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新诊断出 HIV 感染者的焦虑和抑郁预测因素:一项纵向研究。

Predictors of anxiety and depression among newly diagnosed people living with HIV: A longitudinal study.

机构信息

Department of Education and Psychology, Centro Universitario Cardenal Cisneros, Universidad de Alcalá, Madrid, Spain.

Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain.

出版信息

Scand J Psychol. 2020 Oct;61(5):616-624. doi: 10.1111/sjop.12621. Epub 2020 Jan 30.

Abstract

This longitudinal study examined whether past resilience and internalized stigma predicted anxiety and depression among newly diagnosed Spanish-speaking people living with HIV (PLWH). We also analyzed whether coping strategies mediated this relationship. Data were collected at two time points from 119 PLWH. Approximately a third of participants had scores indicative of anxiety symptoms, the same result was found for depressive symptoms. Structural equations modeling revealed that 61% of the variance of anxiety and 48% of the variance of depression 8 months after diagnosis was explained by the proposed model, which yielded a good fit to data. Anxiety and depressive symptoms were significantly and negatively predicted by positive thinking, thinking avoidance, and past resilience, and positively predicted by self-blame. Additionally, anxiety was positively predicted by internalized stigma. Past resilience negatively predicted internalized stigma, self-blame, and thinking avoidance and it positively predicted positive thinking. Internalized stigma positively predicted self-blame. Moreover, internalized stigma had a significant indirect effect on anxiety symptoms through self-blame, and past resilience had significant indirect effects on anxiety symptoms and depressive symptoms through internalized stigma and coping. The results point to the need for clinicians and policy makers to conduct systematic assessments and implement interventions to reduce internalized stigma and train people living with HIV to identify and use certain coping behaviors.

摘要

本纵向研究考察了过去的韧性和内化污名是否能预测新诊断出患有 HIV 的西班牙语裔人群(PLWH)的焦虑和抑郁。我们还分析了应对策略是否在这种关系中起中介作用。数据是从 119 名 PLWH 中在两个时间点收集的。大约三分之一的参与者的焦虑症状得分表明存在症状,抑郁症状的结果也是如此。结构方程模型显示,诊断后 8 个月,焦虑的 61%和抑郁的 48%的方差可由所提出的模型解释,该模型与数据拟合良好。焦虑和抑郁症状与积极思考、思维回避和过去的韧性呈显著负相关,与自责呈显著正相关。此外,焦虑与内化污名呈正相关。过去的韧性负向预测内化污名、自责和思维回避,正向预测积极思考。内化污名正向预测自责。此外,内化污名通过自责对焦虑症状有显著的间接影响,过去的韧性通过内化污名和应对策略对焦虑症状和抑郁症状有显著的间接影响。研究结果表明,临床医生和决策者需要进行系统评估并实施干预措施,以减少内化污名,并培训 HIV 感染者识别和使用某些应对行为。

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