Stress,coping, HIV status,psychosocial resources,and depressive mood in African American gay,bisexual, and heterosexual men

The associations between stress, physical health, psychosocial resources, coping, and depressive mood were examined in a community sample of African American gay, bisexual, and heterosexual men (N=139). Data were collected from physical exams and in-person interviews. In our theoretical framework, depressive mood scores were regressed first on stressors, next on psychosocial resources, and finally on coping strategy variables. Results revealed that psychosocial resources mediate the effects of stressors, including health symptoms, hassles, and life events, on depressive mood. There were no significant differences in depressive mood associated with HIV status or sexual orientation. Results are discussed in terms of community interventions needed to provide social support as a buffer between stress and psychological distress in African American men. The research was completed at the Center for AIDS Prevention Studies, University of California at San Francisco and was supported in part by National Institute of Mental Health Grants MH44045 and MH42459. The authors express their appreciation to the participants in this study.     

Effectiveness of a Group Therapy Program for Children with Psychosocial Deficits: Benefits of Concurrent Participation in Organized Activities

Prior research suggests children’s involvement in organized activities predicts positive outcomes, although benefits for youth with psychosocial deficits remain unclear. This study examines if activity participation predicts response to a group therapy program for children with psychosocial deficits and if improvements depend on children’s functioning within the organized activity context. Participants were 178 children (M age?=?9.6 years) enrolled in a group therapy program. Greater activity participation significantly predicted improvements in family functioning and social skills, suggesting the value of participation in organized activities for youth with psychosocial deficits.     

Counseling in the Era of AIDS

The AIDS (Acquired Immune Deficiency Syndrome) crisis is affecting greater numbers of people, and counselors are being called upon to work with this population. Counseling roles have expanded, and counselors have been thrust into the medical, social service, and political spheres. In this article the authors describe the role of the counselor in the era of AIDS; psychological reactions to a chronic, stigmatized, and ultimately fatal illness; and the special needs of specific populations (gay men, families and friends of gay men, gay youth, significant others, people of color, heterosexual women and lesbians, college students, substance abusers, and the “worried well”). The authors also examine the effects of HIV (human immunodeficiency virus) illness and AIDS on the care giver. Counseling interventions are described throughout the article.     

Psychosocial profile of people with AIDS and their caregivers in Egypt

Caring for individuals with AIDS in developing countries represents a major crisis to families and natural caregivers. This study presents the psychosocial profiles of people with AIDS and their caregivers in Egypt to assess the effects of HIV/AIDS on patients, their caregivers, and the factors that influence caregiving and support. Various stressors and challenges for patients as well as hardships the caregiver faces were explored. The literature documents difficulties such as inadequate health care services, lack of resources, and stigma that patients experience in developing countries. Findings indicate an association between the psychosocial effects of AIDS on patients and their caregivers.     

Stability and Change in Psychosocial Resources during Caregiving and Bereavement in Partners of Men with AIDS

ABSTRACT This study examines the effects of caregiving and bereavement on psychosocial resources in HIV + and HIV? caregivers of men with AIDS. We explored three hypotheses regarding these effects: the “wear and tear” hypothesis, which asserts that the chronic stress of caregiving and bereavement diminishes resources; the “enhancement” hypothesis, which asserts that caregiver resources may increase in response to increased demands; and the “personality” hypothesis, which asserts that psychosocial resources reflect stable personality characteristics. We addressed four questions: (a) What are the effects of caregiving on resources? (b) How do these resources vary by the imminence of the partner's death? (c) What is the effect of the partner's death on these resources? and (d) How does the caregivers' HIV serostatus influence the effects of caregiving and bereavement on resources? Support for the personality hypothesis predominated, with some support for the wear and tear hypothesis, depending on the resource in question. In general, HIV seropositivity did not put people at additional risk for resource depletion.     

Parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China

The objective of this study was to examine the relationship between parental loss, trusting relationship with current caregivers, and psychosocial adjustment among children affected by AIDS in China. In this study, cross-sectional data were collected from 755 AIDS orphans (296 double orphans and 459 single orphans), 466 vulnerable children living with HIV-infected parents, and 404 comparison children in China. The trusting relationship with current caregivers was measured with a 15-item scale (Cronbach's α?=?0.84) modified from the Trusting Relationship Questionnaire developed by Mustillo et al. in 2005 (Quality of relationships between youth and community service providers: Reliability and validity of the trusting relationship questionnaire. Journal of Child and Family Studies, 14, 577-590). The psychosocial measures include rule compliance/acting out, anxiety/withdrawal, peer social skills, school interest, depressive symptoms, loneliness, self-esteem, future expectation, hopefulness about future, and perceived control over the future. Group mean comparisons using analysis of variance suggested a significant association (p?相似文献   

Psychosocial Well-being of Children in HIV/AIDS-Affected Families in Southwest China: A Qualitative Study

We investigated the psychosocial well-being of children in HIV/AIDS-affected families in rural China from the child’s and caregiver’s perspectives. Semi-structured interviews were conducted among children living in HIV/AIDS-affected families (n = 16), their caregivers (n = 16) and key community informants (n = 5). Our findings showed that all of the children relied heavily on caregivers and peers to gain psychological support. Children’s psychosocial problems included fear, anxiety, grief, and loss of self-esteem and confidence. Stigma towards children existed, including isolation, ignorance and rejection. Our study illustrates that HIV/AIDS has impacted negatively on the psychosocial well-being of children. These findings can be used as preliminary data supporting more researches to profoundly explore the psychosocial impact of HIV/AIDS on children and appropriately indicate the need for interventions.     

School adjustment of adolescents affected by HIV and AIDS: A case study

The study examined the school adjustment of South African adolescents affected by HIV and AIDS . Participants were a convenient sample of 60 adolescents from a secondary school in a major South African city (females = 73 .33%, 50% affected by HIV and AIDS, grade 8 = 40%, grade 9 = 30%, grade 10 = 30%, age range = 16–18 years) . Data on their personal functioning were gathered using the Beck Youth Inventory^TM and the Enhanced School Support Inventory (ESSI) . The data analysis comprised between-group and within-group comparisons, using the t-test statistic . Findings suggest that adolescents affected by HIV and AIDS had significantly lower psychological and behavioural functioning than their typical other peers . Results also show that these affected learners had lower school adjustment than their typical peers . The schools environment can support comprehensive interventions to addresses psychosocial vulnerability among adolescents affected by HIV and AIDS .     

Does Natural Mentoring Matter? A Multilevel Meta‐analysis on the Association Between Natural Mentoring and Youth Outcomes

In this meta‐analytic review, we examined the relation between natural mentoring and youth outcomes in four domains: academic and vocational functioning, social‐emotional development, physical health, and psychosocial problems. Natural mentoring relationships are thought to foster positive youth development and buffer against the risks associated with the tumultuous years of adolescence. Two separate meta‐analyses were conducted on the presence of a natural mentor and the quality of the natural mentoring relationship, including thirty studies from 1992 to present. The findings indicated that the presence of a natural mentor was significantly associated with positive youth outcomes (r = .106). A larger effect size was found for the quality of the natural mentoring relationship in terms of relatedness, social support, and autonomy support (r = .208). The largest effect sizes were found for social‐emotional development and academic and vocational functioning. Risk‐status (e.g., teenage mothers, homeless youth, youth in foster care, and youth of alcoholic parents) did not moderate the relation between presence and quality of natural mentoring relationships and youth outcomes, which may indicate that natural mentors are generally beneficial for all youth regardless of risk‐status. Implications for theory and practice concerning the quality of the natural mentoring relationship are discussed.     

The Impact of Community Mental Health Programs for Australian Youth: A Systematic Review

Australia has undergone significant youth mental health reform over the past 10 years, leading to numerous studies examining the effects of community-based mental health care programs for Australian youth. However, no synthesis of this literature currently exists. Therefore, this systematic review aimed to: (1) describe the types of community-based mental health programs that have been delivered to Australian youth in the past 10 years; and (2) examine their impact in improving young people’s mental health symptomology and psychosocial functioning. A systematic search of the peer-reviewed literature was conducted. Studies were included if they evaluated the extent to which such programs improved mental health symptomology (e.g., depression, anxiety, substance use) and/or psychosocial outcomes (e.g., social functioning, school engagement, employment) for Australian youth aged 10–25 years. Thirty-seven studies were included. Four types of community-based youth mental health care programs were identified: therapy (n?=?16), case management (n?=?9), integrated ‘one-stop-shop’ (n?=?6) and lifestyle (n?=?6) programs. The majority of therapeutic programs were effective in reducing mental health symptomology. Case management and integrated approaches consistently yielded significant improvements in both symptomology and psychosocial outcomes. Lifestyle programs were effective in alleviating depressive symptoms, but inconclusive for other outcomes. This review provides support for youth-friendly, systemic, multidisciplinary and integrated assertive outreach models of community mental health care to improve outcomes for young Australians experiencing mental health concerns. Several recommendations for future research are provided to strengthen the local evidence-base supporting community mental health programs to ultimately enhance young people’s life trajectory.

