Predictive genetic screening and anxiety in adults at risk of sudden cardiac death: the role of personality characteristics and perceived social support
F Hafkamp, N Kupper, D A M J Theuns, S S PedersenAbstract
Background
Predictive genetic screening is increasingly used to identify individuals at risk of sudden cardiac death, yet its psychological consequences remain unclear. Previous studies have reported inconsistent associations between genetic test results and anxiety, suggesting that individual differences may play a role in psychological outcomes following testing. The present study examined whether genetic test result, negative affectivity, social inhibition, and perceived social support predict anxiety over a one-year follow-up in adults undergoing predictive genetic screening for cardiac channelopathies or cardiomyopathies.
Methods
A total of 117 patients were included in the study. Anxiety was assessed using the Generalized Anxiety Disorder-7 (GAD-7), negative affectivity and social inhibition using the Type D Scale-14, and perceived social support using the Multidimensional Scale of Perceived Social Support. Linear Mixed-Effects models were applied across four measurement occasions (baseline, 2-month, 6-month, and 12-month follow-up), controlling for age and sex. Missing data were handled using multiple imputation.
Results
At baseline, 14% of patients met criteria for generalized anxiety, decreasing to 10% after one year. Genetic test result and time were not significant predictors of anxiety, indicating no significant changes in anxiety levels during the follow-up period. Higher negative affectivity was significantly associated with increased anxiety (b = 0.61, SE = 0.18, p < .001), whereas social inhibition (b = −0.04, SE = 0.08, p = .61) and perceived social support (b = −0.25, SE = 0.17, p = .13) were not independently associated with anxiety. Exploratory post-hoc analyses demonstrated that individuals high in negative affectivity reported the highest levels of anxiety regardless of perceived social support (Figure 1), suggesting that emotional vulnerability outweighed both genetic risk status and social context.
Disucssion
These findings indicate that anxiety following predictive genetic screening is more strongly related to dispositional emotional vulnerability than to the genetic test result itself. Psychological responses to genetic testing may therefore depend less on objective risk information and more on how individuals emotionally process uncertainty and health-related threat. Identifying individuals high in negative affectivity may help clinicians target psychological support to those at risk for persistent anxiety following genetic screening.Figure 1