and weight. Results The prevalence of those who endorse genetic factors as the most important cause of morbidity increased from 4% in 1982 to 10% in 1992 and remained at that level until 2002. During the study period, lack of exercise and overweight increased, whereas inappropriate diet and stress diminished as causal beliefs about morbidity. Smokers and physically inactive were more likely to endorse genetic than behavioral causes of morbidity, whereas obese respondents were more likely to choose overweight over genetic causes of morbidity. Those who endorse genetic factors as the most important cause had more pessimistic outcome beliefs about health behavior changes, but these outcome beliefs became more positive in all causal belief groups during the study period. Conclusion Despite increased public discussion of genomics, the relative proportion of those who endorse genetic factors as the most important cause of morbidity has remained low. However, within this group beliefs about benefits of health behavior changes have become more positive. This could indicate that increase in genomic health information does not lead to more negative appraisals of efficacy of lifestyle changes.
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Affiliation(s)
- Ari Haukkala
- Department of Social Research, University of Helsinki, Helsinki, Finland.
| | - Hanna Konttinen
- Department of Social Research, University of Helsinki, Helsinki, Finland.
| | - Nelli Hankonen
- Department of Social Research, University of Helsinki, Helsinki, Finland. .,School of Social Sciences and Humanities, University of Tampere, Tampere, Finland.
| | - Markus Perola
- National Institute for Health and Welfare, Helsinki, Finland.
| | | | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland.
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Nguyen AB, Oh A, Moser RP, Patrick H. Perceptions of the roles of behaviour and genetics in disease risk: are they associated with behaviour change attempts. Psychol Health 2014; 30:336-53. [PMID: 25369236 PMCID: PMC6345261 DOI: 10.1080/08870446.2014.972958] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
Abstract
The aims of the present study were to (i) examine the prevalence of perceived behavioural and genetic causal beliefs for four chronic conditions (i.e. obesity, heart disease, diabetes and cancer); (ii) to examine the association between these causal beliefs and attempts at behaviour change (i.e. physical activity, weight management, fruit intake, vegetable intake and soda intake). The data come from the Health Information National Trends Survey, a nationally representative population-based survey of adults (N = 3407). Results indicated that participants held both behavioural and genetic causal beliefs for all four chronic conditions. Multivariate analyses indicated that behavioural causal beliefs were significantly associated with attempts to increase physical activity and vegetable intake and to decrease weight. Genetic causal beliefs for cancer were significantly associated with reported attempts to maintain weight. Behaviour and genetic causal beliefs were not associated with changes in either fruit or soda intake. In conclusion, while behavioural causal beliefs are associated with behavioural change, measurement must capture disease-specific behavioural causal beliefs as they are associated with different health behaviours.
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Affiliation(s)
- Anh B. Nguyen
- Division of Cancer Control and Population Sciences, The National Cancer Institute, Rockville, MD, USA
| | - April Oh
- Division of Cancer Control and Population Sciences, The National Cancer Institute, Rockville, MD, USA
| | - Richard P. Moser
- Division of Cancer Control and Population Sciences, The National Cancer Institute, Rockville, MD, USA
| | - Heather Patrick
- Division of Cancer Control and Population Sciences, The National Cancer Institute, Rockville, MD, USA
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