     

The Nature and Correlates of Psychological Adjustment in Gay Men with AIDS-Related Conditions1

This study assessed differences in the psychological adjustment of gay men who tested positive for the antibody to the human immunodeficiency virus (HIV). Twenty-one were symptomatic for AIDS, and 27 were asymptomatic. A group of 15 gay men who tested negative for the HIV was included as a comparison group. Men in the three groups were equivalent on demographic variables. Symptomatic men reported more health problems than either asymptomatic or seronegative men. Relative to men who were symptomatic, those who were asymptomatic reported more death anxiety, less optimism, and greater severity of psychological distress, and reported more frequent use of avoidance and distancing as coping strategies. The poor psychological functioning of asymptomatic subjects was attributed to the uncertainty regarding their future health status. Generally, positive psychological well-being of symptomatic and asymptomatic men was related to the infrequent use of avoidance coping strategies and high satisfaction with perceived social support.     

Fostering Self-Determination and Resilience Through Sports Counselling: Psychosocial Development of Youth in Botswana

Sports can promote pro-social behaviors and confidence in physical abilities among participants. We conducted an extensive review of the literature on the ways in which youth in Southern African countries, severely affected by the HIV/AIDS pandemic and other hardships may benefit from acquiring the pro-social skills often associated with athletics. This article reviews the current situation of sports in Botswana and offers recommendations for a culturally appropriate developmental sports counselling program in that country. The authors present arguments that support the development of psychosocial skills, self-determination, and resilience among Batswana Youth through sports counselling interventions.     

Support Group Needs for People Living with HIV and AIDS (PLWHA) in Communities around Durban,South Africa

The study constructed a participant centred perspective of what members of a support group for people living with HIV and AIDS (PLWHA) desired from their group meetings. The study sample (n = 34) was from three support groups of PLWHA in a province of South Africa (males = 7, female = 27, mean age = 34.2 years, SD = 6.8 years). Participants completed a brief survey and participated in focus group discussion on views on the ideal support group, actual experience with the support group, and solutions for effective support groups. Findings suggest most members of the support group experienced a high degree of stigma at home and needed a so-called ‘safe space’ to escape to and discuss issues with people experiencing similar problems. Respondents wanted to acquire skills to allow them to help themselves and others in the community. They also desired HIV education so that they could properly understand the virus and help the community understand it to reduce stigma.     

Psychological Control Associated with Youth Adjustment and Risky Behavior in African American Single Mother Families

A distinction between parental behavioral control and psychological control has been elucidated in the literature, yet far less is known about the role of psychological control in youth adjustment broadly or risky behavior in particular. We examined the interrelationship of maternal psychological control, youth psychosocial adjustment, and youth risk behaviors among African American single mother-youth (11–16-year old) dyads (n = 194), families in which youth are more vulnerable to adjustment problems and risky behavior than Caucasian youth or youth from intact homes. Higher levels of maternal psychological control were associated with increased youth psychosocial adjustment problems as well as increased youth risk behavior, after statistically controlling for one domain of behavioral control, parental knowledge about a child’s whereabouts and activities. Furthermore, youth externalizing problems mediated the relation between psychological control and risk behavior. The findings suggest that parenting programs targeting risk behavior among African American youth may benefit from including psychological control among the parenting dimensions that are targeted.     

The psychological impact of AIDS on gay men

The profound psychological impact of the acquired immunodeficiency syndrome (AIDS) epidemic on gay men needs to receive greater attention from mental health professionals. The specific treatment approach depends upon the individual's location on the AIDS-related conditions continuum. For men already diagnosed with AIDS, psychological themes include fears of death and dying, guilt, concerns about exposure of a homosexual life-style, fear of contagion, loss of self-esteem, decreased social support and increased dependency needs, stigmatization, loss of occupational and financial security, confusion over medical treatment options, and severe depression. The integration of a mental health service into AIDS special care hospital wards and participation in support groups are particularly useful for men with AIDS. Anxiety is the major clinical symptom among those who have not developed full-blown AIDS, but show signs of immune suppression. Issues for men in this "gray zone" include isolation, poor social and occupational functioning due to fatigue, shame, and frustration of achievement needs. Stress- reduction techniques are especially important with this population, to eliminate further compromise to the immune system or even to strengthen it. Many asymptomatic gay men ("the worried well") are manifesting acute psychological symptoms such as panic, generalized anxiety, obsessional thinking about AIDS, and somatization. Training in the negotiation of safe-sex agreements can reduce some of this anxiety. In general, the AIDS epidemic has introduced an existential component to psychotherapy with gay men, with a concern over issues such as the meaning of life and death.     

