Social support, stress coping strategies, resilience and posttraumatic growth in a Polish sample of HIV-infected individuals: results of a 1 year longitudinal study

A Meta-Study of Posttraumatic Growth and Coping Strategies

The present study examined the relationship between posttraumatic growth (PTG) and different types of coping strategies to explain the mechanism underlying PTG. It also considered whether the relationship takes on different patterns in different cultures, thereby expanding on the existing literature regarding PTG. Initially, we found 666 articles published and unpublished between 2013 and 2020. All potentially eligible studies were examined based on the inclusion criteria for this study. The inclusion criteria ultimately yielded total of 96 studies. The findings of this meta-analysis indicate that the relationship varies depending on the coping strategy and culture. Moreover, identifying the coping strategies involved in overcoming traumatic events may be the key to differentiating real PTG from illusory PTG. The results show that PTG has different correlations with the four groups of coping strategies: problem-focused coping, positive emotion-focused coping, negative emotion-focused coping, and unclassified coping.

Contribution of personal and community resources to personal growth of mothers from Israel and Turkey

AIMS

The transition to parenthood is considered one of the most important milestones in a person's life, bringing with it various changes and challenges. One possible outcome of such a life-altering and stressful event is the experience of personal growth (PG). This study examines the contribution of a mother's personal resources (emotion regulation strategies, resilience) and environmental resources (sense of community) to her PG following the transition to motherhood, taking into account the role played by ethnicity.

METHODS

Data was collected from 402 Israeli Arab, Israeli Jewish, and Turkish first-time mothers of babies up to twenty-four months old.

RESULTS

It was found that Israeli Arab mothers reported significantly higher expressive suppression and PG than the other two groups. In addition, Israeli Arab mothers scored significantly higher on resilience, and Israeli Jewish mothers scored significantly higher on sense of community, than Turkish mothers. After controlling for mother and baby background variables, cognitive reappraisal and sense of community were found to predict PG. Two interactions emerged: higher sense of community was related to greater PG only among Israeli Arab mothers; and a positive association between resilience and growth was found only among Israeli Jewish mothers. The results are discussed in relation to the literature.

CONCLUSION

Personal and environmental resources contribute differently to growth of first-time mothers in different cultures. Thus, rather than implementing the same type of intervention in all cultures, appropriate interventions should be tailored for each culture in accordance with its unique characteristics.

Predictors of pretraumatic stress during the COVID-19 pandemic in Poland

BACKGROUND

Pretraumatic stress has the same symptoms as post-traumatic stress but instead pertains to anticipated threats. There is evidence that pretraumatic stress occurs among soldiers and pregnant people.

OBJECTIVE

We analyzed correlates of pretraumatic stress concerning the threat of COVID-19 infection.

METHOD

Our pilot study was cross-sectional (N = 74); our main study was longitudinal and consisted of three waves (N = 1067, N = 894, and N = 752 for Waves 1, 2, and 3, respectively). Our pilot study used correlation and multiple linear regression. Our main study used quadratic regression and a random intercept cross-lagged panel model.

RESULTS

The pilot study found that pretraumatic stress was positively correlated with agreeableness (r = .24, p < .01) and negatively correlated with emotional stability (r = -.30, p < .01) and intellect/imagination (r = -.37, p < .01). The main study demonstrated that pretraumatic stress was positively correlated with other measures of mental health problems during the COVID-19 pandemic and with perceived positive aspects of the pandemic (r = .11, p < .01). There is evidence of a U-shaped relationship between pretraumatic stress and perceived positive aspects of the pandemic. A random intercept cross-lagged panel model analysis demonstrated that pretraumatic stress in Wave 2 was negatively predicted by levels of prosocial behavior in Wave 1 (B = -1.130, p < .01).

CONCLUSION

Mental health professionals should take into account pretraumatic stress, not only as a possible consequence of the COVID-19 pandemic outbreak but more generally as a risk in situations that are new, difficult, and challenging for people.

Risk and protective factors for resilience among adolescents and young adults with beta-thalassemia major

BACKGROUND

Resilience is the ability to overcome adversity in response to a potentially traumatic event. It can relieve people's discomfort and build personal capacity when facing a stressful situation such as beta thalassemia major. Resilience is a complex and multidimensional concept and is influenced by protective and risk factors. Therefore, the aims of the present study were to (1) investigate the relationship between protective (social support and hope) and risk (uncertainty and defensive coping) factors with resilience and (2) examine the mediating role of courageous coping between these protective and risk factors in resilience.

METHODS

This descriptive-analytical study was performed on 312 adolescents and young adults with beta-thalassemia major aged 12-24 years; they were selected using purposeful sampling from two different outpatient thalassemia clinics in the south of Iran. Data were collected in a face-to-face survey using Zimmet Multidimensional Scale of Perceived Social Support, Herth Hope, Stewart Uncertainty in Illness scale, Jalowiec Coping, and Connor-Davidson resilience Scale from April 2022 to November 2022. The collected data were analyzed using descriptive tests, Pearson correlation, and a structural equation model.

RESULTS

According to the main findings of mediation analysis, courageous coping partially mediated the relationship between social support and resilience [(β = 0.042; 95% BC CI (0.003, 0.131)] and fully mediated the relationship between hope and resilience [(β = 0.166; 95% BC CI (0.031, 0.348)]. In other cases, uncertainty and defensive coping had a direct and indirect effect on resilience, respectively.

