Cognitive and Emotional Factors Predicting Decisional Conflict Among High-Risk Breast Cancer Survivors Who Receive Uninformative BRCA1/2 Results

Christine Marie Rini*, Suzanne C. O'Neill, Heiddis Valdimarsdottir, Rachel E. Goldsmith, Lina Jandorf, Karen Brown, Tiffani A. DeMarco, Beth N. Peshkin, Marc D. Schwartz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Objective: To investigate high-risk breast cancer survivors' risk reduction decision making and decisional conflict after an uninformative BRCA1/2 test. Design: Prospective, longitudinal study of 182 probands undergoing BRCA1/2 testing, with assessments 1-, 6-, and 12-months postdisclosure. Measures: Primary predictors were health beliefs and emotional responses to testing assessed 1-month postdisclosure. Main outcomes included women's perception of whether they had made a final risk management decision (decision status) and decisional conflict related to this issue. Results: There were four patterns of decision making, depending on how long it took women to make a final decision and the stability of their decision status across assessments. Late decision makers and nondecision makers reported the highest decisional conflict; however, substantial numbers of women-even early and intermediate decision makers-reported elevated decisional conflict. Analyses predicting decisional conflict 1- and 12-months postdisclosure found that, after accounting for control variables and decision status, health beliefs and emotional factors predicted decisional conflict at different timepoints, with health beliefs more important 1 month after test disclosure and emotional factors more important 1 year later. Conclusion: Many of these women may benefit from decision making assistance.

Original languageEnglish (US)
Pages (from-to)569-578
Number of pages10
JournalHealth Psychology
Volume28
Issue number5
DOIs
StatePublished - Sep 2009

Keywords

  • BRCA
  • breast cancer
  • decision making
  • decisional conflict
  • genetic testing

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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