Reflections on genes and sustainable change: toward a trait and state conceptualization of response shift

Objective: This article discusses recent advances in research on adaptation, positive psychology, and genetics, and how these advances apply to response shift in health-related quality-of-life (HRQOL) research. Study Design and Setting: As these advances shed new light on the extent to which HRQOL is changeable or fixed, we explored the extent to which a trait and state distinction is informative for response shift research. Results: Direct and moderated response shift effects are discussed in terms of the trait and state distinction to enable hypothesis generation for future research. Conclusions: Implications for study design and data-analytic methods, as well as clinical practice are discussed. (C) 2009 Elsevier Inc. All rights reserved.