Factors influencing anticipated decisions about genetic testing: Experimental studies
Wroe AL., Salkovskis PM.
Objectives. Increasing availability of predictive testing highlights the importance of understanding the decision-making process when people are confronted with the option to have testing. The present study aimed to demonstrate experimentally the impact of (i) providing relatively positive versus relatively negative information, and (ii) focusing on positive or negative issues, on anticipated decisions regarding genetic testing. Method. Two experimental studies were carried out in order to investigate what influences the anticipated decision, one relating to breast cancer and the other heart disease. In each study, participants mere randomly allocated to either the positive, the negative or the control group. There were two consecutive experimental manipulations. Firstly, participants were given further information on detecting and preventing the disease (positive group) and on the limitations of these methods (negative group). The control group received information about the common cold. Secondly, participants were encouraged to focus on positive (positive group) or negative (negative group) issues of predictive testing. The control group focused on statements referring to the common cold. Participants made pre-experimental and post-information and post-focusing ratings including how likely they would be to opt for the test. Results. Both information and the focusing manipulations separately modified the rating of anticipated likelihood of being tested in the expected direction. There was also a significant decrease of rated anxiety in the negative group. Conclusion. It appears that anticipated decisions are strongly influenced not only by the information received by the decision maker, but also by the factors on which the decision maker focuses at the time of the decision. This second result in particular has implications for the way in which pre-test counselling is carried out; counsellors may believe that they are being non-directive in their questioning when they are in fact directly and systematically influencing the decision whether or not to be tested.