Coping, Social Support, and Attachment Style as Psychosocial Correlates of Adjustment in Men and Women with HIV/AIDS

The purpose of this study was to examine psychosocial correlates of adjustment to HIV/AIDS in a sample of 137 HIV-positive persons (78 men and 59 women). Multiple regression analysis was used to examine relationships between perceived quality of general social support, three attachment styles, and three coping styles with total score on Positive States of Mind Scale (PSOMS), our measure of adjustment. The influence of demographic and medical status variables was also accounted for. PSOMS total score was significantly associated with greater satisfaction with social support related to HIV/AIDS, more secure attachment style, and less use of behavioral disengagement in coping with HIV/AIDS. These results indicate that for people with HIV or AIDS, those individuals who are more satisfied with their relationships, securely engaged with others, and more directly engaged with their illness are more likely to experience positive adjustment. Implications for physical health outcome and opportunities for intervention are discussed.

[1]  S. Folkman,et al.  Coping and mood during aids-related caregiving and bereavement , 1996, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[2]  C. Hazan,et al.  Romantic love conceptualized as an attachment process. , 1987, Journal of personality and social psychology.

[3]  Shirley J. Semple,et al.  Relationship of psychosocial factors to HIV disease progression , 1996, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[4]  R. Goetz,et al.  Maintenance of hope in HIV-spectrum homosexual men. , 1990, The American journal of psychiatry.

[5]  S. Folkman,et al.  Stress, appraisal, and coping , 1974 .

[6]  N. Adler,et al.  A scale for measuring the occurrence of positive states of mind: a preliminary report. , 1988, Psychosomatic medicine.

[7]  M. Kemeny,et al.  Immune System Changes After the Death of a Partner in HIV-Positive Gay Men , 1995, Psychosomatic medicine.

[8]  J. Simpson.  Influence of Attachment Styles on Romantic Relationships , 1990 .

[9]  W. Odets.  In the Shadow of the Epidemic: Being HIV-Negative in the Age of AIDS , 1995 .

[10]  S. Cole,et al.  Social relationships and the progression of human immunodeficiency virus infection: A review of evidence and possible underlying mechanisms , 1998, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[11]  R. Kessler,et al.  Adult attachment in a nationally representative sample. , 1997, Journal of personality and social psychology.

[12]  R. Elashoff,et al.  Malignant melanoma. Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. , 1993, Archives of general psychiatry.

[13]  J. Suls,et al.  The relative efficacy of avoidant and nonavoidant coping strategies: a meta-analysis. , 1985, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[14]  S. Perry,et al.  The impact of multiple bereavement in a gay male sample. , 1997, AIDS education and prevention : official publication of the International Society for AIDS Education.

[15]  L. Sarna,et al.  Comparison of emotional distress in men with acquired immunodeficiency syndrome and in men with cancer. , 1996, Applied nursing research : ANR.

[16]  A. Steptoe,et al.  Psychosocial Stress and Susceptibility to Upper Respiratory Tract Illness in an Adult Population Sample , 1996, Psychosomatic medicine.

[17]  S. Read,et al.  Adult attachment, working models, and relationship quality in dating couples. , 1990, Journal of personality and social psychology.

[18]  R M Royall,et al.  Health and mental health problems of homeless men and women in Baltimore. , 1989, JAMA.

[19]  B. Raphael,et al.  A Comparison of the Psychosocial Aspects of AIDS and Cancer-Related Bereavement , 1996, International journal of psychiatry in medicine.

[20]  M. Dew,et al.  Infection with human immunodeficiency virus and vulnerability to psychiatric distress. A study of men with hemophilia. , 1990, Archives of general psychiatry.

[21]  S. Folkman,et al.  Positive psychological states and coping with severe stress. , 1997, Social science & medicine.

[22]  J. House,et al.  Social relationships and health. , 1988, Science.

[23]  M. Leszcz.  Introduction to special issue on group psychotherapy for the medically ill. , 1998, International journal of group psychotherapy.

[24]  R. Curtis,et al.  The relevance of drug injectors' social and risk networks for understanding and preventing HIV infection. , 1994, Social science & medicine.

[25]  L. Radloff.  The CES-D Scale , 1977 .

