You're One of Us Now: Young people describe their experiences of predictive genetic testing for Huntington disease (HD) and familial adenomatous polyposis (FAP)

被引:72
作者
Duncan, Rony E. [1 ]
Gillam, Lynn [2 ,3 ]
Savulescu, Julian [4 ]
Williamson, Robert [2 ,5 ]
Rogers, John G. [6 ]
Delatycki, Martin B. [6 ,7 ]
机构
[1] Ctr Adolescent Hlth, Parkville, Vic 3052, Australia
[2] Univ Melbourne, Sch Populat Hlth, Melbourne, Vic, Australia
[3] Royal Childrens Hosp, Melbourne, Vic, Australia
[4] Univ Oxford, Oxford Uehiro Ctr Pract Eth, Oxford OX1 2JD, England
[5] Murdoch Childrens Res Inst, Parkville, Vic, Australia
[6] Genet Hlth Serv Victoria, Melbourne, Vic, Australia
[7] Muroch Childrens Res Inst, Bruce Lefroy Ctr Genet Hlth Res, Parkville, Vic, Australia
关键词
genetic predisposition testing; Huntington disease; familial adenomatous polyposis; adolescent; qualitative research; ethics;
D O I
10.1002/ajmg.c.30158
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
There has been much debate about the psychosocial effects of predictive genetic testing in minors. The majority of this debate has been theoretical, with little empirical evidence published. We conducted in-depth interviews with 18 young people who had undergone testing, to explore the range of harms and benefits that they perceived were associated with their tests. Participants were eight individuals who were tested for Huntington disease (two gene-positive, six gene-negative) and ten who were tested for familial adenomatous polyposis (five gene-positive, five gene-negative). At the time of their test they ranged from 10 to 25 years of age. When interviewed they ranged from 14 to 26 years of age. Harms described included knowledge of future illness, witnessing distress in parents, negative effects on family relationships and friendships, effects upon employment and school, experiencing regret, feeling guilty and having to confront difficult issues. Benefits included knowledge of gene-negative status, relief from uncertainty, witnessing relief in parents, feeling able to plan for the future, positive effects on family relationships and friendships, feeling empowered and experiencing a sense of clarity about what is important in life. Harms were described in relation to gene-negative test results, as were benefits in relation to gene-positive test results. The testing process itself had several positive and negative effects for young people, distinct from the actual test result. Future research concerning the effects of predictive genetic testing in young people must remain broad and should aim to measure the beneficial as well as the harmful effects that resonate for young people themselves. (c) 2008 Wiley-Liss, Inc.
引用
收藏
页码:47 / 55
页数:9
相关论文
共 49 条
[1]   A worldwide assessment of the frequency of suicide, suicide attempts, or psychiatric hospitalization after predictive testing for Huntington disease [J].
Almqvist, EW ;
Bloch, M ;
Brinkman, R ;
Craufurd, D ;
Hayden, MR .
AMERICAN JOURNAL OF HUMAN GENETICS, 1999, 64 (05) :1293-1304
[2]   Psychological consequences and predictors of adverse events in the first 5 years after predictive testing for Huntington's disease [J].
Almqvist, EW ;
Brinkman, RR ;
Wiggins, S ;
Hayden, MR .
CLINICAL GENETICS, 2003, 64 (04) :300-309
[3]  
ANDREWS L, 2007, IMPACT FAMILIAL ADEN
[4]   Impact of familial adenomatous polyposis on young adults: Attitudes toward genetic testing, support, and information needs [J].
Andrews, Lesley ;
Mireskandari, Shab ;
Jessen, Jaime ;
Thewes, Belinda ;
Solomon, Michael ;
Macrae, Finlay ;
Meiser, Bettina .
GENETICS IN MEDICINE, 2006, 8 (11) :697-703
[5]  
[Anonymous], SUCCESSFUL QUALITATI
[6]   PREDICTIVE TESTING FOR HUNTINGTON DISEASE IN CANADA - THE EXPERIENCE OF THOSE RECEIVING AN INCREASED RISK [J].
BLOCH, M ;
ADAM, S ;
WIGGINS, S ;
HUGGINS, M ;
HAYDEN, MR .
AMERICAN JOURNAL OF MEDICAL GENETICS, 1992, 42 (04) :499-507
[7]  
Chapman Elizabeth, 2002, J Genet Couns, V11, P351, DOI 10.1023/A:1016840229609
[8]   THE GENETIC TESTING OF CHILDREN [J].
CLARKE, A .
JOURNAL OF MEDICAL GENETICS, 1994, 31 (10) :785-797
[9]  
Clayton EW, 1997, J MED PHILOS, V22, P233
[10]   Genetic testing for cancer in children - Short-term psychological effect [J].
Codori, AM ;
Petersen, GM ;
Boyd, PA ;
Brandt, J ;
Giardiello, FM .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 1996, 150 (11) :1131-1138