CONCLUSION

Based on these results, health professionals and healthcare policymakers should consider this mediator in developing programs to improve resilience. Also, the use of courageous coping could modulate the effect of defensive coping on resilience. Therefore, teaching the use of courageous coping can play an important role in improving resilience.

Turning to Religion During COVID-19 (Part I): A Systematic Review, Meta-analysis and Meta-regression of Studies on the Relationship Between Religious Coping and Mental Health Throughout COVID-19

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person's degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: this first part discusses positive mental health indicators, while the second discusses negative mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023). A systematic review of PubMed, Science Direct, the Cochrane Library, Google Scholar, the Database of Abstracts of Reviews of Effects, and Google Scholar databases was carried out. In addition to the synthesis of information obtained from the research, a meta-analysis of correlation was also performed to determine the strengths of the relationships between the analysed variables, and selected moderators were assessed using meta-regression. Quality of life, well-being, satisfaction with life, happiness, and post-traumatic growth were the positive mental health indicators considered. Meta-analyses indicated a statistically significant relationship between positive religious coping and flourishing (well-being) with overall correlation values of 0.35 [0.30; 0.40]. Further calculations also indicated a relationship between negative religious coping and flourishing - 0.25 [- 0.34; - 0.15]. Data synthesis shows associations between religious coping and such indicators as satisfaction with life and post-traumatic growth, but these issues require further investigation.

Social support and posttraumatic growth: A meta-analysis

BACKGROUND

The beneficial role of social support on posttraumatic growth (PTG) has been assumed by theoretical models and established in some studies. However, there are inconsistent findings and little knowledge on moderators. The present study aims to investigate the overall effect size of the relationship and identify factors affecting the association.

METHODS

Six electronic databases were searched. Newcastle-Ottawa Quality Assessment Scale (NOS) were used to evaluate the quality of studies. Study quality, study design, trauma type, PTG measure, social support measure, continent, publishing language, sample size, gender, religion, and age were analyzed as moderators. Meta-regression was conducted with the significant differential predictors in moderator analysis.

RESULTS

The meta-analysis included 217 samples and a total of 47,940 participants from both longitudinal and cross-sectional studies. There was a medium positive effect size between social support and PTG in random effect model, r = 0.418, p < .001. The meta-regression analysis indicated that the association between social support and PTG was stronger among caregivers (vs. other traumatized samples), Chinese, older individuals and studies with smaller sample size.

LIMITATIONS

Only survey results were included in the analysis. The retrospective self-report may limit a more objective assessment of the relations. In addition, 87 % of the studies were cross-sectional, which may influence the estimation of a valid effect size.

CONCLUSIONS

Regarding the medium positive association between social support and PTG, it is important to enhance social support for trauma survivors. It will be especially effective for caregivers, Chinese, and older people.

Social Support Is Linked to Post-Traumatic Growth among Tunisian Postoperative Breast Cancer Women

The struggle with breast cancer (BC) is often associated with positive changes after diagnosis and treatment, that are being referred to as posttraumatic growth (PTG). We aimed to examine PTG and its relationship with psychosocial (i.e., psychological distress, spiritual well-being, social support), sociodemographic and cancer-related variables in Tunisian women operated on for breast cancer. This was a cross-sectional study. Seventy-nine (79) postoperative BC women were administered the Post-Traumatic Growth Inventory, the Spiritual Well-being Scale, the Depression, Anxiety and Stress Scales, and the Multidimensional Scale of Perceived Social Support. The changes most frequently reported by participants were discovering that they were stronger than they thought they were (70.0%), having stronger religious faith (65.0%), and being better able to accept the way things work out (63.8%). Multivariate analysis showed that anxiety and social support remained significantly associated with PTG, while no significant relationship has been found for spiritual well-being. Overall, the present study adds to the existing body of research by identifying factors related to women’ s experience of PTG in a previously unexplored Arab Muslim cultural context, Tunisia. We believe that our findings may help inform strategies aiming at promoting positive psychological changes after experiencing BC, at least in our context.

A simultaneous concept analysis of resilience, coping, posttraumatic growth, and thriving

BACKGROUND

Research has shifted in recent decades from a focus on negative effects of adversity, trauma, and stress to protective factors and positive outcomes. Resilience and related concepts (coping, posttraumatic growth, thriving, and preparedness) reflect this shift. However, the current state of literature reflects conceptualization challenges in relation to these terms, which blur their differentiation.

AIM

We aim to examine how resilience and related terms are conceptualized in health-related literature.

DESIGN

We used a simultaneous concept analysis to independently explore and further inform the conceptual development of resilience, coping, PTG, and thriving.

DATA SOURCE

We searched PsycINFO and PubMed for literature between 1999 and 2019 for each of our concepts.

REVIEW METHODS

For each of these concepts, we propose a definition, antecedents, attributes, an example, consequences, and related concepts. Next, we concurrently examined the concepts, compared and contrasted findings across them, and clarified similarities as well as differences between them.

RESULTS

Many concepts' definitions lack specificity, clear boundaries, and consistency across the literature. Resilience literature fails to differentiate between attributes and antecedents of resilience. There was overlap regarding conceptualization between resilience and coping, and resilience and thriving.

