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Skogen V, Langseth R, Rohde GE, Rysstad O, Sørlie T, Lie B. Prevalence of mental distress and factors associated with symptoms of major depression among people living with HIV in Norway. AIDS Care 2024; 36:173-180. [PMID: 37909108 DOI: 10.1080/09540121.2023.2275043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
For people living with HIV (PLHIV) who can access lifesaving treatment, HIV has become a chronic lifelong condition; however, PLHIV have more mental and somatic comorbidities than their HIV-negative peers. In this cross-sectional study, we assessed the prevalence of mental distress and identified factors associated with major depression among 244 well-treated PLHIV residing in Norway. Participants completed validated questionnaires covering mental and somatic health. The prevalence of mental distress, defined as a score on the Hopkins Symptom Check List-25 >1.75, was 32%, and that of symptoms of major depression, defined as a score on the Beck Depression Inventory-II ≥20, was 15%. The factors associated with major depressive symptoms identified using logistic regression were risk of drug abuse (adjusted odds ratio (AOR) 15.1, 95% confidence interval (CI) 3.28, 69.3), fatigue (AOR 12.5, 95% CI 3.90, 40.0), trouble sleeping (AOR 7.90, 95% CI 2.85, 21.9), African origin (AOR 3.90, 95% CI 1.28, 11.9), low education (AOR 3.31, 95% CI 1.18, 9.30), and non-disclosure (AOR 3.22, 95% CI 1.04, 10.0). Our findings indicate that the prevalence rates of mental distress and major depressive symptoms are higher among well-treated PLHIV residing in Norway than in the general population. These conditions are under-diagnosed and under-treated, and increased awareness is needed.
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Affiliation(s)
- Vegard Skogen
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
| | - Ranveig Langseth
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
| | - Gudrun E Rohde
- Department of Clinical Research, Hospital of Southern Norway, Kristiansand, Norway
- Faculty of Health & Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ole Rysstad
- Department of Internal Medicine, Hospital of Southern Norway, Kristiansand, Norway
| | - Tore Sørlie
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
- Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromso, Norway
| | - Birgit Lie
- Department of Psychosomatic and Trauma, Hospital of Southern Norway, Kristiansand, Norway
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2
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Daniels I, Anthony T, Peavie J, Miesfeld N, Pyatt T, Robinson D, Jones C. Black Men Who Have Sex with Men with HIV and Providers in HIV Care Settings Reflect on Stigma Reducing Strategies to Promote Engagement in Health Care. AIDS Patient Care STDS 2022; 36:S28-S35. [PMID: 36178381 DOI: 10.1089/apc.2022.0102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Black men who have sex with men (BMSM) with HIV face significant challenges in accessing health care, including routine HIV care and behavioral health care due in part to perceived stigma in health care settings. This study examined the perspectives of BMSM with HIV and health care providers of how stigma experiences can affect health care access to both clinical and behavioral health support services. We explored how providers can mitigate stigma practices and improve health care experiences for BMSM with HIV, which may ultimately improve engagement in care. Working with eight sites as part of the BMSM Initiative, we recruited 20 BMSM with HIV and 13 health care providers to participate in individual virtual interviews. Participants were asked about perceived discrimination and stigma experienced by BMSM with HIV and strategies to reduce stigma experiences. Participants discussed how current practices could be improved to reduce stigma and how the use of telehealth promoted engagement in care. Recommended strategies to reduce stigma in HIV care delivery included offering personable communication, providing nonclinical resources along with standard HIV care, requiring staff diversity training, diversifying health care teams, and offering telehealth options. Employing stigma reduction strategies can create a safe and comfortable environment for BMSM with HIV to engage in behavioral care in HIV care settings. Providers should seek to incorporate these strategies into current and future models of care with the goal to improve overall health outcomes in BMSM with HIV.
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Affiliation(s)
- Imari Daniels
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Tamia Anthony
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Jonovan Peavie
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Noelle Miesfeld
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Tabitha Pyatt
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Deja Robinson
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
| | - Chandria Jones
- Department of Public Health, NORC at the University of Chicago, Bethesda, Maryland, USA
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3
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Adolescent social anxiety undermines adolescent-parent interbrain synchrony during emotional processing: A hyperscanning study. Int J Clin Health Psychol 2022; 22:100329. [PMID: 36111264 PMCID: PMC9449656 DOI: 10.1016/j.ijchp.2022.100329] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/20/2022] [Indexed: 11/22/2022] Open
Abstract
Social anxiety severely impacts adolescents’ social interactions with others; however, the underlying neural mechanism has not been revealed. This study examined how adolescent's social anxiety level influences the interbrain synchrony within adolescent-parent dyads during emotional processing by using electroencephalograph (EEG) hyperscanning. A sample of 25 adolescent-parent dyads completed the picture processing task. Adolescents’ ages ranged from 10 to 14 years old. The results showed that (1) at parietal areas, greater gamma interbrain synchrony was observed in the high social anxiety adolescent-parent dyads (HSAs) than the low social anxiety adolescent-parent dyads (LSAs) in the positive conditions. However, greater gamma interbrain synchrony of the picture processing task was observed in the LSAs than the HSAs in the negative conditions. (2) Compared with the neutral condition, LSAs induced greater interbrain synchronization in the negative condition than in the neutral condition at central and parietal areas. However, HSAs induced greater interbrain synchronization in the positive condition than in the negative condition at parietal areas. (3) HSAs induced greater interbrain synchronization at parietal areas than in the central areas in positive conditions. The results provide neurological evidence that the way parent and adolescent process different emotions in the same emotional episode could be affected by the adolescent's anxiety level.
