Predictors of Resilience and Posttraumatic Growth Among People Living with HIV: A Longitudinal Study

Cognitive processing, resilience, and family functioning as contributors to posttraumatic growth in family caregivers of patients with Alzheimer's disease

OBJECTIVES

The present study examined the existence of posttraumatic growth (PTG) and its association with cognitive processing, resilience, and family functioning in family caregivers of patients with Alzheimer's disease (AD).

METHOD

Family caregivers (N = 114) were surveyed using measures of cognitive processing, resilience, family functioning, and PTG. Data were analyzed using descriptive statistics, Pearson correlations, and multiple regression analyses.

RESULTS

The average PTG score in the sample was 48.6 (SD = 18.7; range 14-105). Race, education level, severity of the patient's AD, cognitive processing, resilience, and family functioning explained 25.8% of the variance in PTG (F [9, 95] = 5.025, p < 0.001). Race was significantly correlated with PTG; specifically, non-White caregivers reported higher PTG than White caregivers (p < 0.05). When controlling for race and education level, mild AD, intrusive rumination, and family satisfaction were significant predictors of PTG (p < 0.05). However, deliberate rumination, resilience, and family communication were not significant predictors PTG (p > 0.05).

CONCLUSION

These findings provide insight into factors that may influence the development of PTG in family caregivers of patients with AD. Results may inform intervention strategies to mitigate the negative consequences of caregiving and promote PTG in this caregiver population.

Structural Inequities, Syndemics, and Resilience: The Critical Role of Social Support in Overcoming Barriers and Empowering Engagement in HIV Care for Young Black Sexual-Minority Men in the US South

Young Black sexual minority men (YBSMM) living in the US South are among those most disproportionately impacted by HIV in the USA. This health inequity is, in part, due to lower rates of sustained engagement in the HIV care continuum, resulting in a lower prevalence of viral suppression and higher overall community-level viral load. Social, structural, and economic inequities have previously been linked with poorer HIV care engagement among YBSMM. HIV-related social support, individual-level resilience, and healthcare empowerment have been shown to be independently associated with improved HIV care engagement. The current study sought to assess the relative contribution of individual, structural, and economic factors on engagement in HIV care and to elucidate the potentially mediating role of healthcare empowerment. Data from 224 YBSMM with HIV in the US South indicated that greater levels of socioeconomic distress, intimate partner violence, and depressive symptoms were associated with lower levels of engagement in HIV care, while greater levels of individual-level resilience and healthcare empowerment were associated with higher levels of HIV care engagement. Importantly, healthcare empowerment mediated the association between resilience and engagement in HIV care and the association between social support and engagement in HIV care. Findings emphasize the critical role that HIV-related social support plays in fostering resilience and overcoming syndemic factors to promote empowerment and engagement in HIV care for YBSMM in the USA.

Resilience and mindful attention as determinants of psychological distress among patients with a stoma: The mediating role of body image

This research investigated if dispositional mindfulness, resilience, and self-efficacy affect quality of life (QoL) and distress in a sample of patients with stoma. Further, it tested if body image distress and post-traumatic growth mediate these associations. A total of 102 patients with a stoma (mean age: 60.37 ± 12.79 years; 60 females, 52 males) volunteered for this cross-sectional study. The results revealed that mindful attention and resilience were direct, significant negative predictors of psychological distress. On the contrary, body image distress was directly and positively associated with psychological distress and significantly mediated the association between resilience and the dependent variable. The results emphasize the importance of interventions aimed at enhancing dispositional mindfulness and resilience as well as reducing body image-related distress to improve the QoL of patients with a stoma. Additional longitudinal and cross-cultural studies are needed to confirm these findings.

Do types of social isolation affect post-traumatic growth outcomes differently in patients undergoing hemodialysis? A moderated chain mediation model

AIMS

The present study aimed to explore the effect of different types of social isolation on post-traumatic growth (PTG) and its underlying mediating and moderating mechanisms.

METHODS

This cross-sectional study recruited 274 patients undergoing hemodialysis between October and November 2022. Structural equation modeling was used to test the proposed relationships.

RESULTS

Objective social isolation negatively predicted PTG. Deliberate rumination mediated the relationship between objective social isolation and PTG, and intrusive rumination and deliberate rumination formed a chain mediating effect on the relationship between subjective social isolation (i.e., loneliness) and PTG. In addition, gratitude strengthened the association between intrusive rumination and deliberate rumination.

CONCLUSIONS

Health care providers should adopt effective preventive and intervention measures to reduce the level of objective social isolation in patients undergoing hemodialysis in order to promote their positive psychological adjustment. Notably, appropriate loneliness can enhance patients' cognitive processes and promote their PTG.

