Predicting posttraumatic growth among Hurricane Katrina survivors living with HIV: the role of self-efficacy,social support,and PTSD symptoms

Abstract

The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.     

中小学教师职业枯竭状况及其与社会支持的关系

该研究提出了中国教师职业枯竭表现的新维度——知识枯竭,检验了四维度枯竭模型在中国的有效性。并采用问卷调查法,对全国679名中小学教师的职业枯竭状况进行了分析,考察了各种人口统计学变量之间的差异,并探讨了职业枯竭各个维度与社会支持之间的关系。结果发现,男教师、教龄在11~20年的教师枯竭程度较高。从社会支持对于教师枯竭的缓解作用来讲,来源于学生和学校领导的支持,以及情感型支持更为有效。     

The Depressive Experiences Questionnaire: a further evaluation

The Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976b) was designed to assess the introjective and anaclitic personality dimensions hypothesized by Blatt (1974) to underlie different forms of depression. Welkowitz, Lish, and Bond (1985) revised the DEQ (RDEQ) in order to simplify its scoring and facilitate cross-gender comparisons. The study described herein explored the relation between the original and revised forms of the DEQ and assessed the reliability and validity of the Welkowitz et al. (1985) version of the inventory. Two samples were employed: (a) 163 psychiatric outpatients; and (b) 144 adolescent and young-adult offspring of patients with major affective disorders, chronic physical diseases, and normal controls. The results indicated that the three scales comprising the RDEQ were highly correlated with the corresponding scales from the original DEQ, however, the original and revised forms of the inventory exhibited different patterns of intercorrelations between scales. The RDEQ was internally consistent and stable over a 6-month period. In addition, it exhibited the predicted patterns of relationships with interview and self-report measures of depression and depressive personality traits and cognitive styles. Finally, the RDEQ was significantly associated with the course of depression in a 6-month follow-up study. The findings were generally similar across samples and genders. Overall, these results support the reliability and validity of the RDEQ, but indicate that there are important structural differences between the original and revised forms of the inventory.     

The cost of caring–the impact of secondary trauma on assumptions,values and beliefs

The aim of this paper is to look at the impact of working with distressed and traumatized clients. The paper describes a survey involving 430 care workers who regularly work with distressed or traumatized clients. The survey involved the participants completing a 21-item beliefs inventory describing their supervision or support and recording whether they had any spiritual or religious beliefs. A factor analysis of the results of the inventory found four factors, three of which involved the negative impact of the work on beliefs while the fourth gave an indication of the positive beliefs or post trauma growth that comes from working in this area. The results showed that while doing a good job and experiencing fulfilment were higher in carers who experienced lower levels of distressing experiences and beliefs, an increase in competence and improved learning opportunities were associated with higher levels of challenge. A review of the information provided on supervision and support showed that there was a wide variation in the sources of support for the different professions. While around 46% of the carers had spiritual beliefs only 29% were members of a religious group. The discussion looked at the implication of the results of the survey including the possible benefit of using the carer belief inventory to identify carers who may be vulnerable to secondary trauma or compassion fatigue. The need to provide support to all professions undertaking caring work with distressed or traumatized clients was highlighted.     

Influence of social support on adaptation to surgery.

The authors investigated the influence of patients' social support on subjective and objective stress indicators before, during, and after surgery. The sample consisted of 42 male and 42 female patients. Social support as perceived by the patients was measured by a surgery-specific inventory with the Emotional Support and Informational Support subscales. Perioperative adaptation was assessed by self-reported anxiety, the amount of narcotics needed for anesthesia induction, and the length of the postoperative stay. Results demonstrated that patients who scored high on social support showed less anxiety, received lower doses of narcotics, and had a shorter hospital stay than did patients with low support. However, gender was a moderator of some of these associations. Compared with men, women exhibited more relationships that were in accordance with the hypotheses.     

The Depressive Experiences Questionnaire: A Further Evaluation

The Depressive Experiences Questionnaire (DEQ; Blatt, D'Afflitti, & Quinlan, 1976b) was designed to assess the introjective and anaclitic personality dimensions hypothesized by Blatt (1974) to underlie different forms of depression. Welkowitz, Lish, and Bond (1985) revised the DEQ (RDEQ) in order to simplify its scoring and facilitate cross-gender comparisons. The study described herein explored the relation between the original and revised forms of the DEQ and assessed the reliability and validity of the Welkowitz et al. (1985) version of the inventory. Two samples were employed: (a) 163 psychiatric outpatients; and (b) 144 adolescent and young-adult offspring of patients with major affective disorders, chronic physical diseases, and normal controls. The results indicated that the three scales comprising the RDEQ were highly correlated with the corresponding scales from the original DEQ, however, the original and revised forms of the inventory exhibited different patterns of intercorrelations between scales. The RDEQ was internally consistent and arable over a 6-month period. In addition, it exhibited the predicted patterns of relationships with interview and self-report actuates of depression and depressive personality traits and cognitive styles. Finally, the RDEQ was significantly associated with the course of depression in a 6-month follow-up study. The findings were generally similar across samples and genders. Overall, these remits support the reliability and validity of the RDEQ, but indicate that there are important structural differences between the original and revised forms of the inventory.     

Impact of Perceived Social Support and Depression on the Parental Attitudes of Mothers of Children Who are Deaf

Literature shows that mothers of children with disabilities report high levels of depression. Social support facilitates the well-being of mothers and it helps to cope with a range of disability related stressors. This study was designed to assess the impact of having a child who is deaf on maternal depression and to test how social support may facilitate coping with the depression caused by deafness as well as the parenting behaviors of those mothers. 103 mothers of children who are deaf, ranging from the 36 months to 72 months of age participated in the study. Parental attitude research instrument, beck depression inventory and multidimensional scale of perceived social support were used for data collection. Results showed that 24.4 % of the mothers showed depression and perceived social support from family and friends were found to be predicting depression. Further analysis showed that depression was found to be affecting authoritarian and hostile parenting styles. Perceived social support from friends and significant other did not have significant effect on parental attitudes. The findings showed that having a child who is deaf causes high levels of depression in mothers which leads to insufficient and/or inappropriate parenting attitudes. On the other hand, social support is a protective source lowering depression levels of mothers as well as indirectly facilitating the maintenance of positive parenting.     

Contributions of the EPN paradigm to HIV prevention: A preliminary study

This study examined the relation between HIV knowledge, behavioural change and Eysenckian personality variables. Neuroticism and Lie Scale correlated negatively with HIV disease knowledge in a general population that had not received HIV disease education. Among those who had received HIV education, Psychoticism, Extraversion and Neuroticism all correlated with unsafe sexual behaviour. Implications of this study for HIV education and for prevention are discussed.     

Perceived emotional and life change impact of AIDS on homosexual men in two countries

Abstract

A comprehensive self-administered life event inventory examining both general life stress and stress from events specific to the homosexual and bisexual male population was developed in order to assess the impact of AIDS and HIV infection on homo- and bisexual men. Ranking of questions revealed that while general stressors affected homosexuals similarly to heterosexuals, there were critical stressors affecting homosexuals not measured by conventional inventories. Specifically, emotional distress from receiving an HIV antibody positive result was not significantly different to that caused by a diagnosis of AIDS or ARC, the diagnosis of AIDS in a lover or the death of a lover. A sharp discrepancy in emotional distress between current safer sex behaviour and current unsafe sexual behaviour was also found, and the implications for behavioural modification in this area noted. Those who were HIV antibody positive tended to evaluate the anticipated impact of further AIDS related diagnoses as having a greater emotional impact than those who had tested negative. There would appear to be a closer relationship between emotional distress and life change in homosexual men than in heterosexual samples. The relative emotional impacts and life change assessments of AIDS and HIV infection are discussed.     