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Bagheri Z, Noorshargh P, Shahsavar Z, Jafari P. Assessing the measurement invariance of the 10-item Centre for Epidemiological Studies Depression Scale and Beck Anxiety Inventory questionnaires across people living with HIV/AIDS and healthy people. BMC Psychol 2021; 9:42. [PMID: 33750473 PMCID: PMC7941965 DOI: 10.1186/s40359-021-00546-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/02/2021] [Indexed: 12/03/2022] Open
Abstract
Background Recently, extensive research has been reported the higher rate of depression and anxiety among people living with HIV/AIDS (PLWHAs) as compared to the general population. However, no single study has been carried out to investigate whether this disparity is a real difference or it happens due to lack of measurement invariance. This study aims to assess the measurement invariance of the Beck Anxiety Inventory (BAI) and 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) questionnaires across PLWHAs and healthy individuals. Methods One hundred and fifty PLWHAs and 500 healthy individuals filled out the Persian version of the BAI and CESD-10 questionnaires. Multi-group multiple-indicators multiple-causes model (MG-MIMIC) was used to assess measurement invariance across PLWHAs and healthy people. Results Our findings revealed that PLWHAs and healthy individuals perceived the meaning of all the items in the BAI and CESD-10 questionnaires similarly. In addition, although depression scores were significantly higher in PLWHAs as opposed to the healthy individuals, no significant difference was observed in anxiety scores of these two groups. Conclusions The current study suggests that the BAI and CESD-10 are invariant measures across PLWHAs and healthy people which can be used for meaningful cross-group comparison. Therefore, in comparison to healthy individuals, higher depression score of PLWHAs is a real difference. It is highly recommended that health professionals develop therapeutic interventions and psychological supports to promote the mental health of PLWHAs which alleviate their depressive symptoms.
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Affiliation(s)
- Zahra Bagheri
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pegah Noorshargh
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Shahsavar
- Department of English Language, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Jafari
- Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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5
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Yousuf A, Musa R, Isa MLM, Arifin SRM. Anxiety and Depression Among Women Living with HIV: Prevalence and Correlations. Clin Pract Epidemiol Ment Health 2020; 16:59-66. [PMID: 32742296 PMCID: PMC7372730 DOI: 10.2174/1745017902016010059] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/20/2020] [Accepted: 05/27/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION It has been found that HIV positive women are becoming increasingly affected by various illnesses, including Common Mental Disorders (CMDs) such as depression. Such comorbidity escalates the disease progression to the severe stage and commonly hinders treatment adherence. This study determined the prevalence of anxiety and depression amidst women living with HIV. METHODS Based on a cross-sectional and facility-based study, 357 HIV positive women were recruited using the systematic sampling technique from two public hospitals in Jijiga town, Ethiopia. The Hospital Anxiety and Depression Scale (HADS) was administered for screening, and followed by a pre-tested questionnaire that comprised of Perceived Social Support and HIV stigma. RESULTS The results revealed that the prevalence of both anxiety and depression amidst HIV positive women was 28.9% and 32.5%, respectively. In the multivariate analysis, it was discovered that lack of formal education, being divorced, unemployed, and earning a monthly income less than 1400 ETB (37.5 USD) were significantly associated with depression. Women with symptomatic HIV clinical stage III (AOR =2.06, 95% C.I (0.75-5.61), with CD4 cell count below 250 (AOR = 1.14, 95% C.I (0.57-2.28), and with co-infections (AOR= 1.04, 95% C.I (0.40-2.71) also suffered from depression. CONCLUSION The study outcomes show that the prevalence of depression in women with HIV was 32.5%, but they were more likely to be depressed if they were illiterate, divorced, unemployed or had a financial burden. In addition, HIV positive women with less CD4 cell count and in the final clinical stage or suffered from a co-infection were also associated with depressive symptoms. This signifies the public health implications of psychological and cognitive morbidities of the illness among these women with chronic illnesses. Hence, future mental health interventions and HIV care should be integrated with substantial emphasis given to vulnerable groups, including HIV positive women.
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Affiliation(s)
- Abdilahi Yousuf
- College of Medicine and Health Sciences, Jijiga University, Jijiga, Ethiopia
| | - Ramli Musa
- Department of Psychiatric, Kulliyah of Medicine, IIUM, Kuantan, Malaysia
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6
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Sabranski M, Erdbeer G, Sonntag I, Stoehr A, Horst HA, Plettenberg A, Lebherz L, Stellbrink HJ, Hoffmann C. Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy. AIDS Care 2020; 33:453-461. [PMID: 32106695 DOI: 10.1080/09540121.2020.1733466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In people living with HIV (PLWH), a decade-long antiretroviral therapy (ART) poses new challenges regarding physical and mental health. The aim of this cross-sectional study is to investigate the health-related quality of life (HRQOL) in adult HIV-infected patients with viral suppression and an ART exposure for at least 5 years in three German HIV centers. Patients were evaluated by the ACTG Augmented Symptoms Distress Module (ASDM) and the SF-12 Health Survey. Among 894 patients, symptom-related distress was highly prevalent. The most common symptoms were fatigue, insomnia, sadness and depression, sexual dysfunction, and changes in body appearance. In the multivariate analysis, ART duration, age and depression were significantly associated with a higher overall symptom summary score. Self-reported mean SF-12 scores were lower for mental health and younger patients compared to the standard random sample of a healthy German population. Depression and occupational status were significantly related to a lower physical component summary score, by contrast older age was associated with higher scores in the mental component summary, implying more favorable mental health status. In this large group of PLWH, the degree of symptom-related distress was high. Mental and physical health should be considered an integral part of ongoing HIV care.
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Affiliation(s)
| | - Gesa Erdbeer
- Department of Medicine II, University of Schleswig-Holstein, Campus Kiel, Germany
| | - Ina Sonntag
- Department of Medicine II, University of Schleswig-Holstein, Campus Kiel, Germany
| | - Albrecht Stoehr
- IFI Institute for Interdisciplinary Medicine, Hamburg, Germany
| | - Heinz-August Horst
- Department of Medicine II, University of Schleswig-Holstein, Campus Kiel, Germany
| | | | - Lisa Lebherz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Christian Hoffmann
- ICH Study Center, Hamburg, Germany.,Department of Medicine II, University of Schleswig-Holstein, Campus Kiel, Germany
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7
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Paulus DJ, Brandt CP, Lemaire C, Zvolensky MJ. Trajectory of change in anxiety sensitivity in relation to anxiety, depression, and quality of life among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy. Cogn Behav Ther 2019; 49:149-163. [PMID: 31264940 DOI: 10.1080/16506073.2019.1621929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Persons living with HIV/AIDS (PLHIV) disproportionately suffer from anxiety and depressive symptoms and disorders. Although past work has examined the efficacy of cognitive-behavioral therapy (CBT) for depression, and to a lesser extent anxiety, among PLHIV, little is known regarding potential mechanisms underlying improvement in anxiety/depression among this group. Anxiety sensitivity is a well-established risk/maintenance factor for anxiety and depressive disorders and is hypothesized to play an important role in maintaining anxiety among PLHIV. Past work has identified anxiety sensitivity as a mechanism of action underlying changes in various anxiety domains yet it is unknown whether changes in anxiety sensitivity relate to changes in anxiety symptoms among PLHIV undergoing transdiagnostic CBT for anxiety. The current study sought to examine treatment-related changes in anxiety sensitivity and how the trajectory of change relates to anxiety and depressive symptoms as well as overall quality of life. Individuals (n = 35) with HIV/AIDS and elevated anxiety symptoms received CBT for anxiety. Results indicated that reductions in anxiety sensitivity were significantly related to changes in anxiety, depression, and quality of life. Together, these data suggest that changes in anxiety sensitivity are significantly related to changes in anxiety/depression and quality of life among PLHIV seeking treatment.