Risk perception predicts post-traumatic growth during the COVID-19 pandemic in China: the mediation effect of engaging in health-protective behaviors

The COVID-19 pandemic exposed the public to enormous health risks and induced wide-ranging impacts on people's mental health. Post-traumatic growth is a possible psychological benefits that may occur during struggling with the COVID-19 pandemic. This research explored 1) demographics differences on risk perception of COVID-19 pandemic, engagement in health-protective behavior and post-traumatic growth during the COVID-19 pandemic; and 2) the mediation effect of engaging in health-protective behaviors between risk perception and post-traumatic growth during the COVID-19 pandemic. Females showed a significant higher level of engagement in health-protective behaviors. People who were married reported a significantly higher level of risk perception, engagement in health-protective behavior and post-traumatic growth than those who were in other marital status (i.e. single, divorced, widowed). People who had acquaintances being infected with COVID-19 reported significant higher level of risk perception and engagement in health-protective behaviors. Engagement in health-protective behaviors mediated the relationship between risk perception and post-traumatic growth. Implications of the results for public health interventions are discussed.

Influence of state of health and personality factors of resilience and coping in healthy subjects and those with diabetes

Introduction

Currently, the most common chronic metabolic disease in our society is Diabetes Mellitus. The diagnosis of Diabetes Mellitus supposes an impact for the patient, since it requires a modification in the lifestyle, which demands a great capacity for adaptation and modification of habits. The aim of the study was to determine whether personality factors and health status influence resilience and coping strategies in a sample of healthy and diabetic subjects.

Methodology

The sample included a total of 401 subjects (201 patients with Diabetes and 200 without pathology). The instruments applied for data collection were: Sociodemographic data questionnaire, the Resilience Scale, the Coping Strategies Questionnaire and The "Big Five" factor taxonomy. The data collection period was approximately 2 years (between February 2018 and January 2020).

Results

Certain personality factors, such as Emotional Stability, Integrity, Conscientiousness and Extraversion, were positively related to Resilience. Additionally, Emotional Stability, Integrity, and Extraversion were positively associated with Rational Coping. On the other hand, emotional stability, agreeableness and extraversion were negatively related to emotional coping. In relation to health status, the absence of pathology is related to the use of rational strategies more than to the diagnosis of diabetes. Therefore, the participants in this study present different psychological patterns depending on personality and health status.

Conclusions

The present study shows that the subjects of the sample present different psychological patterns depending on Personality and health status.

Research hotspots and theme trends in post-traumatic growth: A co-word analysis based on keywords

Objectives

To analyze and summarize the research hotspots and advancement of post-traumatic growth (PTG) over the past 15 years based on co-word analysis of keywords, and provide references for PTG-related research and clinical intervention.

Methods

All studies related to PTG were retrieved from PubMed and Web of Science (WOS) from January 2013 to July 2022. A total of 11 Medical Subject Headings (MeSH) and keywords were used to identify qualified studies. Bibliographic Item Co-occurrence Matrix Builder (BICOMB; version 2.0) was used to conduct high-frequency keywords extraction and matrix setup, Graphical Clustering Toolkit (gCLUTO; version 1.0) was employed to perform clustering analysis, and SPSS (version 25.0) was used to carry out strategic diagram analysis.

Results

A total of 2,370 publications were selected, from which 38 high-frequency keywords were extracted. The results revealed six research hotspots on PTG during the period from 2013 to 2022, including research on i) emotional reactions after negative life events, ii) PTG among cancer survivors, iii) rumination and resilience after trauma, iv) PTG among children and adolescents, v) role of social support and coping strategy in PTG, and vi) association between PTG and quality of life.

Conclusions

This co-word analysis effectively reveals an overview of PTG over the past 15 years. The six research categories deduced from this study can reflect that the research content in the field of PTG is abundant, but some research topics have not yet been mature. The findings of this study are of great value to future investigations associated with PTG.

Post-traumatic growth in caregivers of children hospitalized in the PICU due to traffic accident: a qualitative study

BACKGROUND

Globally, tens of millions of children are hospitalized every year for non-fatal traffic accident injuries, being confronted with an injured child can be extremely stressful for parents. Understandably, a significant level of psychological distress may ensue. Traumatic losses may lead parents to find new insights in life and develop a greater sense of spirituality and strength.

METHOD

Semi-structured interviews were conducted with caregivers of children who were hospitalized in the pediatric intensive care unit (PICU) with traffic accident injuries at children's hospitals in China between January and June 2022. Caregivers were selected using a purposive sampling method until no new data were generated (n = 24).

