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减轻痛苦并增强恢复力:中国近期被诊断出感染艾滋病毒的男男性行为者中认知行为疗法技能干预的初步试验。

Reducing distress and promoting resilience: a preliminary trial of a CBT skills intervention among recently HIV-diagnosed MSM in China.

作者信息

Yang Joyce P, Simoni Jane M, Dorsey Shannon, Lin Zhang, Sun Meiyan, Bao Meijuan, Lu Hongzhou

机构信息

a Department of Psychiatry and Behavioral Sciences , Stanford University , Stanford , CA , USA.

b National Center for PTSD , VA Palo Alto Health Care System , Palo Alto , CA , USA.

出版信息

AIDS Care. 2018 Aug;30(sup5):S39-S48. doi: 10.1080/09540121.2018.1497768. Epub 2019 Jan 10.

Abstract

People living with HIV/AIDS (PLWHA) in China experience significant psychological distress, due to high rates of stigma and low availability of mental health resources. Recently diagnosed Chinese PLWHA who are men who have sex with men (MSM) are particularly vulnerable to distress, facing both HIV and sexual orientation stigma. Reducing distress and enhancing psychological resilience is critical in promoting wellbeing. However, no research to date has examined evidence-based interventions to reduce psychological symptoms and improve resilience in this population. Based on qualitative research on their mental health needs, we developed a culturally tailored, brief 3-session CBT skills-based intervention for integration into primary care [Yang, J. P., Simoni, J., Cheryan, S., Shiu, C., Chen, W., Zhao, H., & Lu, H. (2018). The development of a brief distress reduction intervention for individuals recently diagnosed with HIV in China. Cognitive Behavioral Practice, 25(2), 319-334. doi: 10.1016/j.cbpra.2017.08.002 ]. The intervention includes cognitive restructuring to address depressive thought patterns, behavioral activation to decrease isolation, and paced breathing to reduce anxiety. We conducted a pilot Type 1 hybrid effectiveness-implementation trial assessing pre-post mental health outcomes as well as feasibility, acceptability, and appropriateness information. Ten recently diagnosed MSM completed the research protocol of three individual weekly sessions. Paired-samples t tests demonstrated significant reduction in HIV-related distress, depression, problems with adjustment, as well as improvements in resilience, and perceived social support. Participants and community advisory board members found the intervention highly acceptable, appropriate, and feasible. Preliminary data from the first known study examining a psychological intervention with evidence-based components for recently diagnosed Chinese MSM suggests that this brief intervention may be useful for reducing distress and promoting resilience.

摘要

由于耻辱感发生率高且心理健康资源匮乏,中国的艾滋病毒/艾滋病感染者(PLWHA)面临着严重的心理困扰。最近被诊断出感染艾滋病毒的中国男男性行为者(MSM)特别容易产生困扰,他们既要面对艾滋病毒带来的耻辱,又要面对性取向方面的耻辱。减轻困扰并增强心理韧性对于促进健康至关重要。然而,迄今为止,尚无研究探讨基于证据的干预措施以减轻该人群的心理症状并提高其韧性。基于对他们心理健康需求的定性研究,我们开发了一种针对文化定制的、简短的、为期三节的基于认知行为疗法(CBT)技能的干预措施,以便纳入初级保健 [Yang, J. P., Simoni, J., Cheryan, S., Shiu, C., Chen, W., Zhao, H., & Lu, H. (2018). 为中国最近被诊断出感染艾滋病毒的个体开发一种简短的减轻困扰干预措施。《认知行为实践》, 25(2), 319 - 334。doi: 10.1016/j.cbpra.2017.08.002 ]。该干预措施包括认知重构以解决抑郁思维模式、行为激活以减少孤立感,以及有节奏的呼吸以减轻焦虑。我们进行了一项1型混合有效性 - 实施试验,评估心理健康前后结果以及可行性、可接受性和适宜性信息。十名最近被诊断出感染艾滋病毒的男男性行为者完成了每周一次的三次个人疗程的研究方案。配对样本t检验表明,与艾滋病毒相关的困扰、抑郁、适应问题显著减少,同时韧性和感知到的社会支持有所改善。参与者和社区咨询委员会成员发现该干预措施非常可接受、适宜且可行。来自第一项针对最近被诊断出感染艾滋病毒的中国男男性行为者进行的、包含基于证据成分的心理干预研究的初步数据表明,这种简短干预措施可能有助于减轻困扰并促进韧性。

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