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Qian Z, Li B, Liao L, Liao G, Chen H, Han J, Yu T, Xu X, Peng J, Cai S. Loneliness as a mediation from social support leading to a decrease of health-related quality of life among PLWHIV. Front Public Health 2023; 10:1067870. [PMID: 36684920 PMCID: PMC9846772 DOI: 10.3389/fpubh.2022.1067870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/01/2022] [Indexed: 01/06/2023] Open
Abstract
This study focused on the mental health of people living with HIV(PLWHIV) and explored their relationship between loneliness and perceived social support, health related quality of life (HRQoL) with a method of structural equation model. We collected clinical and psychological data from consecutively enrolled PLWHIV. A total of 201 PLWHIVs were enrolled and measured with self-reporting survey instruments of UCLA Loneliness Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Social Support Ratio Scale and Short Form Health Survey-36. The levels of loneliness, depression, anxiety, perceived social support and HRQoL were assessed. PLWHIV enrolled were divided into two groups of loneliness and non-loneliness based on their UCLA Loneliness Scale scores. Multivariable analysis indicated that being married is a protective factor associated with loneliness (OR = 0.226; P = 0.032). We further found the loneliness group had a higher level of depression (P < 0.001) and anxiety (P < 0.001), but lower level of HRQoL (P < 0.001) than the non-loneliness group. We found there was a positive linear correlation between social support and HRQoL among the enrolled PLWHIVs (r2 = 0.0592; P = 0.0005). A structural equation model (SEM) was established to evaluate whether the loneliness played as a mediation role between social support and HRQoL. The model showed loneliness as a mediation from social support leading to a decrease of HRQoL. Our findings showed a potential psychological pathway from social support to HRQoL, suggesting the need for interventions focusing on social support may improve poor HRQoL lead by loneliness.
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Affiliation(s)
- Zhe Qian
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bing Li
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Leyi Liao
- Division of Hepatobiliopancreatic Surgery, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Guichan Liao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongjie Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | - Tao Yu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuwen Xu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shaohang Cai
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Sun J, Jiang Y, Zilioli S, Xie M, Chen L, Lin D. Psychological and Physical Abuse and Cortisol Response to Stress: The Moderating Role of Psychosocial Resources. J Youth Adolesc 2023; 52:91-104. [PMID: 36370228 DOI: 10.1007/s10964-022-01699-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022]
Abstract
Child abuse is associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis functioning. However, the unique effects of psychological and physical abuse and protective factors against these effects remain largely unknown. To close these gaps, the present study examined the unique effects of psychological and physical abuse on cortisol stress response and explored the moderating role of psychosocial resources in these associations among a sample of Chinese preadolescent children (N = 150; aged 9-13 years; Mage = 10.69 years; 51% boys). The results showed that both psychological and physical abuse were associated with blunted cortisol reactivity slopes. Psychological abuse, but not physical abuse, was associated with lower peak cortisol values and flatter cortisol recovery slopes. Further, psychosocial resources moderated the association between abuse and hyporesponsiveness of the HPA axis. The association between psychological abuse and lower peak cortisol values and the association between physical abuse and steeper cortisol recovery slopes (faster cortisol recovery following the stressor) were observed only among children with low levels of psychosocial resources. These findings indicate the differential effects of psychological and physical abuse on various phases of cortisol stress response, and the protective role of psychosocial resources. This study also has practical implications, given that preadolescence serves as a critical period for maximizing benefit of interventions of adversity.
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Affiliation(s)
- Jianing Sun
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China.,Department of Psychology, The Pennsylvania State University, State College, PA, USA
| | - Yanping Jiang
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.,Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Mingjun Xie
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Lihua Chen
- Higher Education Research Institute, Shantou University, Shantou, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China.
