Anxiety over being diagnosed with a potentially untreatable condition often drives patients to avoid important tests—even when doing so can be detrimental to their health, Jon Fortenbury writes in The Atlantic.
A recent study of college students led by researchers at Claremont McKenna found that 15% of students refused a free test for genital herpes—even though it required no additional bloodwork and opting out cost $10.
Among those who opted out in the study, the top reason given was "unnecessary stress or anxiety." Ghadeer Okayli, a psychiatrist who specializes in anxiety and depression, says that is typical. "Some people avoid tests because they don't want to deal with stress right now and just want to enjoy life," he says.
Some call this the "ostrich effect"—named for the mistaken belief that ostriches bury their heads in the sand when threatened—and it has been found in a variety of contexts, from finance to medicine.
The consequences of avoiding tests
However, avoiding medical tests can make treating even incurable conditions worse.
For instance, there is no known cure for autism, but early interventions have been shown to dramatically reduce its effects later in life.
Harvey Kliman, a researcher at Yale University, helped develop a test of placentas that can strongly predict an infant's risk for autism. Surprisingly, the test has been poorly received by parents. Kliman realized that the test "puts a negative spin" on the emotional experience of having a child, so parents avoid it. Kliman's observation is supported by research; a 2014 study in JAMA found that informed parents often avoid prenatal testing.
Kliman is launching a marketing campaign to educate parents about the benefits of early interventions, which he hopes will counteract some of the stigma and sense of hopelessness that parents feel when their child receives a diagnosis.
Meanwhile, living with the stress of not knowing about a condition can also have negative health effects. The Anxiety and Depression Association of America says that avoiding medical tests because of anxiety can cause fatigue, muscle tension, restlessness, and difficulty sleeping.
Okayli agrees, saying, "It's less painful to know you have a condition and deal with it than to deny it or agonize over the possibilities" (Fortenbury, The Atlantic, 10/21).