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Record identifier : 569811
Personal Name - Primary Intelectual Responsibility : Roberts, Jeffrey Scott
Title and statement of responsibility : Medical decision making in individuals at risk for Alzheimer's disease: The case of predictive testing [Thesis]
Publication, Distribution,Etc. : University of Michigan, 1999
Language of the Item : eng
Dissertation of thesis details and type of degree : Ph.D
Body granting the degree : , University of Michigan
Summary or Abstract : Biomedical research promises widespread predictive genetic testing for Alzheimer's disease (AD). With its high prevalence, late onset, and limited treatment options, AD represents a unique, complex case of testing. Though the psychology of predictive testing for other medical disorders (e.g., Huntington's disease) has been examined, little such research on AD exists. This project's main aims were to gauge interest in testing, assess perceived test costs and benefits, and identify predictors of test intentions. One hundred eighty-nine children and siblings of AD patients (88 response rate; age range: 30-92 years; 74 female) participated in a mail survey that posed varied hypothetical test scenarios. Participants reported test intentions and rated the importance of reasons for and against testing. In addition, AD background, illness representations (e.g., perceived threat, treatment optimism), health psychological styles (e.g., locus of control), and sociodemographic characteristics were measured. Hierarchical regression and path analyses were used to assess predictors of test intentions. In five of six scenarios, a majority Of participants expressed intentions to pursue testing. Seven of eight test pros were rated as more important than any test con. The most important reasons to pursue testing were (1) informing later-life decisions, (2) planning future AD care, and (3) motivating AD treatment monitoring. The most important reasons to decline testing were (1) lack of current AD treatment options, (2) concern about its emotional effects on loved ones, and (3) potential for genetic discrimination. Factors associated with pursuit intentions were male gender, monitoring information-seeking style, perceived AD threat, and appraisal of test pros versus cons (decisional balance). Situational factors such as test accuracy, certainty of results, and available treatment options also affected participants' responses. Results suggested a very positive appraisal of AD testing, with its limitations and risks underrated. Decisional balance, perceived AD threat, and monitoring information-seeking style were the most powerful predictors of test intentions. By anticipating response to predictive testing and detailing AD perceptions and experiences, study findings may inform future AD genetic counseling and health education efforts. Given a booming geriatric population and the rapid pace of AD research, further examination of the psychology of AD predictive testing will be necessary..
Topical Name Used as Subject : Psychotherapy, Alzheimers disease, Decision making, Health risk assessment
: Surgery
: Health care
: Gerontology
Information of biblio record : TL
 
 
 
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