Journal of Genetic Counseling

, Volume 24, Issue 5, pp 862–871 | Cite as

Do Attachment Style and Emotion Regulation Strategies Indicate Distress in Predictive Testing?

  • Lucienne B. van der MeerEmail author
  • Erik van Duijn
  • Erik J. Giltay
  • Aad Tibben
Original Research


Predictive genetic testing for a neurogenetic disorder evokes strong emotions, and may lead to distress. The aim of this study is to investigate whether attachment style and emotion regulation strategies are associated with distress in persons who present for predictive testing for a neurogenetic disorder, and whether these psychological traits predict distress after receiving test results. Self-report scales were used to assess attachment insecurity (anxiety and avoidance) and maladaptive emotion regulation strategies (self-blame, rumination, catastrophizing) in adults at 50 % risk for Huntington’s Disease (HD), Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL), and Hereditary Cerebral Hemorrhage With Amyloidosis - Dutch type (HCHWA-D), when they presented for predictive testing. Distress was measured before testing and twice (within 2 months and between 6 and 8 months) after receiving test results. Pearson correlations and linear regression were used to analyze whether attachment style and emotion regulation strategies indicated distress. In 98 persons at risk for HD, CADASIL, or HCHWA-D, attachment anxiety and catastrophizing were associated with distress before predictive testing. Attachment anxiety predicted distress up to 2 months after testing. Clinicians may consider looking for signs of attachment anxiety and catastrophizing in persons who present for predictive testing, to see who may be vulnerable for distress during and after testing.


Attachment style Emotion regulation strategies Predictive testing Neurogenetic disorders Huntington’s disease CADASIL HCHWA-D Distress 



The authors thank Sanne Huybregts (psychology student) for her help in preparing the introduction.

Conflict of Interest

Lucienne van der Meer, Erik van Duijn, Erik Giltay, and Aad Tibben declare that they have no conflict of interest.

Human Studies and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Animal Studies

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© The Author(s) 2015

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • Lucienne B. van der Meer
    • 1
    Email author
  • Erik van Duijn
    • 2
    • 3
  • Erik J. Giltay
    • 2
  • Aad Tibben
    • 1
    • 4
  1. 1.Department of Clinical GeneticsLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Department of PsychiatryLeiden University Medical CenterLeidenThe Netherlands
  3. 3.Center for Mental Health Care DelflandDelftThe Netherlands
  4. 4.Department of Clinical GeneticsErasmus Medical CenterRotterdamThe Netherlands

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