CONCLUSIONS

Several concepts' definitional literature diverged between a return to baseline functioning and surpassing baseline.

The Wither or Thrive Model of Resilience: an Integrative Framework of Dynamic Vulnerability and Resilience in the Face of Repeated Stressors During the COVID-19 Pandemic

During the first 2 years of the COVID-19 pandemic, empirical efforts in the psychological sciences have been unequivocally focused on understanding the psychosocial impact on resilience and vulnerability. While current empirical work is guided by different existing theoretical models of resilience and vulnerability, the emerging datasets have also pointed to a necessity for an update of these models. Due to the unique features and developments specific to the current pandemic such as the occurrence of repeated collective stressors of varying durations, in the current position paper, we introduce the Wither or Thrive model of Resilience (With:Resilience). It integrates key aspects of prevailing psychological resilience frameworks within the context of the COVID-19 pandemic, and extends them by (1) moving away from single scale approaches towards a higher-order latent expression of resilience and vulnerability incorporating also non-clinical mental health markers, (2) proposing different trajectories of resilience-vulnerability emerging across repeated stressors over long periods of time, and (3) by incorporating multiple influencing factors including aspects of the socio-economic concept of social cohesion as well as separate mediating processing mechanisms. We propose that With:Resilience will enable a more nuanced approach and appropriate analytical investigation of the vast incoming data on mental health and resilience during the COVID-19 pandemic, and we suggest some concrete methodological approaches. This framework will assist in the development of actionable public health guidelines for society in the present and future pandemic contexts as well as aid policy making and the interventional sciences aimed at protecting the most vulnerable amongst us.

Posttraumatic Growth and Posttraumatic Stress Symptoms in People with HIV

Receiving a diagnosis of HIV can be challenging. People with HIV (PWH) can experience high levels of distress, as well as some positive psychological changes associated with post-traumatic growth. However, the mechanisms which underlying the association of a highly stressful event (i.e., being diagnosed with HIV) and posttraumatic growth (PTG) and posttraumatic stress symptoms (PTSS) are under-explored, and this is the focus of the study. Cross-sectional survey data were provided by 77 PWH living in New Zealand. An analysis examined the roles of deliberate rumination and coping strategies as serial mediators of the associations between event centrality and PTG and PTSSs. The relationships between event centrality and PTG and PTSSs were found to be sequentially mediated by deliberate rumination and avoidance coping, but not by deliberate rumination and active coping. Further analyses explored active coping and deliberate rumination as parallel mediators, with avoidance coping as a subsequent mediator, between event centrality and PTG and PTSSs. However, these analyses were not supported. The findings indicate that the more participants appraised the HIV diagnosis as central, the greater PTG they perceived; however, the more they deliberately ruminated on it, and the more avoidance coping they adopted, the less PTG and greater PTSSs they perceived. Future studies need to explore the relationships of event centrality and coping and their associations with PTG and PTSSs.

Post-Traumatic Growth in Women with Breast Cancer: Intensity and Predictors

Experiencing a traumatic situation such as breast cancer can, beside negative consequences, have a positive impact, described as post-traumatic growth (PTG). A factor that facilitates psychological recovery when coping with stressful events is psychological resilience. The aim of the present study was to assess whether PTG occurs in a group of women with breast cancer and whether resilience is a personal trait contributing to its occurrence. The study group comprised 100 women with breast cancer, aged 31-80 years, almost half of whom were aged 61-70 years (n = 46, 46%). The Post-Traumatic Growth Inventory, the Impact of Event Scale, and the Resilience Assessment Questionnaire (KOP) were used for the study. All women manifested PTG, with a mean intensity of 76.61 ± 13.45 points. The greatest changes were observed in the subjects' appreciation of life, and the smallest in their relations with others, self-perception, and spiritual changes. The KOP scale measured a mean resilience of 103.80 ± 16.57. The results obtained confirm the co-occurrence of psychological resilience and PTG, especially personal resilience and social competences. Additionally, women subjected to additional traumatic events other than cancer manifested a higher level of PTG.

Posttraumatic growth and well-being among people living with HIV: A systematic review and meta-analysis in recognition of 40 years of HIV/AIDS

OBJECTIVES

This systematic review and meta-analysis aimed to synthesize, analyze, and critically review existing studies on the relationship between posttraumatic growth (PTG) and psychological well-being (operationalized either via positive or negative well-being indicators) among people living with HIV (PLWH). We also investigated whether this association varies as a function of socio-demographic, clinical characteristics, and study publication year.

METHOD

We conducted a structured literature search on Web of Science, Scopus, MedLine, PsyARTICLES, ProQuest, and Google Scholar. The most important inclusion criteria encompassed quantitative and peer-reviewed articles published in English.

RESULTS

After selection, we accepted 27 articles for further analysis (N = 6333 participants). Eight studies used positive indicators of well-being. The other 19 studies focused on negative indicators of well-being. Meta-analysis revealed that there was a negative weak-size association between PTG and negative well-being indicators (r = - 0.18, 95% CI [- 0.23; - 0.11]) and a positive medium-size association between PTG and positive well-being measures (r = 0.35, 95% CI [0.21; 0.47]). We detected no moderators.

