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J Clin Psychol Med Settings. 2018 Dec;25(4):485-496. doi: 10.1007/s10880-018-9559-6.

Active Coping and Perceived Social Support Mediate the Relationship Between Physical Health and Resilience in Liver Transplant Candidates.

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Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Department of Veterans Affairs, Denver-Seattle Center of Innovation, Aurora, CO, USA.
Smilow Cancer Hospital at Yale-New Haven, New Haven, CT, USA.
Yale-New Haven Transplantation Center, New Haven, CT, USA.
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.


Without a transplant, end-stage liver disease is associated with significant morbidity and mortality. Transplant candidates endure physical and psychological stress while awaiting surgery, yet little is known about the relationship between physical health and psychological resilience during the wait-list period. This study examined predictors of psychological resilience and mediators of the relationship between physical health and psychological resilience in liver transplant candidates. Wait-listed candidates (Nā€‰=ā€‰120) from a single Northeast transplant center completed assessments of physical functioning, coping, perceived social support, and resilience. Findings revealed that physical functioning, active coping, and perceived social support were positively associated with resilience; maladaptive coping was negatively associated with resilience. Perceived social support and active coping partially mediated the relationship between physical functioning and resilience. Transplant center care providers should promote active coping skills and reinforce the importance of effective social support networks. These interventions could increase psychological resilience among liver transplant candidates.


Coping; Liver disease; Liver transplant; Resilience; Social support

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