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Affiliation(s)
- Daniel J Paulus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.,Department of Psychology, University of Houston, Houston, TX, USA
| | | | | | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Health Institute, University of Houston, Houston, TX, USA
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8
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San Miguel GG, Paulus DJ, Brandt CP, Ditre J, Lemaire CM, Mayorga NA, Leonard AD, Zvolensky MJ. Exploring Distress Tolerance as an Underlying Mechanism in the Relation Between Negative Affectivity and Anxiety/Depression Among Persons Living with HIV/AIDS. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2018; 17:369-383. [PMID: 31531002 PMCID: PMC6748336 DOI: 10.1080/15381501.2018.1502707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 03/28/2018] [Accepted: 07/09/2018] [Indexed: 06/10/2023]
Abstract
Persons living with HIV/AIDS (PLHIV) suffer disproportionately from a variety of mood disorders relative to the general population, yet, there is little understanding of the underlying nature behind this. The present study explored the indirect effect of perceived distress tolerance in relation between negative affectivity and anxiety/depressive symptoms and disorders among PLHIV. Participants included 97 PLHIV (60.8% male; 66% Minority; M age = 48.5 years, SE = 7.7). Results revealed indirect effects of negative affectivity via perceived distress tolerance in relation to social anxiety, depression symptoms, as well as the existence of any anxiety disorder; findings were evident after controlling for covariates. Perceived distress tolerance may serve as a construct to aid understanding in the relation between negative affectivity and the expression of anxiety/depressive symptoms and disorders among PLHIV. Future work may consider addressing distress tolerance in efforts to offset the severity of the expression of anxiety/depressive symptoms among PLHIV.
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Affiliation(s)
- Guadalupe G San Miguel
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Daniel J Paulus
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Charles P Brandt
- Houston OCD Program, 708 E. 19 Street, Houston, TX, 77008, United States
| | - Joseph Ditre
- Department of Psychology, Syracuse University, Syracuse NY, 13244, United States
| | - Chad M Lemaire
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX, 77030, United States
- Behavioral Health Department, Legacy Community Health, 1415 California St, Houston, TX, 77006, United States
| | - Nubia A Mayorga
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Amy D Leonard
- Behavioral Health Department, Legacy Community Health, 1415 California St, Houston, TX, 77006, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
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9
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Wong CCY, Paulus DJ, Lemaire C, Leonard A, Sharp C, Neighbors C, Brandt CP, Zvolensky MJ. Emotion Dysregulation: An Explanatory Construct in the Relation Between HIV-Related Stigma and Hazardous Drinking among Persons Living with HIV/AIDS. STIGMA AND HEALTH 2018; 4:293-299. [PMID: 31777759 DOI: 10.1037/sah0000113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of hazardous alcohol use among people living with HIV/AIDS (PLHIV) is common and related to numerous health problems among individuals in this group. Stigma is associated with hazardous drinking among stigmatized groups, but this relationship has yet to be examined among PLHIV. Moreover, there is a lack of research in identifying the mechanisms underlying this association. Emotion dysregulation is one potential construct that may explain the association between stigma and hazardous alcohol use among PLHIV. The present study examined the indirect effect of HIV stigma and hazardous alcohol use via emotion dysregulation. The sample included 98 PLHIV (60.2% male, M age = 48.40, SD = 7.75). Results indicated significant and medium-sized indirect effects of HIV stigma and its subfacets (enacted stigma and negative self-image) in terms of hazardous alcohol use via emotion dysregulation. Alternative models did not yield significant indirect effects. The results document an indirect association between HIV stigma and hazardous alcohol use via emotion dysregulation. These findings may provide novel, initial empirical insight into the nature of the stigma-hazardous drinking relation among PLHIV.
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Affiliation(s)
- Celia C Y Wong
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Daniel J Paulus
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Chad Lemaire
- Legacy Community Healthcare, Houston, Texas, United States
| | - Amy Leonard
- Legacy Community Healthcare, Houston, Texas, United States
| | - Carla Sharp
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Clayton Neighbors
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Charles P Brandt
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States.,Department of Psychiatry, Baylor College of Medicine, 1 Baylor Plaza, Houston TX, 77030, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas, United States
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10
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Wong CCY, Paulus DJ, Lemaire C, Leonard A, Sharp C, Neighbors C, Brandt CP, Lu Q, Zvolensky MJ. Examining HIV-Related stigma in relation to pain interference and psychological inflexibility among persons living with HIV/AIDS: The role of anxiety sensitivity. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2018; 17:1-15. [PMID: 30034300 PMCID: PMC6051718 DOI: 10.1080/15381501.2017.1370680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Pain is highly prevalent among people living with HIV (PLHIV). Although the association between stigma and pain among stigmatized individuals has been well-established in the non- HIV chronic pain literature, little is known about the association between stigma and pain among PLHIV and the mechanisms that underlie this association. The present study examined the indirect effect of HIV stigma and pain via anxiety sensitivity (fear of anxiety symptoms). The sample included 97 PLHIV (60.2% male, Mage = 48.40, SD = 7.75). Results indicated significant and medium-sized indirect effects of HIV stigma on pain severity, pain interference, and psychological inflexibility in pain via anxiety sensitivity. Alternative models did not yield significant indirect effects. The results suggest anxiety sensitivity may explain the association between stigma and pain among PLHIV. These findings provide novel empirical insight into the nature of stigma-pain relation among PLHIV and could be used to guide pain-based intervention development for this population.
