Lodder et al. [2001]
add to the growing body of data concerning the psychosocial impact of genetic screening for BRCA1/2 mutations. Importantly, theirs is the ®rst study to focus on European women seeking genetic testing in the absence of a personal history of cancer, unlike many American studies that recruit women both with and without personal histories of cancer. As these authors observe, women with a history of cancer may have different motives for testing and view results as potentially con®rmatory and, therefore, less threatening. Additionally, Lodder et al. include both women with recent knowledge of their familial cancer risk and women for whom this knowledge is longstanding. Previous investigators have often sampled women with prior involvement in familial cancer registries, calling into question the generalizability of their ®ndings [Coyne et al., 2000].
Consistent with previous work [Audrain et al., 1997;Coyne et al., 2000], Lodder et al. [2001] indicate that, as a group, women anticipating genetic testing are not distressed and that receipt of test results is not associated with substantial psychological morbidity, even when it reveals a mutation [Croyle et al., 1997;Lerman et al., 1996]. Like some past investigators, Lodder et al. do not fully explore the implications of these ®ndings. Furthermore, there are aspects of their analysis and interpretation that invite perpetuation of a common misperception concerning the psychological risks associated with genetic testing for BRCA1/2 mutations.
In the Lodder et al. [2001] study, two self-report measures are used to assess distress, the Impact of Events Scale (IES) [Horowitz et al., 1979] and the Hospital Anxiety and Depression Scale (HADS) [Zigmond and Snaith, 1983]. As used in their study, however, the interpretation of each is problematic.
The IES is widely used as a cancer-speci®c measure of distress, and is intended to measure intrusive thoughts and avoidant behavior resulting from trauma.