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The role of perceived social support for loneliness in the Chinese elderly: hope and core self-evaluations as mediators. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03967-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zhang Y, Wan J, Ji L, Liu G, Shi Y, Zhao J, Li X. Does HIV-Related Stigma Depress Social Well-Being of Youths Affected by Parental HIV/AIDS? Front Psychiatry 2022; 13:898543. [PMID: 35815026 PMCID: PMC9260187 DOI: 10.3389/fpsyt.2022.898543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
Parental illness or death due to HIV/AIDS has long-term impacts on children's social well-being, potentially challenging the children's basic developmental needs and future. Based on the theoretical model of social well-being, the present study tested a moderated mediation model that HIV-related stigma moderated the mediating role of social trust on the relationship between perceived social support (PSS) and social well-being. A sample of 297 youths aged 20-30 years affected by parental HIV/AIDS (57.2% male), including 129 (43.40%) AIDS orphans and 168 vulnerable youths (56.60%) completed questionnaires of perceived social support, social well-being, social trust, and HIV-related stigma. IBM SPSS 25.0 was used to conduct descriptive statistics and multiple regressions. Results showed that the mean score of PSS was 61.34 (SD = 13.99), social well-being was 57.33 (SD = 10.15), social trust was 56.21 (SD = 11.55), perceived stigma was 64.44 (SD = 16.72), and enacted stigma was 21.91 (SD = 9.73) among youths affected by parental HIV/AIDS and the PSS could predict increasing social well-being via increasing social trust. Moreover, the positive influence of PSS on social trust was moderated by the enacted stigma (p = 0.03), in which the positive influence was stronger among youths affected by parental HIV/AIDS who perceived or experienced low enacted stigma than those who perceived or experienced high enacted stigma. The positive impact of social trust on social well-being was moderated by perceived stigma (p = 0.04), in which the positive impact was more significant among youths affected by parental HIV/AIDS who perceived or experienced high perceived stigma than those who perceived or experienced low perceived stigma. These findings explained how and when the PSS affected social well-being and contributed toward an understanding of the experiences and perceptions of HIV-related stigma among youths affected by parental HIV/AIDS. This understanding may inform future research and policies toward improving the social well-being of youths affected by parental HIV/AIDS. The study also highlighted the importance of strengthening interventions on social relations and reducing HIV-related stigma for them.
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Affiliation(s)
- Yafei Zhang
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Jiaojiao Wan
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Lili Ji
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Gaigai Liu
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Yixin Shi
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Junfeng Zhao
- School of Psychology, Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States
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Saraswat N, Yadav P, Singal A. Scholastic performance and ambitions in retropositive and vulnerable pediatric patients: A prospective study. Ind Psychiatry J 2022; 31:38-42. [PMID: 35800870 PMCID: PMC9255612 DOI: 10.4103/ipj.ipj_174_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION It is widely recognized that HIV epidemic has a negative impact on retropositive pediatric patients. However, at present, the school performance and ambitions in retropositive and vulnerable pediatric patients from India are lacking. AIMS The aim of this study was to analyze the possible association between scholastic performance and ambitions in retropositive and vulnerable status in pediatric patients. MATERIALS AND METHODS Case-control study was conducted over a period of 2 years. Forty-two retropositive, vulnerable, and equal age- and gender-matched controls between the age of 6 and 16 years were included. All children or parents were enquired about performance, attendance, grades in last academic year, and their ambitions in life. The data were collected in a prevalidated questionnaire and analyzed using SPSS Version 20. RESULTS A total 42 children between the age of 6 and 16 years were included. Twenty-seven (64.3%) were males and 15 (35.7%) females. Eleven (26.2%) were retropositive, 27 (64.3%) had one infected parent, and 4 (9.5%) patients had both the parents retropositive. Twelve (28.5%) cases failed their previous academic years compared to 1 (2.3%) control. Only 2 (4.7%) had attendance more than 90% in cases as compared to 18 (42.8%) among controls. Twenty-one (50%) attributed feeling of isolation as a cause of poor academic performance, while none of the controls did the same. There was a significant association between poor grades and poor attendance at school and retropositive (P < 0.001). The odds ratio of feeling of isolation was 1.62. CONCLUSION Retropositive and vulnerable status significantly affect the academic performance and ambitions in these children.