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Affiliation(s)
- Celia C. Y. Wong
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Daniel J. Paulus
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Amy Leonard
- Legacy Community Healthcare, Houston, TX, USA
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Charles P. Brandt
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Qian Lu
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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11
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Brandt CP, Bakhshaie J, Jardin C, Lemaire C, Kauffman BY, Sharp C, Zvolensky MJ. The Moderating Effect of Smoking Status on the Relation between Anxiety Sensitivity, Sexual Compulsivity, and Suicidality among People with HIV/AIDS. Int J Behav Med 2017; 24:92-100. [PMID: 27169410 DOI: 10.1007/s12529-016-9568-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The present study examined the moderating effect of cigarette smoking status on the relation between anxiety sensitivity (fear of the expected negative consequences of anxiety and bodily sensations) and hazardous alcohol consumption, sexual compulsivity, and suicidality. METHOD A series of multiple hierarchical regressions were used to test the proposed hypothesis among a sample of 94 persons living with HIV/AIDS in the USA (64.5 % male, M age = 48.3, SD = 7.5). Fifty-seven percent of the participants (n = 54) reported past-month smoking. RESULTS The results indicated that those who reported smoking and had higher anxiety sensitivity demonstrated the highest rates of hazardous alcohol use, sexual compulsivity, and suicidality. Simple slope analyses indicated that anxiety sensitivity was associated with higher rates of hazardous alcohol use, sexual compulsivity, and suicidality among individuals who reported past-month smoking, but not among individuals who did not smoke. CONCLUSION The present results suggest that smoking status moderates the relation between anxiety sensitivity and hazardous alcohol use, sexual compulsivity, and suicidality among persons living with HIV/AIDS. These data add to a growing literature, suggesting that smoking has a negative impact among persons living with HIV/AIDS, which extends beyond physical health problems to a variety of clinically significant behavioral health sequelae.
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12
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Brandt CP, Paulus DJ, Jardin C, Heggeness L, Lemaire C, Zvolensky MJ. Examining anxiety sensitivity as an explanatory construct underlying HIV-related stigma: Relations to anxious arousal, social anxiety, and HIV symptoms among persons living with HIV. J Anxiety Disord 2017; 48:95-101. [PMID: 27527687 PMCID: PMC5293677 DOI: 10.1016/j.janxdis.2016.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 12/01/2022]
Abstract
Persons living with HIV (PLHIV) are a health disparity subgroup of the overall population for mental and physical health problems. HIV-related stigma has been shown to increase anxiety symptoms and HIV symptoms among PLHIV. However, little is known about factors that may impact the relations between HIV-related stigma and anxiety symptoms and HIV symptoms among PLHIV. To address this gap in the literature, the current study examined anxiety sensitivity (i.e., the extent to which individuals believe anxiety and anxiety-related sensations) in the relation between HIV-related stigma, social anxiety, anxious arousal, and HIV symptoms among a sample of 87 PLHIV (60.9% cis gender male, 52.9% Black, non-Hispanic). Results indicated that anxiety sensitivity mediated the relations between HIV-related stigma and the dependent variables, with effect sizes indicating moderate to large effects of anxiety sensitivity on these relations. Findings suggest that anxiety sensitivity be a mechanistic factor in the relations between HIV-related stigma and social anxiety, anxious arousal, and HIV symptoms, and therefore, be important element in efforts to reduce mental/physical health disparity among this population.
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Affiliation(s)
- Charles P. Brandt
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204,Baylor College of Medicine. 1 Baylor Plaza, Houston, Texas 77030,Corresponding author may be reached at
| | - Daniel J. Paulus
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204
| | - Charles Jardin
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204
| | - Luke Heggeness
- Kent State University, Department of Psychology. 144 Kent Hall, Kent, Ohio 44242
| | - Chad Lemaire
- Legacy Community Health. 1415 California St, Houston, Texas 77006
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology. 3695 Cullen Blvd. Room 126, Houston, Texas 77204,The University of Texas MD Anderson Cancer Center, Department of Behavioral Science. 1515 Holcombe Blvd, Houston, Texas 77030
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13
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Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People With HIV: A Clinical Case Study. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2016.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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14
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Brandt CP, Paulus DJ, Garza M, Lemaire C, Norton PJ, Zvolensky MJ. A Novel Integrated Cognitive-Behavioral Therapy for Anxiety and Medication Adherence Among Persons Living With HIV/AIDS. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 25:105-118. [PMID: 29750006 DOI: 10.1016/j.cbpra.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Persons living with HIV/AIDS (PLHIV) are able to live full lifespans after infection, however, rates of anxiety disorders among this population are elevated compared to national samples. Importantly, these anxiety symptoms and disorders have a negative effect on medication adherence, quality of life and other psychological disorders, such as depression. In order to reduce the impact of anxiety among PLHIV, a six-session transdiagnostic CBT-based treatment manual for anxiety among PLHIV named the HIV/Anxiety Management-Reduction Treatment (HAMRT) was developed and implemented. The current manuscript discusses the content of this manual as well as results from three cases examining the impact of HAMRT. Results indicated that HAMRT was effective in reducing symptoms of anxiety, anxiety sensitivity, depression, and negative affect among our sample. Additionally, results indicated that HAMRT was effective in increasing HIV medication adherence as well as quality of life. Results are discussed in terms of the potential utility of an anxiety-reduction therapy program aimed at increasing medication adherence among PLHIV.