RESULTS

We identified eleven sub-themes and four higher-order themes based on these sub-themes: (1) changes in their life philosophy, (2) personal strength enhancement, (3) relationship improvements, and (4) effective responses. The findings of our research contribute to a better understanding of the psychological status of the caregivers of children injured by traffic accidents.

CONCLUSION

Professionals should guide caregivers from a positive perspective, stimulate their strengths and potential, increase personnel support and communication, promote positive coping, formulate targeted management countermeasures to improve the PTG level of caregivers, and develop strategies to maintain stable mental health and well-being.

Rumination influences the relationship between trauma and depression over time among youth living with HIV

BACKGROUND

Traumatizing events often result in long-term mental health symptoms. Identifying the features of the post-trauma experiences that can impact mental health symptoms is key to designing effective interventions.

METHODS

Youth living with HIV (YLH),1 predominantly sexual and gender minorities (SGM;2 84 % gay, bisexual, transgender, queer, pansexual identities), 78 % Black and Latino, (N = 170) were recruited in New Orleans, LA and Los Angeles, CA from 13 youth-serving agencies. They were assessed for trauma, rumination and depression, with 78 % reassessed for depression at 4 and 74 % at 8 months later. Relationships between these variables were examined using a Bayesian approach to structural equation modeling.

RESULTS

At recruitment, 78 % of YLH reported at least one traumatic event, and 21 % met the cut-off score indicating depression on the PHQ-9. Ruminations were reported by 41 % of YLH. While associations between trauma and depression were modest (rmean = 0.19), ruminations were moderately associated with depressive symptoms over time (rmean = 0.34). Ruminations were only modestly associated with trauma (rmean = 0.19) but had a robust negative association (λSTD = -0.29) with the slope of depressive symptoms such that the more ruminations YLH experienced, the smaller the decline in depression over time. The associations between trauma and depression were more modest (λSTD ≤ 0.12). Limitations The main limitations of this study are the lack of a scale to measure trauma and the use of a single item measure of rumination.

CONCLUSION

Ruminations appear to be associated with traumatic events for a large subset of young people, suggesting that future interventions should consider including components addressing ruminations.

CLINICALTRIALS

gov registration NCT03109431.

Posttraumatic growth and posttraumatic depreciation among people living with HIV: the role of resilience and HIV/AIDS stigma in the person-centered approach

Posttraumatic growth (PTG) among people living with HIV (PLWH) remains an understudied and controversial topic, and several research gaps need to be filled. In our study, we focused on one such gap by implementing parallel assessment of positive (PTG) and negative changes (posttraumatic depreciation [PTD]) following trauma related to HIV diagnosis, along with measurement of resilience and HIV/AIDS stigma and socio-medical data. The study sample comprised 509 PLWH, which completed the standardized psychometric inventories measuring the study variables. The results showed an unexpected positive relationship between PTG and PTD among participants. In addition, following the person-centered approach, we observed specific PTG/PTD clusters in the study sample with different resilience and HIV/AIDS stigma levels. Our study may shed some light on understanding PTG/PTD processes among PLWH and inspire planning for effective psychological help adjusted to patients' specific needs.

The role of resilience in daily experiences of posttraumatic growth, affect, and HIV/AIDS stigma among people living with HIV

This study investigated the intraindividual variability in daily posttraumatic growth (PTG) versus posttraumatic depreciation (PTD), positive and negative affect (PA and NA), and HIV/AIDS stigma among people living with HIV (PLWH). In particular, we examined whether this variability derives from participants' resilience operationalized on a trait level. The participants included 67 PLWH, who completed a baseline questionnaire on resilience, measured with the Brief Resilience Scale. Following this, they completed the shortened versions of the following inventories over five consecutive days: the Posttraumatic Growth and Posttraumatic Depreciation Inventory V Expanded version Inventory, the Positive and Negative Affect Schedule - Expanded Form, and the Berger HIV Stigma Scale. Hierarchical linear modeling (HLM) was utilized to analyze the study results. We observed significant intraindividual variability in PTG, PTD, PA, NA, and perceived HIV/AIDS stigma. Resilience was related to PTG, PTD, PA, and NA but not to stigma. Moreover, higher resilience was associated with higher, stabler PA and lower, stabler NA. Our results highlight the need of further studies on the daily functioning of PLWH. Specifically, while health status is important, it does not appear to be the predominant source of everyday distress for PLWH. Consequently, psychological counselling for PLWH should concentrate more on the life of the person as a whole and not only on coping with HIV infection.

