Baseline Anxiety Levels Research Articles

Change in Caregiver Health-Related Quality of Life from before to early after Surgery: Findings from the Sustaining Quality of Life of the Aged: Transplant or Mechanical Support (SUSTAIN-IT) Study

Purpose Understanding health-related quality of life (HRQOL) informs support needs for caregivers (CGs) of patients (pts) with advanced heart failure (HF). We compared HRQOL before/6 months post surgery for CGs of pts undergoing heart transplantation (HT), with or without mechanical circulatory support (MCS), and destination therapy (DT) MCS. Methods Between 10/1/15-12/31/18 we enrolled 302 CGs from 12 U.S. sites: 89 HT with MCS, 104 HT without MCS, and 109 DT MCS. CGs completed the EQ-5D-3L (Visual Analog Scale [VAS]: 0 [worst] to 100 [best] imaginable health state and 5 HRQOL dimensions), PHQ-8 (range = 0-24 with ≥10 = significant depressive symptoms), and STAI-state (range = 20-80; higher score = more anxiety). Results CGs were aged 61.0±10.3 years, majority were spouses (85%), female (86%), and white (86%). CGs reported high overall HRQOL before (83.9±14.0) and after (82.9±15.7) surgery, with no significant differences between groups. CGs in all 3 groups reported low baseline (2.6±2.9) and follow-up (2.9±3.9) depressive symptoms. DT CGs reported significantly higher baseline anxiety levels compared to HT-MCS and HT-non MCS. DT and HT-non MCS caregivers showed significantly reduced anxiety levels over time. See Figure. There were no significant differences in anxiety between groups 6 months post-surgery. Conclusions CGs of pts with advanced HF reported relatively high levels of HRQOL and low levels of depression at baseline and early after surgery. DT CGs reported higher baseline anxiety levels when compared to CGs of HT pts. At 6 months, anxiety levels were similar and low for all groups, suggesting CG adjustment. Identifying CG psychological distress may inform support options and potential treatment.

Metformin reverses the schizophrenia-like behaviors induced by MK-801 in rats

Schizophrenia is known to be a complex and disabling psychiatric disorder. Dopamine receptor antagonists have a significant therapeutic effect in improving the positive symptoms that are associated with the illness. Therefore, dopamine receptor antagonists are commonly used in the treatment of schizophrenia; however, they do not achieve satisfactory results in improving negative symptoms and cognitive impairment. Metformin, widely known as an antidiabetic drug, has been found to enhance spatial memory formation and improve anxiety-like behaviors in rodents. Metformin's neuroprotective effect has been well documented in several neurological disorders including Alzheimer’s disease, Parkinson’s disease, strokes, Huntington’s disease, and seizures. In the present study, we used a rat model to explore the effect of metformin on schizophrenia-like behaviors induced by MK-801 (dizocilpine), an N-methyl-D-aspartate (NMDA) receptor antagonist. We found that the pre-pulse inhibition (PPI) deficit caused by MK-801 could be alleviated by metformin. The hyperlocomotion in the open field test induced by chronic treatment of MK-801 was reversed by administration of metformin. Metformin has no effect on the baseline level of anxiety in normal naive rats, while metformin could relieve the anxiety-like behaviors in MK-801-treatment rats, though this effect is not reaching a significant level. Additionally, metformin could significantly ameliorate working memory impairments induced by MK-801. Moreover, the increased level of phosphorylation of Akt and GSK3β in the frontal cortex induced by MK-801 was normalized by metformin. In conclusion, our results demonstrate that metformin improved schizophrenia-like symptoms in rats, and is therefore a potential agent for the treatment of schizophrenia.

Impact of Face-to-Face Educational Outreach Plus Printed Materials on Preoperative Anxiety level in Iranian Parturient Undergoing Elective Cesarean Section Delivery