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Brandt C, Zvolensky MJ, Woods SP, Gonzalez A, Safren SA, O'Cleirigh CM. Anxiety symptoms and disorders among adults living with HIV and AIDS: A critical review and integrative synthesis of the empirical literature. Clin Psychol Rev 2017; 51:164-184. [PMID: 27939443 PMCID: PMC5195877 DOI: 10.1016/j.cpr.2016.11.005] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 09/09/2016] [Accepted: 11/04/2016] [Indexed: 12/21/2022]
Abstract
There are over 35 million people worldwide infected with the Human Immunodeficiency Virus (HIV) and its progression to Acquired Immunodeficiency Syndrome (AIDS; WHO, 2014). With the advent of combined antiretroviral therapy (i.e., cART) in 1996, persons living with HIV/AIDS (PLWHA) now have much longer life expectancies. However, living with HIV remains challenging, as it is associated with a number of significant and recurrent (chronic) stressors including physical pain, side effects of cART, social stigma, and discrimination, among other social stressors. Presumably, as a result of these types of stressors, a disproportionately high number of PLWHA struggle with clinically-significant psychiatric symptoms and disorders. Although much scientific and clinical attention has focused on depressed mood and psychopathology among PLWHA, there has been comparably less focus on anxiety and its disorders. The paucity of work in this area is concerning from a public health perspective, as anxiety symptoms and disorders are the most common class of psychiatric disorders and often maintain a large negative impact on life functioning.
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Affiliation(s)
- Charles Brandt
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States.
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd. Houston, Texas, 77030, United States
| | - Steven P Woods
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Adam Gonzalez
- Department of Psychiatry and Behavioral Sciences, Stony Brook University, 101 Nicolls Rd, Stony Brook, NY, United States
| | - Steven A Safren
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL, 33124, United States
| | - Conall M O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Square, Suite 701, Boston Ma, 02114, United States
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Bezabhe WM, Chalmers L, Bereznicki LR, Gee P, Peterson GM. Antiretroviral adherence and treatment outcomes among adult Ethiopian patients. AIDS Care 2016; 28:1018-22. [PMID: 26829232 DOI: 10.1080/09540121.2016.1139039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Developing appropriate strategies to sustain optimal medication adherence among the increasing number of HIV-positive patients taking antiretroviral therapy (ART) in sub-Saharan Africa is a major challenge. The objective of this study was to determine patient, regimen, disease, patient-provider, and healthcare-related factors associated with adherence with ART over a one-year period, and assess the impact of adherence on treatment outcomes. We performed a prospective, observational study among 246 patients who were initiated on ART in Ethiopia. Of 172 who completed follow-up, 130 (75.6%) had ≥95% adherence. In the multivariate analyses, a higher baseline BMI (OR, 1.2; 95% CI 1.0, 1.4) and use of reminder devices (OR, 9.1; 95% CI 2.0, 41.6) remained positively associated with adherence, while a higher HIV symptom and adverse drug reaction distress score was an independent negative predictor of adherence (OR, 0.90; 95% CI 0.9, 1.0) CD4 count increase was significantly higher in the adherent patients compared to non-adherent patients at 12 months (159 cells/µL [interquartile range (IQR), 72-324 cells/µL] vs. 132 cells/µL [IQR, 43-190 cells/µL]; p = 0.026). Our findings indicate that interventions aimed at improving adherence and thereby treatment outcomes in patients initiated on ART should promote the use of reminder devices, and monitor HIV symptoms and adverse reaction distress and nutritional status.
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Affiliation(s)
| | - Leanne Chalmers
- a Division of Pharmacy, School of Medicine , University of Tasmania , Tasmania , Australia
| | - Luke R Bereznicki
- a Division of Pharmacy, School of Medicine , University of Tasmania , Tasmania , Australia
| | - Peter Gee
- a Division of Pharmacy, School of Medicine , University of Tasmania , Tasmania , Australia
| | - Gregory M Peterson
- a Division of Pharmacy, School of Medicine , University of Tasmania , Tasmania , Australia
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17
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Brandt CP, Sheppard DP, Zvolensky MJ, Morgan EE, Atkinson JH, Woods SP. Does Age Influence the Frequency of Anxiety Symptoms and Disorders in HIV Disease? JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2016; 15:380-403. [PMID: 28070173 PMCID: PMC5218542 DOI: 10.1080/15381501.2016.1189865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Charles P Brandt
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, Texas, 77004, United States
| | - David P Sheppard
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, Texas, 77004, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, Texas, 77004, United States; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, 1515 Holcomb Blvd. Houston, Texas, 77030, United States
| | - Erin E Morgan
- Department of Psychiatry, 220 Dickinson Street, Suite B, University of California, San Diego, San Diego, California 92103, United States
| | - J Hampton Atkinson
- Department of Psychiatry, 220 Dickinson Street, Suite B, University of California, San Diego, San Diego, California 92103, United States
| | - Steven Paul Woods
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, Texas, 77004, United States; Department of Psychiatry, 220 Dickinson Street, Suite B, University of California, San Diego, San Diego, California 92103, United States
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Kee MK, Lee SY, Kim NY, Lee JS, Kim JM, Choi JY, Ku NS, Kang MW, Kim MJ, Woo JH, Kim SW, Song JY, Baek JH, Choi BY, Kim SS. Anxiety and depressive symptoms among patients infected with human immunodeficiency virus in South Korea. AIDS Care 2015. [PMID: 26197063 DOI: 10.1080/09540121.2015.1035861] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patients infected with human immunodeficiency virus (HIV) may develop mental health problems such as anxiety and depression, which negatively impact of disease progression. We investigated factors associated with the prevalence of anxiety and depression symptoms among HIV-infected patients in Korea. A total of 840 HIV-infected patients who participated in the Korea HIV/AIDS Cohort Study from 2006 to 2012 were evaluated. Socio-demographic, epidemiologic, and clinical variables were obtained through standardized questionnaires. The State-Trait Anxiety Inventory and Beck Depression Inventory were used to assess the symptoms of anxiety and depression. Multiple logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of anxiety and depressive symptoms among HIV-infected patients was 32% and 36%, respectively. Ex-smoker and persistent symptoms for more than one week within the past six months and diagnosis of HIV infection within one year were associated with increased anxiety symptoms (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.09-2.69; OR 1.52, 95% CI 1.09-2.11; OR 1.49, 95% CI 1.02-2.20) and current smoking and persistent symptoms were also associated with increased depressive symptoms (OR 2.10, 95% CI 1.31-3.30; OR 1.87, 95% CI 1.25-2.79). Marital status, current smoking, current drinking, and persistent symptoms were associated with both increased anxiety and depressive symptoms (OR 1.75, 95% CI 1.07-2.88; OR 1.66, 95% CI 1.06-2.61; OR 1.88, 95% CI 1.18-2.99). The prevalence of anxiety and depressive symptoms among HIV-infected patients is higher than those estimated for the general population. This study shows the necessity to evaluate symptoms of anxiety and depression and suggest psychological support for HIV-infected patients who smoke or have persistent symptoms or have sexual partner or drink.
