The symptom discounting effect: what to do when negative genetic test results become risk factors for alcohol use disorder

Abstract

Most consumers of genetic testing for health conditions test negative, yet the psychological perils of this are hardly known. In three experiments (N = 2103) participants discounted repercussions of alcohol use disorder (AUD), after learning or imagining that they were not genetically predisposed to AUD. Such discounting can lead people to avoid treatment and to feel safe to continue or even increase their drinking, ironically turning the negative genetic feedback into a risk factor for AUD. Concerningly, the debriefing currently used by a direct-to-consumer genetic testing company failed to counteract this discounting among those already engaging in problematic drinking in all three studies. It was hypothesized that this discounting derives from not understanding the Causal Markov condition; once AUD symptoms are present, their ramifications remain the same regardless of whether genes or environmental factors caused the symptoms. Educating participants about this principle successfully mitigated the irrational discounting of threats of AUD.

Impacts of Learning One’s Own Genetic Susceptibility to Mental Disorders

“…In a recent study (Ahn & Perricone, 2022), we empirically examined false reassurance using AUD as a target condition. The type of reassurance we tested was not just the type that can be considered justifiable.…”

“…We also tested the effectiveness of the debriefing process currently used by 23andMe, which was designed to prevent false reassurance by emphasizing that environmental factors and genetic factors not examined in the test could still put someone at risk. Results were concerning, as we found that these materials were ineffective for those individuals who reported already engaging in problematic drinking behaviors (Ahn & Perricone, 2022). To address this problem, we developed additional educational materials emphasizing that once the symptoms of AUD are present, their ramifications should be taken as equally risky whether or not these symptoms were caused by genes (as formalized as the causal Markov condition; see Pearl, 1988, and Fig.…”

“…Additionally, given that most people who undergo genetic testing for a certain mental disorder will learn that they do not have elevated risk, more attention needs to be paid to examining the potential perils of this feedback. For instance, future studies can test the generalizability of false reassurance as well as the efficacy of interventions based on the causal Markov condition (as in Ahn & Perricone, 2022).…”

“…Illustrations of the causal Markov condition as presented to participants inAhn and Perricone (2022). According to this condition, when X causes Y, which causes Z, once the value of Y is known, the value of X has no bearing on the value of Z.…”