Mark A. Vosvick

Effects of quality of life and coping on depression among adults living with HIV/AIDS.

This prospective study examined the effect of maladaptive coping strategies and psychological quality of life (QOL) on depression at two time points in a diverse sample of persons living with HIV/AIDS (N = 85). The use of maladaptive coping strategies to deal with the stress of living with HIV/AIDS, particularly engaging in various kinds of avoidant behaviors, was significantly associated with greater depression at baseline and increased depression at three months. QOL was the single most important predictor of depression. In an effort to develop effective clinical methods aimed at decreasing depression among adults living with HIV, future studies need to focus on improving quality of life and increasing adaptive coping strategies associated with the stress of living with HIV/AIDS.

Attachment style, stigma and psychological distress among HIV+ adults

This study explored the role of adult attachment style in reported experiences of HIV-related stigma, stress and depression in a diverse sample of HIV+ adults. Participants (N = 288) recruited from AIDS service organizations were administered the Experiences in Close Relationships Scale, Perceived Stress Scale, CES-D, HIV Stigma Scale and a health information questionnaire. Adult romantic attachment style was significantly associated with perceived stress, depression and HIV-related stigma. Results of regression analyses supported contentions that in addition to HIV symptomatology, other psychosocial risk factors such as attachment style and stigma contribute to perceived stress and depression among HIV+ men and women.

Spiritual striving, acceptance coping, and depressive symptoms among adults living with HIV/AIDS.

We prospectively examined the effects of spiritual striving, social support, and acceptance coping on changes in depressive symptoms among adults living with HIV/AIDS. Participants were 180 culturally diverse adults with HIV/AIDS. Participants completed measures of spiritual striving, social support, coping styles, and depressive symptoms at baseline, three-month follow-up, and six-month follow-up. A path model showed that spiritual striving had direct and indirect inverse effects on changes in depressive symptoms. The relationship between spiritual striving and depressive symptoms was partially mediated by acceptance coping, but not by social support. Results suggest that people living with HIV/AIDS who strive for spiritual growth in the context of their illness experience less negative affect.

Pessimism, Trauma, Risky Sex: Covariates of Depression in College Students.

OBJECTIVE To explain variance in depression in students (N = 648) using a model incorporating sexual trauma, pessimism, and risky sex. METHOD Survey data collected from undergraduate students receiving credit for participation. RESULTS Controlling for demographics, a hierarchical linear regression analysis [Adjusted R(2) = .34, F(5,642) = 67.38, P<.001] suggests that higher pessimism (t = 16.05, P < .001), more sexual trauma (t = 3.76, P<.001), and more risky sex (t = 3.40, P<.001) were associated with increased depression. Not being in a relationship (t = 3.54, P<.001) and being unemployed (t = 3.10, P<.01) also predicted more depression in students. CONCLUSIONS Results identify key access points for the treatment of depression in students.

Stress, social support and depression in informal caregivers to people with HIV/AIDS in Lomé, Togo

Purpose – This study examined factors associated with depression in 125 informal caregivers to adults living with HIV/AIDS in Lome, Togo.Methodology – Each caregiver completed a questionnaire that assessed primary and secondary stressors, social support and depression. Most of the participants were women (78 per cent), married (53 per cent), and had been giving care to nuclear family members (63 per cent) for about 11 months. OLS regression was used to examine the association of primary and secondary stressors with self‐reported depression.Findings – The analysis showed that caregiving demand, role captivity, and job conflict were positively associated with self‐reported depression. This suggests that work‐related strains and role strains were associated with depression levels among caregivers in our sample.Research limitations/implications – The study is based on a small convenience sample of volunteers and this may limit the generalisability of the results.Practical implications – This knowledge can ben...

Attachment, forgiveness, and physical health quality of life in HIV + adults

Abstract Research aims to help HIV + individuals improve and maintain a healthy quality of life, while managing a chronic illness. Using Lazarus and Folkmans model of stress and coping, we examined the main and interactive effects of attachment style and forgiveness on physical health quality of life of HIV + adults. Participants (n=288, 49% women) were recruited in Dallas/Fort Worth and self-identified as African-American (52%), European-American (32%), Latino(a) (12%), and other (4%), with an average age of 41.7 (SD=8.6). The average number of years participants reported being HIV + was 7.6 (SD=5.4). Participants completed medical and demographic information, measures assessing attachment anxiety and avoidance, forgiveness of self and others, and five quality of life scales (physical functioning, pain, role functioning, social functioning, and health perceptions). Significant correlations revealed that attachment anxiety was inversely related to physical health quality of life, while forgiveness of self was associated with greater quality of life. Hierarchical multiple regression analyses revealed that attachment anxiety and avoidance, forgiveness of self and others, as well as interactions between attachment style and forgiveness, were related to the physical health quality of life of HIV + adults. Interpretation of the interactions identified that for individuals who endorsed greater attachment anxiety, forgiveness of others was associated with greater pain, while forgiveness of self was associated with a greater perception of health. Research has indicated that forgiveness interventions lead to positive health outcomes for most individuals; however, in HIV + adults, whether an outcome is health promoting may be dependent on attachment style.

