The role of current affect, anticipated affect and spontaneous self-affirmation in decisions to receive self-threatening genetic risk information

Abstract

One reason for not seeking personally threatening information may be negative current and anticipated affective responses. We examined whether current (e.g., worry) and anticipated negative affect predicted intentions to seek sequencing results in the context of an actual genomic sequencing trial (ClinSeq®; n = 545) and whether spontaneous self-affirmation mitigated any (negative) association between affect and intentions. Anticipated affective response negatively predicted intentions to obtain and share results pertaining to both medically actionable and non-actionable disease, whereas current affect was only a marginal predictor. The negative association between anticipated affect and intentions to obtain results pertaining to non-actionable disease was weaker in individuals who were higher in spontaneous self-affirmation. These results have implications for the understanding of current and anticipated affect, self-affirmation and consequential decision-making and contribute to a growing body of evidence on the role of affect in medical decisions.

Keywords:

• Anticipated affect
• Current affect
• Self-affirmation
• Defensiveness
• Information seeking
• Information avoidance

Leslie G. Biesecker is an uncompensated consultant to the Illumina Corporation and receives royalties from the Genentech Corporation.

Leslie G. Biesecker is an uncompensated consultant to the Illumina Corporation and receives royalties from the Genentech Corporation.

Supplementary material

Supplementary material is available via the ‘Supplementary’ tab on the article's online page (http://dx.doi.org/10.1080/02699931.2014.985188).

Notes

¹ The sample size for this study was determined based on the number of participants who responded to the invitation to participate in this ancillary study; there were no data exclusions except when participants did not answer items included in the study; there were no experimental manipulations; and although the complete list of study items is not listed due to the size of the survey, it is available upon request.

² Participants were asked whether they had previously received any result from a genetic test, which did not specify the type of genetic test result. It is largely unknown whether or how receiving one genetic test result might influence how threatening a subsequent but different result would be. As such, we retained the full sample for analyses. However, the pattern of results did not differ when these 17% were excluded.

³ The low variance in the items may contribute to the low correlation. The pattern and significance of results did not differ when these items were analysed as two separate outcomes.

⁴ Original preventable intentions scale kurtosis: 2.48, skewness: –1.68; transformed preventable intentions scale kurtosis: –.198, skewness: –1.087; Original non-preventable intentions scale kurtosis: 2.08, skewness: –1.58; transformed non-preventable intentions scale kurtosis: –.583, skewness: –.876. These items also appear as outcomes in separate papers examining the role of individual differences in information avoidance on intentions to receive sequencing results (Taber et al., in press-a) optimism and risk perceptions on intentions to receive sequencing results (Taber et al., 2014), and ambiguity-related constructs and optimism on intentions to receive and share sequencing results (Taber et al., in press-b). Ancillary analyses including predictors from other manuscripts as covariates did not change the pattern of results.

⁵ Self-affirmation was included as a predictor in these analyses, and univariate associations among self-affirmation and outcome variables are presented in Table 1. However, we do not highlight these main effects in the discussion, as they are ancillary to our hypotheses. The association between self-affirmation and intentions to obtain medically actionable/non-actionable results is also presented as ancillary to main analyses in a separate manuscript (Taber et al., under review).