Background: Anxiety, in demanding situations such as the perioperative period, can exacerbate underlying diseases and lead to a variety of perioperative complications. Educating patients not only improves the level of knowledge but can also help patients coping skills. The aim of the present study is to determine the effect of face-to-face plus printed educational materials on the anxiety level of Iranian pregnant women undergoing elective cesarean section delivery in the perioperative period. Methods: STAI questionnaire was distributed to 50 pregnant women undergoing cesarean section on the day before operation, then the intervention group was educated face to face for one session followed by the pamphlet. After training, the STAI questionnaire was again distributed to the intervention group on the same day. For evaluating the level of anxiety, we also used the Visual Analog Scale (VAS). The presence of nausea/vomiting after surgery and the type of anesthesia technique were recorded. Results: Basic characteristics of the parturient regarding age, education level and the baseline level of anxiety were similar. In the intervention group, the average anxiety level with STAI(S) questionnaire was 48.1 before the education and 45.2 after face to face outreach (P = 0.019). The average anxiety level with VAS score was 5.6 before the education and 4.8 after the outreach in the interventional group (P = 0.018). STAI(S) and VAS scores in the control group were 43.3 and 5.1 respectively which increased to 44.2 and 5.7 in the second survey. The correlation coefficient between score in the STAI questionnaire and VAS was 0.479. Conclusion: A single period of face to face education followed by handing out a pamphlet before an operation reduces the anxiety of mothers before cesarean section delivery.

Stress Management and Resilience Intervention in a Women's Heart Clinic: A Pilot Study.

Background: In general, women report higher stress levels than men. High baseline anxiety, depression, and stress levels are associated with greater risk of cardiovascular diseases. Current evidence for efficacy of stress management interventions for women is limited. This study aimed at assessing the effect of a stress management and resiliency training (SMART) program for decreasing stress, anxiety, and depressive symptoms. Methods: Fifty moderately or severely stressed Women's Heart/Preventive Cardiology Clinic patients consented to the SMART intervention delivered online (n = 36) or in-person (n = 9). Primary outcome measures were the observed changes between baseline and at 12 weeks for the following psychometric tools: General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaires (PHQ-9), Perceived Stress Scale (PSS), and Brief Resiliency Scale (BRS). Results: Forty-five patients completed the study. We observed significant improvements in PSS and GAD-7, but not in PHQ-9 or BRS, after the SMART intervention. When assessing outcomes among those with depressive symptoms at baseline (PHQ-9 > 15), we observed significant changes in PSS, GAD-7, and PHQ-9. No differences between online and in-person program delivery methods were found (all p-values >0.05). Conclusions: Training exposure using the SMART program to decrease stress and anxiety in women seeking preventive cardiology services was feasible and similarly effective, whether delivered online or in a single in-person session. Impacts on depression and resilience likely require a more intensive approach. In the future, larger randomized clinical trials with additional training and longer follow-up are warranted.

The Effect of a Pet Therapy and Comparison Intervention on Anxiety in Hospitalized Children

The purpose of this study was to evaluate the effect of a brief pet therapy visit and a comparison intervention on anxiety in hospitalized children. This quasi-experimental study compared state anxiety before and after structured research interventions in a convenience sample of children between the ages six and 17 (N = 93) in two groups. Participants were assigned to the pet therapy group or control group, based upon timing of data collection. Participants in each group received either a visit from the research assistant, therapy dog and handler, or from the research assistant for completion of a puzzle. The child's anxiety was measured using the State-Trait Anxiety Scale for Children (STAIC) S-Anxiety Scale before and after the visit and parents completed a brief background questionnaire. Intervention and comparison groups had no significant differences in key demographic factors or baseline anxiety level. While state anxiety decreased significantly in both groups, children in the pet therapy group experienced a significantly greater decrease in anxiety (p = .004). In addition, parents reported high levels of satisfaction with the pet therapy program. Study findings provide support for a brief pet therapy visit with a trained dog and handler as a tool decrease to anxiety in hospitalized children while promoting parent satisfaction. When resources for providing pet therapy visits are limited, clinicians may consider prioritizing children who are most affected by anxiety.

Improving the Patient Experience and Decreasing Patient Anxiety With Nursing Bedside Report

The study's purpose was to explore the patient experience in an intervention group participating in nursing bedside report and the control group not participating. This descriptive, observational study had 3 objectives: (1) to measure baseline anxiety on admission to the hospital using the Beck Anxiety Inventory, (2) to describe patient self-reported anxiety and patient experiences during hospitalization, and (3) to evaluate the opinions by the intervention group about participating in nursing bedside report. This mixed-methods study included quantitative and qualitative data. Three data collection tools were used: a demographic data tool, the Beck Anxiety Inventory, and daily journal entries. Quantitative data were analyzed using SPSS, and qualitative data using content analysis. There were no differences in baseline anxiety scores between patient groups. Anxiety levels decreased during hospitalization. About 73% of patients completed their journals. Themes that emerged were patients' perceptions of care, patient engagement, communication, and teamwork. Journal responses showed communication played a significant role in patients' perceptions of their patient experience. Because patients exhibited different baseline anxiety levels, assessing anxiety level on admission may help nurses develop plans of care that improve the patient experience. Further study is needed about the patient experience.