CONCLUSIONS

The present meta-analysis and systematic review revealed expected negative and positive associations between PTG and negative versus positive well-being indicators among PLWH. Specifically, the relationship between PTG and positive well-being indicators was more substantial than the link between PTG and negative well-being measures in these patients. Finally, observed high heterogeneity between studies and several measurement problems call for significant modification and improvement of PTG research among PLWH.

Depression, anxiety and post-traumatic growth among COVID-19 survivors six-month after discharge

BACKGROUND

Pre-hospitalisation, hospitalisation and post-hospitalisation factors may significantly affect depression, anxiety and post-traumatic growth (PTG) among COVID-19 survivors.

OBJECTIVE

Our study investigated depression, anxiety and PTG and their correlates among COVID-19 survivors.

METHOD

A cross-sectional telephone survey recruited 199 COVID-19 patients (Mean age = 42.7; 53.3% females) at six-month follow-up after hospital discharge in five Chinese cities (i.e. Wuhan, Shenzhen, Zhuhai, Dongguan and Nanning). Their demographic information, clinical records and experiences during (e.g. severity of covid-19 symptoms, treatment and exposure to other patients' suffering) and after hospitalisation (e.g. perceived impact of covid-19, somatic symptoms after hospitalisation), and psychosocial factors (e.g. perceived discrimination, self-stigma, affiliate stigma, resilience and social support) were investigated. Depressive and anxiety symptoms were measured by the Patient Health Questionnaire (PHQ-9) and the Generalised anxiety disorder (GAD-7) scale, respectively. PTG was examined by the Post-traumatic Growth Inventory (PTGI) instrument.

RESULTS

The proportion of depressive symptoms <5, ≥5 and <10, ≥10 were 76.9%, 12.0% and 11.1%, respectively. The proportion of anxiety symptoms <5, ≥5 and <10, ≥10 were 77.4%, 15.1% and 7.5%, respectively. Multivariate logistic regression showed that receiving mental health care services during hospitalisation, somatic symptoms after discharge, perceived affiliate stigma and perceived impact of being infected with COVID-19 were significantly and positively associated with probable depression. Significant correlates of probable anxiety also included permanent residents of the city, somatic symptoms after discharge, perceived impact of being infected with COVID-19 and self-stigma. Social support, self-stigma and receiving mental health care services during hospitalisation were positively associated with PTG.Conclusions: The results suggest that post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors. Promoting social support and social inclusion may be useful strategies to improve the mental health of COVID-19 survivors.

HIGHLIGHTS

• Post-hospitalisation and psychosocial factors had relatively stronger associations with depression, anxiety and PTG than pre-hospitalisation and hospitalisation factors, promoting social support and social inclusion may be useful strategies to improve mental health of COVID-19 survivors.

Longitudinal transitions in patterns of post-traumatic stress disorder symptoms and psychological distress among South Korean adults with traumatic experiences

This study aimed to investigate transitions in patterns of post-traumatic stress disorder (PTSD) symptoms and psychological distress among South Koreans with traumatic experiences. This study consists of two parts: In Part 1 the time since trauma ranged between 0 and 41 years, while in Part 2 participants experienced at least one traumatic event within the previous three years. We identified subgroups and transitions between classes over a one-year period using latent profile analysis and latent transition analysis. First, in Part 1, four classes were identified at T1 and T2. Second, we explored whether age, sex, time since trauma, and time perspective (TP) predicted class membership at T1. Age, past-negative (PN), present-fatalistic, and future TPs were significant predictors of class membership at T1. Finally, sex, PN, and future TPs were identified as significant predictors of class transition over time. The same analysis was conducted in Part 2 with individuals chosen from the Part 1 participants. Differential effects of TP on class membership and transitions in PTSD symptoms and psychological distress indicated the need for intervention programs that consider the TP profiles of individuals with traumatic experiences.

The Consequences of COVID-19 Toward Human Growth: The Role of Traumatic Event and Coping Strategies Among Indonesian Sample

COVID-19 has brought a massive psychological impact on individuals' life. The current study sets a significant purpose to test the model whether post-traumatic stress and coping strategies affect stress-related growth regarding the COVID-19 event. One hundred and ninety-nine participants have participated in an online survey in the period of lockdown. The proposed hypotheses model is further tested using PLS-SEM. The first model explains a significant moderate, 46% amount of variance for stress-related growth. With gender as moderator, the second model explains a significant 29% amount of variance for stress-related growth, which is also moderate. This study shows that active coping strategies and positive affirmation significantly influence individual stress-related growth. The trauma event (COVID-19) does not significantly affect growth. Women experience trauma compared to men, besides active coping with the COVID-19 situation is higher in men than women. Using the Bio-centric perspective, having a positive connection through acceptance and awareness of the situation, self-care, and affective interaction with others would develop growth regarding traumatic situations. Further, interventions about coping skills and positive affirmations are essential to give, especially to vulnerable groups such as women.

