title: Group-Based Trajectory Modeling of Distress and Well-Being Among Caregivers of Children Undergoing Hematopoetic Stem Cell Transplant.
abstract: To examine the trajectories of caregiver psychological responses in the year following their child's hematopoetic stem cell transplant (HSCT), and whether cognitive and social processing strategies differentiated between trajectories.
  
  
  
  One hundred and eight caregivers randomized to the control condition of a cognitive-behavioral intervention study completed measures of distress, coping, and social support at baseline, 1 month, 6 months, and 1 year post HSCT of their child.
  
  
  
  The majority reported moderate or low anxiety, depression, or distress that decreased over time, but a small group demonstrated high anxiety, depression, or distress that persisted or increased over time. Maladaptive coping was highest among caregivers in the high-persistent distress subgroup compared with the moderate-decreasing and low-stable groups. Adaptive coping was minimally associated with trajectory subgroups.
  
  
  
  Screening HSCT caregivers for distress and maladaptive coping may be useful in identifying caregivers likely to experience persistently high distress who may benefit from psychological intervention.
authors.affiliation: Clinical Psychology Departments of Pediatrics and Psychiatry, Columbia University School of Medicine, New york, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Sands
authors.affiliation: Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Mee
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Abraham
authors.initials: A
authors.lastname: Bartell
authors.affiliation: Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Manne
authors.affiliation: Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
authors.forename: Katie A
authors.initials: KA
authors.lastname: Devine
authors.affiliation: Clinical Psychology Departments of Pediatrics and Psychiatry, Columbia University School of Medicine, New york, USA.
authors.forename: Mirko
authors.initials: M
authors.lastname: Savone
authors.affiliation: Department of Psychology, Michigan State University, East Lansing, MI, USA.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Kashy
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000523:psychology* / Q000628:therapy; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012944:Social Support; D033581:Stem Cell Transplantation / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
keywords: behavioral intervention; caregivers; distress; parents; pediatric transplantation