Appraisals of fear, helplessness, and perceived life-threat during emergent cardiac surgery: relationship to pre-surgical depression, trauma history, and posttraumatic stress

Abstract

Depression and posttraumatic stress (PTS) have been linked to medical/psychological outcomes following coronary artery bypass graft (CABG) surgery. This study assessed pre-surgical trauma history, PTS, and depression; and peri-surgical appraisals of fear, helplessness, and perceived life-threat among 110 patients. All CABGs were emergent, rather than elective, surgeries. In hierarchical multiple regressions, total severity score for pre-surgical PTS predicted fear regarding the cardiac event and the CABG, and perceived life-threat regarding the cardiac event and the CABG. Pre-surgical depression predicted perceived helplessness regarding the cardiac event and the CABG, and contributed to prediction of perceived life-threat. Trauma history contributed to prediction of fear and perceived helplessness regarding surgery (but not regarding the cardiac event necessitating surgery). When posttraumatic stress disorder diagnosis (PTSD) was entered, rather than total severity of PTS, PTSD did not predict any appraisals, and depression showed stronger prediction of fear, helplessness, and perceived life-threat than did PTSD.