Post-traumatic Growth and Related Influencing Factors in Discharged COVID-19 Patients: A Cross-Sectional Study

The purpose of this study is to investigate the current state of post-traumatic growth (PTG) and identify its influencing factors in discharged COVID-19 patients. PTG refers to individual experiences of significant positive change arising from the struggle with a major life crisis. This descriptive cross-sectional study used the convenient sampling method to recruit 140 discharged COVID-19 patients in Hunan, China. The results show that the PTG of the discharged COVID-19 patients was positively correlated with self-esteem, post-traumatic stress disorder, coping style tendency, and social support, but negatively correlated with the time from onset to diagnosis. Our findings could provide guidance on improving the psychological state and well-being of discharged COVID-19 patients.

Moderating Effect of Posttraumatic Growth on the Relationship Between Social Support and Quality of Life in Colorectal Cancer Patients With Ostomies

BACKGROUND

Little research has examined the moderating influence of posttraumatic growth (PTG) on the relationship between social support and quality of life.

OBJECTIVES

This study examined the relationship between social support and quality of life by the level of PTG in colorectal cancer patients with ostomies.

METHODS

Using a cross-sectional design, colorectal cancer patients with ostomies (n = 140) were recruited using convenience sampling. The City of Hope Quality of Life-Ostomy, the Multidimensional Scale of Social Support, and the Posttraumatic Growth Inventory measured quality of life, social support, and PTG, respectively.

RESULTS

Social support and PTG were positively related to psychological and social well-being. Higher social support was associated with better psychological and social well-being. Posttraumatic growth moderated the relationship between psychological and social well-being. At a low and moderate level of PTG, social support was more strongly associated with psychological and social well-being, whereas at high levels, this association was not significant.

CONCLUSIONS

Findings highlight the significance of social support to improve the quality of life for colorectal cancer patients with an ostomy, particularly those with low levels of PTG.

IMPLICATIONS FOR PRACTICE

Screening for patients' positive cognitive adaptations while living with an ostomy could identify those who might need further social support to improve their quality of life. Further, intensive social support programs might promote the quality of life for colorectal patients with an ostomy, which was found to be effective for those with low levels of PTG.

Black and Latino Persons Living with HIV Evidence Risk and Resilience in the Context of COVID-19: A Mixed-Methods Study of the Early Phase of the Pandemic

The COVID-19 pandemic has great potential to disrupt the lives of persons living with HIV (PLWH). The present convergent parallel design mixed-methods study explored the early effects of COVID-19 on African American/Black or Latino (AABL) long-term survivors of HIV in a pandemic epicenter, New York City. A total of 96 AABL PLWH were recruited from a larger study of PLWH with non-suppressed HIV viral load. They engaged in structured assessments focused on knowledge, testing, trust in information sources, and potential emotional, social, and behavioral impacts. Twenty-six of these participants were randomly selected for in-depth semi-structured interviews. Participants were mostly men (64%), African American/Black (75%), and had lived with HIV for 17 years, on average (SD=9 years). Quantitative results revealed high levels of concern about and the adoption of recommended COVID-19 prevention recommendations. HIV care visits were commonly canceled but, overall, engagement in HIV care and antiretroviral therapy use were not seriously disrupted. Trust in local sources of information was higher than trust in various federal sources. Qualitative findings complemented and enriched quantitative results and provided a multifaceted description of both risk factors (e.g., phones/internet access were inadequate for some forms of telehealth) and resilience (e.g., “hustling” for food supplies). Participants drew a direct line between structural racism and the disproportional adverse effects of COVID-19 on communities of color, and their knowledge gleaned from the HIV pandemic was applied to COVID-19. Implications for future crisis preparedness are provided, including how the National HIV/AIDS Strategy can serve as a model to prevent COVID-19 from becoming another pandemic of the poor.

Challenges to the conceptualization and measurement of resilience in HIV research

The purpose of this study was to evaluate the conceptualization and measurement of resilience in HIV research. Terms related to resilience and HIV were searched in three databases to identify peer-reviewed research articles. Of the 156 articles identified, 49 were included in the analyses. Applied thematic analysis was used to analyze the definitions and measurement of resilience. Articles were reviewed independently by two raters to establish inter-rater reliability. Six recurring themes were identified in the definitions of resilience: adaptation, positive mental health symptoms, the absence of negative mental health symptoms, hardiness, coping, and the ability to "bounce back". Among the articles examined, 14 measures were used to assess resilience, half of which were indirect. These findings help make sense of the available literature on resilience and highlight the importance of clearly operationalizing resilience and measuring it in a way that is congruent with its definition in future HIV research studies.

Employment and Occupational Productivity Among Women Living With HIV: A Conceptual Framework

ABSTRACT

Women living with HIV (WLWH) have lower employment rates and more difficulty finding and keeping employment compared with their counterparts without HIV. These disparities affect physical, psychological, and socioeconomic outcomes, and they may compound the disadvantages associated with living with HIV. Although historical literature has emphasized the impact of clinical factors on employment, current evidence suggests that socioeconomic and psychosocial factors associated with HIV should be included for a more comprehensive view. Based on this broader inclusion, a conceptual framework is presented describing how socioeconomic and psychosocial characteristics influence employment acquisition and maintenance among WLWH. The framework posits that there is a reciprocal relationship between employment acquisition and occupational productivity, and psychological health, physical health, social support, and empowerment. Implications for future research and interventions include (a) an extended conceptualization of vocational rehabilitation and (b) the use of peer support groups to increase social capital, empowerment, knowledge, and resources among WLWH.

