Title

The effects of a cognitive/behavioral stress management program on psychological distress and the immune system in HIV-1 seropositive and seronegative gay men

Date of Award

1992

Availability

Article

Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Michael H. Antoni, Committee Chair

Abstract

Psychological and immunologic effects of a ten week cognitive/behavioral stress management (CBSM) program were assessed for HIV-1 seropositive (HIV+) and seronegative (HIV$-$) gay men. Forty-nine gay men were randomly assigned to a CBSM group (N = 14 HIV$-$; N = 10 HIV+) or an assessment only control group (N = 16 HIV$-$; N = 9 HIV+). Both groups learned of their HIV-1 serostatus during the 5th week of the protocol. The CBSM group met twice a week for ten weeks and the program consisted of cognitive restructuring techniques, assertiveness training, coping skills, and progressive muscle relaxation training. In addition to psychological (anxiety, depression) and immunologic (CD4#, CD56#, NKCC, PHA, PWM) measures, both groups were assessed on potential immunomodulatory confounds (i.e., alcohol abuse, sleep, physical activity, sexual behavior). An additional seven HIV+ subjects served in a second protocol and received the same CBSM program but entered the study already knowing their HIV serostatus. Differences in psychological distress measures between protocols were examined. Within protocol 1 HIV$-$ controls showed a decrease in anxiety while HIV$-$ CBSM subjects showed a marginal increase across the 10 week period. Similarly, HIV+ controls also significantly reduced anxiety while HIV+ CBSM subjects showed no changes across the 10 weeks. No changes were found in depression for any of the groups. HIV$-$ CBSM subjects showed significant increases in CD4# while HIV$-$ controls showed increases in lymphocyte responsivity to PHA across the 10 weeks. Relaxation frequency was associated with decreases in anxiety for HIV$-$ men when post-notification effects were partialled out. No significant relationships were found between relaxation frequency and distress for HIV+ subjects. HIV+ subjects, however, showed positive associations between relaxation frequency and both PWM and NKCC values. Finally, no differences in psychological distress were found between protocol 1 and protocol 2, suggesting that participation in the program itself rather than HIV-1 status notification was responsible for changes in distress measures.

Keywords

Psychology, Psychobiology; Psychology, Behavioral

Link to Full Text

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