Stigma and posttraumatic growth among COVID-19 survivors during the first wave of the COVID-19 pandemic in Malaysia: a multicenter cross-sectional study

Background

Contracting COVID-19 can cause negative and distressing psychological sequelae, but traumatic stressors may also facilitate the development of positive psychological change beyond an individual's previous level of adaptation, known as posttraumatic growth (PTG). As a result, studies have investigated the negative effects of COVID-19 on mental health, but data on PTG among patients who have recovered from COVID-19 remains limited. This study aims to evaluate the level of PTG and its associations with stigma, psychological complications, and sociodemographic factors among COVID-19 patients 6 months post-hospitalization.

Method

A cross-sectional online survey of 152 COVID-19 patients was conducted after 6 months of being discharged from Hospital Canselor Tuanku Muhriz, MAEPS Quarantine Center, or Hospital Sungai Buloh, Malaysia. Patients completed a set of questionnaires on sociodemographic and clinical data. The Posttraumatic Growth Inventory (PTGI-SF) was used to assess the level of PTG, the Kessler Psychological Distress (K6) was used to measure the degree of psychological distress, the General Anxiety Disorder-7 (GAD-7) was used to evaluate the severity of anxiety symptoms, the Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression symptoms, and the Explanatory Model Interview Catalog Stigma Scale (EMIC-SS) was used to record the degree of perceived stigma toward COVID-19.

Results

The median PTGI SF score of the respondents was 40.0 (Interquartile range 16.0). Multivariable general linear model with bootstrapping (2,000 replications) revealed factors that significantly predicted PTG, which were at the higher level of the perceived stigma score, at 37 (B = 0.367, 95% CI = 0.041 to 0.691, p = 0.026), among the Malay ethnicity (B = 12.767, 95% CI 38 = 7.541 to 17.993, p < 0.001), retirees (B = -12.060, 95% CI = -21.310 to -2.811, p = 0.011), and those with a history of medical illness (B = 4.971, 95% CI = 0.096 to 9.845, p = 0.046).

Conclusion

Experiencing stigma contributed to patients' PTG in addition to psychosocial factors such as ethnicity, history of medical illness, and retirement.

The use of online social media for the recruitment of people living with HIV in Spain and Latin America: Lessons from two studies

Various barriers make recruiting a difficult task for researchers, especially when recruiting people living with HIV (PLWH) or conducting longitudinal studies. Effective recruitment is crucial to the validity of studies, and in this regard, social media can come to aid, although researchers usually rely on paid advertisements. This paper describes the free social media strategies used for participant recruitment in two studies carried out with PLWH in Spain and Latin America. Study 1 was a cross-sectional study on the validation of two stigma scales with a 1-month retest. Study 2 was a longitudinal study exploring the mental health of newly diagnosed PLWH, with a second assessment after 6 months. Facebook posts, Twitter mentions, and discussion forums were used in both studies. Study 2 also recruited participants through a healthcare centre. In Study 1, 5-month recruitment yielded a sample of 458 PLWH, averaging 91.6 surveys/month and a 43% retention rate. In study 2, recruitment took 16 months, yielding a final sample of 145 newly diagnosed PLWH, 92 from the healthcare centre (5.75 surveys/month) and 53 from social media (3.31 surveys/month), with 95% and 60% retention rates, respectively. Participants in Study 2 did not differ in sociodemographic characteristics by recruitment method, except for the region of origin and financial difficulty (more diverse origin and greater difficulty emerged in social media participants). Greater psychological distress and lower personal and social resources were also found in social media participants. These data indicate that free social media recruitment is a feasible and effective tool for the recruitment of Spanish-speaking PLWH, although it is best used in combination with traditional methods for newly diagnosed PLWH and longitudinal studies.

Trajectories of posttraumatic growth and posttraumatic depreciation: A one-year prospective study among people living with HIV

Objective

Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) are considered two sides of growth after trauma. Nevertheless, previous studies pointed out that in trauma living with a life-threatening illness, they may be experienced as two independently and share distinct predictors. In our study we aimed to find the different trajectories of PTG and PTD among a sample of people living with HIV (PLWH) and to investigate its predictors out of psychological resilience, and gain and loss of resources from the conservation of resources theory (COR).

Methods

We designed a longitudinal study that consisted of three measurements at 6-month intervals, and we recruited, respectively, 87, 85 and 71 PLWH. Each time participants filled out the following questionnaires: the expanded version of the PTG and PTD Inventory (PTGDI-X), the Brief Resilience Scale (BRS), the Conservation of Resources Evaluation (COR-E), and a survey on sociodemographic and medical data.

Results

We observed two separate trajectories of PTG and PTD within participants and found that each of the trajectories were related to different predictors from the studied variables. More specifically, we found a positive relationship between resilience and a descending PTD trajectory that stabilized over time. Gain of resources generally predicted a PTG trajectory, while loss of resources predicted the dynamics of PTD.

