Bennett David S, Hersh Jill, Herres Joanna, Foster Jill
Department of Psychiatry, GLAD Program, Drexel University, 4700 Wissahickon Avenue, Philadelphia, PA, 19144, USA.
Psychology Department, Immaculata University, Immaculata, PA, USA.
Child Psychiatry Hum Dev. 2016 Aug;47(4):657-64. doi: 10.1007/s10578-015-0599-y.
Youth living with HIV (YLH) are at elevated risk of internalizing symptoms, although there is substantial individual variability in adjustment. We examined perceived HIV-related stigma, shame-proneness, and avoidant coping as risk factors of internalizing symptoms among YLH. Participants (N = 88; ages 12-24) completed self-report measures of these potential risk factors and three domains of internalizing symptoms (depressive, anxiety, and PTSD) during a regularly scheduled HIV clinic visit. Hierarchical regressions were conducted for each internalizing symptoms domain, examining the effects of age, gender, and maternal education (step 1), HIV-related stigma (step 2), shame- and guilt-proneness (step 3), and avoidant coping (step 4). HIV-related stigma, shame-proneness, and avoidant coping were each correlated with greater depressive, anxiety, and PTSD symptoms. Specificity was observed in that shame-proneness, but not guilt-proneness, was associated with greater internalizing symptoms. In multivariable analyses, HIV-related stigma and shame-proneness were each related to greater depressive and PTSD symptoms. Controlling for the effects of HIV-related stigma and shame-proneness, avoidant coping was associated with PTSD symptoms. The current findings highlight the potential importance of HIV-related stigma, shame, and avoidant coping on the adjustment of YLH, as interventions addressing these risk factors could lead to decreased internalizing symptoms among YLH.
感染艾滋病毒的青少年（YLH）出现内化症状的风险较高，尽管他们在适应方面存在很大的个体差异。我们研究了感知到的与艾滋病毒相关的耻辱感、羞耻倾向和回避应对方式，将其作为YLH内化症状的风险因素。参与者（N = 88；年龄在12 - 24岁之间）在定期安排的艾滋病毒诊所就诊期间，完成了关于这些潜在风险因素以及内化症状三个领域（抑郁、焦虑和创伤后应激障碍）的自我报告测量。对每个内化症状领域进行了分层回归分析，考察了年龄、性别和母亲教育程度的影响（第一步）、与艾滋病毒相关的耻辱感的影响（第二步）、羞耻和内疚倾向的影响（第三步）以及回避应对方式的影响（第四步）。与艾滋病毒相关的耻辱感、羞耻倾向和回避应对方式均与更严重的抑郁、焦虑和创伤后应激障碍症状相关。观察到特异性在于，羞耻倾向而非内疚倾向与更严重的内化症状相关。在多变量分析中，与艾滋病毒相关的耻辱感和羞耻倾向均与更严重的抑郁和创伤后应激障碍症状相关。在控制了与艾滋病毒相关的耻辱感和羞耻倾向的影响后，回避应对方式与创伤后应激障碍症状相关。当前的研究结果突出了与艾滋病毒相关的耻辱感、羞耻感和回避应对方式对YLH适应的潜在重要性，因为针对这些风险因素的干预措施可能会减少YLH的内化症状。
