title: Predictors of post-traumatic psychological growth in the late years after lung transplantation.
abstract: BACKGROUND
  Although lung transplantation improves quality of life, most psychosocial research focuses on adverse psychological and social functioning outcomes. Positive effects, particularly in the late-term years as physical morbidities increase, have received little attention. We provide the first data on a psychological benefit - post-traumatic growth (PTG) - and we focused on long-term (>5 yr) survivors.
  
  
  METHODS
  Among 178 patients from a prospective study of mental health during the first two yr post-transplant, we recontacted survivors 6-11 yr post-transplant. We assessed PTG (i.e., positive psychological change resulting from the transplant) and examined its relationship to other patient characteristics with multivariable regression analyses.
  
  
  RESULTS
  Sixty-four patients (86% of survivors) were assessed (M = 8.1 yr post-transplant, SD = 1.2). Mean PTG exceeded the scale's midpoint (M = 38.6, SD = 10.0; scale midpoint = 25). Recipients experiencing greater PTG were female (p = 0.022), less educated (p = 0.014), and had a history of post-transplant panic disorder (p = 0.005), greater friend support (p = 0.048), and better perceived health (p = 0.032). Neither other pre- or post-transplant mood and anxiety disorders nor transplant-related morbidities (acute rejection, bronchiolitis obliterans syndrome) predicted PTG.
  
  
  CONCLUSIONS
  PTG exceeded levels observed in other chronic disease populations, suggesting that lung transplantation may uniquely foster positive psychological change in long-term survivors. PTG occurs despite physical and psychiatric morbidities. Whether PTG promotes other positive post-transplant psychosocial outcomes deserves attention.
authors.affiliation: Department of Psychology, Ohio University, Athens, OH, USA.
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Fox
authors.forename: Donna M
authors.initials: DM
authors.lastname: Posluszny
authors.forename: Andrea F
authors.initials: AF
authors.lastname: DiMartini
authors.forename: Annette J
authors.initials: AJ
authors.lastname: DeVito Dabbs
authors.forename: Emily M
authors.initials: EM
authors.lastname: Rosenberger
authors.forename: Rachelle A
authors.initials: RA
authors.lastname: Zomak
authors.forename: Christian
authors.initials: C
authors.lastname: Bermudez
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D016014:Linear Models; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011446:Prospective Studies; D011581:Psychological Tests; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D013315:Stress, Psychological; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
keywords: lung transplantation; post-traumatic growth; psychological outcomes
references.citation: J Consult Clin Psychol. 1998 Dec;66(6):979-86
references.pmid: 9874911
references.citation: Women Health. 2012;52(5):503-16
references.pmid: 22747186
references.citation: J Health Psychol. 2012 Jul;17(5):627-39
references.pmid: 22100393
references.citation: J Psychosom Res. 2012 Apr;72(4):293-9
references.pmid: 22405224
references.citation: Anxiety Stress Coping. 2010;23(2):127-37
references.pmid: 19582640
references.citation: N Engl J Med. 2006 Jun 1;354(22):2360-7
references.pmid: 16738272
references.citation: Can Respir J. 2009 Sep-Oct;16(5):153-8
references.pmid: 19851533
references.citation: Psychosomatics. 2001 Jul-Aug;42(4):300-13
references.pmid: 11496019
references.citation: Clin Transplant. 2007 Sep-Oct;21(5):590-6
references.pmid: 17845632
references.citation: Respir Med. 2010 Sep;104(9):1246-53
references.pmid: 20457513
references.citation: Am J Transplant. 2005 May;5(5):1099-104
references.pmid: 15816892
references.citation: Transplantation. 2008 Sep 15;86(5):662-8
references.pmid: 18791447
references.citation: J Clin Oncol. 2005 Jan 20;23(3):599-608
references.pmid: 15659507
references.citation: J Heart Lung Transplant. 2007 Dec;26(12):1229-42
references.pmid: 18096473
references.citation: Clin Chest Med. 2011 Jun;32(2):253-64
references.pmid: 21511088
references.citation: J Trauma Stress. 1996 Jul;9(3):455-71
references.pmid: 8827649
references.citation: Health Psychol. 1985;4(3):219-47
references.pmid: 4029106
references.citation: Dig Dis Sci. 2007 Sep;52(9):2452-9
references.pmid: 17417728
references.citation: Arch Gen Psychiatry. 1990 Aug;47(8):737-44
references.pmid: 2378544
references.citation: Psychol Med. 1997 Mar;27(2):395-409
references.pmid: 9089832
references.citation: Transplantation. 2008 Jan 27;85(2):193-202
references.pmid: 18212623
references.citation: J Heart Lung Transplant. 2011 Nov;30(11):1275-80
references.pmid: 21724418
references.citation: Gen Hosp Psychiatry. 2003 Mar-Apr;25(2):95-102
references.pmid: 12676422
references.citation: Health Psychol. 2005 May;24(3):266-73
references.pmid: 15898862
references.citation: Psychol Med. 1994 Nov;24(4):929-45
references.pmid: 7892361
references.citation: Health Psychol. 2006 Jan;25(1):47-56
references.pmid: 16448297
references.citation: Psychol Health. 2009 Jun;24(5):583-95
references.pmid: 20205013
references.citation: Chest. 2000 Jul;118(1):115-22
references.pmid: 10893368
references.citation: J Trauma Stress. 2012 Oct;25(5):567-73
references.pmid: 23073975
references.citation: Am Psychol. 2003 Jan;58(1):78-9
references.pmid: 12674822
references.citation: J Clin Nurs. 2009 Dec;18(24):3472-9
references.pmid: 19686323
references.citation: Prog Transplant. 2004 Dec;14(4):338-45
references.pmid: 15663019
references.citation: Heart Lung. 2003 Jul-Aug;32(4):250-7
references.pmid: 12891165
references.citation: J Health Soc Behav. 1978 Mar;19(1):2-21
references.pmid: 649936
references.citation: J Heart Lung Transplant. 2012 Oct;31(10):1073-86
references.pmid: 22975097
references.citation: Lung. 2007 Mar-Apr;185(2):55-65
references.pmid: 17393235
references.citation: J Heart Lung Transplant. 2002 Mar;21(3):297-310
references.pmid: 11897517
references.citation: J Psychosoc Oncol. 2011;29(5):561-72
references.pmid: 21882935
references.citation: Psychol Aging. 2003 Dec;18(4):746-54
references.pmid: 14692861
references.citation: Psychol Med. 2004 Aug;34(6):1065-82
references.pmid: 15554577
references.citation: Gen Hosp Psychiatry. 2012 Mar-Apr;34(2):127-38
references.pmid: 22245165
references.citation: Thorac Surg Clin. 2012 Nov;22(4):517-29
references.pmid: 23084615
references.citation: Prog Transplant. 2012 Mar;22(1):41-7; quiz 48
references.pmid: 22489442
references.citation: J Psychosom Res. 2007 Jan;62(1):93-100
references.pmid: 17188126
references.citation: J Heart Lung Transplant. 2006 Jun;25(6):716-25
references.pmid: 16730578
references.citation: Annu Rev Clin Psychol. 2005;1:293-319
references.pmid: 17716090
references.citation: J Trauma Stress. 2010 Aug;23(4):452-60
references.pmid: 20648562
references.citation: Support Care Cancer. 2012 Aug;20(8):1719-28
references.pmid: 21927993
references.citation: J Heart Lung Transplant. 1996 Jan;15(1 Pt 1):1-15
references.pmid: 8820078