Conclusions

Including two parallel constructs, i.e., PTG and PTD, confirmed the independence of their mechanisms in growth processes among PLWH. The initial insight concerning the role of resilience and resources in PTG/PTD processes may inspire more effective planning for psychological help for PLWH, and it may stimulate studies on growth after trauma to further examine the two sides of this phenomenon.

The Importance of Positive Psychological Factors among People Living with HIV: A Comparative Study

We aim to identify the differences in psychological well-being, resilience, and coping strategies between healthy subjects and HIV patients. The design followed in this work was empirical, not experimental, and cross-sectional with a correlational objective. The sample included a total of 399 participants (199 patients with HIV and 200 without pathology). The instruments applied for data collection were as follows: a questionnaire on socio-demographic data, the Psychological Well-being Scale, the Resilience Scale and the Coping Strategies Questionnaire. The study period was from February 2018 to January 2020. Patients with HIV had a significantly lower score than healthy subjects, in the resilience factors of perseverance and self-confidence. Subjects with HIV scored less in all dimensions of psychological well-being, with the exception of the dimension of autonomy. Finally, it was observed that HIV-positive subjects used rational coping strategies less frequently than healthy subjects, based on social support seeking and problem-solving coping. However, HIV patients scored higher in emotional coping strategies than healthy individuals.

Prediction of post-traumatic growth in the face of the COVID-19 crisis based on resilience, post-traumatic stress and social participation: A longitudinal study

The COVID-19 crisis has generated a severe and negative psychological impact worldwide. Despite this, it is also possible to experience post-traumatic growth (PTG). This study aimed to longitudinally explore the prevalence of PTG in the Spanish population and test a predictive model for PTG from resilience, post-traumatic stress symptoms (PTSS), and participation in social activities. Data were collected longitudinally in March, July, and November 2020 via an online survey. About 20% of the sample showed moderate-high levels of PTG, with no significant differences over time. The predictive model explained 19% of the variance in PTG, showing that the inverse relation between resilience and PTG was mediated by PTSS. Additionally, participation in social activities acted as a predictor of PTG. Women, young people, those who had lost their job and people who had experienced COVID-19 symptoms or the loss of a loved one presented higher PTG. Thus, people have experienced positive changes (PTG), but these did not protect them from adverse symptomatology (PTSS).

The effects of trait resilience and rumination on psychological adaptation to breast cancer

This cross-sectional study examined the effect of trait resilience and specific types of rumination on positive psychological adaptation post-diagnosis among 201 breast cancer patients. They completed self-reported measures describing trait resilience, rumination, posttraumatic growth, and health-related quality of life. Hierarchical analysis showed that trait resilience significantly predicted higher quality of life and posttraumatic growth after controlling for demographic and clinical variables. Additionally, “intrusion” and “brooding” subtypes of rumination negatively predicted quality of life, with “instrumentality” positively predicting quality of life and posttraumatic growth, suggesting the importance of trait resilience and multidimensional rumination for positive psychological changes among breast cancer survivors.

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

OBJECTIVES

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Differences in Resilience, Psychological Well-Being and Coping Strategies between HIV Patients and Diabetics

The aim of the study was to determine the differences in resilience, psychological well-being and coping strategies between patients with HIV and diabetics. The sample included a total of 400 subjects (199 patients with HIV and 201 subjects with diabetes). The instruments applied for data collection were a sociodemographic data questionnaire, the Resilience Scale (Wagnild and Young), the Ryff Psychological Well-being Scale and the Coping Strategies Questionnaire (Sandín and Chorot). The data collection period was approximately 2 years (between February 2018 and January 2020). Based on the results of our work it was found that the subjects with HIV had lower scores than the diabetic subjects in all the resilience factors, except for the factor "feeling good alone". In addition, the subjects with HIV scored significantly lower than the diabetic subjects on all the variables of psychological well-being. Subjects with HIV used problem-solving coping, social support seeking, positive reappraisal, religious coping and avoidance coping with less frequency than diabetic subjects. However, they used more negative auto-focused coping compared to diabetic subjects. Therefore, subjects with HIV show a different psychological pattern in relation to resilience, psychological well-being and use of coping strategies compared to diabetic subjects.

HIV Treatment Adherence Strategies Among Virally Suppressed Black Sexual Minority Men in Baltimore, Maryland, and Los Angeles, California: A Theory-Based Qualitative Study

ABSTRACT

The goals and strategies of Black sexual minority men living with HIV (BSMMLWH) who achieve viral suppression require further investigation. This study explored treatment adherence strategies among BSMMLWH with sustained viral suppression. We conducted 27 in-depth qualitative interviews with BSMMLWH in Baltimore, Maryland, and Los Angeles, California, between December 2018 and May 2019. Interviews included questions guided by Positive Deviance and Life Course theoretical frameworks regarding multilevel factors and explicit strategies for antiretroviral therapy adherence. Themes regarding intentional, age group-specific strategies such as using technology (among younger men) and taking HIV medications with other daily pills (among older men) were identified. Participants also reported symbiotic goals and values that encouraged adherence, such as having a desire to live, strong familial relationships with clinicians, and support networks. Identifying personal goals and having supportive clinical and social relationships could be key to improving treatment adherence and viral suppression among BSMMLWH.

