The relationship between positive psychological attributes and psychological well-being in persons with HIV/AIDS

Adolescent personality development as a longitudinal marker for burnout and happiness in emerging adulthood

This study examined whether individual differences in personality (development) from adolescence to emerging adulthood were associated with burnout and happiness in emerging adulthood. At Time 1 (2009; Mage = 15.7 years), Time 2 (2012), and Time 3 (2015), Belgian participants ( N = 329; 43.1% boys) reported on the personality dimensions of extraversion, agreeableness/benevolence, conscientiousness, emotional stability, and openness/imagination. Burnout (exhaustion, disengagement) and happiness (life satisfaction, overall affect) were measured through self-reports at Time 4 (2018). For each personality dimension, except benevolence, higher levels were associated with fewer burnout symptoms. Initial levels of all personality dimensions were related to more happiness. Shallower decreases in extraversion, emotional stability, and stronger increases in imagination were related to fewer burnout symptoms and more happiness. Results indicate the importance of studying personality development as a determinant of later well-being, above and beyond effects of initial levels. Findings offer new insights into the field of personality, occupational, and positive psychology.

Psychosocial Resources and Emotions in Women Living With HIV Who Have Cognitive Impairment: Applying the Socio-Emotional Adaptation Theory

Decreased cognitive function is related to undesirable psychological outcomes such as greater emotional distress and lower quality of life, particularly among women living with HIV who experience cognitive impairment (WLWH-CI). Yet, few studies have examined the psychosocial resources that may attenuate these negative emotional outcomes. The current study sought to identify the interrelated contributions of social relationships and psychological resources in 399 WLWH-CI by applying Socio-Emotional Adaptation (SEA) theory using data from the Women's Interagency HIV Study (WIHS). Cognitive impairment (CI) was defined as impairment on two or more cognitive domains. Logistic regression models were used to estimate the odds of experiencing specific emotions due to a combination of four psychosocial resources. Emotions (i.e., depression, apathy, fear, anger, and acceptance) were related to a combination of binary (positive/negative) psychosocial resources including relationship with an informal support partner, relationship with a formal caregiver, coping, and perceived control. Understanding the conditions that may influence emotions in WLWH-CI is important for identifying and appropriately addressing the needs of this population. As CI increases, these individuals experience increasing challenges with articulating their care needs and having their needs met. As such, it becomes increasingly important to identify possible triggers for emotional responses to best address these underlying challenges.

Validation of the shortened Perceived Medical Condition Self-Management Scale in patients with chronic disease

Self-efficacy, or perceived competence, has been identified as an important factor in self-management behaviors and health outcomes in patients with chronic disease. Measures of self-management self-efficacy are currently available for multiple forms of chronic disease. One established measure is the 8-item Perceived Medical Condition Self-Management Scale (PMCSMS). This study investigated the use of the PMCSMS in samples of patients with a chronic disease to develop an abbreviated version of the scale that could be more readily used in clinical contexts or in large population health cohort studies. The PMCSMS was administered as either a generic scale or as a disease-specific scale. The results of analyses using item response theory and classical test theory methods indicated that using 4 items of the scale resulted in similar internal consistency (α = .70-0.90) and temporal stability (test-retest r = .75 after 2 to 4 weeks) to the 8-item PMCSMS (r = .81 after 2 to 4 weeks). The 4 items selected had the greatest discriminability among participants (α parameters = 2.49-3.47). Scores from both versions also demonstrated similar correlations with related constructs such as health literacy (r = .13-0.29 vs. 0.14-0.27), self-rated health (r = .17-0.48 vs. 0.26-0.50), social support (r = .21-0.32 vs. 0.25-0.34), and medication adherence (r = .20-0.24 vs. 0.20-0.25). The results of this study indicate that 4-item PMCSMS scores are equally valid but more efficient, and have the potential to be beneficial for both research and clinical applications. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Psychosocial factors associated with flourishing among Australian HIV-positive gay men

Background

Mental health outcomes among HIV-positive gay men are generally poorer than in the broader population. However, not all men in this population experience mental health problems. Although much is known about factors associated with depression and anxiety among HIV-positive gay men, little is known about factors associated with positive mental health. Such knowledge can be useful for optimizing well-being support programs for HIV-positive gay men.