Misperception Among Gay Men of the Risk for AIDS Associated with Their Sexual Behavior1

Until a vaccine against AIDS is developed, the most effective strategy for preventing the spread of the disease among gay men, the largest risk group, is to persuade them to abstain from particular kinds of sexual practices implicated in the transmission of the AIDS virus. Motivation to comply with risk-reduction guidelines, however, is dependent in part on a realistic appraisal of the degree of risk associated with one's sexual practices. Data are presented from 160 asymptomatic gay men. Their subjective assessment of the riskiness of their sexual behavior is compared to an objective assessment of the riskiness of their sexual practices. Factors associated with a tendency to underestimate the riskiness of one's practices are examined. Finally, the implications of the findings for public health education efforts among gay men are discussed.     

The AIDS Risk Reduction Model: Examining Intentions to Use Condoms Among Injection Drug Users1

This paper uses the AIDS Risk Reduction Model (ARRM) to examine psychosocial factors involved in adopting safer sex practices in a sample of Los Angeles injection drug users (IDUs; n= 161) who reported having more than one sex partner in the year preceding the interview. The ARRM hypothesizes that behavior change is a process occurring in three stages: (a) labeling one's behavior as problematic, (b) making a commitment to behavior change, and (c) taking action to accomplish that change. We test the first two stages of the model using a measure of perceived risk of HIV infection (Stage I), and intentions to use condoms always during vaginal or anal sex in the next year (Stage 2). We examine differences in the predictive value of the ARM between IDUs who reported using condoms in the year prior to the interview and those who reported not using them. We identify leverage points in the model-factors which appear to have a major influence on intentions to use condoms and which may be amenable to change through educational or other types of intervention. For both condom users and non-users, susceptibility to AIDS predicted perceived infection risk (Stage I). For condom users, knowledge about AIDS also predicted perceived risk. For both groups, self efficacy, peer norms concerning condom use, and the perceived pleasure of using condoms predicted intentions to use condoms (Stage 2). Our findings do not support either direct or indirect relationships between the Stage 1 and Stage 2 outcome variables for either group.     

Cross-sectional and Longitudinal associations in coping strategies and physical health outcomes among HIV-Positive youth

This study assessed whether coping styles had an influence on physical health outcomes either concurrently or longitudinally in a sample of HIV-positive youth. Coping styles were characterized as positive, passive, depressive withdrawal, and escapist. A cross-sectional latent variable analysis (N = 279) assessed associations among environmental stress, self-esteem, social support, coping styles, AIDS symptoms, and CD4 count. A more restricted longitudinal analysis (N = 174) tested associations among earlier environmental stress, self-esteem, coping styles, and AIDS symptoms at follow-up. CD4 count was not associated with coping styles in the cross-sectional analysis. Concurrent AIDS symptoms were significantly predicted by depressive withdrawal and environmental stress. A passive coping style modestly predicted more AIDS symptoms longitudinally. Correlates of perceived health and well-being of persons with HIV/AIDS are important to investigate in addition to more objective measures such as CD4 count that may not be amenable to change through coping style interventions alone.     

Maternal borderline personality disorder symptoms and adolescent psychosocial functioning

Borderline personality disorder (BPD) is characterized by severe disruption of interpersonal relationships, yet very little research has examined the relationship between maternal BPD and offspring psychosocial functioning. The present study examined 815 mothers and their 15-year-old children from a community-based sample to determine (1) if there is an association between mothers' BPD symptoms and the interpersonal functioning, attachment cognitions, and depressive symptoms of their offspring, and (2) if the association of maternal BPD and youth outcomes is independent of maternal and youth depression. Measures of youth psychosocial functioning included self, mother, interviewer rated, and teacher reports. Results indicated that there was a significant association between maternal BPD symptoms and youth outcomes, and that this association remained even after controlling for maternal lifetime history of major depression, maternal history of dysthymic disorder, and youth depressive symptoms. This study provides some of the first empirical evidence for a link between mother's BPD symptoms and youth psychosocial outcomes.