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.     

Reducing HIV risk-associated sexual behavior among african american adolescents: Testing the generality of intervention effects

This randomized controlled trial tested the effects of a theory-based culture-sensitive HIV risk-reduction intervention among 496 inner-city African American adolescents (mean age = 13 years) and examined the generality of its effects as a function of the facilitator's race and gender and the gender composition of the intervention group. Adolescents who received the HIV risk-reduction intervention expressed more favorable behavioral beliefs about condoms, greater self-efficacy, and stronger condom-use intentions postintervention than did those who received a control intervention on other health issues. Six-month follow-up data collected on 93% of the adolescents revealed that those who received the HIV risk-reduction intervention reported less HIV risk-associated sexual behavior, including unprotected coitus, than did their counterparts in the control condition. Self-reported sexual behavior and changes in self-reported behavior were unrelated to scores on a standard measure of social desirability response bias. There was strong evidence for the generality of intervention effects. Moderator analyses testing eight specific interaction hypotheses and correlational analyses indicated that the effects of the HIV risk-reduction intervention did not vary as a function of the facilitator's race or gender, participant's gender, or the gender composition of the intervention group. This research was supported in part by grants from the National Institute of Child Health and Human Development (R01-HD24921), the National Institute of Mental Health (R01-MH45668), and the Social Science and Humanities Research Council of Canada. The authors gratefully acknowledge the contributions to this research of Margaret Bleier, Daria Boccher-Lattimore, Nancy L. Moore, Tatiana Perrino, Paul Pintella, and Fran Rosenfeld and the helpful suggestions of Isabel Fernandez, Caryn Lerman, and Ann O'Leary regarding an earlier version of this article.     

Personality Inventory Responses of Males With Medically Intractable Seizures

The psychosocial adjustment of 50 male patients to intractable seizures was assessed by comparing their responses to a combined version of the Minnesota Multiphasic Personality inventory (MMPI) and the California Psychological inventory (CPI) to the responses of 50 medical, psychiatric, or nonclinical controls who denied seizures. The two groups were significantly different (p < .01) on one MMPI and 10 CPI scales. Significant (p < .01) between-group differences were also rejected in 29 of the 704 personality inventory items. Those items were rationally clustered according to content into six conceptually, identifiable subscales; 30 additional items with similar content that were significant at the .05 level were added to those subscales. Comparison of subscale scores of an additional 30 seizure and 30 nonseizure subjects using analysis of variance revealed F values that reached statistical significance (p < .05) in four cases and approached significance (p = .07) in another. Applying coefficients derived from discriminant analysis of the first samples correctly classified 99% of the original patients, and 85% of the validation subjects. Results reveal a logical, understandable, and largely adaptive response to intractable seizures and offer little support for the concept of a dysfunctional or pathological interictal personality style.     

Regrets and Advice from Mothers who have Disclosed their HIV + Serostatus to their Young Children

Qualitative interviews were conducted with mothers (N = 47) who had disclosed their HIV status to their child. Mothers described their preparation and the process of the disclosure event, and discussed any regrets they had about disclosing or the process of disclosing. They were also asked what advice they had for other HIV-positive mothers who were trying to determine whether to disclose their serostatus to their young children. Overall, the majority of the mothers (68%) did not regret disclosing their HIV status. Regrets fell into five categories: preparation, timing, context, content, and outcomes of the disclosure event. Based on these findings, mothers who have not disclosed their serostatus to their children need assistance with behavioral practice and support in order to prepare for the process. Furthermore, follow-up support for the children may be beneficial.     

