Helplessness and depression in end-stage renal disease.

End-stage renal disease (ESRD), a chronic life-threatening condition, and its treatment by hemodialysis impose severe limitations over a number of significant life dimensions. Variations in treatment, however, afford patients with differing degrees of control over this facet of their illness, and renal transplantation removes these constraints. This situation was employed as a naturally occurring experiment to test the reformulated learned helplessness theory of depression and to explore the psychological impact of limited controllability in ESRD. Participants were 45 dialysis and 25 posttransplant patients. Standardized interviews were conducted by two experimenter-interviewers. The data package sampled information from a concept formation task, psychometric tests of depression, self-esteem, generalized and health locus of control, and separate ratings by hospital staff, family, and participants themselves. Principal-components analysis reduced the 16 dependent variables to six factor scores (accounting for 69.0% of the variance). A hierarchical multiple regression-correlation data-analytic strategy tested two families of hypotheses that applied helplessness theory to