Lewis Jennifer V, Abramowitz Susan, Koenig Linda J, Chandwani Sulachni, Orban Lisa
a Department of Pediatric Infectious Diseases , NYU Langone Medical Center , New York , NY , USA.
b Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA.
AIDS Care. 2015;27(10):1265-74. doi: 10.1080/09540121.2015.1050984. Epub 2015 Aug 27.
The prevalence of negative life events (NLE) and daily hassles, and their direct and moderated associations with depression, were examined among HIV-infected adolescents. Specifically, we examined whether the negative association with depression of NLE, daily hassles, and/or passive coping were moderated by social support or active coping strategies. Demographic characteristics, depression, coping, social support, NLE, and daily hassles were collected at baseline as part of the Adolescent Impact intervention via face-to-face and computer-assisted interviews. Of 166 HIV-infected adolescents, 53% were female, 72.9% black, 59.6% with perinatally acquired HIV (PIY), the most commonly reported NLE were death in family (81%), violence exposure (68%), school relocation (67%), and hospitalization (61%); and for daily hassles "not having enough money (65%)". Behaviorally infected youth (BIY--acquired HIV later in life) were significantly more likely to experience extensive (14-21) lifetime NLE (38.8% vs. 16.3%, p < .012) than PIY. In multiple stepwise regression analysis, the model accounting for the greatest variability in depression scores (32%) included (in order of entry): daily hassles, low social support, behaviorally acquired HIV, minority sexual orientation, and passive coping. A significant passive coping-by-social support interaction revealed that the association between passive coping and depression was exacerbated when social support was low. Social support moderated the effect of NLE, such that NLE were associated with greater depression when social support was low, although the effect did not remain statistically significant when main effects of other variables were accounted for. Daily hassles, poor coping, and limited social support can adversely affect the psychological well-being of HIV-infected adolescents, particularly sexual minority youth with behaviorally acquired HIV. Multimodal interventions that enhance social support and teach adaptive coping skills may help youth cope with environmental stresses and improve mental health outcomes.
在感染艾滋病毒的青少年中，研究了负面生活事件（NLE）和日常烦恼的患病率，以及它们与抑郁症的直接和调节关联。具体而言，我们研究了社会支持或积极应对策略是否会调节NLE、日常烦恼和/或消极应对与抑郁症之间的负相关。作为青少年影响干预的一部分，在基线时通过面对面和计算机辅助访谈收集了人口统计学特征、抑郁症、应对方式、社会支持、NLE和日常烦恼。在166名感染艾滋病毒的青少年中，53%为女性，72.9%为黑人，59.6%为围产期感染艾滋病毒（PIY），最常报告的NLE是家人死亡（81%）、接触暴力（68%）、学校搬迁（67%）和住院（61%）；日常烦恼方面是“没有足够的钱（65%）”。行为感染青年（BIY——在生命后期感染艾滋病毒）比PIY更有可能经历广泛（14 - 21个）的终生NLE（38.8%对16.3%，p < 0.012）。在多元逐步回归分析中，解释抑郁症得分最大变异性（32%）的模型（按进入顺序）包括：日常烦恼、低社会支持、行为感染艾滋病毒、少数性取向和消极应对。显著的消极应对与社会支持的交互作用表明，当社会支持较低时，消极应对与抑郁症之间的关联会加剧。社会支持调节了NLE的影响，即当社会支持较低时，NLE与更严重的抑郁症相关，尽管在考虑其他变量的主效应时，这种影响在统计学上不再显著。日常烦恼、不良应对方式和有限的社会支持会对感染艾滋病毒的青少年的心理健康产生不利影响，尤其是行为感染艾滋病毒的性少数青年。增强社会支持并教授适应性应对技能的多模式干预措施可能有助于青少年应对环境压力并改善心理健康结果。
