Conscientiousness predicts disease progression (CD4 number and viral load) in people living with HIV.

OBJECTIVE: Psychosocial factors (e.g., depression, avoidant coping, life stress) have been related to disease progression in HIV. This study examined the relationship between the Big Five Conscientiousness factor and HIV disease progression (CD4 cell and viral load) over 1 year in 119 seropositive participants. The study also examined whether Conscientiousness effects were mediated by adherence, perceived stress, depression, or coping measures. DESIGN: In a 1-year longitudinal design, participants completed the NEO Five-Factor Inventory Conscientiousness scale (P. T. Costa & R. R. McCrae, 1992). Participants also completed psychosocial assessments and underwent blood draws at initial assessments and 1-year follow-up. MAIN OUTCOME MEASURES: Multiple hierarchical regression models were used to predict change in CD4 cell numbers and viral load log 10, controlling for demographic variables, initial disease status, and antiretroviral medications. RESULTS: Conscientiousness predicted significant increases in CD4 number and significant decreases in viral load at 1 year. Conscientiousness was related positively to medication adherence and active coping and negatively to depression and perceived stress. Only perceived stress emerged as a possible mediator. CONCLUSION: The significant relationship between Conscientiousness and medication adherence, distress, and coping suggests that an assessment of Conscientiousness in patients with HIV may help specify or target behavioral interventions to promote optimal disease management.     

Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients.

Much work on psychosocial sequelae of breast cancer has been guided by the assumption that body image and partner reaction issues are focal. In a tri-ethnic sample of 223 women treated for early-stage breast cancer within the prior year, the authors assessed a wider range of concerns and relations to well-being. Strongest concerns were recurrence, pain, death, harm from adjuvant treatment, and bills. Body-image concerns were moderate; concern about rejection was minimal. Younger women had stronger sexual and partner-related concerns than older women. Hispanic women had many stronger concerns and more disruption than other women. Life and pain concerns and sexuality concerns contributed uniquely to predicting emotional and psychosexual disruption; life and pain concerns and rejection concerns contributed to predicting social disruption. In sum, adaptation to breast cancer is a process bearing on several aspects of the patient's life space.     

Social Support Mediates Loneliness and Human Herpesvirus Type 6 (HHV-6) Antibody Titers

The current study investigated the impact of a severe environmental stressor and the role that declining social integration played in mediating its effect on loneliness and immune status. Increased loneliness and decreased social support in the months following the stressor (storm) were significantly associated with increased HHV-6 antibody liters, reflecting poorer control over the virus. Poorer social integration mediated the relationship between loneliness and HHV-6, even after controlling for nonspecific polyclonal B-cell activation, disease status (CD3+CD4+ cell counts), living arrangements, acute social losses (bereavement), and potential disruptions in social-support resources. These findings suggest that specific elements of social support may explain the oft-noted negative effects of loneliness on the immune system, and generalized to a medically vulnerable population.     

God-mediated control beliefs and the Epstein-Barr virus: Is more God-mediated control always better?

Research on the locus of control construct conveys the impression that more control is always better. However, some studies suggest that very high levels of control are associated with negative outcomes. The purpose of this study was to see if this is true of religiously oriented feelings of control (i.e., God-mediated control). The outcome was antibody titers to the Epstein-Barr virus (EBV). The findings suggest that very high God-mediated control is associated with higher EBV values. However, this finding was only observed among young adults (age 18–40), but not among middle-aged (age 41–64), or older adults (aged 65 and older).     

The Protective Role of the Family and Social Support Network in a Sample of HIV-Positive African American Women: Results of a Pilot Study

This study examined the role of family functioning and social support in protecting HIV-positive African American women from the adverse psychological consequences associated with deterioration in their CD4 cell count. Participants were 38 African American HIV-positive women who had recently given birth. Results demonstrated that changes in CD4 cell counts were inversely predictive of psychological distress and were moderated by family functioning and social support satisfaction. Women with good family functioning were less affected by changes in their CD4 cell counts, and women with poor family functioning were more emotionally responsive to changes in CD4 cell count. Unexpectedly, women from families where conflicts tended to be clearly laid out and discussed were also more responsive to both changes in CD4 cell counts. Interventions are recommended that increase a client's social support satisfaction, foster an adaptive level of connectedness to family, and enhance the family's range of conflict resolution styles.     

