Cognitive-behavioral stress management in a symptomatic HIV-1 seropositive population: Effects on mood, coping, immune and neuroendocrine factors

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Michael H. Antoni - Committee Chair

Second Committee Member

Gail Ironson - Committee Member


This study examined the effect of a ten week group cognitive behavioral intervention on mood, coping, social support, and on immunologic and neuroendocrine parameters as compared to a wait-list and one day seminar control group in 24 symptomatic HIV-1 seropositive gay men. Psychosocial and physiological measures were taken before and after the ten-week intervention. The intervention significantly attenuated depression as measured by the BDI, and anxiety as measured by the POMS over the course of the study. Over the 10-week period, the control group demonstrated significant decreases in acceptance of HIV status and in ability to see their situation in a new light while the intervention buffered these changes. There were no significant intervention effects on other aspects of coping, social support, intrusive or avoidant cognitions. Immunologically, the intervention produced significant pre-post intervention decreases in HSV-2 antibody levels, while the control group showed no significant changes. Intervention-related effects were not observed on other immunological parameters, including other herpesvirus antibodies (EBV-VCA, CMV, HHV6, or HSV-1), neopterin levels, CD4 cell percentages, numbers, or subsets, or in CD8 cells. The intervention did not produce any significant group differences in 24 hour urinary norepinephrine, epinephrine, or cortisol levels. Individual difference analyses revealed the following relationships: (1) Greater increases in IES avoidance were significantly positively associated with a number of markers indicating poorer immunologic functioning. (2) Increased acceptance and social support and decreased denial were significantly associated with decreased neopterin levels over the study period. (3) Individuals practicing relaxation more frequently had significantly lower levels of 24 hour urinary norepinephrine, but not of epinephrine. (4) Greater increases in overall distress (measured by the POMS TMD) were found to be significantly associated with increased cortisol levels. (5) Increased depression (BDI) was associated with higher HSV-2 antibody levels. These findings extend previous research by showing that even in symptomatic HIV seropositive men, a short-term CBSM intervention can be effective in reducing depression and anxiety, and in attenuating HSV-2 antibody levels. Methodological considerations related to small sample size and possible confounds are discussed.


Psychology, Clinical; Health Sciences, Immunology; Psychology, Physiological

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