Perceived and Actual Growth Following Hematopoietic Stem-Cell Transplantation: Longitudinal Evidence of Greater Decline than Growth

Abstract

Background. This prospective longitudinal study examined perceived and actual changes in post-traumatic growth following Hematopoietic Stem-Cell Transplantation (HSCT) and their relationships with mental health and psychological disposition. We also tested the hypothesis that unwillingness to be in contact with distressing thoughts and feelings—i.e. experiential avoidance—would moderate the relationship between Post-Traumatic Stress Disorder (PTSD) and growth.Methods. This study was carried out with 187 patients. All patients completed the Post-Traumatic Growth Inventory (PTGI) five months after HSCT and also scales tapping into the five domains of PTGI during and 5 months after HSCT. Mental health and psychological disposition were also assessed prior to hospitalization. A PTSD scale was administrated at the five-month follow-up.Results. Perceived and actual change were weakly correlated. Bayesian pre/post-HSCT comparisons in actual growth revealed substantial to very strong decline in four of the five dimensions assessed. Overall, RCI indicated a reliable increase for 5.6% of patients and a reliable decrease for 40.8% of patients. Confirming that perceived and actual growth reflect different processes, they were not related to the same mental health and psychological disposition variables. Moreover, the hypothesis that acquiring positive outcomes from a traumatic event, such as HSCT, requires direct confrontation with the source of distress that was supported in the case of perceived growth but not in the case of actual growth.Conclusions. Retrospective measures such as the PTGI do not appear to assess actual pre- to post-HSCT change. HSCT seems more linked to psychological decline than to growth.