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Affiliation(s)
| | - Prateek Yadav
- Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
| | - Ankit Singal
- Department of Psychiatry, Command Hospital SC, Pune, Maharashtra, India
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The promotive effects of peer support and active coping in relation to negative life events and depression in Chinese adolescents at boarding schools. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-019-0143-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ezell J, Harrison SE, Jiang Y, Li X. Impact of Adverse Childhood Events on the Psychosocial Functioning of Children Affected by Parental HIV in Rural China. Front Psychol 2021; 11:617048. [PMID: 33584452 PMCID: PMC7873901 DOI: 10.3389/fpsyg.2020.617048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Children affected by parental HIV are more likely than unaffected peers to experience trauma and are at-risk for negative psychological and social outcomes. This study aimed to examine the relationship between adverse childhood events and psychosocial functioning among children affected by parental HIV. Methods: A total of 790 children ages 6-17 from Henan, China were enrolled in a longitudinal, randomized controlled trial of a resilience-based psychosocial intervention. At baseline, children reported on numerous psychosocial factors, including trauma exposure, symptoms of anxiety and depression, and peer social functioning. We used linear regression analysis to test the direct effect of trauma exposure on peer social functioning. We then tested whether depression and anxiety symptoms served as two potential parallel mediators in the association between trauma exposure and peer social functioning. Results: Trauma exposure was significantly associated with poor peer social functioning (β = -0.10, p = 0.005) when controlling for key covariates. When depression and anxiety symptoms were added to the model, the association between trauma exposure and peer social functioning became nonsignificant. Instead, there were significant indirect effects from trauma exposure to peer social functioning via depression (β = -0.06, 95%CI[-0.09, -0.03]) and anxiety (β = -0.02, 95%CI[-0.04, -0.00]). Conclusion: This study is among the first to link trauma exposure to peer social functioning deficits for children affected by parental HIV and demonstrates that symptoms of anxiety and depression mediate this relationship. Findings underscore the need for comprehensive psychosocial support for children affected by HIV, including screening for trauma exposure and mental health disorders.
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Affiliation(s)
- Jordan Ezell
- Department of Psychology, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| | - Sayward E. Harrison
- Department of Psychology, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
| | - Yanping Jiang
- Department of Psychology, Wayne State University, Detroit, MI, United States
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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Perceived Social Support and Children's Physiological Responses to Stress: An Examination of the Stress-Buffering Hypothesis. Psychosom Med 2021; 83:51-61. [PMID: 33060454 DOI: 10.1097/psy.0000000000000875] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The current study aimed to examine the stress-buffering effect of children's perceived social support on their hypothalamic-pituitary-adrenocortical axis and autonomic nervous system reactivity to an acute laboratory stressor. METHODS A sample of 150 children (aged 9-13 years, mean [standard deviation] age = 10.69 [0.93] years, 74 girls) reported perceived social support, stressful life events, and underwent the Modified Trier Social Stress Test, during which six saliva samples were collected. A two-piece multilevel growth curve model with landmark registration was used to detect trajectory differences in the reactivity and recovery phases of the stress response and account for individual variation in the timing of poststressor peak hormone concentrations. RESULTS The interaction between stressful life events and perceived social support significantly predicted poststressor peak cortisol levels (β = 0.0805, SE = 0.0328, p = .015) and cortisol recovery slope (β = -0.0011, SE = 0.0005, p = .040). Children with more life events and low social support exhibited the lowest poststressor peak cortisol levels and the flattest cortisol recovery slope. In contrast, children high in stressful life events and high in social support displayed cortisol response profiles more similar to those of children with low stressful life events. Conversely, there were no statistically significant two-way interactions of stressful life events and perceived social support on salivary α-amylase parameters (i.e., poststressor peak [p = .38], reactivity slope [p = .81], and recovery slope [p = .32]). CONCLUSIONS These results provide preliminary evidence for the buffering effect of children's perceived social support on the association between life stress and hypothalamic-pituitary-adrenocortical axis response profiles.
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Qiao S, Li X, Zhao G, Zhao J, Kamat D. A physical symptom-based measure of quality of care for children affected by HIV/AIDS. VULNERABLE CHILDREN AND YOUTH STUDIES 2019; 14:274-286. [PMID: 32983249 PMCID: PMC7518714 DOI: 10.1080/17450128.2019.1612130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/08/2019] [Indexed: 06/11/2023]
Abstract
Based on cross-sectional data of 1,625 children aged 6-18 years who were affected by parental HIV/AIDS in central rural China, we evaluated a physical symptom based measure of quality of care (QOC_PS) for these children. The QOC_PS has acceptable reliability estimates for children of both genders, at different age, and by orphanhood status. Known-group validation and construct validity analysis demonstrated a good validity of QOC_PS indicator. The QOC_PS score was significantly associated with psychosocial well-being measures among children. The physical symptom based measure provides a psychometrically appropriate indicator of quality of care for children affected by HIV/AIDS in China. It could be used as an alternative measure to assess quality of care in resource-poor settings where other objective measurements are not available or feasible. Future research is needed to further validate the scale among children in different living environments across various cultural settings.
