ELSIcon2022 Paper: A genetic counseling tool to reduce genetic essentialism and stigma/discrimination related to a hypothetical genetic risk for psychosis by educating high risk individuals about genetic malleability

ELSIcon2022 • Paper • June 3, 2022

Presented by: Drew Blasco

Haley Park, Eleanor Zinn, Tanya Mehdizadeh, Lawrence Yang

Psychosis is likely caused by both genetic and environmental factors. Routine clinical genetic testing has not been realized; however, extensive efforts to develop a genetic test indicating risk of psychosis persist. Given the limited number of psychiatric genetic counselors, we created an educational tool to be delivered by non-genetic specialists about psychosis development to prepare for when genetic risk is incorporated into routine clinical care. We hypothesized that educating individuals at clinical high-risk for psychosis (CHR-p) about genetic malleability in the context of a hypothetical genetic risk for psychosis would reduce perceptions of genetic immutability/determinism and any stigma/discrimination because of one’s genetic risk. Individuals (N=16) identified as CHR-p participated in an education session delivered by a clinician with limited formal genetic counseling training to convey conceptions of genetic malleability related to a hypothetical genetic risk for psychosis. A pre-post design to measure genetic determinism/essentialism and stigma/discrimination prior to and after the intervention was used. Exploratory paired-sample t-tests were conducted. Results demonstrated a trend finding that participants’ perceptions of genes as deterministic and immutable decreased post-session (M=11.9, SD=1.7) compared to their pre-session scores (M=13.0, SD=1.9); t(15)= 1.9, p=0.076. Although overall stigma scores decreased over time, this was not significant; however, participants reported that they would experience less discrimination post-session (M=41.0, SD=12.0) compared to their pre-session scores (M=44.1, SD=11.1); t(15)= 2.8, p<0.05. Creation of an effective educational intervention delivered by non-specialists about psychosis development using a gene-by-environment interaction paradigm is crucial and appears to have beneficial effects among this stakeholder group.