Psychosocial screening in cancer genetics clinics: the potential benefit of a patient administered easy to use tool to help guide psychological resources and approaches to intervention. (#184)
Aims: A significant proportion of individuals undergoing genetic testing experience psychological distress. In addition to the common psychological risk factors associated with a life threatening illness, there are additional “markers” that are specific to genetic testing such as anticipated impacts of a genetic testing results and the perception of the disease. A brief self-administered psychosocial screening instrument specific for the genetic testing context was developed involving 5 genetic centres in Canada. The objective of this presentation is to briefly describe the Genetic Psychosocial Risk Instrument (GPRI) and provide examples for its clinical application. Method: The 20 item GPRI was developed using a two phases approach: item generation with a sample of 141 participants and item refinement and validation with another samples of 712 participants. Results: GPRI demonstrated high reliability with a Cronbach's Alpha at 0.81. Its construct validity was supported by a high correlations between GPRI and Impact of Event Scale (r = .51, p< .001), and GPRI with Brief Symptom Index (r = .58, p< .001). The predictive value was demonstrated by a Receiver Operating Characteristic (ROC) curve of 0.78 plotting GPRI against follow up assessments using Hamilton Rating Scale for Depression and Anxiety. With a cut off score of 50, GPRI identified 84% of participants who displayed distress post genetic testing results. The tool has a 3-factor structure: 1) Perceived impact and personal adjustment to genetic testing; 2) Past history of mental health concerns and 3) Personal history/family history/loss to cancer. These identified risk factors will be presented and linked to specific clinical interventions to demonstrate potential uses of the tool. Conclusion: GPRI can potentially assist geneticists and genetic counselors to assess psychological risk factors, tailor and streamline the genetic consults to specific issues that may potentially contribute to difficulties in adjustment post genetic testing results.