Efficacy of an Emotional Disclosure Intervention in HIV

艾滋病毒情绪表露干预的功效

• 批准号: 6891073
• 负责人: GAIL H IRONSON
• 金额: $ 64.72万
• 依托单位: UNIVERSITY OF MIAMI CORAL GABLES
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-15 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6891073
• 关键词: AIDS therapy; HIV infections; alternative medicine; behavioral /social science research tag; clinical research; coping; cortisol; emotions; helper T lymphocyte; high risk behavior /lifestyle; human subject; human therapy evaluation; injury /disease stressor; outcomes research; patient oriented research; quality of life; questionnaires; self concept; sex behavior; social support network; stress management; therapy compliance; virus load

DESCRIPTION (provided by applicant): With the advent of potent combination antiretroviral therapy, persons with HIV or AIDS now face the prospect of living longer with this disease as a chronic condition. In addition to the distress of having this chronic illness, persons with HIV infection have been shown to have high rates of sexual and physical abuse, other life stresses and traumas, and depression. Our previous research and others have documented the detrimental impact of stress, depression, lack of social support and avoidant coping strategies on immune changes and disease progression in HIV infection. Studies in normal adults and those with chronic illness have further documented improvements in medical symptoms and cellular immune response among those who disclose traumatic events through writing. Thus, the goal of the current study is to test the efficacy of emotional disclosure through writing in patients with HIV infection. We will compare two interventions, that is, emotional disclosure through writing about traumatic experiences (experimental) to writing about emotionally neutral topics (control) on the following: HIV disease progression, health status, psychosocial variables, and health behavior. Our study sample of HIV infected men and women will be recruited from South Florida. We will obtain completed data on 200 patients who will be equally randomized to one of two groups: The intervention group (emotional disclosure/processing) will write for four sessions about their stressors. The control group will write for four sessions on trivial topics. All patients will be assessed at baseline, each writing session and at one, six and twelve months post intervention. We hypothesize that subjects who write about traumatic experiences will have greater reductions in HIV RNA viral load, HIV and non-HIV somatic symptoms, urinary and salivary cortisol, psychological distress, passive and self-blaming coping strategies, and risky sexual behaviors, and greater increases in CD4 T-lymphocytes, health related quality of life, self-esteem, well-being, social support, and medication adherence at the followup assessments. Among patients in the emotional disclosure intervention, we will further determine how the efficacy of the intervention varies as a function of race, gender, socio-economic status (SES), abuse/trauma history, recent stressful events, psychological symptoms, coping strategies, social support, and quality of emotional disclosure and depth processing. Confirmation of our hypotheses will have important clinical implications for the treatment of HIV infected men and women in that it will provide a rationale for the use of stress reduction through writing as an adjunct to psychological and biological based treatments.

描述（由申请人提供）：随着有效的联合抗逆转录病毒疗法的出现，艾滋病毒或艾滋病患者现在面临着将这种疾病作为慢性疾病活得更长的前景。除了患有这种慢性疾病的痛苦之外，艾滋病毒感染者还表现出较高的性虐待和身体虐待、其他生活压力和创伤以及抑郁症的发生率。我们之前的研究和其他研究已经记录了压力、抑郁、缺乏社会支持和回避应对策略对艾滋病毒感染的免疫变化和疾病进展的不利影响。对正常成年人和慢性病患者的研究进一步证明，通过写作披露创伤事件的人的医学症状和细胞免疫反应有所改善。因此，当前研究的目标是测试艾滋病毒感染者通过书写表达情感的功效。我们将比较两种干预措施，即通过撰写创伤经历（实验）来进行情感披露，与撰写情感中性主题（对照），内容涉及以下内容：艾滋病毒疾病进展、健康状况、心理社会变量和健康行为。我们的艾滋病毒感染男性和女性研究样本将从南佛罗里达州招募。我们将获得 200 名患者的完整数据，这些患者将被同等地随机分配到两组中的一组：干预组（情绪披露/处理）将撰写关于他们的压力源的四次会议。对照组将就琐碎主题撰写四次会议。所有患者都将在基线、每次写作阶段以及干预后 1、6 和 12 个月进行评估。我们假设，写下创伤经历的受试者的 HIV RNA 病毒载量、HIV 和非 HIV 躯体症状、尿液和唾液皮质醇、心理困扰、被动和自责应对策略以及危险性行为将有更大的减少，并且 CD4 T 淋巴细胞、健康相关的生活质量、自尊、幸福感、社会支持和药物依从性会有更大的增加。 后续评估。在情绪表露干预的患者中，我们将进一步确定干预效果如何随着种族、性别、社会经济地位（SES）、虐待/创伤史、近期压力事​​件、心理症状、应对策略、社会支持以及情绪表露和深度处理的质量而变化。我们假设的证实将对艾滋病毒感染男性和女性的治疗产生重要的临床意义，因为它将为通过写作作为心理和生物治疗的辅助手段来减轻压力提供依据。