Dopaminergic Mechanisms Underlying Normal Variation in Trait Anxiety.

Trait anxiety has been associated with altered activity within corticolimbic pathways connecting the amygdala and rostral anterior cingulate cortex (rACC), which receive rich dopaminergic input. Though the popular culture uses the term "chemical imbalance" to describe the pathophysiology of psychiatric conditions such as anxiety disorders, we know little about how individual differences in human dopamine neurochemistry are related to variation in anxiety and activity within corticolimbic circuits. We addressed this issue by examining interindividual variability in dopamine release at rest using [11C]raclopride positron emission tomography (PET), functional connectivity between amygdala and rACC using resting-state functional magnetic resonance imaging (fMRI), and trait anxiety measures in healthy adult male and female humans. To measure endogenous dopamine release, we collected two [11C]raclopride PET scans per participant. We contrasted baseline [11C]raclopride D2/3 receptor binding and D2/3 receptor binding following oral methylphenidate administration. Methylphenidate blocks the dopamine transporter, which increases extracellular dopamine and leads to reduced [11C]raclopride D2/3 receptor binding via competitive displacement. We found that individuals with higher dopamine release in the amygdala and rACC self-reported lower trait anxiety. Lower trait anxiety was also associated with reduced rACC-amygdala functional connectivity at baseline. Further, functional connectivity showed a modest negative relationship with dopamine release such that reduced rACC-amygdala functional connectivity was accompanied by higher levels of dopamine release in these regions. Together, these findings contribute to hypodopaminergic models of anxiety and support the utility of combining fMRI and PET measures of neurochemical function to advance our understanding of basic affective processes in humans.SIGNIFICANCE STATEMENT It is common wisdom that individuals vary in their baseline levels of anxiety. We all have a friend or colleague we know to be more "tightly wound" than others, or, perhaps, we are the ones marveling at others' ability to "just go with the flow." Although such observations about individual differences within nonclinical populations are commonplace, the neural mechanisms underlying normal variation in trait anxiety have not been established. Using multimodal brain imaging in humans, this study takes initial steps in linking intrinsic measures of neuromodulator release and functional connectivity within regions implicated in anxiety disorders. Our findings suggest that in healthy adults, higher levels of trait anxiety may arise, at least in part, from reduced dopamine neurotransmission.

Influence of covariates on heterogeneity in Hamilton Anxiety Scale ratings in placebo-controlled trials of benzodiazepines in generalized anxiety disorder: Systematic review and meta-analysis.

Generalized anxiety disorder is a common psychiatric condition that is associated with decreased quality of life and significant disability. Benzodiazepines are anti-anxiety drugs used widely in the treatment of generalized anxiety disorder. This study examines the influence of several variables on benzodiazepine efficacy in generalized anxiety disorder. We performed a systematic review of placebo-controlled randomized controlled trials with benzodiazepines in generalized anxiety disorder. Fifty-eight studies were deemed eligible to include in the meta-analysis. The studies dated from 1977 to 2013 and included over 5400 participants. From each paper, we extracted: benzodiazepine name and dose, dosing regimen, baseline Hamilton Anxiety Scale (HAM-A) score, change in HAM-A score at study endpoint, drop-out rate, year of study publication, diagnostic criteria used, study size, study duration, location, any conflicts of interest and side-effect profile. We then assessed the influence, direct and indirect, of individual variables on the primary outcome (mean difference at endpoint, HAM-A score). Three factors were shown to be associated statistically with change in HAM-A; baseline HAM-A for benzodiazepine arm, baseline HAM-A for the placebo arm, and duration of the study. A higher baseline HAM-A in both arms was associated with a greater mean difference in HAM-A. A shorter study length was also associated with a greater mean difference. The major factors determining benzodiazepine response was baseline anxiety level for the benzodiazepine arm and study duration. In any design of further meta-analyses and clinical trials for generalized anxiety disorder we suggest that these should be considered these as confounding factors.

The Timing of Instructions Given to Patients Subjected to Third Molar Removal: Effect on Memory and Pain

The objective of this study was to assess whether patient instructions for the post-operative period are best remembered when given well before, just before or after surgical removal of a third molar. Also, the effect of preoperative anxiety on memory and pain was evaluated. A total of 105 patients were included. Baseline anxiety levels were assessed by a questionnaire. Next, patients were assigned to one of three groups in which the instructions for the postoperative period were given verbally before (in the consulting room), just before (in the treatment room) or after the surgical procedure (in the consulting room).

