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"It's Not Deterministic and It Will Never Be Deterministic": A Qualitative Study on Stakeholder Perspectives of
Brandy M Fox1,2
1Department of Pediatrics, Stanford Medicine, Center for Biomedical Ethics, Stanford, California, USA.
Summary
Polygenic risk score (PRS) testing for post-traumatic stress disorder (PTSD) shows promise for veterans, but stakeholders express concerns about genetic emphasis and complexity. Understanding these views is key for responsible clinical integration.
Area of Science:
- Psychiatry
- Genetics
- Veterans Health
Background:
- Post-traumatic stress disorder (PTSD) affects many, but predicting its development and manifestation remains challenging.
- Genetic factors influence PTSD risk, yet clinical integration of genetic findings is difficult.
- Military veterans experience high PTSD rates and unique treatment outcomes, making genetic insights crucial for this population.
Purpose of the Study:
- To explore stakeholder expectations and concerns regarding polygenic risk score (PRS) testing for PTSD risk.
- To understand how military veterans with PTSD, clinicians, and PTSD genetics researchers conceptualize PRS in relation to PTSD.
- To identify potential avenues for managing PTSD and address ethical considerations for PRS implementation.
Main Methods:
- Qualitative study utilizing semi-structured interviews.
- Involved three stakeholder groups: military veterans with PTSD, clinicians treating them, and PTSD genetics researchers.
- Analysis focused on identifying emergent themes regarding PRS for PTSD.
Main Results:
- Three key themes emerged: "Controlling what you can," "The complexity of PTSD," and "Potential risks for an increased emphasis on the genetic component of PTSD."
- Participants conceptualized PRS in ways that reflect proactive coping strategies and awareness of PTSD's multifaceted nature.
- Concerns were raised about overemphasizing genetics and the inherent complexity of PTSD.
Conclusions:
- Stakeholder perspectives are vital for developing effective educational materials and anticipating ethical challenges.
- Responsible and equitable integration of PRS into clinical settings requires understanding and addressing these diverse viewpoints.
- Future efforts should focus on balancing genetic information with the complex biopsychosocial aspects of PTSD.
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