Leyro Teresa M, Vujanovic Anka A, Bonn-Miller Marcel O
Department of Psychology, Rutgers, The State University of New Jersey, Tillett Hall, 53 Avenue E, Piscataway, NJ, 08853, USA,
Int J Behav Med. 2015 Feb;22(1):139-48. doi: 10.1007/s12529-014-9404-8.
Little research on symptom impairment and quality of life among HIV-positive (HIV+) individuals has attended to the potential role of cognitive-affective vulnerabilities. Emerging research indicates that emotion regulation (ER), anxiety sensitivity (AS), and distress tolerance (DT) are associated with a range of mental health outcomes and demonstrate meaningful relations to clinical outcomes in HIV+ individuals.
In this investigation, we sought to concurrently examine these factors in relation HIV symptom severity, barriers to medication adherence, and disease viral load.
Participants were 139 HIV+ individuals (34 female; age M = 48.2 years, SD = 8.1, 42% Black) receiving outpatient HIV care and prescribed at least one antiretroviral medication. We used hierarchical regression analyses to concurrently examine ER, AS, and DT in relation to severity of HIV symptoms, barriers to medication adherence, and disease viral load.
After accounting for alcohol use problems, cannabis dependence, gender, and education, AS was significantly associated with HIV symptom severity (β = .35, p < .01) whereas ER evidenced a trend relation (β = .19, p = .07). ER (β = .45, p < .01), but not AS or DT, was significantly related to barriers to medication adherence, above and beyond variance accounted for by covariates. Finally, ER evidenced a trend level relation to viral load (β = .21, p = .07), above and beyond variance accounted for by cannabis use.
Findings provide an extension of previous research, suggesting unique roles of cognitive-affective vulnerabilities in terms of HIV symptom severity, medication use barriers, and infection symptomatology, and inform the refinement of current treatments for HIV+ individuals so as to improve functioning.
在感染人类免疫缺陷病毒（HIV）呈阳性（HIV+）的个体中，针对症状损害和生活质量的研究很少关注认知-情感脆弱性的潜在作用。新出现的研究表明，情绪调节（ER）、焦虑敏感性（AS）和痛苦耐受性（DT）与一系列心理健康结果相关，并且在HIV+个体中与临床结果存在有意义的关系。
在本研究中，我们试图同时考察这些因素与HIV症状严重程度、药物依从性障碍和疾病病毒载量之间的关系。
研究参与者为139名接受门诊HIV治疗且至少开具了一种抗逆转录病毒药物的HIV+个体（34名女性；年龄M = 48.2岁，标准差SD = 8.1，42%为黑人）。我们使用分层回归分析同时考察ER、AS和DT与HIV症状严重程度、药物依从性障碍和疾病病毒载量之间的关系。
在考虑了酒精使用问题、大麻依赖、性别和教育因素后，AS与HIV症状严重程度显著相关（β = 0.35，p < 0.01），而ER呈现出一种趋势关系（β = 0.19，p = 0.07）。ER（β = 0.45，p < 0.01），而非AS或DT，与药物依从性障碍显著相关，且超出了协变量所解释的方差。最后，ER与病毒载量呈现出一种趋势水平的关系（β = 0.21，p = 0.07），且超出了大麻使用所解释的方差。
研究结果扩展了先前的研究，表明认知-情感脆弱性在HIV症状严重程度、药物使用障碍和感染症状方面具有独特作用，并为优化当前针对HIV+个体的治疗方法以改善其功能提供了参考。
