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. |