Correlates and Racial/Ethnic Differences in Bareback Sex Among Men Who Have Sex with Men with Unknown or Negative HIV Serostatus

Men who have sex with men (MSM), particularly racial/ethnic minority MSM, are disproportionately affected by HIV in the United States and Texas. Bareback sex or condomless anal intercourse (CAI) can be a high HIV risk behavior. Despite this, a majority of MSM continues to engage in barebacking. Research suggests racial/ethnic differences in barebacking exist; however, these conclusions remain unclear due to insufficient sample sizes to compare racial/ethnic groups. Our cross-sectional correlational design explores barebacking correlates (substance use during sex, safe sex fatigue, and optimistic HIV treatment beliefs) within and between racial/ethnic groups among 366 MSM. Regression models are significant for Latino and African-American MSM alone and for all MSM combined, though not significant for European-American and Other Race/Ethnicity MSM alone. Our findings suggest motivations and behaviors underlying barebacking among MSM vary by racial/ethnic membership with clinical implications for informing culturally sensitive HIV interventions and prevention programs for target racial/ethnic groups.ResumenEn los Estados Unidos de América y en el estado de Texas, los hombres que tienen sexo con hombres (HSH), en especial aquellos que forman parte de minorías raciales/étnicas, son afectados desproporcionadamente por el VIH. El sexo anal “bareback” o sin condón puede ser un riesgo para contraer VIH. Aun así, una gran mayoría de los HSH continúan teniendo sexo sin condón. Previas investigaciones sugieren que existen diferencias raciales/étnicas en cuanto al sexo anal sin condón, pero las conclusiones de estos estudios no son claras debido al insuficiente tamaño de las muestras de cada grupo racial/étnico. Nuestro estudio transversal con diseño correlacional explora varios correlatos (uso de sustancias durante el sexo, fatiga de tener sexo seguro, y creencias optimistas del tratamiento para el VIH) dentro y entre grupos raciales/étnicos entre 366 HSH. Los modelos de regresión son significantivos para los HSH Latinos y Afro-Americanos y para todos los grupos de HSH combinados, pero no son significantivos para los HSH Europeo-Americanos o HSH de otros grupos raciales/étnicos. Nuestros resultados sugieren que puede haber motivos o comportamientos subyacentes por los cuales tener sexo sin condón varía dependiendo del grupo racial/étnico, lo cual tiene implicaciones clínicas para desarrollar intervenciones y programas de prevención de VIH enfocados a minorías raciales/étnicas.

Psychological quality of life in a lesbian, gay, bisexual, transgender sample: Correlates of stress, mindful acceptance, and self-esteem.

Because of a history of marginalization, lesbians, gay men, bisexuals, and transgender (LGBT) individuals experience stress associated with their minority status (Meyer, 2003), which may threaten self-esteem (Herek, Gillis, & Cogan, 2009) and psychological quality of life (Radkowsky & Siegel, 1997). Mindful attention and self-esteem are associated with increased mental health (Rasmussen & Pidgeon, 2011); however, these constructs have not been studied together in a sample of LGBT people. We hypothesized that mindful acceptance and self-esteem explain a significant proportion of variance in psychological quality of life of LGBT individuals, and that the relationship between stress and psychological quality of life is moderated by mindful attention & self-esteem. We recruited 177 participants from the Dallas/Ft. Worth area and performed both a linear regression analysis and two moderation analyses to test our hypotheses. Controlling for age and years of education, we found that mindful acceptance and self-esteem accounted for a significant proportion of the variance in psychological quality of life (adj. R2 = .56, p = .02). Moderation analyses revealed that both mindful acceptance (&bgr; = −.17, p < .01) and self-esteem (&bgr; = .47, p < .01) moderate the relationship between stress and psychological quality of life. Our findings suggest that clinicians should consider the relationship between mindful acceptance, self-esteem, and stress when addressing the psychological quality of life of sexual and gender minorities. Future research should further examine positive psychological constructs of members of the LGBT communities in effort to address LGBT quality of life.