Family environment, intrusive ideation, and adjustment among renal transplant candidates.

Waiting for an organ transplant is a stressful experience frequently associated with symptoms of depression and anxiety. Little empirical work has examined patients during the stressful period prior to transplantation, particularly among patients waiting for a renal transplant. A large body of research has demonstrated that social and family support variables are associated with psychological adjustment in a variety of medical populations. Little research has examined the mechanism by which social support exerts its effects on psychological well-being. We examined two possible models of the role of intrusive thoughts on the relationship between a supportive family environment and both depression and anxiety in a sample of 75 patients with end-stage renal disease (ESRD) waiting for a kidney transplant. Path analyses provided modest support for a mediational model, showing that intrusive thoughts partly accounted for the relationship between family expressiveness and psychological distress. A moderational model examining the interactive effects of family environment and intrusive thinking on adjustment was not supported.