With the long-term survival rate of infant and pediatric heart transplant recipients reaching as high as 85%, there is now a significant number of these youths entering adolescence. Although psychological factors thought to be associated with pediatric heart transplant have reached clearer delineation in the literature, few studies have been conducted. Given the emphasis on development typically seen in adolescence combined with the unique experience of receiving a heart transplant, factors such as body image, self-perception, stress and mood have emerged from the literature. As such, this study assessed psychosocial variables of body image satisfaction, self-concept, depression, and social stress in adolescents age 13-18 who received a heart transplant either as an infant or child, and compared these variables to non-transplant, non-clinical controls. The Body Esteem Scale for Adolescents and Adults, Piers Harris Children’s Self-Concept Scale-2nd Edition, and Behavior Assessment Scale for Children-2nd Edition were utilized for the study. Heart transplant adolescents from Loma Linda University Children’s Hospital were delivered packets via mail, and were followed up to ensure response. Control participants were approached in the waiting room of the Faculty Medical Offices’ General Pediatric Clinics and invited to participate in the study as they waited for their medical appointment. Comparisons between the heart transplant group and control group found no significant differences in levels of body image satisfaction, self-concept, depression, or social stress. Regression analysis revealed a significant model for both groups with self-concept and depression accounting for 48% of the variance in body image within the control group and 16% within the heart transplant group. Examination of the unique variables contributions indicated that self-concept accounted for a significant amount of variance in the controls, with neither self-concept nor depression accounting for a significant amount of variance in the heart transplant group. Additionally, the level of association between body image satisfaction and self-concept was much stronger in the control group as was the relationship between body image and depression. Results of this study can shed light on current psychological functioning of the adolescent transplant recipient and provide meaningful information for the future studies assessing heart transplant youth.

LLU Discipline

Clinical Psychology


Clinical Psychology


Graduate Studies

First Advisor

Kimberly Freeman

Second Advisor

Todd Burley

Third Advisor

Richard Chinnock

Fourth Advisor

Jamie Pivonka-Jones

Fifth Advisor

Janet Sonne

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Heart Transplantation -- in infancy and childhood -- psychology; Adolescent Psychology; Body Image; Attitude to Health; Stress, Psychological; Adaptation, Psychological; Self Concept; Personal Satisfaction; Control Groups; Cross-Sectional Studies.



Page Count

xii; 102

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives