Murphy D A, Moscicki A B, Vermund S H, Muenz L R
Health Risk Reduction Projects, Department of Psychiatry, University of California at Los Angeles, Los Angeles, California, USA.
J Adolesc Health. 2000 Dec;27(6):391-8. doi: 10.1016/s1054-139x(00)00158-0.
To investigate the effects of life events, social support, and coping on anxiety and depression among human immunodeficiency virus (HIV)-infected adolescents. It was hypothesized that higher levels of stressful events would be associated with higher levels of anxiety and depression, but that this association would be moderated by satisfaction with social support and by adaptive coping.
HIV-infected adolescents from 16 locations in 13 U.S. cities (N = 230, median age 16.09 years, standard deviation 1.2, range 13-19; 77% females) were recruited into the Reaching for Excellence in Adolescent Care and Health (REACH) project. REACH is the first large-scale disease progression study of HIV(+) adolescents infected through sexual behavior or injection drug use. The adolescent assessment was conducted by audio-computer assisted self-interview. Least squares regressions were used to test hypotheses.
Life events with high impact were associated with higher levels of depression and anxiety. Frequently reported events included: being prescribed medications (74%), family financial problems (61%), and parental alcohol abuse (20%). Contrary to expectations, the buffering hypotheses of social support and adaptive coping were not supported. Satisfaction with social support and adaptive coping methods were both associated directly with lower levels of depression, but no association was detected between these two measures and anxiety.
Although life event distress was directly associated with psychological distress, neither social support nor adaptive coping seemed to moderate this association. However, both satisfaction with support and adaptive coping were associated directly with depression in HIV-infected adolescents.
探讨生活事件、社会支持和应对方式对感染人类免疫缺陷病毒（HIV）的青少年焦虑和抑郁的影响。研究假设为，较高水平的应激事件会与较高水平的焦虑和抑郁相关，但这种关联会受到对社会支持的满意度和适应性应对方式的调节。
从美国13个城市的16个地点招募了感染HIV的青少年（N = 230，中位年龄16.09岁，标准差1.2，年龄范围13 - 19岁；77%为女性）参与“青少年关爱与健康卓越计划”（REACH）项目。REACH是首个针对通过性行为或注射吸毒感染HIV的青少年进行的大规模疾病进展研究。青少年评估通过音频计算机辅助自我访谈进行。采用最小二乘法回归来检验假设。
具有高影响力的生活事件与较高水平的抑郁和焦虑相关。经常报告的事件包括：被开处方药（74%）、家庭财务问题（61%）以及父母酗酒（20%）。与预期相反，社会支持和适应性应对的缓冲假设未得到支持。对社会支持的满意度和适应性应对方式均与较低水平的抑郁直接相关，但未发现这两种测量方式与焦虑之间存在关联。
尽管生活事件困扰与心理困扰直接相关，但社会支持和适应性应对似乎均未调节这种关联。然而，对支持的满意度和适应性应对均与感染HIV的青少年的抑郁直接相关。
