The role of current affect, anticipated affect and spontaneous self-affirmation in decisions to receive self-threatening genetic risk information

Abstract

One reason for not seeking personally threatening information may be negative current and anticipated affective responses. We examined whether current (e.g., worry) and anticipated negative affect predicted intentions to seek sequencing results in the context of an actual genomic sequencing trial (ClinSeq®; n = 545) and whether spontaneous self-affirmation mitigated any (negative) association between affect and intentions. Anticipated affective response negatively predicted intentions to obtain and share results pertaining to both medically actionable and non-actionable disease, whereas current affect was only a marginal predictor. The negative association between anticipated affect and intentions to obtain results pertaining to non-actionable disease was weaker in individuals who were higher in spontaneous self-affirmation. These results have implications for the understanding of current and anticipated affect, self-affirmation and consequential decision-making and contribute to a growing body of evidence on the role of affect in medical decisions.

Information Avoidance

“…When asked whether they "avoid visiting their doctor even when they suspect they should [visit]," 40.4 percent of those under fifty and 29.4 percent of those over fifty said they did so. Ferrer et al (2015) 7 Consistent with this prediction, Emanuel et al (2015) find that, against the backdrop of 39 percent of survey respondents who reported that they would "rather not know [their] chance of getting cancer," those who believed that there isn't much one can do to prevent cancer were more likely to not want to obtain the information.…”

“…They find that neither the base rate nor the diagnosticity have an effect on the proportion of people who would like to avail themselves of the test, perhaps because the two effects involving worry and hope operate in opposing directions, or perhaps because the preference is largely driven by powerful heterogeneity in personal preferences. However, much as in Ferrer et al (2015), the potential for treatment does have a big effect; the proportion of people willing to get tested increases from 33-47 percent with no treatment to 80-93 percent when a treatment is available.…”

Bias in predicted and remembered emotion

“…People who anticipated feeling more devastated if they learned they were at risk of developing a serious, but medically actionable, disease were less willing to obtain results of genetic tests [19]. In another study, women who anticipated greater stress if they took recommended medication to reduce their high risk of breast cancer were more likely to refuse those medications [20].…”

Spontaneous self-affirmation is associated with psychological well-being: Evidence from a US national adult survey sample

“…The longer scale includes two key subscales assessing strengths and values with high reliability; the two items load highly on their respective subscales, and reliability decreases when these particular items are omitted (Harris et al, 2016). Moreover, a version of this two-item index has been used successfully in earlier research examining spontaneous self-affirmation Ferrer et al, 2014). Participants selected one of four response options: strongly agree, somewhat agree, somewhat disagree, strongly disagree.…”