Determinants of Common Mental Disorders Among People Living with HIV/AIDS Attending ART Service in Southern Ethiopia

Background

Worldwide, the rates of psychological problems have been shown to have a dramatic increase, particularly among people living with chronic diseases. Besides the known clinical factors, it is important to address an individual’s level of resilience as an included factor for mental health outcome for people living with HIV/AIDS.

Aim

The aim of the study was to assess determinants of common mental disorders among people living with human immune virus/acquired immune deficiency virus (HIV/AIDS).

Setting

ART clinic of Gedeo zone public hospital, South, Ethiopia.

Methods

A facility-based unmatched case control study was conducted. A total of 360 adults (180 cases and 180 controls) aged 18 and above who attended the anti-retro viral therapy (ART) service participated. The Self-Reporting Questionnaire (SRQ-20) screening tool was used to determine cases and controls based on the status of common mental disorders. The treatment register at each HIV treatment center was used to systematically select study participants for the interview. The cases were common mental disorder (CMD) positively screened adults who scored seven and above, while the controls were adults who scored below seven. Then the cases and controls who took part in the study were selected using a simple random sampling method with a proportional allocation method for each hospital. Multivariable logistic regression was used. A p-value of less than 0.05 was considered statically significant.

Results

Lower resilience level was found to be significant predictors of common mental disorder among HIV patients [AOR = 3.16 95% CI; 1.83, 5.46]. The other predictors were being female (adjusted odds ratio [AOR] = 2.01 95% CI; 1.21, 3.34); single [AOR = 8.10 95% CI; 3.50, 18.76]; divorced and widowed [AOR = 3.31 95% CI; 1.76, 6.22]; more than ten years of illness duration [AOR = 2.30 95% CI; 1.39, 3.80]; and having perceived stigma [AOR = 5.39 95% CI; 2.65, 10.82].

Conclusion

HIV-positive adults with lower resilience levels and experiencing perceived stigma exhibited significantly higher risk of mental disorders. Hence, improving personal resilience and working to mitigate perceived stigma play a great role in decreasing the risk of common mental disorders.

Post-traumatic growth mediates the relationship between valences of trauma centralisation and health-related quality of life

Emotions arising from health-related trauma can be complex (as positive and negative feelings are possible) and can influence the way patients perceive themselves and the world. Health outcomes can also be affected by the valence of emotions. We hypothesised that post-traumatic growth is the mediating link between the valences of event centrality and health-related quality of life among people living with HIV. Three hundred (male = 194 and female = 106; mean age = 35.30 years) people living with HIV in Nigeria completed measures of relevant variables. Mediation analysis was performed using path analysis and structural equation modelling. Results showed that post-traumatic growth mediated the association between positive event centrality and health-related quality of life in the physical health symptoms and treatment impact domains. Post-traumatic growth also mediated the association between negative event centrality and health-related quality of life in the physical health symptom and relationship domains. In light of these findings, it might be concluded that fostering post-traumatic growth among people living with HIV by clinicians could be helpful in enhancing the health-related quality of life of people living with HIV.

Associations Between Experienced and Internalized HIV Stigma, Adversarial Growth, and Health Outcomes in a Nationwide Sample of People Aging with HIV in Germany

HIV-related stigmatization and adversarial growth are known to influence health outcomes in people living with HIV. But not much is known how these psychosocial factors are related to each other and how they interact to influence health outcomes. We tested whether the effect of experienced and internalized stigma on mental health and self-rated health is mediated by adversarial growth, and whether each of these factors is uniquely associated with health outcomes. In our sample of 839 people aging with HIV in Germany based on a cross-sectional study design we did not find an indirect effect of experienced HIV stigma on health outcomes and a very small indirect effect of internalized HIV stigma. All variables were significant predictors of health outcomes in multiple regression analyses.

