Psychological adjustment among male partners in response to women's breast/ovarian cancer risk: a theoretical review of the literature

Abstract

For women at high risk of developing hereditary breast and/or ovarian cancer the process of undergoing genetic testing is anxiety provoking and stressful, entailing difficult and complex decisions. Partners of high-risk women are frequently perceived by the women as a source of support during this challenging time. Utilising Self Regulatory Theory, this paper provides a theoretically guided overview of existing data to delineate how partners respond emotionally and behaviourally to the woman's high-risk status. An extensive literature search was undertaken. Online searches of MEDLINE, CINAHL and PsycINFO databases were conducted, reference lists of all publications identified were examined; and the databases were searched for authors identified in these publications. The systematic search yielded 10 published studies on at-risk women and their male partners; one study did not investigate male partner distress as an outcome variable. Heterogeneity of methodology in this literature precluded quantitative meta-analyses of study outcomes. Review of the evidence suggests that the genetic testing process may be distressing for some partners, particularly for partners of women identified as mutation carriers. Associations were identified between partner distress and partner beliefs about the woman's perceived breast cancer risk; partner feelings of social separation and lack of couple communication; and partner perceptions of being alienated from the testing process. Lack of partner support was found to be associated with increased distress of the tested woman at the time of testing and following results disclosure. Data are lacking on the role of partner beliefs about breast cancer, partner perceived consequences of genetic testing, and personality factors such as information processing style, on partner distress. The high level of behavioural and psychological interdependence that exists between a tested woman and her partner means that future research seeking to understand the coping and adjustment processes of partners needs to adopt a dyadic, transactional approach that is grounded in psychological theory. Specific suggestions for future research in this context are delineated.