Assessment of HIV counselling and social care services in a London hospital

The use of, and satisfaction with, counselling and social care services was investigated among HIV-infected clients attending HIV specialist climes at Guy's Hospital and Southwark Social Services, London. A survey of 71 clients with HIV infection was carried out using a self-administered questionnaire. The greatest demand was for advice about income support, housing, counselling for the HIV test, counselling for depression or anxiety, psychological support for coping with HIV, help with sleeping problems, mobility allowance, and help with furniture/household appliances. Overall, 57% thought the service was good or excellent; 66% of respondents thought they would use the services in the future. Over nine in ten clients had used the psychosocial support services at some stage since their HIV diagnosis, although only two-thirds anticipated that they would have need of these services in the future. The psychosocial support service will need to remain responsive to the shift in demand for this service, as well as the changing needs of clients who use it.     

An AIDS Hotline: Analysis of Callers,Presenting Problems,and Social Factors1

This research is an analysis of all calls received by an AIDS hotline over an 8-month period. Caller demographics and types of presenting problems of callers are reported. Overall, callers were most concerned about how the virus was transmitted and requested information about HIV testing for themselves, a partner, a friend, or a relative. Despite the fact that adolescents are at high risk for contracting HIV, few adolescents called the hotline, but those who did were more likely to request safer sex information than HIV testing information. In contrast, all other age groups requested HIV testing more than safer sex information, often by a 2:1 or 3:1 margin. Men called most frequently because of concerns about self, whereas women called most frequently with concerns about others. These results are discussed in the context of the AIDS epidemic and in terms of social factors.     

HIV counselling in the 1990s and beyond

It is 15 years since AIDS was first described in the medical literature. Reports of immune system disorders among gay men in large cities in the USA in 1981 signalled the start of what has now become a pandemic affecting millions of people. The psychological impact of HIV infection has been well-documented and it is widely reported that psychological treatment is mosdy provided for the treatment of adjustment reactions. Counselling for HIV prevention and HIV antibody testing has also been at the forefront of psychological support services. More recenuy, there has been a determined effort among counsellors to develop a range of psychotherapeutic approaches to help people to cope with and adjust to living with terminal illness. Most research published in the 1980s on the psychological impact of HIV addressed the infected individual. This symposium introduces a growing interest in the field for counselling those who are affected by HIV, including families, health-care workers and communities. This trend is becoming the focus of many counselling programmes worldwide and is likely to continue throughout the 1990s and beyond.     

Forgiveness and Marriage: Preliminary Support for a Measure Based on A Model of Recovery From A Marital Betrayal

Forgiveness is an issue that recently has received increasing attention in the psychological literature, yet little empirical research has been conducted on this topic. This article presents initial support and validation of an inventory based upon Gordon and Baucom s (1998) three-stage synthesized model of forgiveness in marital relationships. This model places forgiveness in the framework of a reaction to a traumatic interpersonal event. One hundred seven community couples completed several measures of marital functioning, along with the new measure of forgiveness. The measure achieved internal reliability, and a confirmatory factor analysis suggested that the resulting subscales are a good fit with the data. Further results offered preliminary support for the inventory s validity and its relation to various aspect of marital functioning. Individuals placed into groups based upon their scores on this measure reported expected levels of global forgiveness, relationship power and closeness, and assumptions about themselves and their partners. The limitations of the study are identified, and clinical and research implications of these findings are discussed.     

Social support,psychological vulnerability,and HIV risk among African American men who have sex with men

Previous research has suggested a need to understand the social-psychological factors contributing to HIV risk among African American men who have sex with men (MSM). We conducted individual in-depth interviews with 34 adult African American MSM to examine their personal experiences about: (i) sources of social support, (ii) psychological responses to the presence or absence of social support and (iii) influences of social support on sexual behaviours. The majority of participants described limited positive encouragement and lack of emotional support from family, as well as few meaningful personal relationships. Feelings of isolation and mistrust about personal relationships led many participants to avoid emotional intimacy and seek physical intimacy through sexual encounters. Findings highlight a need for multilevel interventions that enhance social support networks and address the social-psychological, emotional and interpersonal factors that contribute to HIV risk among African American MSM.