Medicine and health psychology

How genetics will change medicine and health psychology
One of the valuable lessons gained from the chapter “How genetics will change medicine and health psychology” by McCaffrey, is the promising nature of personalized medicine in identifying the genes that predict certain complex diseases. Tailored medical treatment based on a person’s gene or simply the use of genetic or genomic information will be able to provide more accurate disease diagnosis and prognosis for certain illnesses as well as develop medicines appropriate for each gene. Personalized medicine will also enhance early healthy behavior change since it will enable early warning of a disease risk before its onset through the use of genotype information.

This technology gets based on the numerous kinds of illnesses which studies have confirmed a genetic association. These diseases include diabetes, cardiovascular diseases, cancer, autoimmune diseases, gastrointestinal and neuropsychiatric diseases. Type 2 diabetes (T2D) is one of the diseases that get prevented through personalized behavioral medicine. The use of genetic testing could identify early in advance individuals with elevated T2D risk factors thus caution them. Genetic testing for T2D could identify people at increased risk of the disease before they become obese and for obese persons identify the increased risk before they develop impaired glucose tolerance. These circumstances are reversible through behavioral and lifestyle interventions such as increased physical activity, controlled diet and pharmacological treatment with metformin; hence enhancing T2D prevention. Suls, Davidson & Kaplan (2010), states that TCF7L2 (a microsatellite marker in the transcription factor 7-like 2 gene) has a consistent association with risk for T2D. TCF7L2 got replicated in groups that include Caucasian, Asian and African population thus could get used in predicting diabetes. Lifestyle intervention got identified as the effective approach of minimizing overall diabetes since it reduces the risk for T2D and also deters the genetic risks for T2D conferred by rs7903146.

Through the use of the technology, it will be possible to tailor pharmaceutical treatment. According to Suls, Davidson & Kaplan (2010), breast cancer chemotherapeutic trastuzumab (Herceptin), is a perfect example of a medicine tailored to a genetic diagnosis. This medicine that uses genetic information targets a protein that gets overexpressed on breast cancer cells in most breast cancer patients. Tailored medical treatment in medicine will enhance effectiveness and safety of treating complex diseases. Tailoring of pharmaceutical drugs has enabled the use of direct target pharmacological interventions for treatment of complex illnesses.

Both genetic and behavioral factors significantly influence the risk of a disease. Thus behavioral and genetic interventions would be effective means of disease prevention. Behavioral changes to prevent lung cancer such as quitting smoking lacked smoking cessation intervention. Genetic testing is thus more effective than behavioral interventions since it can increase fear of arousal and motivation of behavioral change. A comprehensive understanding of the combined effects of genetic and behavioral factors is significant for understanding the role of personalized behavioral medicine. Another critical challenge is the correct interpretation of genetic test results since it requires both basic health literacy and an understanding of the mathematical concepts.

The personalized medicine technology, however, gets faced with various challenges concerning defining a genetic test. The challenges include the number of genes to include in a clinical genetic test, how to define risk based on this test, the extent of risk to necessitate for genetic test and the particular populations that are fit for the genetic test. When using the technology of genetic testing, it is also important to ensure that valid genetic test results get acquired. It is because genotyping errors are common and should get prevented as much as possible especially when giving clinical feedback to patients or research participants based on the information obtained.

After an individual obtains valid genetic results, it is vital to consider the benefits risk ration according to the type of results obtained. The genetic results may be beneficial for both the persons who test positive and those who test negative. A person who tests positive can adapt health behavioral change in an attempt to minimize the risk and also could seek advanced medical screening to identify emerging disease. The positive can also make appropriate plans regarding medical and financial aspects. A valid negative genetic test is beneficial to the person if it reaffirms their commitment to behavior change. However, accurate genetic results also may cause more harm than good to persons who test positive or negative. A person who tests positive may encounter risks such as fatalism and get affected psychologically concerning the condition, as well as a negative impact on the belief that changing behavior can minimize their disease risk. A valid negative genetic test to a person may affect them negatively since individuals feel relieved and hence reduce their motivation for behavioral change thus increasing their disease risk. The kind of genetic test received may also be subjected to illegal discrimination in various decision making such as health insurance and employment decisions.

Personalized medicine and tailored medical treatment are significant advances in the field of medicine. These technologies using genetic information promise increase in a healthy population by predicting disease risk factors as well as improve effectiveness and safety of treatment by allowing the application of direct target pharmacological interventions.

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