Degree Date

8-2026

Document Type

Dissertation - Public Access

Degree Name

Psy.D. Doctor of Clinical Psychology

Academic Discipline

Clinical Psychology

First Advisor

Emese Vitalis, PhD

Second Advisor

Todd Doyle, PhD

Third Advisor

Wendy Baker, PsyD

Abstract

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was significantly associated with psychosocial risk classification after accounting for diagnosis category and psychological symptom severity. Patients endorsing a more stress-is-enhancing mindset were less likely to be classified as elevated psychosocial risk. Linear regression analyses showed that stress mindset was associated with lower depressive symptoms, but not anxiety, when controlling for related variables. Stress mindset was also associated with perceived stress at the univariate level; however, this relationship was no longer significant after accounting for depressive symptoms. These findings suggest that stress mindset is related to both psychosocial transplant risk and emotional functioning in patients undergoing liver transplant evaluation. Cognitive appraisal of stress may represent a relevant factor in transplant assessment and may offer a potential target for intervention within transplant behavioral medicine.

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