A profile analysis of post-traumatic stress disorder and depressive symptoms among Chinese Shidu parents

BACKGROUND

Due to the one-child policy implemented in China, most families have only one child. When parents experience the death of their only child, these parents receive the label 'Shidu parents'. Shidu is a major public health issue in China. However, the patterns of post-traumatic stress disorder (PTSD) and depressive symptoms that are present in this population remain unclear.

OBJECTIVE

This study aims to identify profiles of PTSD and depressive symptoms among Shidu parents and to explore the predictors of profile membership.

METHODS

A total of 363 participants (M age = 61.5 years, SD = 7.5) were asked to complete questionnaires assessing PTSD, depressive symptoms, perceived social support, and demographic information. Latent profile analyses and multivariate logistic regressions were used.

RESULTS

Three distinct profiles were identified: low (39.4%), moderate (32.8%), and high symptoms (27.8%). Parents who were younger and perceived lower levels of support from family and significant others were more likely to experience higher levels of PTSD and depressive symptoms.

CONCLUSIONS

These results indicate that the severity of PTSD and depressive symptoms tightly cohere, providing evidence for the co-occurrence of PTSD and depressive symptoms after bereavement. The findings provide valuable information for the development of tailored professional interventions for bereaved parents.

Direct and Indirect Associations Between Interpersonal Resources and Posttraumatic Growth Through Resilience Among Women Living with HIV in China

This study aims to test the associations between interpersonal resources and posttraumatic growth (PTG) and their indirect associations through resilience among women living with HIV (WLWH). A cross-sectional study interviewed 546 WLWH from eight clinics of Yunnan and Guangxi provinces in China. PTG, resilience and doctors' empathy were assessed by the validated scales. Family support, friend support, and partner intimacy were assessed by the self-constructed scales. Significant background factors of PTG included duration of residence in the area, monthly family income, number of years since HIV diagnosis, self-reported presence of AIDS-related symptoms, and current pregnancy. Family social support, partner intimacy, doctors' empathy, and resilience were positively associated with PTG; friend support was negatively associated with PTG (p < .05). Furthermore, resilience partially mediated the relationships between family support/partner intimacy and PTG, explaining 13.6-14.2% of the variance. Structural equation modeling showed that family support was significantly and indirectly associated with PTG through resilience when controlling for other interpersonal resource indicators. Implications and potential interventions to promote PTG are discussed.

Affective Well-Being, Rumination, and Positive Reappraisal among People Living with HIV: A Measurement-Burst Diary Study

Background

Changes of affective well‐being are usually analysed either as longitudinal processes or as daily fluctuations. We used a three‐burst diary study to combine these perspectives.

Method

The participants were 211 patients with a diagnosis of HIV infection. In three bursts with 6‐month intervals, they completed an online diary for five consecutive days, which gives 15 days of measurements. They evaluate affective well‐being (positive and negative affect), stress associated with a central hassle, and coping (rumination and positive reappraisal).

Results

Higher daily stress coupled with higher rumination was related to lower well‐being. For positive reappraisal, the picture was more complex. First, its interaction with daily stress had an effect on negative, but not on positive, affect. Second, this effect was significant only at the first burst.

Conclusions

These results suggest a stable debilitating effect of daily rumination, but a limited and diminishing beneficial effect of daily positive reappraisal among people living with HIV. As such, they do not confirm the view that positive reappraisal sustains affective well‐being during chronic health conditions. This may inform stress management interventions for PLWH, which are now increasingly taking the form of mobile applications, adapted to the daily lives of patients in their natural environment.

Sociodemographic and psychosocial correlates of resilience among older adults living with HIV in the Deep South

This cross-sectional study assessed the psychosocial and sociodemographic correlates of resilience among older adults living with HIV. Data were obtained from 103 men and 53 women aged 50 years and older in South Carolina. Multivariable linear regression models showed that employment (any) (B: 3.52; 95% confidence interval : 1.04, 5.99), education (B: -3.56; 95% confidence interval : -6.15, -0.98), time since diagnosis (B: 0.18; 95% confidence interval : 0.04, 0.31), and social support (B: 0.27; 95% confidence interval : 0.20, 0.34) were associated with resilience. Interventions tailored for older adults living with HIV to support resilience could facilitate social support, particularly for those who are newly diagnosed, unemployed, and have lower educational attainment.

What is the effect of self-identified HIV activism in willingness to participate in HIV cure-related clinical trials? Results from the ANRS-APSEC study

OBJECTIVES

Enrolling people living with HIV with undetectable viral load into HIV cure-related clinical trials (HCRCT) is challenging. Few data are currently available about the individual factors that influence willingness to participate in HCRCT (WPHCRCT). We hypothesised that WPHCRCT would be more frequent among people living with HIV considering themselves HIV activists. The objective of this study was to investigate the individual characteristics associated with both WPHCRCT and self-identification as an HIV activist.

METHODS

The study enrolled 195 long-term ART-treated and virologically suppressed people living with HIV, followed-up in 19 French HIV services, 2016-2017. A Bayesian model averaging approach was used to assess correlates of both outcomes i.e. WPHCRCT and self-identified HIV activism.

