Telephone Intervention /Depressed Older Adults /HIV/AIDS

描述(申请人提供)：截至2000年6月，超过81,000人 在美国，艾滋病携带者年龄在50岁或以上 盗窃案诊断的时间。然而，由于艾滋病心理健康研究已经 主要关注患有艾滋病毒的年轻人，许多人 老年医生对老年人的心理健康需求缺乏概念化。 感染艾滋病毒/艾滋病的老年人。通过一系列初步研究 在NIA的支持下，我们的研究团队表征了生活压力源的水平 中老年负担、应对困难与心理困扰的相关研究 以及感染艾滋病毒/艾滋病的老年人。我们的形成性研究预示 许多感染艾滋病毒的老年人抑郁水平升高 症状学和自杀意念，高水平的生活应激源负担，以及 与世隔绝的感觉更加强烈。最近，私家侦探和同事们 证明了一个旨在改善应对方式的团体干预 特别是针对感染艾滋病毒的老年人可以提高调整力度 以及这一群体的生活质量。采用滞后处理的对照组 设计，拟议的I期临床试验将评估短期和 电话传递的应对方式改善组的长期效果 对80例50岁以上HIV感染者调整努力的干预 符合抑郁症诊断标准的年龄。干预措施是 基于Lazarus和Folkman(1984)的压力和应对的交易模型 并使用认知-行为原理来提高应对压力的技能 评估、应对决策和获得社会支持。参与者将 在三个不同的评估点完成电话调查 测量共病健康状况、认知功能、 生活压力源负担、应对方式、应对自我效能感、精神病学 苦恼、生活质量和对社会支持的看法。初步测试 对40名参与者进行干预，然后进行交叉验证 对另一组40名老年人的干预将评估 电话传递式改善应对干预的有效性。在……里面 除了提供干预的初步测试外，研究数据还将 通知开发向NIH申请进行第三阶段的申请 电话递送、改善应对方式团体干预的临床试验 针对情绪脆弱的老年抑郁症艾滋病毒携带者群体 感染。

DESCRIPTION (provided by applicant): Through June 2000, more than 81,000 persons living with AIDS in the United States were 50 years of age or older at the time of theft diagnosis. However, because AIDS mental health research has focused primarily on young individuals living with HIV disease, many geropractitioners have a poor conceptualization of the mental health needs of older adults living with HIV/AIDS. Across a series of preliminary studies supported by NIA, our study team has characterized levels of life-stressor burden, coping difficulties, and psychological distress among late middle-aged and older adults living with HIV/AIDS. Our formative research portends that many HIV-infected older adults experience elevated levels of depressive symptomatology and suicidal ideation, high levels of life-stressor burden, and heightened perceptions of isolation. Recently, the P.I. and colleagues demonstrated that a coping improvement group intervention designed specifically for HIV-infected older adults can improve the adjustment efforts and life quality of this group. Using a lagged-treatment control-group design, the proposed Phase I clinical trial will evaluate the short-term and longer-term effects of a telephone-delivered, coping improvement group intervention on the adjustment efforts of 80 HIV-infected persons 50-plus years of age who meet diagnostic criteria for depression. The intervention is based on Lazarus and Folkman's (1984) Transactional Model of Stress and Coping and uses cognitive-behavioral principles to improve skills in stress appraisal, coping decisions, and obtaining social support. Participants will complete telephone-based surveys at three different assessment points measuring the prevalence of comorbid health conditions, cognitive functioning, life-stressor burden, ways of coping, coping self-efficacy, psychiatric distress, quality of life, and perceptions of social support. An initial test of the intervention with 40 participants, followed by a cross-validation of the intervention with a second group of 40 older adults, will assess the effectiveness of the telephone-delivered coping improvement intervention. In addition to providing a preliminary test of the intervention, study data will inform the development of an application to NIH to conduct a Phase III clinical trial of a telephone-delivered, coping improvement group intervention for the emotionally-vulnerable group of depressed older adults living with HIV infection.