[26]  H. Kraemer,et al.  EFFECT OF PSYCHOSOCIAL TREATMENT ON SURVIVAL OF PATIENTS WITH METASTATIC BREAST CANCER , 1989, The Lancet.

[27]  B. Penninx,et al.  Effects of social support and personal coping resources on depressive symptoms: different for various chronic diseases? , 1998, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[28]  C. Carver,et al.  How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. , 1993, Journal of personality and social psychology.

[29]  K. Bartholomew,et al.  Attachment styles among young adults: a test of a four-category model. , 1991, Journal of personality and social psychology.

[30]  M. Watson,et al.  Development of a questionnaire measure of emotional control. , 1983, Journal of psychosomatic research.

[31]  A. Steptoe,et al.  Psychosocial influences on upper respiratory infectious illness in children. , 1998, Journal of psychosomatic research.

[32]  N. Adler,et al.  Additional Validation of a Scale to Assess Positive States of Mind , 1998, Psychosomatic medicine.

[33]  D. Shapiro,et al.  Immunological and physiological changes associated with induced positive and negative mood. , 1994, Psychosomatic medicine.

[34]  M. Mikulincer,et al.  Adult attachment style and affect regulation: strategic variations in subjective self-other similarity. , 1998, Journal of personality and social psychology.

[35]  C. Carver,et al.  Assessing coping strategies: a theoretically based approach. , 1989, Journal of personality and social psychology.

[36]  J. Fleishman,et al.  Coping and depressive symptoms among people with AIDS. , 1994, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[37]  M. Mikulincer,et al.  Appraisal of and Coping with a Real-Life Stressful Situation: The Contribution of Attachment Styles , 1995 .

[38]  J. Kelly,et al.  Group psychotherapy for persons with HIV and AIDS-related illnesses. , 1998, International journal of group psychotherapy.

[39]  L. Temoshok,et al.  Perceptions of Social Support in Men with AIDS and ARC: Relationships with Distress and Hardiness1 , 1987 .

[40]  D. Perkins,et al.  Severe life stress as a predictor of early disease progression in HIV infection. , 1997, The American journal of psychiatry.

[41]  John Bowlby,et al.  Separation: Anxiety and Anger , 1973 .

[42]  C. Sherbourne,et al.  Social support and stressful life events: age differences in their effects on health-related quality of life among the chronically ill , 1992, Quality of Life Research.

[43]  M. Mikulincer,et al.  The relationship between adult attachment styles and emotional and cognitive reactions to stressful events. , 1998 .

[44]  C. Koopman,et al.  Relationships of perceived stress to coping, attachment and social support among HIV-positive persons , 2000, AIDS Care.

[45]  R. Schwarzer,et al.  The multidimensional nature of received social support in gay men at risk of HIV infection and AIDS , 1994, American journal of community psychology.

[46]  V. Cain,et al.  Stage of illness, level of HIV symptoms, sense of coherence and psychological functioning in clients of community-based AIDS counseling centers. , 1993, The Journal of the Association of Nurses in AIDS Care : JANAC.

[47]  Attachment styles, coping strategies, and posttraumatic psychological distress: the impact of the Gulf War in Israel. , 1993, Journal of personality and social psychology.

[48]  J. Friedland,et al.  Coping and social support as determinants of quality of life in HIV/AIDS. , 1996, AIDS care.

[49]  T. Revenson,et al.  Stress and coping in the explanation of psychological adjustment among chronically ill adults. , 1984, Social science & medicine.

[50]  Mario Mikulincer,et al.  Attachment styles and fear of personal death: A case study of affect regulation. , 1990 .

[51]  A. Stone,et al.  Stress and humoral immunity: a review of the human studies. , 1994, Advances in neuroimmunology.

[52]  A. Nyamathi,et al.  Impoverished women at risk for AIDS. Social support variables. , 1996, Journal of psychosocial nursing and mental health services.

[53]  A. Nyamathi,et al.  Psychosocial correlates of emotional distress and risk behavior in african-american women at risk for hiv infection , 1993 .

[54]  C. Carver.  You want to measure coping but your protocol’ too long: Consider the brief cope , 1997, International journal of behavioral medicine.