Anxiety, depression, and cardiac outcomes after a first diagnosis of acute coronary syndrome.

Depression is an established risk factor for acute coronary syndrome (ACS), with an impact on cardiac prognosis; nonetheless, the literature disagrees on the role played by anxiety. No study has evaluated this relationship in a cardiac population with no history of depression and after their first diagnosis of ACS. The aim of this study is to explore these associations without the confounding role of long-lasting heart disease or psychiatric illnesses. Two hundred sixty-six patients with no history of depression completed the Hospital Anxiety and Depression Scale and the Primary Care Evaluation of Mental Disorder at baseline and at 1, 2, 4, 6, 9, 12, and 24 months follow-up after their first diagnosis of ACS. During the follow-up period, we collected information regarding the major adverse cardiac events. Developing a first-ever depressive episode, in a proportional hazard model, was associated with almost 3 times the risk of a recurrent cardiac event (odds ratio = 2.590, 95% confidence interval [CI] [1.321, 5.078], p = .006). Furthermore, a moderation analysis revealed that increasing levels of baseline anxiety had opposing effects on cardiac outcomes, being protective only in those who did not develop incident depression (B = -0.0824, 95% CI [-0.164, -0.005], p = .048). No dose-response effect between depressive or anxious symptoms and cardiac outcomes emerged. Our results confirm the detrimental effect of depression on cardiac prognosis in a selected population and suggest that anxiety after the first diagnosis of ACS might have different roles depending on the illness' course. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Two-year effectiveness of a stepped-care depression prevention intervention and predictors of incident depression in primary care patients with diabetes type 2 and/or coronary heart disease and subthreshold depression: data from the Step-Dep cluster randomised controlled trial

IntroductionMajor depressive disorders (MDD), diabetes mellitus type 2 (DM2) and coronary heart disease (CHD) are leading contributors to the global burden of disease and often co-occur.ObjectivesTo evaluate the 2-year effectiveness...

Taking anxiety out of active learning

Education As STEM (science, technology, engineering, and mathematics) education becomes more centered on active learning practices, what happens to students' anxiety levels? Specifically, what aspects of evaluative active learning practices cause student anxiety to increase or decrease? After measuring students' baseline anxiety levels, Cooper et al. conducted semi-structured interviews to explore how students' anxiety levels were altered in an active learning classroom. Results show that the way that the active learning activity is implemented and the extent to which students perceive the activity to be beneficial influence its effect on their anxiety. The authors encourage instructors to consider student anxiety when implementing active learning. Int. J. STEM Educ. 10.1186/s40594-018-0123-6 (2018).

Effects of Creative Thinking and Its Personality Determinants on Negative Emotion Regulation.

This study investigated the relationship between creativity and negative emotion, and the effects of integrating creative insight into the reappraisal process on negative emotions. In Study 1, participants' creativity and baseline anxiety levels were measured; then anxiety was induced, and anxiety levels were reassessed. In Study 2, participants wrote about past negative events and then completed the positive and negative affect schedule. They were split into three groups (insight reappraisal, simple reappraisal, or control groups); each of them received a separate intervention, and then they completed positive and negative affect schedule again. In Study 3, participants were randomly assigned to insight reappraisal or control groups; apart from measuring cognitive changes, the procedures were identical to Study 2. All participants were undergraduate students. Results showed that flexibility, originality, risk-taking, and complexity are negatively correlated with anxiety, and that insight reappraisal can induce insight experience and enhance cognitive changes, and reduce negative emotional responses. Therefore, integrating creative insight into the reappraisal process can enhance its effectiveness in reducing negative emotions.

Brief coping strategy enhancement for distressing voices: Predictors of engagement and outcome in routine clinical practice.