Methods

In this study, we examined flourishing, which broadly covers most aspects of positive mental health. A sample of 357 Australian HIV-positive gay men completed a survey on their mental health and well-being, including the Flourishing Scale. Given the lack of previous research, we explored a wide range of psychosocial factors, including demographics, stigma, discrimination, and social support, to identify key factors linked to flourishing.

Results

The sample showed a similar level of flourishing to those in general population samples. Several independent factors were found to be associated with flourishing outcomes. Those who were most likely to be flourishing tended to have low or no internalized HIV-related stigma, were employed, received higher levels of practical support, had a sense of companionship with others, and felt supported by family.

Conclusions

These and other findings presented in this article may be used to help inform strategies for promoting optimal levels of mental health, and its associated general health benefits, among HIV-positive gay men.

Affectivity as mediator of the relation between optimism and quality of life in men who have sex with men with HIV

Background/Objective: Increased life expectancy has made quality of life the primary objective in the care of chronic patients and people living with HIV. It found evidence of the link between optimism, quality of life and well-being. This article aimed to determine whether affectivity in its two dimensions (positive and negative) played a mediating role in the association between optimism and quality of life in men living with HIV. Method: 116 men living with HIV (the average age was 36.8 years (SD=9.06), and the average time from the diagnosis was 8.2 years) responded to three instruments: Life Orientation Test revised version (LOT-R), the Positive and Negative Affect Schedule (PANAS) and the World Health Organization Quality of Life-Bref (WHOQoL-Bref). Results: The results showed that positive affect had no mediating effect, whereas negative affect mediated the relation of optimism with two quality-of-life dimensions (overall quality of life and environment). Conclusion: In conclusion, negative affect was found to participate only partially, acting as a mediating variable.

Examining the relationship between psychological distress and adherence to anti-retroviral therapy among Ugandan adolescents living with HIV

Psychological distress is common among adolescents living with HIV (ALHIV) worldwide, and has been associated with non-adherence to anti-retroviral therapy (ART), leading to poor virologic suppression, drug resistance, and increased risk for AIDS morbidity and mortality. However, only a few studies have explored the relationship between psychological distress and ART adherence among adolescents in sub-Saharan Africa. The paper examines the relationship between psychological distress and ART adherence, and effect of psychosocial resources on ART adherence. We conducted a cross-sectional survey of 464 ALHIV (aged 12-19; 53% female) seeking HIV care at a large HIV treatment center in Kampala, Uganda. ALHIV were recruited during routine clinic visits. Three self-reported binary adherence measures were utilized: missed pills in the past three days, non-adherence to the prescribed medical regimen, and self-rated adherence assessed using a visual analog scale. Psychological distress was measured as a continuous variable, and computed as the mean score on a locally developed and validated 25-item symptom checklist for Ugandan ALHIV. Psychosocial resources included spirituality, religiosity, optimism, social support, and coping strategies. After adjusting for respondents' socio-demographic characteristics and psychosocial resources, a unit increase in psychological distress was associated with increased odds of missing pills in past 3 days (Odds Ratio(OR) = 1.75; Confidence Interval (CI): 1.04-2.95), not following the prescribed regimen (OR = 1.63; CI: 1.08-2.46), and lower self-rated adherence (OR = 1.79; CI: 1.19-2.69). Psychosocial resources were associated with lower odds for non-adherence on all three self-report measures. There is a need to strengthen the psychosocial aspects of adolescent HIV care by developing interventions to identify and prevent psychological distress among Ugandan ALHIV.