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Affiliation(s)
- Mee-Kyung Kee
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
| | - Sae-Young Lee
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
| | - Na-Young Kim
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
| | - Joo-Shil Lee
- b Korea National Institute of Health , Chungbuk , Republic of Korea
| | - June Myung Kim
- c Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.,d AIDS Research Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Jun Yong Choi
- c Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.,d AIDS Research Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Nam Su Ku
- c Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea.,d AIDS Research Institute, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Moon Won Kang
- e Division of Infectious Diseases, Department of Internal Medicine , College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea , Seoul , Republic of Korea
| | - Min Ja Kim
- f Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Jun Hee Woo
- g Department of Infectious Diseases , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea
| | - Shin-Woo Kim
- h Department of Internal Medicine , School of Medicine, Kyungpook National University , Daegu , Republic of Korea
| | - Joon Young Song
- f Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Ji-Hyeon Baek
- i Department of Internal Medicine , Inha University School of Medicine , Incheon , Republic of Korea
| | - Bo Youl Choi
- j Department of Preventive Medicine , College of Medicine, Hanyang University , Seoul , Republic of Korea
| | - Sung Soon Kim
- a Division of AIDS , Center for Immunology and Pathology, Korea National Institute of Health , Chungbuk , Republic of Korea
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Wang PW, Lin HC, Yen CN, Yeh YC, Hsu CY, Chung KS, Chang HC, Wu HC, Yen CF. Comparison of outcomes after 3-month methadone maintenance treatment between heroin users with and without HIV infection: a 3-month follow-up study. Harm Reduct J 2015; 12:13. [PMID: 25953093 PMCID: PMC4436145 DOI: 10.1186/s12954-015-0047-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 04/27/2015] [Indexed: 01/03/2023] Open
Abstract
Background The aim of this study was to compare the changes in primary (heroin use-related) and secondary (depressive symptoms and quality of life, QOL) outcome indicators of 3-month methadone maintenance treatment (MMT) between heroin users with and without HIV infection. Methods A total of 242 intravenous heroin-dependent individuals (30 with and 212 without HIV infection) receiving MMT were recruited. Primary (severity of heroin dependence, harm caused by heroin use and current heroin use) and secondary (depressive symptoms and QOL) outcome indicators were determined before and after receiving 3-month MMT. Changes in primary and secondary outcome indicators between the two groups were compared using mixed-model analysis. Results Heroin users both with and without HIV infection showed significant improvement in three primary outcome indicators after 3-month MMT, and there was no difference in the changes of these primary outcome indicators between the two groups. However, improvements in depressive symptoms and the physical domain of QOL among HIV-infected heroin users were poorer than in those without HIV infection. Conclusions The results of this study indicated that heroin users with HIV infection did improve in the primary but not the secondary outcomes after 3-month MMT.
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Affiliation(s)
- Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Huang-Chi Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Chia-Nan Yen
- Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan.
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
| | - Chih-Yao Hsu
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No. 130, Kaisyuan 2nd Rd., Lingya Dist, Kaohsiung City, 80276, Taiwan.
| | - Kuan-Sheng Chung
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No. 130, Kaisyuan 2nd Rd., Lingya Dist, Kaohsiung City, 80276, Taiwan.
| | - Hsun-Cheng Chang
- Department of Psychiatry, Tainan Hospital, Department of Health, Executive Yuan, Tainan, Taiwan.
| | - Hung-Chi Wu
- Department of Community Psychiatry, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No. 130, Kaisyuan 2nd Rd., Lingya Dist, Kaohsiung City, 80276, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. .,Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
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20
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Brandt CP, Bakhshaie J, Zvolensky MJ, Grover KW, Gonzalez A. The examination of emotion dysregulation as a moderator of depression and HIV-relevant outcome relations among an HIV+sample. Cogn Behav Ther 2014; 44:9-20. [PMID: 25243931 DOI: 10.1080/16506073.2014.950323] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The present study examined whether emotion dysregulation moderated the relations between depressive symptoms and HIV symptoms, HIV medication adherence due to medication side effects, avoidant coping, and distress tolerance among people living with HIV/AIDS (PLHA). Participants included 115 PLHA (16.8% female; Mage = 49.70, SD = 8.57). Results indicated that there was a significant interaction between depressive symptoms and emotion dysregulation in relation to HIV symptoms, HIV medication adherence due to medication side effects, avoidant coping, and distress tolerance. The form of the interaction indicated that PLHA experiencing higher depressive symptoms and higher levels of emotion dysregulation reported the highest levels of HIV symptoms and lowest levels of distress tolerance. Additionally, results indicated that at lower levels of depressive symptoms, very high levels of emotion dysregulation predicted higher rates of medication nonadherence, whereas at higher levels of depressive symptoms, very high levels of emotion dysregulation predicted the lowest rates of medication nonadherence. Moreover, those experiencing lower levels of depressive symptoms and higher levels of emotion dysregulation reported the greatest rates of avoidant coping. In total, the present results suggest a complex interplay between emotion dysregulation and depressive symptoms with regard to HIV symptoms, medication nonadherence, and self-regulatory processes (e.g., avoidant coping, distress tolerance) among PLHA.