Intervention Program to Improve Grief-Related Symptoms in Caregivers of Patients Diagnosed With Dementia

The objectives of the present study were to adapt a grief intervention program to family caregivers of patients with dementia, and assess its effectiveness in improving the symptoms of grief and other health-related variables. The intervention was based on Shear and Bloom's grief intervention program, with the necessary adaptations for use in the grieving process for a family member's illness. A total of 52 family caregivers of individuals with dementia participated. They were evaluated using a battery of self-report measures assessing grief, overload, resilience, post-traumatic growth, experiential avoidance, health-related quality of life, and benefits of care. The results suggest that the program is effective in improving grief symptoms, caregiver burden, resilience, post-traumatic growth, and quality of life of family caregivers. It is necessary to create and implement interventions targeting caregivers' feelings and manifestations of ambiguous grief, because there is a lack of programs providing an efficient solution for the mental and physical health of caregivers, and because of the human and socioeconomic cost involved in neglecting this group.

What shapes resilience among people living with HIV? A multi-country analysis of data from the PLHIV Stigma Index 2.0

OBJECTIVE

To inform efforts to promote greater resilience among people living with HIV (PLHIV), we examined associations between resilience and factors at the individual, interpersonal and structural/policy levels in three countries.

DESIGN

Data come from the PLHIV Stigma Index 2.0, a cross-sectional survey with PLHIV, implemented from 2017 to 2019 in Cambodia (n = 1207), the Dominican Republic (n = 891), and Uganda (n = 391).

METHODS

Hierarchical multiple regression was used to assess associations between resilience and factors at the individual/interpersonal/structural-policy levels, controlling for potential confounders. Resilience was measured by the previously tested PLHIV Resilience Scale.

RESULTS

About 60% of respondents were women; mean time since HIV diagnosis was 11 years in Cambodia and seven in the Dominican Republic /Uganda. Resilience varied substantially across the six province/districts per country (all p < 0.001). In multivariable analyses, higher resilience was associated with lower internalized stigma (all three countries), no experience of human rights abuses (Dominican Republic), no food/housing insecurity (Uganda), and greater community awareness of legal protections for PLHIV (Cambodia and Dominican Republic). HIV-related enacted stigma (i.e., discrimination) in the community was associated with lower resilience in Cambodia, but higher resilience in the Dominican Republic. The set of structural/policy-level factors in Cambodia and the Dominican Republic, and individual-level in Uganda, explained the most variance in resilience.

CONCLUSION

Factors at multiple levels affect whether PLHIV in Cambodia, the Dominican Republic, and Uganda report resilience. Multilevel interventions are required to promote resilience among PLHIV, and should incorporate efforts to reduce internalized stigma and promote supportive structural/legal environments including broader awareness of legal protections for PLHIV.

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

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

Does Posttraumatic Growth Buffer the Association Between Death Anxiety and Quality of Life Among People living with HIV/AIDS?

People living with HIV (PLWH) may experience death anxiety (DA), which can be detrimental to quality of life. Posttraumatic growth (PTG), however, is antithetical to DA, with its positive attributes at odds with negative psychosocial outcomes. Previous research has not examined the buffering effect of PTG on the association between DA and quality of life. Therefore, in addition to the direct effects of DA and PTG on health-related quality of life (HRQoL), we investigated the moderating role of PTG on the relationship between DA and HRQoL among people living with HIV/AIDS (PLWH) in Nigeria. Using cross-sectional design and availability sampling method, we selected 201 outpatients (men, n = 63, 31.3%, women, n = 138, 68.7%, mean age = 40.1, SD = 10.5) managed for HIV/AIDS in a Nigerian tertiary healthcare institution. Death Anxiety Inventory-Revised, Posttraumatic Growth Inventory-Short Form, and Patient-Reported Outcome Quality of Life-HIV were used to access DA, PTG and HRQoL, respectively. Results showed that while adjusting for socio-demographic factors (age, gender, time since diagnosis and educational status), DA was associated with physical health, mental health and social relationships domains of HRQoL as well as overall HRQoL. In contrast, PTG did not evidence significant association with HRQoL dimensions and overall HRQoL. The moderation effect of PTG on the association between DA and HRQoL was not supported. Independent of PTG, alleviating DA may be an important target in terms of therapeutic intervention towards improving quality life of PLWH.

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

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

[Resilience trajectories-examples from longitudinal studies]

BACKGROUND

According to current research concepts resilience can be defined as adaptation to past and ongoing exposure. Accordingly, adaptation to exposure is a dynamic process, which can be different in different population groups. Prospective longitudinal studies provide unique opportunities to investigate resilience processes.

OBJECTIVES

The aim of this article is to define the concept of resilience, describe examples of longitudinal studies investigating resilience in children, adults and older individuals, exemplary describe four ongoing longitudinal resilience studies in which the authors of the article are participating and identify and analyze methodological challenges in empirical resilience research.

MATERIAL AND METHODS

This study was based on a qualitative literature review of published prospective studies investigating resilience listed in PubMed and study protocols of the four longitudinal studies.

