Salama Christina, Morris Mary, Armistead Lisa, Koenig Linda J, Demas Penelope, Ferdon Corinne, Bachanas Pamela
Department of Psychology, Georgia State University, Atlanta, USA.
AIDS Care. 2013;25(2):160-8. doi: 10.1080/09540121.2012.687815. Epub 2012 Jun 12.
Emerging research suggests the importance of psychosocial characteristics (e.g., coping and social support) for positive adaptation among youth with behaviorally acquired HIV. However, little is known about how these traits interact with cognitive abilities to impact emotional and behavioral adjustment. This study examined whether coping skills and executive functioning interact in their association with psychological adjustment in HIV-positive youth. Data from Project Adolescents Living with HIV/AIDS (ALPHA), a study to examine psychosocial, behavioral and neuropsychological functioning of youth with behaviorally acquired HIV, were used. Fifty-nine participants, aged 14-23, diagnosed with HIV prior to age 20 and receiving care in one of two HIV clinics in Atlanta or New York City, were recruited, consented and enrolled. Participants completed measures of depressive symptoms (Beck Depression Inventory), conduct disorder (Adolescent Symptom Index), and use of positive and negative coping strategies (Kidcope). The Wisconsin Card Sorting Test (WCST) assessed abstract reasoning (categories completed) and cognitive inflexibility (perseverative errors). In this sample of HIV-positive youth, depressive symptoms were best predicted by an interactive combination of negative coping skills and poor neuropsychological functioning. Neuropsychological functioning (cognitive inflexibility) and negative coping skills were directly associated with conduct disorder symptoms. Results highlight the importance of including neuropsychological assessment in the evaluation of HIV-positive youth, particularly those with emotional or behavioral problems.
新出现的研究表明，心理社会特征（如应对方式和社会支持）对于行为感染艾滋病毒的青少年实现积极适应具有重要意义。然而，对于这些特征如何与认知能力相互作用以影响情绪和行为调整，我们却知之甚少。本研究考察了应对技能和执行功能在与艾滋病毒阳性青少年的心理调整之间的关联中是否存在相互作用。研究使用了“青少年与艾滋病毒/艾滋病共存项目”（ALPHA）的数据，该项目旨在研究行为感染艾滋病毒的青少年的心理社会、行为和神经心理功能。招募了59名年龄在14至23岁之间、20岁之前被诊断出感染艾滋病毒且在亚特兰大或纽约市的两家艾滋病毒诊所之一接受治疗的参与者，他们均签署了知情同意书并被纳入研究。参与者完成了抑郁症状测量（贝克抑郁量表）、品行障碍测量（青少年症状指数）以及积极和消极应对策略的使用情况测量（儿童应对量表）。威斯康星卡片分类测验（WCST）评估了抽象推理能力（完成的类别数）和认知灵活性（持续性错误）。在这个艾滋病毒阳性青少年样本中，消极应对技能和较差的神经心理功能的交互组合最能预测抑郁症状。神经心理功能（认知灵活性）和消极应对技能与品行障碍症状直接相关。研究结果凸显了在评估艾滋病毒阳性青少年，尤其是那些有情绪或行为问题的青少年时纳入神经心理评估的重要性。
