Past, present or future? Word tense and affect in autobiographical narratives of women with HIV in relation to health indicators

Language of violence: Do words matter more than we think?

Firearm violence is a leading cause of morbidity and mortality among young adults. Identification of intervention targets is crucial to developing and implementing effective prevention efforts. Hospital Violence Intervention Programs (HVIPs) have used a multiprong social care approach to mediate the cycle of interpersonal violence. One struggle continually encountered is how to change the conversation around the future. Speech patterns have been associated with health outcomes and overall behavior modification. During violence prevention efforts, young victims of violence say things such as ‘I’m living on borrowed time’ and ‘why should I worry about getting an education when I’ll likely die soon anyway?’ Such speech patterns may contribute to the cycle of violence and increase the likelihood of reinjury. Presented is a narrative review of the impact language has on health outcomes and how psychotherapy may be able to change thought patterns, alter language structure, and ultimately reduce risk of reinjury.

The biopsychosocial model of health posits that a person’s health is dictated by a combination of biological, psychological, and social factors. By understanding that language exists in the personal context, it can serve as both an indicator and a tool for targeted interventions. Cognitive–behavioral therapy (CBT) works by retraining thought and speech patterns to affect change in emotion, physiology, and behavior. It is proposed here that CBT could be used in the HVIPs’ multidisciplinary case management model by involving trained psychotherapists. Language is an important indicator of a patient’s psychological state and approach to life-changing decisions. As such, language alteration through CBT could potentially be used as a novel method of injury prevention. This concept has not before been explored in this setting and may be an effective supplement to HVIPs’ success.

Positive Psychological Factors and Life Themes in Relation to Health Outcomes in Women Living with HIV

BACKGROUND

This mixed methods study identified positive psychological factors and life themes expressed in autobiographical narratives of predominantly Black women living with HIV (WLWH) and investigated these in relation to depressive symptoms, antiretroviral therapy (ART) adherence (≥ 95% of time), and undetectable HIV viral load (VL) (< 80 copies/ml).

METHOD

Ninety-eight WLWH from the Women's Interagency HIV Study Chicago site (M age = 45.3; 91% Black) narrated three autobiographical life turning points, reliably coded for positive factors and life themes. ART adherence, VL and depressive symptoms, assessed with Center for Epidemiologic Studies Depression Scale total score (TOT) including its four factors (negative affect (NA), positive affect (PA), somatic symptoms (SS), and interpersonal problems (IP)), were collected over two time points: concurrently with narratives and 6 months later. Composite scores across the two time points were used in all analyses.

RESULTS

Ten positive psychological factors (gratitude, insight, compassion, meaning-making, acceptance, mindfulness, generativity, optimism, self-reliance, and benevolent God beliefs) and three positive life themes (health improvements, positive relationships, and accomplishments) were identified in narratives. Higher accomplishments, overall positive factors, insight, mindfulness, self-reliance, optimism, meaning-making, and acceptance related to lower depressive symptoms (TOT, NA, SS, or IP). Positive factors and life themes did not significantly relate to PA. Higher compassion related to higher ART adherence. Higher accomplishments related to undetectable VL independent of ART adherence.

CONCLUSION

Findings that positive psychological factors and life accomplishments may relate to better health, especially to lower depression, potentially contribute to developing positive psychology interventions for Black WLWH.

Positive affect and medication adherence in chronic conditions: A systematic review

OBJECTIVE

This review aims to inform research and clinical care on the current state of knowledge on the relationship between positive affect and medication adherence.

METHOD

Searches were carried out in PsycINFO, PubMed MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and Embase. There were no limits on study type, publication date, language, or participant demographics. Studies reporting a relationship between positive affect and medication adherence were eligible for inclusion if positive affect was measured prior to or concurrently with medication adherence.

RESULTS

Nine studies met inclusion criteria. All studies were prospective cohort or cross-sectional and examined positive affect and medication adherence in people living with HIV or cardiovascular conditions. The majority of results indicated positive associations between positive affect and medication adherence, with Cohen's d effect sizes ranging from -0.40 to 1.27.

CONCLUSIONS

Consistent with previous theoretical work, this systematic review provides evidence of a link between positive affect and improved medication adherence. Better measurement of both affect and medication adherence across chronic conditions is an important focus for future research and will inform targeted interventions to improve adherence and, ultimately, decrease the morbidity, mortality, and cost associated with suboptimal adherence in chronic physical conditions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).