Dispositional hope to predict resilience after hereditary colorectal cancer genetic testing: a prospective outcome trajectory study

Abstract

Genetic testing for hereditary colorectal cancer (HCRC) had significant psychological consequences for test recipients. This prospective longitudinal study aimed at investigating factors predicting psychological resilience in adults undergoing genetic testing for HCRC. A longitudinal study was carried out on Hong Kong Chinese HCRC family members recruited and offered genetic testing by the Hereditary Gastrointestinal Cancer Registry to determine psychological outcome after genetic testing. Self-completed questionnaires were administered immediately before (pre-disclosure baseline) as well as 2 weeks, 4 months and 1 year after result disclosure. Using validated psychological inventories, the cognitive style of hope was measured at baseline and psychological distress of depression and anxiety was measured at all time points. Seventy-six subjects participated among whom 71 persons (43 men and 28 women; mean age 38.9 ± 9.2 years) from 9 FAP and 24 HNPCC families completed the study including 39 mutated gene carriers. Four patterns of outcome trajectories were created using established norms for the specified outcome measures of depression and anxiety. These included chronic dysfunction (13% and 8.7%), recovery (0% and 4.3%), delayed dysfunction (13% and 15.9%) and resilience (76.8% and 66.7%). Because of the small number of participants, the chronic dysfunction and delayed dysfunction groups were combined into a non-resilient group to compare with the resilient group in all subsequent analysis. Two logistic regression analyses were conducted using hope at baseline to predict resilience with depression and anxiety as outcome indicators. Both regression equations were significant. Baseline hope tended to be a significant predictor resilience outcome trajectory for depression (B = - 0.24, p < 0.01 for depression); and anxiety (B = -0.11, p = .05 for anxiety). The current findings suggest that hopefulness might predict resilience after HCRC genetic testing in Hong Kong Chinese. Interventions to increase the level of hope may be beneficial to psychological adjustment of HCRC genetic testing recipients.