Zusammenfassung
Unsere Studien über asymptomatische, mit dem "human immunodeficiency virus" (HIV) infizierte homosexuelle Männer zeigen, dass kognitiv-behaviorales Stressmanagement (CBSM) ein geeignetes Mittel ist, die durch die Mitteilung eines positiven HIV-Befundes verursachte psychische Belastung zu reduzieren und zugleich einige immunologische Parameter zu modifizieren. Aus neueren Studien über HIV-infizierte Männer mit Prä-Aids-Symptomatik geht hervor, dass CBSM beitragen kann: a) Dysphorie, Angst und Stresssymptome zu lindern; b) Kortisol und Noradrenalin zu reduzieren und die Testosteronwerte zu erhöhen; c) die Zahl der Antikörper gegen einige Herpes-Viren zu reduzieren und zugleich die Zahl der T-zytotoxischen/Suppressorzellen (CD8) und der naiven T-Helfer- (CD4-) Lymphozyten aufrechtzuerhalten. Vorläufige Daten unserer neuesten Studien weisen darauf hin, dass mit CBSM die Viruslast bei Männern, die hoch aktive antiretrovirale Therapie erhalten, reduziert werden kann.
Abstract
Our studies conducted on asymptomatic gay men with HIV infection indicate that cognitive behavioral stress management (CBSM) can buffer distress and some measures of immune function associated with notification of a positive HIV diagnosis. More recent studies conducted on symptomatic pre-AIDS men with HIV infection have indicated that CBSM can: a) ameliorate dysphoria, anxiety, and stress related symptoms; b) decrease cortisol and norepinephrine while increasing testosterone level; c) decrease antibody titers of some herpes viruses as well as maintain the number of T-cytotoxic/suppressor (CD8) and naive T-helper/inducer (CD4) lymphocytes. Preliminary data from our most recent studies indicate that CBSM can decrease viral load in men receiving highly active antiretroviral therapy.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Antoni HM, Baggett L, Ironson G et al. (1991) Cognitive behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity. J Consult Clin Psychol 59:906–915
Antoni HM, Cruess SE, Cruess DG et al. (2000a) Cognitive behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men. Ann Behav Med 22:29–37
Antoni MH, Cruess DG, Cruess SE et al.(2000b) Cognitive behavioral stress management intervention effects on anxiety, 24-hour urinary norepinephrine output, and T-cytotoxics/suppressor cells over time among symptomatic HIV-infected gay men. J Consult Clin Psychol 68:31–45
Antoni MH, Cruess DG, Klimas N et al. (2002) Stress management and immune system reconstitution in symptomatic HIV-infected gay men over time: Effects on transitional naive T-cells. Amer J Psychiatr 159:143–145
Belkin GS, Fleishman JA, Stein MD, Piette J, Mor V (1992) Physical symptoms among individuals with HIV infection. Psychosom 33:416–427
Cruess DG, Antoni MH, Schneiderman N et al. (2000) Cognitive-behavioral stress management increases free testosterone and decreases psychological distress in HIV-seropositive men. Health Psychol 19:12–20
Esterling BA, Antoni MH, Schneiderman N, Ironson G, La Periere A, Klimas N, Fletcher MA (1992) Psychosocial modulation of antibody to Epstein-Barr viral capsid antigen and herpes virus type-6 in HIV-1 infected and at-risk gay men. Psychosom Med 54:354–371
Ironson G, Freidman A, Klimas N et al. (1994) Distress, denial, and low adherence to behavioral interventions predict faster disease progression in HIV-1 infected gay men. Int J Behav Med 1:90–105
Lutgendorf S, Antoni MH, Ironson G et al. (1997) Cognitive behavioral stress management decreases dysphoric mood and herpes simplex virus type2 antibody titers in symptomatic HIV-seropositive gay men. J Consult Clin Psychol 65:31–43
Lutgendorf S, Antoni MH, Ironson G et al. (1998) Changes in cognitive coping skills and social support mediate distress outcomes in symptomatic HIV-seropositive gay men during a cognitive behavioral stress management intervention. Psychosom Med 60:204–214
Malow RM, McPherson S, Klimas N et al. (1998) Adherence to complex combination antiretrovital therapies in HIV-drug abusers. Psychiatr Serv 49:1021–1024
McPherson-Baker S, Malow RM, Penedo F, Jones DL; Schneiderman N (2000) Enhancing adherence to combination antiretroviral therapy in non-adherent HIV-positive men. Aids Care 12:399–404
McPherson-Baker S, Jones D, Duran R, Klimas N, Schneiderman N (2003) Development and implementation of a medication adherence training instrument (MATI) for people living with HIV. Behav Modification (in press)
Montagnier L, Gruest S, Chamaret C (1984) Adaptation of lymphoadenopathy associated virus (LAV) to replication in EBV-transformed B-lymphoblastoid cell lines. Science 226:63–66
Paterson D, Swindell S, Mohr J et al. (1999) How much adherence is enough? A prospective study of adherence to protease inhibitor therapy using MEMS caps. 6th Conference on Retroviruses and Opportunistic Infections, p 6
Author information
Authors and Affiliations
Corresponding author
Additional information
Aus dem Englischen übersetzt von Dipl.-Psych. Erika Nemény, Berlin und Prof. Dr. Ulrike Ehlert, Zürich
Rights and permissions
About this article
Cite this article
Schneiderman, N., Antoni, M.H. & Ironson, G. Verhaltensmedizin bei HIV-Infektion. Psychotherapeut 48, 342–347 (2003). https://doi.org/10.1007/s00278-003-0328-z
Issue Date:
DOI: https://doi.org/10.1007/s00278-003-0328-z