Telephone Intervention /Depressed Older Adults /HIV/AIDS

描述（由申请人提供）：截至2000年6月，超过81，000 美国艾滋病患者年龄在50岁或以上， 盗窃诊断的时间。然而，由于艾滋病心理健康研究 主要集中在感染艾滋病毒的年轻人身上， 老年护理人员对老年人的心理健康需求概念化较差， 感染艾滋病毒/艾滋病的老年人。 在一系列的初步研究中， 在NIA的支持下，我们的研究小组对生活压力源的水平进行了表征， 中年后期的负担、应对困难和心理困扰 和老年艾滋病毒/艾滋病感染者。 我们的形成性研究预示着， 许多感染艾滋病毒的老年人的抑郁水平升高， 精神病学和自杀意念，高水平的生活压力负荷，以及 孤立感增强。最近，PI和同事 表明，一个应对改善小组干预设计， 专门针对感染艾滋病毒的老年人可以改善调整工作 和生活质量。 使用滞后治疗对照组 设计，拟议的I期临床试验将评估短期和 电话传递的应对改善小组的长期效果 对80名50岁以上艾滋病病毒感染者的调整努力进行干预 符合抑郁症诊断标准的年龄。 述干预 根据Lazarus和Folkman（1984）的压力和应对的跨学科模型 并运用认知行为原则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 测量共病健康状况的患病率，认知功能， 生活压力源负担，因应方式，因应自我效能，精神科 痛苦、生活质量和对社会支持的感知。 初始测试 40名参与者的干预，然后进行交叉验证， 对第二组40名老年人的干预将评估 电话传递应对改善干预的有效性。 在 除了提供干预措施的初步测试外，研究数据还将 通知NIH申请的开发，以进行第三阶段 电话传递的应对改善小组干预的临床试验 对于那些情绪脆弱的老年艾滋病感染者， 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.