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Being ‘at-risk’ for developing cancer: cognitive representations and psychological outcomes

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Abstract

This study investigated cognitive representations and psychological effects of being ‘at-risk’ for cancer. Perceived personal risk for cancer and causal attributions for cancer were measured in four groups: women identified as carriers of mutations in breast/ovarian cancer genes BRCA1 BRCA2, habitual smokers, X-ray technicians, and an average-risk group. Despite differences in awareness of their risk status and perceived risk for cancer, the groups did not differ in health anxiety, cancer worry interference, and self-assessed health. Motivated reasoning processes were identified as potential strategies used by individuals at-risk to regulate levels of psychological distress. Evidence for biased risk perceptions and unrealistic optimism were found among smokers, and patterns indicative of self-enhancement through self-assessments and defensive discounting of cancer causal attributions were found in the genetically susceptible group. These findings highlight the role of cognitive representations in adjustment to being at-risk for cancer.

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Notes

  1. Being 'at-risk' for cancer is used throughout this paper as indicating an increased lifetime relative risk for developing the disease compared to the general population, based on a known risk factor.

  2. The concept of risk is likely to relate to a time frame. However, since our measure did not mention the imminence of risk, we assume that participants made their evaluations regarding a lifetime frame.

  3. Another version of the questionnaire asking about causes of cancer in the general population was also administered, but was not used in the study described here.

  4. A perceptive reviewer has justly noted that inferring individual risk status from aggregate statistics is problematic, and that individuals cannot deny something that they have not known.

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Authors and Affiliations

  1. Tel Aviv University, Tel Aviv, Israel

    Shoshana Shiloh, Erga Drori, Avi Orr-Urtreger & Eitan Friedman

  2. Genetic Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    Avi Orr-Urtreger

  3. Susanne Levy Gertner Oncogenetics Unit, Sheba Medical Center, Tel-Hashomer, Israel

    Eitan Friedman

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  1. Shoshana Shiloh
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  2. Erga Drori
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  4. Eitan Friedman
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Correspondence to Shoshana Shiloh.

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Shiloh, S., Drori, E., Orr-Urtreger, A. et al. Being ‘at-risk’ for developing cancer: cognitive representations and psychological outcomes. J Behav Med 32, 197–208 (2009). https://doi.org/10.1007/s10865-008-9178-z

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  • DOI: https://doi.org/10.1007/s10865-008-9178-z

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