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Affiliation(s)
- Charles P Brandt
- a Department of Psychology , University of Houston , 126 Heyne Building, Houston , TX 77204 , USA
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21
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Garey L, Bakhshaie J, Sharp C, Neighbors C, Zvolensky MJ, Gonzalez A. Anxiety, depression, and HIV symptoms among persons living with HIV/AIDS: the role of hazardous drinking. AIDS Care 2014; 27:80-5. [PMID: 25223279 DOI: 10.1080/09540121.2014.956042] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Hazardous drinking is common among persons living with HIV/AIDS (PLWHA) and associated with numerous negative health consequences. Despite the well-established negative effects of hazardous drinking among PLWHA, scholarly work has neglected to explore the role of such drinking in regard to anxiety/depressive symptoms and HIV symptom expression. The current study investigated associations between hazardous drinking and anxiety/depressive symptoms and HIV symptoms among PLWHA. Participants (n = 94; 88.3% male; Mage = 48.55; SD = 9.15) included PLWHA recruited from AIDS service organizations in the northeast. Hazardous drinking was significantly associated with anxiety/depressive symptoms and HIV symptom expression above and beyond the variance accounted for by sex, race, recruitment site, and CD4 T-Cell count, as well as other cognitive-affective variables (emotion dysregulation, distress intolerance, and anxiety sensitivity). The present results provide empirical support that hazardous drinking is indeed related to depressive and anxiety symptoms as well as HIV symptom distress and that this effect is not attributable to other factors commonly related to both alcohol use problems and emotional distress among PLWHA. Results highlight the importance of alcohol interventions for excessive drinking specifically tailored for PLWHA to facilitate better mental and physical health adjustment.
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Affiliation(s)
- Lorra Garey
- a Department of Psychology , University of Houston , Houston , TX , USA
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Misko AN, Nelson DL, Duggan JM. Three case studies of community occupational therapy for individuals with human immunodeficiency virus. Occup Ther Health Care 2014; 29:11-26. [PMID: 25180539 DOI: 10.3109/07380577.2014.941452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Three case studies illustrate the complexities and opportunities in providing community-based occupational therapy services to persons with HIV. An infectious disease physician recommended three clients for therapy sessions in both the home and community. The Model of Human Occupation (MOHO) in conjunction with the Conceptual Framework for Therapeutic Occupation (CFTO) was used to guide the therapeutic process. Assessments measured challenges to clients and client progress in the following areas: leisure, mobility, organization, problem solving, community involvement, transitioning to independent living, fatigue, childcare/play, and home management. This paper describes the three cases with findings suggesting that community-based occupational therapy has potential to address important issues such as habits, roles, and volition in the HIV/AIDS population.
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Affiliation(s)
- Alexis N Misko
- 1Acute Rehabilitation Unit, Springfield Regional Medical Center, Springfield, Ohio, USA
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23
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Leyro TM, Babson KA, Bonn-Miller MO. Anxiety sensitivity in relation to sleep quality among HIV-infected individuals. J Assoc Nurses AIDS Care 2014; 25:638-45. [PMID: 24759056 DOI: 10.1016/j.jana.2014.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 02/04/2014] [Indexed: 11/15/2022]
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24
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Examining Associations Between Cognitive-Affective Vulnerability and HIV Symptom Severity, Perceived Barriers to Treatment Adherence, and Viral Load Among HIV-Positive Adults. Int J Behav Med 2014; 22:139-48. [DOI: 10.1007/s12529-014-9404-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Kosiba JD, Gonzalez A, O'Cleirigh C, Safren SA. Medication Adherence and HIV Symptom Distress in Relation to Panic Disorder Among HIV-Positive Adults Managing Opioid Dependence. COGNITIVE THERAPY AND RESEARCH 2014; 38:458-464. [PMID: 26146476 DOI: 10.1007/s10608-014-9608-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Panic disorder (PD) occurs at greater rates among those with HIV compared to those without HIV. Rates of PD may be elevated among those with opioid dependence (persons who inject drugs, PWID). Persons with HIV experience common bodily symptoms as a result of the disease and these symptoms overlap with those of PD which may contribute to a "fear of fear" cycle present in PD. HIV-positive, PWID represent an at-risk population in terms of poor medication adherence. HIV symptoms and HIV medication side-effects commonly overlap with panic symptoms and may affect HIV medication adherence. The aim of this investigation was to examine the impact of PD on HIV-related symptom distress and HIV medication adherence in HIV-positive adults (N = 131) in treatment for opioid use. Those with a diagnosis of PD evidenced greater levels of HIV symptom distress and lower levels of medication adherence than those without current PD. Results highlight the clinical importance of assessing for and treating PD among individuals with HIV that are prescribed antiretroviral therapy. Future work would benefit from examining observed associations longitudinally and identifying potential mechanisms involved.
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Affiliation(s)
- Jesse D Kosiba
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Adam Gonzalez
- Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA; The Fenway Institute, Boston, MA, USA
| | - Steven A Safren
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA; The Fenway Institute, Boston, MA, USA
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26
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Nillni YI, Rohan KJ, Mahon JN, Pineles SL, Zvolensky MJ. The role of anxiety sensitivity in the experience of menstrual-related symptoms reported via daily diary. Psychiatry Res 2013; 210:564-9. [PMID: 23910240 PMCID: PMC6605776 DOI: 10.1016/j.psychres.2013.07.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 07/02/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
The current study examined the interactive effects of Anxiety Sensitivity (AS) and menstrual cycle phase in the experience of menstrual-related symptoms. Participants were 55 community women who completed prospective tracking of menstrual-related symptoms across at least one full menstrual cycle using the Daily Record of Severity of Problems (DRSP) and completed the Menstrual Distress Questionnaire (MDQ) once in their premenstrual and follicular cycle phases. Results revealed that women with higher levels of AS reported greater menstrual-related symptoms, regardless of cycle phase, as compared to women with lower levels of AS. These findings suggest that AS may be an important psychological factor involved in the experience of psychological and somatic symptoms across the menstrual cycle. Results are consistent with previous literature documenting the role of AS in menstrual-related symptoms as well as in other physical health conditions.