RESULTS

The exemplarily described studies have shown that resilience processes are changeable in all age groups and subject to a variety of influencing factors. The specific and potentially age-associated types of alterations have so far been difficult to determine and need further clarification.

DISCUSSION

In view of the dynamic course of resilience, prospective longitudinal studies are urgently needed. Prospective longitudinal studies have the potential to identify resilience mechanisms and predictors of the course of resilience in different population groups, such as children, adolescents, adults and older individuals. Furthermore, resilience research needs to develop an improved and precise assessment of exposure to stressors.

The Association of Trauma with the Physical, Behavioral, and Social Health of Women Living with HIV: Pathways to Guide Trauma-informed Health Care Interventions

BACKGROUND

Trauma is increasingly recognized as a near-universal experience among women living with HIV (WLHIV) and a key contributor to HIV acquisition, morbidity, and mortality.

METHODS

We present data from the baseline analysis of a planned intervention trial of the impact of trauma-informed health care on physical, behavioral, and social health outcomes of WLHIV in one clinic, with a particular focus on quality of life and viral suppression. Data were collected through interviewer-administered surveys and electronic health record data abstraction.

RESULTS

Among 104 WLHIV, 97.1% of participants reported having experienced lifetime trauma, and participants had experienced on average 4.2 out of 10 Adverse Childhood Experiences. WLHIV with more lifetime trauma were significantly more likely to report post-traumatic stress disorder, depression, and anxiety symptoms; significantly more likely to report potentially harmful alcohol and drug use; and had a significantly poorer quality of life. In addition, women who had experienced more lifetime trauma were significantly less likely to report being on and adhering to HIV medications, although trauma was not significantly associated with having an undetectable HIV viral load.

CONCLUSIONS

These data suggest that trauma is associated with much of the morbidity and mortality experienced by WLHIV. The results of this study support the implementation and study of trauma-informed approaches to health care for WLHIV.

Are Posttraumatic Stress Symptoms and Avoidant Coping Inhibitory Factors? The Association Between Posttraumatic Growth and Quality of Life Among Low-Grade Gliomas Patients in China

Background: Diagnosing with low-grade gliomas (LGGs) can be a very shocking and stressful experience, a traumatic event potentially leading to the development of posttraumatic stress symptoms (PTSS), and posttraumatic growth (PTG). Understanding how patients cognitively and behaviorally response to their diagnosing is also important to postoperative treatment. Thus, the current study explored the association between PTG and quality of life (QoL) of Chinese patients with LGGs. The moderation effects of coping strategies and PTSS on the relationship between PTG and QoL have been examined as well. Methods: Posttraumatic stress symptoms, Posttraumatic growth, coping strategies, and QoL were measured by using self-report surveys. Three hundred and thirty patients completed surveys approximately 1 month after surgery. We used three multiple regression models and added interaction terms in these models to test the moderation effects of PTSS and coping strategies on the relationship between PTG and QoL. Results: The results of hierarchical multiple regression suggested that PTG significantly predicted QoL, both PTSS and coping strategies moderated the association between PTG and QoL. Specifically, the association between PTG and QoL for patients who have non-significant PTSS is stronger than those who have significant PTSS. Furthermore, as the score of Avoidant Coping increases, the association between PTG and QoL becomes weaker. Conclusion: Posttraumatic growth may help to improve the QoL of LGGs patients, but PTSS and Avoidant Coping impeded the positive effect of PTG on QoL.

Posttraumatic growth among people living with HIV: A systematic review

OBJECTIVES

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

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

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

Analysis of resilience and sexual behavior in persons with HIV infection

The main objective of this study was to evaluate ex post facto resilience in persons with HIV infection and its relationship to socio-demographic and sexual behavior variables. Participants included 159 persons with HIV infection, of both sexes, aged between 19 and 55 years. Fifty-one percent of patients were infected through homosexual means. Sixty-seven percent were in the asymptomatic phase of infection. Assessment instruments used were the following: a questionnaire on socio-demographic data and sexual behavior and the Connor-Davidson Resilience Scale. The evaluation was individual, voluntary, and anonymous. The results showed that 49.05% of patients had average resilience, 27.68% had high resilience, and 23.37% had low resilience. They found that heterosexual patients infected with HIV, diagnosed between 1985 and 1990 (23 and 28 years of diagnosis) and those who had disclosed their HIV status to more than 30 people, had greater resilience than homosexual patients, diagnosed between 1996 and 2000 (13 and 17 years of diagnosis) and those who had disclosed their HIV status to 1–5 people. Finally, resilience was not a predictor of sexual risk factor. It is suggested that health interventions take into account the resilience and psychological variables that may be beneficial to improve coping with the disease.