The Risky Self. How people perceive and respond to being at risk for...


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Title The Risky Self. How people perceive and respond to being at risk for diabetes and cardiovascular disease; the role of genetic risk information and self-concept
Period 06 / 2004 - 06 / 2011
Status Completed
Dissertation Yes
Research number OND1310269
Data Supplier Website CaRe; Website EMGO


OBJECTIVES: Little is known about how people experience genetic risks and how they integrate this information into their self-image. The objective of the proposed research is to investigate how people think about a genetic risk (predisposition to disease or passing the predisposition on to children) for a future disease and how this knowledge is affected by, and in turn affects, their self-image and health behaviour.
METHODS: Participants with three different types of risks will be included (i.e. genetic, family history, lifestyle). This will make it possible to compare the effects of different risks on self-image and preventive behaviour. People who are at risk for two major diseases (diabetes and cardiovascular disease) will be asked to participate to make it possible to generalise across diseases. All participants will be at risk, but not all will have the disease. This is a d escriptive questionnaire study with semi-structured interviews; it will include 100 people with an established hereditary condition, 100 people with only a family history, and 100 people with primarily lifestyle risk factors. These numbers are sufficient for a descriptive study. Interviews will be held with a sub-sample of 20 participants from each group.
RESULTS: In a pilot study, a static-dynamic self-concept questionnaire was validated. The final seven-item questionnaire showed internal reliability and generalisability across populations and did not correlate with other psychological constructs such as optimism, neuroticism, depression, and self-esteem. The questionnaire displayed predictive validity. When asked to imagine themselves in different health scenarios (representing a lifestyle risk for cardiovascular diseases, a risk based on a positive family history of cardiovascular disease, and a genetic risk of cardiovascular disease), people with static self-concepts, compared to people with a dynamic self-concepts, perceived less control and showed a stronger preference for cholesterol-lowering drugs over lifestyle changes, especially when the risk was presented as a genetic susceptibility.

Abstract (NL)

Claassen vond dat de vrees van sommige zorgverleners dat genetische risico informatie aanleiding geeft tot fatalistische reacties ongegrond is. Mensen met een positieve familiegeschiedenis van diabetes en hart en vaatziekten ervaren weliswaar een hoger risico dan mensen zonder familiegeschiedenis maar zien in een gezonde leefstijl een even goede manier om het risico te verlagen. Bovendien zeggen ze vaker een gezondere leefstijl te hebben dan mensen zonder familiegeschiedenis. Informatie over een familiair risico op ziekte werkt blijkbaar motiverend. Ook bleek uit haar onderzoek dat de meeste mensen wel weten wat de belangrijkste oorzaken en risicofactoren van diabetes en hart- en vaatziekten zijn, maar het hebben van een risicofactor (bijv. overgewicht) vaak niet zien als een verhoogd risico voor zichzelf. Zorgverleners zouden het begrip van het persoonlijke risico kunnen verbeteren door duidelijker te zijn over de invloed van persoonlijke risicofactoren op het ontstaan van ziekten.

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King's College Londen

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D24000 Health sciences

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