Cognitive behaviour therapy is recommended internationally as a treatment for psychosis (targeting symptoms such as auditory hallucinations, or "voices"). Yet mental health services are commonly unable to offer such resource-intensive psychological interventions. Brief, symptom-specific and less resource-intensive therapies are being developed as one initiative to increase access. However, as access increases, so might the risk of offering therapy to clients who are not optimally disposed to engage with and benefit from therapy. Thus, it is important to identify who is most/least likely to engage with and benefit from therapy, and when. In the current study, 225 clients were assessed for suitability for a brief, 4-session, manualized, cognitive behaviour therapy-based intervention for voices (named coping strategy enhancement therapy) and 144 commenced therapy, at a transdiagnostic voices clinic based in Sussex, UK. This article reports on the value of depression, anxiety, stress, insight into the origin of voices, length of voice hearing, and demographics in the prediction of engagement and outcomes. The study found that higher levels of baseline depression, anxiety, and stress were significantly associated with poorer outcomes, especially if clients also had high levels of voice-related distress. The engagement analyses showed that levels of voice-related distress at baseline predicted dropout. These findings highlight the importance of assessing negative affect and voice-related distress prior to commencing therapy for distressing voices, to help determine if the client is suitable or ready for brief-coping strategy enhancement.

Internet Use, Depression, and Anxiety in a Healthy Adolescent Population: Prospective Cohort Study.

BackgroundPsychiatric disorders, including conduct disturbances, substance abuse, and affective disorders, emerge in approximately 20% of adolescents. In parallel with the rise in internet use, the prevalence of depression among adolescents has increased. It remains unclear whether and how internet use impacts mental health in adolescents.ObjectiveWe assess the association between patterns of internet use and two mental health outcomes (depression and anxiety) in a healthy adolescent population.MethodsA total of 126 adolescents between the ages of 12 and 15 years were recruited. Participants reported their typical computer and internet usage patterns. At baseline and one-year follow-up, they completed the Beck Depression Index for primary care (BDI-PC) and the Beck Anxiety Inventory for Primary Care (BAI-PC). Individual linear regressions were completed to determine the association between markers of internet use at baseline and mental health outcomes at one-year follow-up. All models controlled for age, gender, and ethnicity.ResultsThere was an inverse correlation between minutes spent on a favorite website per visit and BAI-PC score. No association was found between internet use and BDI-PC score.ConclusionsThere is no relationship between internet use patterns and depression in adolescents, whereas internet use may mitigate anxiety in adolescents with higher levels of baseline anxiety.

Online insomnia treatment and the reduction of anxiety symptoms as a secondary outcome in a randomised controlled trial: The role of cognitive-behavioural factors

Insomnia and anxiety commonly co-occur, yet the mechanisms underlying this remain unclear. The current paper describes the impact of an Internet-based intervention for insomnia on anxiety, and explores the influence of two cognitive-behavioural constructs - dysfunctional beliefs about sleep and sleep-threat monitoring. A large-scale, 9-week, two-arm randomised controlled trial ( N = 1149) of community-dwelling Australian adults with insomnia and elevated yet subclinical depression symptoms was conducted, comparing a cognitive behavioural therapy-based online intervention for insomnia (Sleep Healthy Using The Internet) with an attention-matched online control intervention (HealthWatch). Symptoms of anxiety were assessed at pretest, posttest, and 6-month follow-up. Dysfunctional beliefs about sleep and sleep threat monitoring were assessed only at pretest. Sleep Healthy Using The Internet led to a greater reduction in anxiety symptoms at both posttest ( t724.27 = -6.77, p < 0.001) and at 6-month follow-up ( t700.67 = -4.27, p < 0.001) than HealthWatch. At posttest and follow-up, this effect was found to moderated by sleep-threat monitoring ( t713.69 = -2.39, p < 0.05 and t694.77 = -2.98, p < 0.01 respectively) but not by dysfunctional beliefs about sleep at either posttest or follow-up ( t717.53 = -0.61, p = 0.55 and t683.79 = 0.22, p = 0.83 respectively). Participants in the Sleep Healthy Using The Internet condition with higher levels of sleep-threat monitoring showed a greater reduction in anxiety than those with lower levels from pretest to posttest, ( t724.27 = -6.77, p < 0.001) and through to 6-month follow-up ( t700.67 = -4.27, p < 0.001). This result remained after controlling for baseline anxiety levels. The findings suggest that online cognitive behavioral therapy interventions for insomnia are beneficial for reducing anxiety regardless of people's beliefs about their sleep and insomnia, and this is particularly the case for those with high sleep-threat monitoring. This study also provides further evidence for cognitive models of insomnia.

Does dexmedetomidine given as a premedication or intraoperatively reduce post-hospitalisation behaviour change in children? A study protocol for a randomised controlled trial in a tertiary paediatric hospital

IntroductionIt has been reported that post-hospitalisation behaviour change (PHBC) occurs in over 50% of children undergoing a general anaesthetic and manifests as behaviours such as sleep and eating disorders, defiance...

