The specific aims of this application are twofold: 1) To enhance the candidate's clinical and research training to include genetics, genetic screening, measurement and instrument development; and 2) to conduct the proposed research project. The objective of the proposed research is to develop a standardized questionnaire that will describe the nature of psychosocial problems experienced by women at high risk for developing breast cancer. In addition to relevant psychosocial domains, the questionnaire will include three psychometrically established instruments that measure: psychological distress; uncertainty; and functioning and well being. Ultimately, the questionnaire will be used in population based studies to describe the type and severity of psychosocial problems experienced by women faced with the option to pursue predisposition genetic testing for breast cancer. The questionnaire will also have utility as a clinical screening instrument in that it will identify women who require ongoing psychosocial interventions. The psychosocial accompaniments of the new found ability to determine genetic susceptibility to cancer have not kept pace with recent scientific and technological advances. The time to develop a standard approach to describe and quantify the psychosocial problems that women at high risk for breast cancer face is now. Such work will pave the way for longitudinal follow up of women who are at increased risk for developing breast cancer, including examination of related problems, characteristics that place them at risk for ongoing or severe psychosocial sequelae and the testing of relevant psychosocial interventions.
The specific aims of the study are: 1) To identify relevant psychosocial aspects of being at high risk for breast cancer and being faced with the option to seek predisposition genetic testing. 2) To construct a standardized measure that will describe the nature, severity and duration of psychosocial problems as well as relevant risk factors in women at high risk for breast cancer. 3) To assess content validity of the newly developed measure through review with a panel of experts and with women who are at high risk of breast cancer. 4) To pilot test the questionnaire (including the newly developed measure and three established instruments) to determine its feasibility and psychometric characteristics with a sample of women who are at high risk for breast cancer. 5. To describe psychosocial problems, psychological distress, uncertainty, and functioning and well being in a sample of women at high risk for breast cancer. RESEARCH PLAN