Religious involvement,God images,and life satisfaction

This study addresses two issues. The first is to identify the aspects of religious life that are associated with benevolent images of God including denominational affiliation (Conservative Christians versus others), church attendance, and church-based social support (i.e., spiritual support). Data from a nationwide survey suggests that church-based support appears to be the most consequential. The second issue involves embedding these constructs in a conceptual model that traces effects of benevolent God images on life satisfaction. The following hypotheses form the core of this model: (1) Conservative Christians will attend worship services more often, (2) individuals who go to church more often tend to receive more support, (3) people who receive more support are more likely to have benevolent images of God, (4) benevolent images of God are associated with greater hope, and (5) greater hope is associated with greater life satisfaction. The findings provide support for each hypothesis.     

Humility,stressful life events,and psychological well-being: Findings from the landmark spirituality and health survey

A growing body of research suggests that people who are more humble tend to enjoy better physical and mental health than individuals who are less humble. The next step in moving this literature forward involves explaining and empirically demonstrating how the potentially beneficial effects of humility arise. The purpose of this study is to address this issue by seeing whether humility buffers the effects of stressful life events on four measures of well-being: happiness, life satisfaction, depressed affect, and generalized anxiety disorder. Data from a new nationwide survey (N = 3010) suggest that the magnitude of the negative relationship between stressful life events and all four measures of well-being is reduced among people who are more humble. The theoretical implications of these findings are discussed.     

Verhaltensmedizin bei HIV-Infektion

Zusammenfassung Unsere Studien über asymptomatische, mit dem "human immunodeficiency virus" (HIV) infizierte homosexuelle Männer zeigen, dass kognitiv-behaviorales Stressmanagement (CBSM) ein geeignetes Mittel ist, die durch die Mitteilung eines positiven HIV-Befundes verursachte psychische Belastung zu reduzieren und zugleich einige immunologische Parameter zu modifizieren. Aus neueren Studien über HIV-infizierte Männer mit Prä-Aids-Symptomatik geht hervor, dass CBSM beitragen kann: a) Dysphorie, Angst und Stresssymptome zu lindern; b) Kortisol und Noradrenalin zu reduzieren und die Testosteronwerte zu erhöhen; c) die Zahl der Antikörper gegen einige Herpes-Viren zu reduzieren und zugleich die Zahl der T-zytotoxischen/Suppressorzellen (CD8) und der naiven T-Helfer- (CD4-) Lymphozyten aufrechtzuerhalten. Vorläufige Daten unserer neuesten Studien weisen darauf hin, dass mit CBSM die Viruslast bei Männern, die hoch aktive antiretrovirale Therapie erhalten, reduziert werden kann.Aus dem Englischen übersetzt von Dipl.-Psych. Erika Nemény, Berlin und Prof. Dr. Ulrike Ehlert, Zürich     

A stress and coping model of medication adherence and viral load in HIV-positive men and women on highly active antiretroviral therapy (HAART).

The authors tested a structural model that incorporated age, time since diagnosis, social support, coping, and negative mood as predictors of medication adherence and HIV viral load on 188 men and 134 women on highly active antiretroviral therapy (HAART). The authors used psychosocial latent factors formed from baseline measures to predict latent factors of adherence, as assessed by electronic monitoring and self-report, and viral load defined by indicators assessed over a 15-month period. Results from the model indicate that greater negative mood and lower social support are related to greater use of avoidance-oriented coping strategies. Use of these coping strategies by patients on HAART is related to poorer medication adherence and, subsequently, higher viral load. This model advances researchers' understanding of the contribution of psychosocial variables in predicting treatment adherence and disease progression in HIV-positive men and women.