RESULTS

WPHCRCT was reported by 43% of participants and was positively associated with self-identification as an HIV activist (adjusted odds ratio [aOR] 2.90 95% confidence interval [CI] 2.17-3.63], P<0.05) and self-confidence as an HIV positive person (aOR 1.17, 95% CI 0.99-1.35, P<0.1). Self-identified HIV activists (56% of participants) were more likely to have a higher 'relationship with others' score using the post-traumatic growth inventory (aOR 1.10, 95% CI 0.99-1.20, P<0.1), to obtain information about HIV from a greater number of sources (aOR 1.35 [95% CI 1.00-1.68], P<0.1), and to feel greatly affected by mandatory daily treatment (aOR 2.15, 95% CI 1.27-3.03, P<0.1). All associations had relative importance weight>0.75, indicating strong evidence.

CONCLUSIONS

WPHCRCT is strongly related to HIV activism, and also to positive psychosocial characteristics as a person living with HIV, especially regarding relationships with others. The desire to contribute to the fight against HIV for the sake of the HIV community and society should be taken into account to improve participation in upcoming HCRCT.

Health benefits of positive reappraisal coping among people living with HIV/AIDS: A systematic review

People living with HIV/AIDS (PLWHA) often face significant stress, ranging from perceiving identity changes to encountering barriers to daily health behavior engagement. To manage these experiences, many people use positive reappraisal coping (including benefit finding and perceiving growth). Effective coping is highly important for PLWHA; stress reduction has salutary effects on multiple indicators of health. The present systematic review, conducted in PubMed, PsycINFO, and CINAHL, synthesises findings from 33 studies of PLWHA, addressing effects of positive reappraisal on health-related outcomes for adults living with HIV as a chronic illness. Studies were evaluated based on methodological considerations, measurement of key variables, and implications for specific aspects of health. Results suggest that positive reappraisal is often beneficial when dealing with the implications of a potentially traumatic HIV diagnosis on one's identity, although effects may be contextually bound. Implications of these findings are reviewed, emphasizing the importance of positive reappraisal for enhancing health promotion and self-management of HIV. Although the present review is limited by inclusion of multiple disparate outcomes and exclusion of non-English-language articles, these findings inform a comprehensive model of direct and indirect effects of positive reappraisal on emotional, functional, physiological, and behavioural aspects of health useful for guiding future research.

Social support and post-traumatic growth among a sample of arthritis patients: Analysis in light of conservation of resources theory

The study examined the association between social support dimensions and post-traumatic growth (PTG) among a sample of arthritis patients. In particular, we wanted to verify the mediating role of resources, as described by the Conservation of Resources (COR) theory, on the aforementioned relationship. A total of 207 patients with a clinical diagnosis of arthritis were recruited to participate in the study, including 149 females and 58 males. This was a cross-sectional study, with PTG evaluated by the Post-Traumatic Growth Inventory (PTGI) and social support assessed via the Berlin Social Support Scales (BSSS). To assess the level of subjectively possessed resources among participants, we used the COR evaluation questionnaire (COR-E). Provided support, but not received support, was positively related to the level of PTG among participants. In addition, the level of spiritual resources mediated the aforementioned relationship. The results of this contribute to the literature on the psychological aspects of arthritis. It seems that providing support may be related to positive consequences among arthritis patients, in the form of PTG, with spiritual resources being of significant value in this process.

Posttraumatic growth among people living with HIV: A systematic review

OBJECTIVES

The aim of this systematic review was to analyse, synthesise and review existing results on posttraumatic growth (PTG) among PLWH. In particular, we investigated the relationship of PTG with sociodemographic, HIV-related clinical variables, positive and negative psychological correlates as well as HIV-related social issues among PLWH.

METHOD

A literature search was performed on Web of Science, PsyARTICLES, MedLine, Proquest and Scopus databases using appropriate descriptors for positive changes among PLWH. Articles were analysed by title, abstract, and full text.

RESULTS

We accepted a set of 24 articles for systematic review and analysis. Consistent findings were obtained with respect to the positive association between psychological and social correlates (optimism, resilience, positive reappraisal coping, positive affect, self-efficacy and social support) and PTG among PLWH. PTG was also negatively related to various aspects of HIV-related distress (depression, substance use, PTSD symptoms, HIV stigma). On the contrary, sociodemographic and especially HIV-related clinical variables were mostly unrelated to PTG among PLWH.

CONCLUSIONS

The self-reported PTG among PLWH may be related to psychological variables rather than to objective characteristics of HIV infection itself. Nevertheless, several aspects of research on PTG among PLWH require modification, both theoretically and methodologically.

