Reductions in depressed mood and denial coping during cognitive behavioral stress management with HIV-Positive gay men treated with HAART.
BACKGROUND
Stress management interventions for HIV-positive persons have been designed to enhance coping skills and encourage health-promoting behaviors with the hope of decreasing distress and slowing disease progression.


OBJECTIVE
We examined the efficacy of a cognitive behavioral stress management (CBSM) intervention in combination with medication adherence training (MAT) in 130 gay and bisexual men living with HIV infection.


METHODS
Participants were randomized to either a 10-week CBSM+MAT intervention (n = 76) or a MAT-only condition (n = 54). Measures of self-reported adherence, active cognitive coping (i.e., acceptance and positive reinterpretation), avoidant coping (i.e., denial and behavioral disengagement), and depressed mood were examined over the 10-week intervention period.


RESULTS
Men in CBSM+MAT reported reductions in depressed mood and denial coping during the 10-week intervention period, but no changes in active cognitive coping or self-reported adherence were observed. Using path analysis, greater reliance on denial coping at baseline was associated with decreased depressed mood at 10 weeks. We also determined that CBSM+MAT may decrease depressed mood by reducing reliance on denial coping over the 10-week intervention period.


CONCLUSIONS
Although denial may be an effective means of distress reduction in the short term, reliance on this coping strategy may result in a decreased capacity to effectively manage a variety of disease-related stressors in the long term. CBSM+MAT addresses this potentially detrimental pattern by teaching stress reduction skills that may decrease depressed mood via reduced reliance on denial coping.
Department of Psychology, University of Miami, USA.
Adam W
AW
Carrico
Michael H
MH
Antoni
Ron E
RE
Duran
Gail
G
Ironson
Frank
F
Penedo
Mary Ann
MA
Fletcher
Nancy
N
Klimas
Neil
N
Schneiderman
D000222:Adaptation, Physiological; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D015928:Cognitive Behavioral Therapy; D003717:Denial, Psychological; D003863:Depression / Q000150:complications / Q000628:therapy; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010349:Patient Compliance; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology / Q000628:therapy; D019562:Viral Load
D019380:Anti-HIV Agents