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Knowing Your Fate

How will learning your genetic risk for disease affect your behavior?

If you carry a gene for a serious genetic disorder would you want to know? How would such knowledge affect your life? Now that you can have your genes sequenced easily by companies marketing over the internet, this question has become a reality. Researchers, led by Ilan Dar-Nimrod at the University of Sydney and collaborators have investigated the interesting question of how learning one’s genetic disposition toward specific diseases will affect the person’s psyche and behavior. The researchers employed a rather tricky experimental procedure. Rather than describe it to you, imagine that you are a participant in the study:

You walk into the bustling hospital to participate in a study titled “The Genetics of Sleep Disorders and Alcoholism.” A man in a white lab coat escorts you from the waiting room into the exam room.

“The field of genetics has advanced so far, we can obtain the results in less than 15 minutes, ”he says.

“That’s amazing,” you reply.

“Please sign this permission form and provide us a sample of your saliva using this cotton swab.”

You fish the dry cotton swab around inside your mouth and drop it into the sterile tube.

“Thank you. We’ll have this genotyped now and we should have the results in about 15 minutes. In the meantime, please complete this questionnaire.”

You are given two written psychological tests that measure your current mood: the Positive Affect and Negative Affect tests to quantify your positive and negative emotions at the present time. Are you anxious, happy, apprehensive?

Fifteen minutes pass and finally the researcher returns to the room. “I’m sorry. The test is taking us longer than it should. We have a new technician on board and he’s still learning the ropes. It will only be a few more minutes. Thanks for your patience.”

“No problem,” you reply.

You scan the worn copies of People Magazine on the table to pass time.

Five minutes later the researcher opens the door. “Here are the results,” he says, handing you a sealed envelope. “Take your time and look over the report.”

“I’ve got to deliver results to a few other participants. I’ll be back in a couple of minutes.” And he leaves you alone to ponder your genetic fate.

You begin reading over the results and now your genetic fate is clear. The test either shows that you do or that you do not have a gene causing a propensity for alcoholism. Either your heart sinks or soars.

A few minutes later the door bursts open. “I’m so sorry! The new tech put the wrong results in the wrong envelope! This is awful. I’m really sorry for the mistake. Please let me have those results back so I can deliver them to the correct person.”

“Here are your results,” he says. “Again, I really apologize for this mistake. Please take your time looking them over. I’ll give these results to the correct person and come back in a minute.”

Now you read your “real” results. Either you are suddenly relieved or disappointed by the report of your true genetic disposition toward alcoholism.

A few minutes later the researcher returns. “Please complete these tests and we’ll be done. Thank you very much for your participation.”

You are given two more tests to gauge your positive and negative mood.

The experimental design results in four scenarios, all applied randomly to the participants. Your results may be the same or different from the other (factious) participant’s results. In each case you may or may not receive results indicating that you have a gene for alcoholism. Of course, all of these results are contrived—there was no genetic testing done, and there was no mix-up in envelopes.

What the experiment has achieved by this cleaver deceit is to separate the impact of receiving good news or bad news about your own genetic predisposition for alcoholism from the general effect of having gone through this somewhat stressful experience of actually confronting the possibility that you may carry a gene for a serious disorder. Possibly going through the process itself would heighten your awareness of health issues and encourage you to make more healthy life choices, rather than having your attitudes and behaviors affected by the results of your genetic analysis. If that were true, your attitudes and behavior toward alcohol consumption in the future would be the same if the “other” person received the bad news and you did not.

Here’s what the researchers learned. People who learned that they have a genetic risk for alcoholism had a marked drop in positive emotion after learning the news. Not too surprising. There was no change in mood if the genetic test showed no such risk. The negative emotional state of participants also increased markedly after receiving the “bad news.” People who received a report not indicating a risk for alcoholism displayed a sharp drop in negative affect after the test compared to their scores on the tests given when they provided the saliva sample for analysis.

So how did this insight change people’s behavior? People who received a report indicating that they had a gene for alcoholism also reported having weaker control over their ability to avoid drinking alcohol. This did not translate into changing their behavior toward drinking in the next month, however. All participants reported they would likely consume the same amount of alcohol in the next month as they did before the genetic test, regardless of whether they were told they have a gene for alcoholism. However, women who learned that they had the alcoholism gene increased their willingness to participate in a responsible drinking workshop to modify their behavior. Men did not.

To summarize, learning about one’s genetic susceptibility to alcoholism did not affect intentions to drink in the near future, nor did learning about someone else’s susceptibility have any affect. The genetic screen did cause immediate changes in mood consistent with whether the individual received good or bad news. But the result did change the way people think about themselves and their ability to control their own behavior. If you are told that you have a gene for alcoholism you will feel that you have less ability to control your drinking, according to this study. Feeling this way could backfire, as a perceived loss of control might paradoxically lead to more drinking.

If you are a woman, you are more likely to take action to correct your behavior in a way that would ameliorate your perceived genetic disposition for alcoholism by enrolling in a class in responsible drinking. If you are a man, you will not do this. One can only speculate on the reason for the gender difference at this point. The authors of the study suggest, among other possibilities, that alcoholism is perceived in our society more negatively for women than it is for men, so women may have a greater motivation to correct the problem through behavioral intervention. Increased fatalism can accompany news that your genes predispose you to a disease, and you may actually reduce vigilant behaviors as a result.

Learning about one’s own genetic susceptibility to contract a specific diseases does have psychological consequences. Now that you can look into a crystal ball and learn your fate would you do it?

Dar-Nimrod, I., Zuckerman, M., Duberstein, P.R. (2012) The effects of learning about one’s own genetic susceptibility to alcoholism: a randomized experiment. Genetics in Medicine, doi: 10.1038/gim.2012.2012.111

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