Emotional adaptation in children after liver transplantation

The emotional adaptation of 25 children who had undergone successful liver transplantation at least 1 year previously was evaluated and compared with that of a control group of 26 children with diabetes mellitus, matched for age, gender, and socioeconomic status, and with reported normative values. With the use of parent- and self-report measures, emotional adaptation was assessed in terms of behavioral adjustment (Child Behavior Checklist), depressive experiences (Children's Depression Inventory), anxiety (State-Trait Anxiety Inventory for Children), and self-concept (Piers-Harris Children's Self-concept Scale). Similar variables were also assessed by a projective personality measure (Rorschach). We found minimal differences in emotional adjustment between liver transplant and diabetic groups; on self-report measures, the adjustment of those with liver transplants was as good as, or better than, that of normative samples. However, on other tests, children with transplants differed from normative samples. On projective measures, liver transplant recipients had an increased number of depressive experiences, situationally related internal distress, and a greater tendency toward negative self-focus and evaluation. We conclude that in pediatric liver transplant recipients, behavioral and emotional adjustment is as good as in children with another chronic illness; in comparison with physically well children, the transplant recipients have subtle signs of emotional difficulties.