DEPRESSION IN ADAPTATION TO OPEN-HEART SURGERY

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Applicant?s Description: The proposed study will examine the effects of depressive symptomatology on physical and psychological adaptation to open-heart surgery. There is growing evidence suggesting that depression may influence the development and progression of coronary heart disease as well as recovery following cardiac events. While several physiological and behavioral pathways have been proposed to explain these associations, potential psychological mechanisms have rarely been considered. In addition to evaluating effects of depression on adaptation to cardiac surgery, this study will examine the role of social cognitive variables as mediators of these effects. The specific aims of this study are to test the following hypotheses: (1) Lower levels of preoperative depression will predict shorter hospitalizations following surgery; (2) Lower levels of preoperative depression will predict less angina and better physical functioning six months after surgery; (3) Lower levels of preoperative depression will predict less anxiety six months after surgery; and (4) These effects will be partially mediated by outcome expectancies and efficacy expectancies regarding behavioral and social activities associated with recovery. This project seeks to advance theoretical understanding of the relationship between psychosocial factors and physical illness. Additional long-term goals of this research include improving pre-surgical identification of cardiac patients at risk for poor outcomes, the development of psychosocial interventions for this population, and ultimately, the enhancement of surgical outcomes and long-term adaptation to chronic disease.