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Affiliation(s)
- Yael I. Nillni
- University of Vermont, Burlington, VT, USA,National Center for PTSD, Women′s Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA,Boston University School of Medicine, Boston, MA, USA,Correspondence to: National Center for PTSD, Women′s Health Sciences Division, Veteran′s Affairs Boston Healthcare System, 150 South Huntington Ave.(116B-3), Boston, MA 02130, USA. Tel.: +1 857 364 4637; fax: +1 857 364 4515., , (Y.I.Nillni)
| | | | | | - Suzanne L. Pineles
- National Center for PTSD, Women′s Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA,Boston University School of Medicine, Boston, MA, USA
| | - Michael J. Zvolensky
- University of Houston, Houston, TX, USA,MD Anderson Cancer Center, Houston, TX, USA
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27
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Mall S, Honikman S, Evans B, Swartz L, Lund C. The impact of antenatal mental distress on functioning and capabilities: views of health care providers and service users in Cape Town, South Africa. Disabil Rehabil 2013; 36:1092-9. [PMID: 24050814 DOI: 10.3109/09638288.2013.833300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE Antenatal mental distress has disabling consequences. It affects functioning and participation in daily activities and can lead to postnatal depression. This study employs the International Classification of Functioning Disability and Health (ICF), to explore the experiences of pregnant women with mental distress attending the Perinatal Mental Health Project (PMHP). The analysis also adopts Amartya Sen's capabilities approach to provide suggestions for appropriate interventions. METHODS We conducted in-depth interviews with seven pregnant women experiencing antenatal mental distress, three postnatal women who had experienced antenatal mental distress and seven health care providers all affiliated with the PMHP. We used an open-ended interview guide employing domains from the ICF as well as from the capabilities approach. FINDINGS Participants attributed their antenatal mental distress to a range of environmental factors. Difficulties in functioning were reported by participants including difficulties at work and caring for children. Participants stated that services provided by the PMHP have a positive impact on functioning and capabilities. CONCLUSION The study suggests that the ICF is useful for exploring the impact of antenatal mental distress on functioning. It is well complemented by the capabilities approach to inform interventions. Implications for Rehabilitation Antenatal mental distress is a significant public health issue that impacts on women's functioning and participation exacerbated by social factors such as poverty and exposure to violence. This study explored restrictions in functioning and participation faced by women with antenatal mental distress including the ability to care for children, find meaningful employment and sustain relationships. Counselling services can play a role in restoring functioning and capabilities for women experiencing antenatal mental distress. Counselling services have the ability to discuss restrictions in functioning caused by antenatal mental distress with their clients and to offer support for creating capabilities once functioning has improved.
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Affiliation(s)
- Sumaya Mall
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town , Cape Town , South Africa and
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28
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Grover KW, Gonzalez A, Zvolensky MJ. HIV symptom distress and smoking outcome expectancies among HIV+ smokers: a pilot test. AIDS Patient Care STDS 2013; 27:17-21. [PMID: 23305258 DOI: 10.1089/apc.2012.0333] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Smoking occurs at high rates among people with HIV/AIDS, but little attention has been paid to understanding the nature of tobacco use among HIV+ smokers, especially the role that HIV symptoms may play in cognitive smoking processes. Accordingly, the present investigation examined the relation between HIV symptom distress (i.e., the degree to which HIV symptoms are bothersome) and smoking outcome expectancies. Fifty-seven HIV+ adult smokers (82.50% male; M(age)=47.18; 45.6% White, 28.1% Black, 17.5% Hispanic) were recruited from AIDS service organizations and hospital-based clinics. On average, participants reported knowing their HIV+ status for 16 years and the majority of participants reported that they acquired HIV through unprotected sex (66.6%). Participants completed measures pertaining to HIV symptoms, smoking behavior, and smoking outcome expectancies. HIV symptom distress was positively related to negative reinforcement, negative consequences, and positive reinforcement smoking outcome expectancies after accounting for relevant covariates. The present research suggests that HIV symptom distress may play an important role in understanding smoking outcome expectancies for smokers with HIV/AIDS. Clinical implications for HIV+ smokers are discussed, including the importance of developing effective smoking cessation treatments that meet the unique needs of this group of smokers.
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Affiliation(s)
- Kristin W. Grover
- Department of Psychology, The University of Vermont, Burlington, Vermont
| | - Adam Gonzalez
- Department of Psychiatry and Behavioral Science, Stony Brook University, Stony Brook, New York
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Brandt CP, Gonzalez A, Grover KW, Zvolensky MJ. The Relation Between Emotional Dysregulation and Anxiety and Depressive Symptoms, Pain-Related Anxiety, and HIV-Symptom Distress Among Adults with HIV/AIDS. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2012. [DOI: 10.1007/s10862-012-9329-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Peterson K, Togun T, Klis S, Menten J, Colebunders R. Depression and posttraumatic stress disorder among HIV-infected Gambians on antiretroviral therapy. AIDS Patient Care STDS 2012; 26:589-96. [PMID: 22989270 DOI: 10.1089/apc.2012.0089] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mood disorders are more frequent among people with HIV infection than among non-HIV-infected individuals of the same age, socioeconomic status, and HIV risks. They have been associated with worse adherence and clinical outcomes, yet remain underdiagnosed and undertreated in sub-Saharan Africa. We explored the relationship between mood disorders using the 10-item depression scale of the Centers for Epidemiological Studies (CES-D10) and the 22-item Impact of Events Scale-Revised (IES-R) for posttraumatic stress disorder, and a range of demographic and HIV-related variables among 252 consecutive subjects on antiretroviral therapy (ART). The study was conducted in the Genito-Urinary Medicine Clinic of the Medical Research Council's Gambia Unit. These screening tests were positive in 7% and 30%, respectively, of the patients, with higher scores (more depression or more post-traumatic stress) associated with female gender, more advanced WHO clinical stage, and lower Karnofsky Perfomance Scale rating. Higher CES-D10 scores were also seen among those on their second ART regimen. No relationship was seen with age, time on ART, viral load, or CD4 cell count. Compared to an earlier study at the same site in subjects prior to starting ART, the prevalence of depression in those stabilized on ART was dramatically reduced (by 34%, from 41%) while that of PTSD dropped less (by 13%, from 43%). Integrating the CES-D10 or a similar instrument into patient preparation for ART is recommended in order to identify those who may benefit from further mental health investigations, specific therapy, or closer follow-up during early ART.
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Affiliation(s)
- Kevin Peterson
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Toyin Togun
- Medical Research Council (UK) The Gambia Unit, Vaccinology Theme, Banjul, The Gambia
| | - Sandor Klis
- Department of Internal Medicine, University of Groningen, Groningen, The Netherlands
| | - Joris Menten
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Robert Colebunders
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Epidemiology and Social Medicine, Universitgy of Antwerp, Wilrijk, Belgium
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