Positive and Negative Psychological Predictors of Long-Term Recovery after Cardiac Arrest

Recent advances in treatment for cardiac arrest (CA) have allowed patients to survive neurologically intact, but 1 in 3 report high negative psychological factors (NPF; e.g., depression, posttraumatic stress disorder) at hospital discharge that may increase risk for poor recovery marked by low health-related quality of life (QoL) and lack of independence in activities of daily living (ADL) as well as dangerously reduced cardiac vagal control, which is an index of the health of the autonomic nervous system that predicts risk for future cardiovascular events and mortality. Although NPF cannot be prevented, modifiable positive psychological factors (PPF; e.g., optimism, positive affect, and purpose in life) predict improved recovery and physical activity (PA) in non-CA patients, and therefore this study will test whether PPF predict long-term post-CA recovery—independent of NPF—and whether PA may be a behavioral mechanism underlying these associations. There are currently no clinical practice guidelines for identifying either cardioprotective or harmful psychological factors after CA because there is currently little evidence to guide clinicians, so the proposed research will represent a first step toward developing standard psychosocial interventions with a focus on positive psychological resources and negative psychological risk factors to improve recovery after CA.