title: The role of perceived social support in loneliness and self-esteem among children affected by HIV/AIDS: a longitudinal multilevel analysis in rural China.
abstract: OBJECTIVE
  To delineate the trajectories of loneliness and self-esteem over time among children affected by parental HIV and AIDS, and to examine how their perceived social support (PSS) influenced initial scores and change rates of these two psychological outcomes.
  
  
  METHODS
  We collected longitudinal data from children affected by parental HIV/AIDS in rural central China. Children 6-18 years of age at baseline were eligible to participate in the study and were assessed annually for 3 years.
  
  
  METHODS
  Multilevel regression models for change were used to assess the effect of baseline PSS on the trajectories of loneliness and self-esteem over time. We employed maximum likelihood estimates to fit multilevel models and specified the between-individual covariance matrix as 'unstructured' to allow correlation among the different sources of variance. Statistics including -2 Log Likelihood, Akaike Information Criterion and Bayesian Information Criterion were used in evaluating the model fit.
  
  
  RESULTS
  The results of multilevel analyses indicated that loneliness scores significantly declined over time. Controlling for demographic characteristics, children with higher PSS reported significantly lower baseline loneliness score and experienced a slower rate of decline in loneliness over time. Children with higher PSS were more likely to report higher self-esteem scores at baseline. However, the self-esteem scores remained stable over time controlling for baseline PSS and all the other variables.
  
  
  CONCLUSIONS
  The positive effect of PSS on psychological adjustment may imply a promising approach for future intervention among children affected by HIV/AIDS, in which efforts to promote psychosocial well being could focus on children and families with lower social support. We also call for a greater understanding of children's psychological adjustment process in various contexts of social support and appropriate adaptations of evidence-based interventions to meet their diverse needs.
authors.affiliation: aPrevention Research Center, Carman and Ann Adams Department of Pediatrics, School of Medicine, Wayne State University, Detroit, Michigan, USA bInstitute of Behavior and Psychology, Henan University, Kaifeng, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Qiao
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.forename: Guoxiang
authors.initials: G
authors.lastname: Zhao
authors.forename: Junfeng
authors.initials: J
authors.lastname: Zhao
authors.forename: Bonita
authors.initials: B
authors.lastname: Stanton
mesh_terms: D000293:Adolescent; D002648:Child; D002681:China; D005192:Family Health; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008132:Loneliness; D008137:Longitudinal Studies; D008297:Male; D055361:Multilevel Analysis; D010287:Parent-Child Relations; D012424:Rural Population; D012649:Self Concept; D012944:Social Support