Posttraumatic Growth, Immunity and Survival in Patients with Hepatoma

Department of Medicine, Division of Rheumatology and Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
Digestive Diseases and Sciences (Impact Factor: 2.61). 10/2007; 52(9):2452-9. DOI: 10.1007/s10620-006-9477-6
Source: PubMed


This study was designed to assess the relationship between posttraumatic growth (PTG), immunity, and survival in patients with biopsy-proven hepatocellular carcinoma (HCC). Forty-one patients with HCC were administered the Posttraumatic Growth Inventory. Total and differential peripheral blood leukocytes (PBL) counts were measured at baseline, 3-, and 6-month follow-up. Survival also was measured from the data of diagnosis to death. Participants who scored above the median for the PTGI total scale score (423 days) survived 186 days longer than participants who scored below the median PTGI total score (237 days). Patients with PTG scores above the median had higher PBL counts. The results of this study suggest that patients with greater PTG scores recover more rapidly from chemotherapy in regards to their white blood cell counts. Further research is warranted regarding the possible immune mediation between PTG and survival.

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    • "Posttraumatic growth (PTG) is defined as the experience of positive consequences arising from the struggle with a traumatic experience , where the resulting transformation leads not only to a return to previous levels of well-being (such as with thriving, benefitfinding or resilience), but to a higher level of functioning in some aspects of life [6] [9]. PTG has been associated with reduced mortality among cancer patients [10] and Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) patients [11] and morbidity among cardiac patients [5]. In particular, Affleck et al. (1987) showed that male myocardial infarction patients who experienced such positive psychology in the weeks after their cardiac event were less likely to have another infarction and experienced less morbidity eight years later [12]. "
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    ABSTRACT: Posttraumatic growth (PTG) is frequently reported after the strike of a serious medical illness. The current study sought to: 1) assess the relationship between degree of cardiac "threat" and PTG one-year post-hospitalization; and 2) to explore the association between PTG and healthcare utilization. In a cohort study, 2636 cardiac inpatients from 11 Ontario hospitals completed a sociodemographic survey; clinical data were extracted from charts. One year later, 1717 of these outpatients completed a postal survey, which assessed PTG and healthcare utilization. Morbidity data were obtained retrospectively through probabilistic linkage to administrative data. The predicted risk of recurrent events for each participant was calculated using a logistic regression model, based on participants' sociodemographic and clinical characteristics. The relationship among PTG, trauma and health service use was examined with multiple regression models. Greater PTG was significantly related to greater predicted risk of recurrent events (p<0.001), but not the actual rate of recurrent events (p=0.117). Moreover, greater PTG was significantly related to more physician visits (p=0.006), and cardiac rehabilitation program enrolment (p=0.001) after accounting for predicted risk and sociodemographic variables. PTG was not related to urgent healthcare use. Greater PTG was related to greater objective risk of morbidity but not actual morbidity, suggesting that contemplation about the risk of future health problems may spur PTG. Moreover, greater PTG was associated with seeking non-urgent healthcare. Whether this translates to improved health outcomes warrants future study.
    Journal of psychosomatic research 04/2012; 72(4):293-9. DOI:10.1016/j.jpsychores.2011.12.011 · 2.74 Impact Factor
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    • "This is disconcerting given that symptoms of depression for example double the risk of cardiac mortality (Grace et al., 2005). Psychological resilience on the other hand, may serve to counteract negative psychological consequences and promote successful coping, adaptation, and increased survival (Affleck & Tennen, 1996; Dunigan, Carr, & Steel, 2007). Such positive emotional responses are generally conceptualized as post-traumatic growth (PTG), thriving, or benefit-finding in the literature (Affleck & Tennen, 1996; Bower, Kemeny, Taylor, & Fahey, 1998). "
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    ABSTRACT: This study evaluated the sociodemographic, clinical and behavioral correlates of post-traumatic growth (PTG) in coronary artery disease (CAD) patients, and the degree of PTG compared to other patient groups. Using a prospective design, 1497 CAD outpatients completed a survey assessing potential PTG correlates. A total of 1268 responded to a nine-month follow-up survey assessing PTG. Significant PTG correlates were being younger, non-white, having lower income, functional status, and depressive symptoms, greater social support, and positive illness perceptions. The degree of PTG was equivalent to that of cardiac patients in other countries, but was lower than that of breast cancer and multiple sclerosis patients.
    Journal of Health Psychology 10/2010; 15(7):1049-63. DOI:10.1177/1359105309360577 · 1.88 Impact Factor
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    ABSTRACT: The evaluation and treatment of psychosocial problems in patients diagnosed with HCC is critical as unmet psychosocial needs or distress can increase morbidity and mortality in patients diagnosed with HCC. This chapter will provide clinicians with (1) information regarding modifiable risk factors in the development of HCC; (2) tools to facilitate the evaluation of psychosocial distress and cancer-related symptoms in HCC; (3) a brief introduction of the emotional responses commonly expressed in patients with HCC; (4) frequently presenting psychological disorders in patients diagnosed with HCC; (5) common cancer-related symptoms in which behavioral treatments that can be employed to complement conventional pharmacological treatment; and (6) information regarding issues related to caregiving, cultural and religious factors in the treatment of HCC, end of life issues, and alternative and complementary medicine in the treatment.
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