Reductions in depressed mood and denial coping during cognitive behavioral stress management with HIV-Positive gay men treated with HAART

• Published in: Annals of behavioral medicine Vol. 31; no. 2; pp. 155 - 164
• Main Authors: Carrico, Adam W, Antoni, Michael H, Duran, Ron E, Ironson, Gail, Penedo, Frank, Fletcher, Mary Ann, Klimas, Nancy, Schneiderman, Neil
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-04-2006
• Subjects: Adaptation, Physiological; Adult; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Behavior; Cognitive Therapy; Denial (Psychology); Depression - complications; Depression - therapy; Health psychology; HIV; HIV Infections - drug therapy; Homosexuality, Male; Humans; Intervention; Male; Models, Psychological; Patient Compliance; Stress; Stress, Psychological - complications; Stress, Psychological - psychology; Stress, Psychological - therapy; Viral Load
• ISSN: 0883-6612; 1532-4796
• DOI: 10.1207/s15324796abm3102_7

Stress management interventions for HIV-positive persons have been designed to enhance coping skills and encourage health-promoting behaviors with the hope of decreasing distress and slowing disease progression.
We examined the efficacy of a cognitive behavioral stress management (CBSM) intervention in combination with medication adherence training (MAT) in 130 gay and bisexual men living with HIV infection.
Participants were randomized to either a 10-week CBSM+MAT intervention (n = 76) or a MAT-only condition (n = 54). Measures of self-reported adherence, active cognitive coping (i.e., acceptance and positive reinterpretation), avoidant coping (i.e., denial and behavioral disengagement), and depressed mood were examined over the 10-week intervention period.
Men in CBSM+MAT reported reductions in depressed mood and denial coping during the 10-week intervention period, but no changes in active cognitive coping or self-reported adherence were observed. Using path analysis, greater reliance on denial coping at baseline was associated with decreased depressed mood at 10 weeks. We also determined that CBSM+MAT may decrease depressed mood by reducing reliance on denial coping over the 10-week intervention period.
Although denial may be an effective means of distress reduction in the short term, reliance on this coping strategy may result in a decreased capacity to effectively manage a variety of disease-related stressors in the long term. CBSM+MAT addresses this potentially detrimental pattern by teaching stress reduction skills that may decrease depressed mood via reduced reliance on denial coping.