Randomized trial on the effectiveness of long- and short-term psychotherapy on psychosocial functioning and quality of life during a 5-year follow-up

Knowledge is incomplete on whether long-term psychotherapy is more effective than short-term therapy in treating mood and anxiety disorder, when measured by improvements in psychosocial functioning and life quality. In the Helsinki Psychotherapy Study, 326 outpatients with mood or anxiety disorder were randomized to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP), or long-term psychodynamic psychotherapy (LPP), and followed up for 5 years from the start of treatment. The outcome measures comprised 4 questionnaires on psychosocial functioning, assessing global social functioning (Social Adjustment Scale (SAS-SR), sense of coherence (Sense of Coherence Scale (SOC)), perceived competence (Self-Performance Survey), dispositional optimism (Life Orientation Test (LOT)), and 1 questionnaire assessing quality of life (Life Situation Survey (LSS)). Short-term therapies improved psychosocial functioning and quality of life more than LPP during the first year. The only exceptions were LOT and perceived competence, which did not differ between SPP and LPP. Later in the follow-up, SOC and perceived competence showed significantly more improvement in LPP than in the short-term therapy groups. No direct differences between SFT and SPP were noted. Short-term therapy has consistently more short-term effects on psychosocial functioning and quality of life than LPP, whereas LPP has some additional long-term benefits on psychosocial functioning.

Finding meaning in life while living with HIV: validation of a novel HIV meaningfulness scale among HIV-infected participants living in Tennessee

BACKGROUND

People living with HIV who maintain a positive outlook on their future may manage stress better than those who do not, leading to improved coping behaviors and better health outcomes.

METHODS

While studying 125 HIV+ adults participating in two clinical trials of expressive writing we assessed their HIV-specific meaningfulness of life with a short, unidimensional scale (the HIVMS).

RESULTS

The HIVMS had a strong Cronbach's alpha (0.80) and acceptable test-retest reliability (0.70). HIVMS scores were strongly correlated with measures of perceived control, optimism, and psychological well-being. Participants with lower HIVMS scores had higher probability of non-adherence to antiretroviral medication, suggesting a decreased ability to manage their illness successfully. Neither the control nor expressive writing intervention groups showed increased HIVMS scores.

CONCLUSIONS

Future research is necessary to determine the effect of HIV meaning on long-term health outcomes and to develop interventions that can significantly improve a person's perception of their meaning in life.

Consensus on context-specific strategies for reducing the stigma of human immunodeficiency virus/acquired immunodeficiency syndrome in Zambézia Province, Mozambique

Stigma has been implicated in poor outcomes of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) care. Reducing stigma is important for HIV prevention and long-term treatment success. Although stigma reduction interventions are conducted in Mozambique, little is known about the current nature of stigma and the efficacy and effectiveness of stigma reduction initiatives. We describe action research to generate consensus on critical characteristics of HIV stigma and anti-stigma interventions in Zambézia Province, Mozambique. Qualitative data gathering methods, including indepth key-informant interviews, community interviews and consensus group sessions, were utilized. Delphi methods and the strategic options development analysis technique were used to synthesize qualitative data. Key findings are that stigma enacted by the general public might be declining in tandem with the HIV/AIDS epidemic in Mozambique, but there is likely excessive residual fear of HIV disease and community attitudes that sustain high levels of perceived stigma. HIV-positive women accessing maternal and child health services appear to shoulder a disproportionate burden of stigma. Unintentional biases among healthcare providers are currently the critical frontier of stigmatization, but there are few interventions designed to address them. Culturally sensitive psychotherapies are needed to address psychological distress associated with internalized stigma and these interventions should complement current supports for voluntary counseling and testing. While advantageous for defining stakeholder priorities for stigma reduction efforts, confirmatory quantitative studies of these consensus positions are needed before the launch of specific interventions.

Predictors of late presentation for HIV diagnosis: a literature review and suggested way forward

Early commencement of antiretroviral treatment can be beneficial and economical in the long run. Despite global advances in access to care, a significant proportion of adults presenting at HIV/AIDS care facilities present with advanced HIV disease. Understanding factors associated with late presentation for HIV/AIDS services is critical to the development of effective programs and treatment strategies. Literature on factors associated with late presentation for an HIV diagnosis is reviewed. Highlighted is the current emphasis on socio-demographic factors, the limited exploration of psychosocial correlates, and inconsistencies in the definition of late presentation that make it difficult to compare findings across different studies. Perspectives based on experiences from resource limited settings are underreported. Greater exploration of psychosocial predictors of late HIV diagnosis is advocated for, to guide future intervention research and to inform public policy and practice targeted at 'difficult to reach' populations.