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Affiliation(s)
- Shan Qiao
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Guoxiang Zhao
- Department of Psychology, Henan Normal University, Xinxiang, China
| | - Junfeng Zhao
- Institute of Behavior and Psychology, Henan University, Kaifeng, China
| | - Deepak Kamat
- Carman and Ann Adams Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
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Peyre M, Gauchet A, Bissuel F, Blanc M, Boibieux A, Cotte L, Forestier E, Janssen C, Legout L, Epaulard O. Satisfaction with sexual life in people living with HIV/AIDS: the persistent weight of the fear of transmission. AIDS Care 2018; 31:681-686. [PMID: 30350713 DOI: 10.1080/09540121.2018.1537465] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Sexual life is an important dimension of quality of life, which may be affected by the fear of transmission in people living with HIV/AIDS (PLWHA), despite the fact that antiretroviral therapy prevents person-to-person transmission. We, therefore, aimed to explore the sexual life satisfaction of PLWHA and its correlation with their fear of HIV transmission and self-esteem. Consecutive adult PLWHA from seven HIV care facilities in the Rhone-Alpes region, France, were asked to complete a self-administered, anonymous questionnaire concerning sociological and medical data, satisfaction with sexual life (18 questions), and self-esteem (Rosenberg score). Overall, 690 PLWHA answered the questionnaire (mean age 49.2 ± 11 years); 74.9% were men, of which 75.1% had sex with men. Overall, 68.0% of respondents feared transmitting HIV (a lot/a bit). A lower satisfaction with sexual life was significantly associated with being female, not having a stable sexual partner, being unemployed, having a low income, experiencing a fear of HIV transmission, having lower self-esteem, and not reporting an excellent/very good health status. These results strongly suggest that the information concerning the antiretroviral-induced suppression of infectivity should be widely diffused, as this may enhance the quality of sexual life in PLWHA.
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Affiliation(s)
- M Peyre
- a Department of Infectious Diseases , Centre Hospitalier Universitaire Grenoble-Alpes , Grenoble , France.,b COREVIH Arc-Alpin , Grenoble , France.,c Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin , Université Grenoble Alpes , Grenoble , France
| | - A Gauchet
- d Laboratoire InterUniversitaire de Psychologie, Personnalité, Cognition, Changement Social (LIP/PC2S), EA 4145 , Université Grenoble Alpes , Grenoble , France
| | - F Bissuel
- b COREVIH Arc-Alpin , Grenoble , France.,c Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin , Université Grenoble Alpes , Grenoble , France.,e Department of Infectious Diseases , Centre Hospitalier de Thonon , Thonon-les-Bains , France
| | - M Blanc
- a Department of Infectious Diseases , Centre Hospitalier Universitaire Grenoble-Alpes , Grenoble , France.,b COREVIH Arc-Alpin , Grenoble , France.,c Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin , Université Grenoble Alpes , Grenoble , France
| | - A Boibieux
- f Department of Infectious Diseases, Hôpital de la Croix-Rousse , Hospices Civils de Lyon , Lyon , France
| | - L Cotte
- f Department of Infectious Diseases, Hôpital de la Croix-Rousse , Hospices Civils de Lyon , Lyon , France
| | - E Forestier
- b COREVIH Arc-Alpin , Grenoble , France.,c Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin , Université Grenoble Alpes , Grenoble , France.,g Department of Infectious Diseases , Centre Hospitalier Métropole-Savoie , Chambéry , France
| | - C Janssen
- b COREVIH Arc-Alpin , Grenoble , France.,c Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin , Université Grenoble Alpes , Grenoble , France.,h Department of Infectious Diseases , Centre Hospitalier d'Annecy-Genevois , Annecy , France
| | - L Legout
- b COREVIH Arc-Alpin , Grenoble , France.,c Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin , Université Grenoble Alpes , Grenoble , France.,i Department of Infectious Diseases , Centre Hospitalier Alpes-Léman , Contamines , France
| | - O Epaulard
- a Department of Infectious Diseases , Centre Hospitalier Universitaire Grenoble-Alpes , Grenoble , France.,b COREVIH Arc-Alpin , Grenoble , France.,c Fédération d'Infectiologie Multidisciplinaire de l'Arc Alpin , Université Grenoble Alpes , Grenoble , France
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Zilioli S, Slatcher RB, Chi P, Li X, Zhao J, Zhao G. The impact of daily and trait loneliness on diurnal cortisol and sleep among children affected by parental HIV/AIDS. Psychoneuroendocrinology 2017; 75:64-71. [PMID: 27810705 PMCID: PMC5256636 DOI: 10.1016/j.psyneuen.2016.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/23/2016] [Accepted: 10/17/2016] [Indexed: 01/22/2023]