The Relationship Between Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Among HIV-Infected Men Who Have Sex With Men in Beijing, China: The Mediating Roles of Coping Strategies

The traumatic experience of contracting and living with HIV/AIDS may produce a myriad of mental health problems, especially posttraumatic stress disorder (PTSD) symptoms, and conversely, bring posttraumatic growth (PTG), that is, positive changes resulting from a struggle with trauma. The growing body of research into the relationship between PTSD symptoms and PTG has produced mixed results. In addition, some research has suggested that psychosocial and cognitive factors may mediate the development of PTG after trauma exposure. Specifically, individuals experience fewer psychological symptoms and better mental health when adaptive coping strategies align with stressors; however, little research is available on the relationship and the mediating effect of coping strategies on the link of PTSD symptoms and PTG among HIV-infected men who have sex with men (MSM) in China. The aims of the current study were to investigate the relationship between PTSD symptoms and PTG as well as the potential mediating effects of coping strategies through which PTSD symptoms contributes to PTG among this vulnerable population. One hundred and forty HIV-positive MSM were recruited from the Beijing Center for Disease Prevention and Control and were asked to complete a battery of self-administered questionnaires, covering sociodemographic and HIV-related characteristics, coping strategies (i.e., problem-solving, seeking social support, self-blame, and wishful thinking), PTSD symptoms, and PTG. Results showed that, after controlling for sociodemographic and HIV-related variables, a negative linear relationship was found between PTSD symptoms and PTG. In addition, problem-solving and self-blame played significant mediating roles in the association between PTSD symptoms and PTG. The mediating effects of seeking social support and engaging in wishful thinking on the PTSD symptoms and PTD link were, however, non-significant. The present study contributes to an understanding of the association between PTSD symptoms and PTG and underscores the mediators through which individuals gain growth from traumatic experience in the context of HIV infection in Beijing, China. Given these findings, the future efforts at psychological intervention should differentiate and target various types of coping strategies, especially focusing on enhancing problem-solving skills and decreasing self-blame, in response to the promotion of positive growth among HIV-infected MSM.

Psychometric Properties of the Multidimensional Scale of Perceived Social Support in Greek Nurses

BACKGROUND

Psychosocial well-being in the workplace may increase retention of oncology nurses, while a lack of social support has been a predictor of occupational stress in nurses.

PURPOSE

To further explore this phenomenon by examining the psychometric properties of the Multidimensional Scale of Perceived Social Support in Greek nurses working in oncology and mental health settings.

METHODS

A cross-sectional design was used. The sample consisted of 150 nurses (70 oncology nurses and 80 mental health nurses) from the area of greater Athens who joined the study. The scale was translated to Greek using the "forward-backward" procedure. The Multidimensional Scale of Perceived Social Support's internal consistency reliability (Cronbach's α), stability (intraclass correlation coefficient), factor structure (factor analysis), and convergent validity (correlation with Ways of Coping Questionnaire) were examined.

RESULTS

A three-factor (significant others, family, and friends) model was confirmed. The subscales representing the three factors demonstrated excellent internal consistency reliability (Cronbach's αs > .90) and stability intraclass correlation coefficient (>.90).

CONCLUSIONS

The measure is reliable and valid, and it can be used to assess nurses' social support; the results of such an assessment could be helpful when selecting strategies for assisting nurses.

A longitudinal analysis of posttraumatic growth and affective well-being among people living with HIV: The moderating role of received and provided social support

Objectives

The aim of this one-year longitudinal study was to examine the temporal relationship between the level of posttraumatic growth (PTG) and affective well-being, measured by the presence of positive and negative affect among people living with the HIV (PLWH). In addition, the moderating effects of received and provided support with respect to the above-mentioned relationship were investigated.

Method

Study participants completed the following psychometric inventories: the Posttraumatic Growth Inventory (PTGI), the Positive and Negative Affect Schedule (PANAS-X), and the Berlin Social Support Scales (BSSS). Three assessments were performed: 129 patients were recruited for the first assessment, 106 patients agreed to participate in the second assessment, and 82 of the initial 129 participants (63.6%) participated in all three assessments.

Results

An indirect association between PTG and positive affect was observed. However, no association was found between PTG and negative affect. Received support, but not provided support, completely moderated the relationship between PTG and positive affect.

Conclusions

This study adds to the literature by examining the temporal relationship between PTG and affective-wellbeing among PLWH. It appears from the results that in this patient group, PTG may enhance the positive affect over time. However, receiving support is vital in this process.

Social support and posttraumatic growth in a longitudinal study of people living with HIV: the mediating role of positive affect

Background: Psychological research in people living with HIV (PLWH) has been dominated by studies on the negative consequences of HIV infection. However, recently, positive changes following the diagnosis of HIV have been examined, namely the phenomenon of posttraumatic growth (PTG). Objectives: The aim of this one-year longitudinal study was to investigate the level of PTG and its relationship with social support dimensions (perceived support, need for support, actually received support) and positive and negative affect among PLWH. Specifically, this study explored the mediating role of positive and negative affect in the link between social support and PTG. Method: Participants filled out the following psychometric tools: Posttraumatic Growth Inventory (PTGI), Berlin Social Support Scales (BSSS) and Positive and Negative Affect Schedule (PANAS-X). Three assessments were performed. Altogether, 129 patients were recruited for the first assessment, 106 patients participated in the second assessment and 82 participants (63.6%) out of the initial sample of 129 participated in all three assessments. Results: The positive relationship between all examined social support dimensions and PTG was entirely mediated by positive affect. There was no association between negative affect and PTG. Selected socio-medical covariates (sex, employment, higher education, being in a stable relationship and HIV/AIDS status) were related to social support and PTG among participants. Conclusions: This study points to the need for more research on positive aspects of HIV/AIDS, notably PTG. More specifically, interventions focused on enhancement and sustainment of positive affect among PLWH should be an adjunct to traditional mental health screening among this patient group.