title: Reflections on genes and sustainable change: toward a trait and state conceptualization of response shift.
abstract: OBJECTIVE
  This article discusses recent advances in research on adaptation, positive psychology, and genetics, and how these advances apply to response shift in health-related quality-of-life (HRQOL) research.
  
  
  METHODS
  As these advances shed new light on the extent to which HRQOL is changeable or fixed, we explored the extent to which a trait and state distinction is informative for response shift research.
  
  
  RESULTS
  Direct and moderated response shift effects are discussed in terms of the trait and state distinction to enable hypothesis generation for future research.
  
  
  CONCLUSIONS
  Implications for study design and data-analytic methods, as well as clinical practice are discussed.
authors: DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, USA. carolyn.schwartz@deltaquest.org
authors: Carolyn Emily
authors: CE
authors: Schwartz
authors: Mirjam A G
authors: MA
authors: Sprangers
mesh_terms: D000223:Adaptation, Psychological; D001294:Attitude to Health; D006801:Humans; D008960:Models, Psychological; D010549:Personal Satisfaction; D010551:Personality / Q000235:genetics; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results