Utilization of Postpenile Surgery Illustrated Healing Atlas: A Comparative Study

To determine the effect of the postpenile surgery illustrated healing atlas on caregivers' anxiety levels pre- and postoperatively, the frequency of family's postoperative communication with the urology care team, and the number of unplanned emergency room (ER) return for wound checks. A prospective cohort enrolled children who underwent penile surgeries (distal hypospadias repair and phalloplasty) with no concomitant procedures from December 2016 to June 2017. A 6-item short-form Spielberger State-Trait Anxiety Inventory (STAI) was used to determine baseline and postoperative anxiety levels of the caregivers. Two groups were created: caregivers who did not view the illustrated atlas vs caregivers who were shown the atlas. Baseline characteristics and demographics were compared, along with caregiver's pre- to postoperative anxiety level difference, frequency of postoperative communication, and number of unplanned ER return for wound checks. Fifty-four patients were enrolled with 27 families in each group. Baseline characteristics and demographics were comparable with no significant differences. The assessment of the pre- to postoperative anxiety levels in both groups showed no significant differences (median difference -5 [interquartile range -8 to -5] vs -5 [interquartile range -8 to -4], P = .94). Although no differences were noted for ER-return rates between the groups (18% vs 11.1%, P = .704), significantly less postoperative calls and e-mails were noted among families who received or viewed the postpenile surgery illustrated healing atlas (51.9% vs 11.1%, P = .003). The utilization of a postpenile surgery illustrated healing atlas as part of the postoperative support provided to families was able to decrease postoperative calls and e-mails.

What the child "SAID" to the dentist: A UK randomized controlled trial.

The electronic Survey of Anxiety and Information for Dentists (eSAID) allows children to tell dentists about their feelings and coping preferences. It is a computer "quiz" with 26 questions and free-text responses that produces a report for the children that they can then hand to their dentist. This is the first study to report the use of eSAID in a hospital paediatric dental clinic. This was a randomized controlled trial to evaluate whether children thought that eSAID benefitted them, made them less anxious, and improved cooperation and their treatment satisfaction. Fifty-one children aged 8-13years were randomized to complete either eSAID or a control version in the waiting room before their scheduled dental appointment. The study group had a 26-item questionnaire; the control had only two items. Both groups scored their anxiety on a 7-point anxiety scale at the start and again at the end of the quiz. All subjects handed the resultant eSAID report as a printout to their dentist. Dental treatment proceeded as planned. After treatment, each child reported how they thought the eSAID quiz had benefitted them by scoring on a 10cm Visual Analogue Scale and their satisfaction on the Modified Treatment Evaluation Inventory. The operating dentists scored the children's cooperation using a 10cm Visual Analogue Scale. Overall, the baseline anxiety levels were low (study: mean 1.2; control: mean 1.5). The study group's post-survey anxiety reduced by 0.4, whereas controls' increased by 0.2; this difference is statistically significant (p=.04). However, it made no difference to the children's self-reported benefit (p=.30), satisfaction (p>.05), or cooperation (p=.34). eSAID reduced pre-treatment anxiety but made no difference to children's perceived benefit, satisfaction, or cooperation. Future study should include known anxious children.

Trajectories of self-care agency and associated factors in lung transplant recipients over the first 12months following transplantation.

Self-care agency (SCA), defined as one's ability and willingness to engage in self-care behaviors, can influence actual performance of self-care behaviors in lung transplant recipients (LTRs). Understanding patterns of SCA over time may inform the design of interventions to promote self-care in LTRs. Using group-based trajectory modeling, we sought to identify patterns and correlates of SCA among 94 LTRs over the first 12months post-transplant. Baseline measures of sociodemographic, clinical, and psychosocial factors, and longitudinally assessed psychological distress were examined for their associations with predicted trajectory group membership. Three distinct stable (ie, zero slope) SCA trajectories were identified as follows: persistently low, persistently moderate, and persistently high. Based on the final multivariate model, requiring a re-intubation after transplant (P=.043), discharged to a facility rather than home (P=.048), and reporting a higher level of baseline anxiety (P=.001) were significantly associated with lower SCA. Linear mixed models revealed that higher levels of anxiety and depression were associated with lower SCA in the persistently moderate and low SCA groups over the 12-month time period (Ps<.05). LTRs who require a re-intubation after transplant and are discharged to a facility other than home, and report high psychological distress, may need additional assistance to engage in post-transplant self-care behaviors.