Can behavioral theory inform the understanding of depression and medication nonadherence among HIV-positive substance users?
Can behavioral theory inform the understanding of depression and medication nonadherence among HIV-positive substance users?
复制标题
行为理论能否帮助理解艾滋病毒阳性物质使用者的抑郁症和药物不依从性？
DOI：
10.1007/s10865-014-9606-1
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发表时间：
2015
影响因子：
3.1
通讯作者：
Daughters,StaceyB
中科院分区：
文献类型：
--
作者：
Magidson,JessicaF;Listhaus,Alyson;Seitz-Brown,CJ;Safren,StevenA;Lejuez,CW;Daughters,StaceyB
药物依从性对各种慢性疾病，特别是艾滋病毒/艾滋病的健康结果具有高度预测性。抑郁症总是与更差的依从性相关，但很少有研究试图了解抑郁症与依从性的关系。本研究测试了行为抑郁理论的三个组成部分-目标导向激活，正强化和环境惩罚-作为潜在的间接影响，在低收入，主要是非洲裔美国人的物质使用者（n= 83）之间的关系，抑郁症状和药物不依从性。药物不依从性被评估为在不依从性的常见原因中漏服剂量的频率。非参数自举法用于评估间接效应。在三个中介变量中，只有环境惩罚的间接影响;抑郁症状与更大的不遵守通过更大的环境惩罚。目标导向激活和正强化与坚持无关。研究结果表明，抑郁症和药物依从性之间的关系，环境惩罚的重要性，并可能为未来的干预工作，这一人群。
Medication adherence is highly predictive of health outcomes across chronic conditions, particularly HIV/AIDS. Depression is consistently associated with worse adherence, yet few studies have sought to understandhowdepression relates to adherence. This study tested three components of behavioral depression theory—goal-directed activation, positive reinforcement, and environmental punishment—as potential indirect effects in the relation between depressive symptoms and medication nonadherence among low-income, predominantly African American substance users (n= 83). Medication nonadherence was assessed as frequency of doses missed across common reasons for nonadherence. Non-parametric bootstrapping was used to evaluate the indirect effects. Of the three intermediary variables, there was only an indirect effect of environmental punishment; depressive symptoms were associated with greater nonadherence through greater environmental punishment. Goal-directed activation and positive reinforcement were unrelated to adherence. Findings suggest the importance of environmental punishment in the relation between depression and medication adherence and may inform future intervention efforts for this population.