Abstract
Dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis and disruptions of restorative processes (e.g., sleep) have been proposed as two key mechanisms through which loneliness leads to medical morbidity in adults and late adolescents. Whether loneliness acts through these biological and behavioral intermediaries in children as well remains unexplored. In a sample of 645 children aged 8-15 affected by parental HIV/AIDS in rural China, trait and state (i.e., daily) loneliness were measured in a 3-day diary study, wherein participants also provided cortisol samples and sleep measures. Whereas high levels of trait loneliness were found to predict lower morning cortisol levels, longer time in bed, lower sleep quality, and a higher number of night awakenings, daily loneliness was associated with a flatter diurnal cortisol slope and shorter time in bed. Although the association between trait loneliness and daily loneliness with HPA activity remained significant after controlling for psychological constructs that overlap with loneliness (e.g., depression and daily negative affect), some of the associations between loneliness and sleep measures became non-significant after including these additional covariates. These findings provide the first empirical evidence to our knowledge of associations between trait and state loneliness and health-related outcomes among school-aged children and young adolescents.
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Affiliation(s)
- Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit, MI 48202, USA; Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48202, USA.
| | - Richard B. Slatcher
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan 48202, USA
| | - Peilian Chi
- Department of Psychology, University of Macau, Macau, China
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University South Carolina, Columbia 29208, USA
| | - Junfeng Zhao
- Institute of Behavior and Psychology, Henan University, Department of Psychology, Kaifeng 475004, China
| | - Guoxiang Zhao
- Institute of Behavior and Psychology, Henan University, Department of Psychology, Kaifeng 475004, China
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Psychosocial adjustment in perinatally human immunodeficiency virus infected or exposed children - a Retrospective Cohort Study. J Int AIDS Soc 2016; 19:20694. [PMID: 27341885 PMCID: PMC4920943 DOI: 10.7448/ias.19.1.20694] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 04/28/2016] [Accepted: 05/31/2016] [Indexed: 11/09/2022] Open
Abstract
Objective To determine whether perinatal HIV infection and exposure adversely affected psychosocial adjustment (PA) between 6 and 18 years of life (i.e. during school-age and adolescence). Methods We enrolled 58 perinatally HIV-infected, 56 HIV-exposed uninfected and 54 unexposed controls from Kampala, Uganda. Perinatal HIV status was determined by 18 months of age using a DNA-polymerase chain-reaction test and was confirmed via HIV rapid diagnostic test at psychosocial testing when the children were 6 to 18 years old. Five indicators of PA (depressive symptoms, distress, hopelessness, positive future orientation and esteem) were measured using validated, culturally adapted and translated instruments. Multivariable linear regression analyses estimated HIV-status-related percent differences (β) in PA indicators and corresponding 95% confidence intervals (CIs). Results During school-age and adolescence, positive outlook (β=−3.8, 95% CI: −7.2, −0.1) and self-esteem (β=−4.3, 95% CI: −6.7, −1.8) scores were significantly lower, whereas depressive (β=11.4, 95% CI: 3.3, 19.5) and distress (β=12.3, 95% CI: 5.9, 18.7) symptoms were elevated for perinatally HIV-infected, compared to unexposed controls and exposed uninfected children. Similarly, positive outlook (β=−4.3, 95% CI: −7.3, −1.2) and self-esteem were lower for exposed controls versus HIV-unexposed children. Hopelessness was similar by perinatal HIV status. Likewise, the distress and depressive symptom levels were comparable for HIV-exposed uninfected and HIV-unexposed children. Conclusions Perinatal HIV infection predicted higher distress and depressive symptoms, while HIV-affected status (infection/exposure) predicted low self-esteem and diminished positive outlook in the long term. However, HIV-affected status had no impact on hopelessness, suggesting that psychosocial interventions as an integral component of HIV care for infected children or primary care exposed uninfected children may improve PA and quality of life in these vulnerable groups.
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