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Illness perceptions and coping strategies among individuals diagnosed with HIV

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Abstract

Illness perceptions can influence the coping strategies used in response to HIV-related stressors, and ultimately patients’ clinical status. With this work, we aimed to: (1) identify illness perception-related profiles of HIV-positive patients; (2) evaluate the association between the profiles, illness-related coping strategies, HIV-progression biomarkers (CD4+ cell counts and viral load) and antiretroviral therapy use. Data about illness perceptions, HIV-related coping strategies and HIV-progression biomarkers (CD4+ and viral load) were collected from 248 Italian HIV-positive patients. Three latent classes (“high,” “moderate” and “low” influence perception) that differed on consequences, emotional representation, personal control and identity were identified. A greater perception of illness influence was associated with dysfunctional coping strategies (e.g., passive coping and alcohol use), and greater viral load was observed among patients with high and moderate influence perception. In conclusion, patients with detectable or high viral load may show a greater perception of illness influence (i.e., consequences), which is associated with dysfunctional coping strategies in response to HIV-related stressors.

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References

  • Agresti, A. (1984). Analysis of ordinal categorical data. New York, NY: Wiley.

    Google Scholar 

  • Asparouhov, T., & Muthén, B. (2013). Auxiliary variables in mixture modeling: 3-step approaches using Mplus. Mplus Web Notes, 15, 1–24.

    Google Scholar 

  • Baum, M. K., Rafie, C., Lai, S., Sales, S., Page, J. B., & Campa, A. (2010). Alcohol use accelerates HIV disease progression. AIDS Research and Human Retroviruses, 26, 511–518. doi:10.1089/aid.2009.0211

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246.

    Article  CAS  PubMed  Google Scholar 

  • Bollen, K. A. (1989). Structural equations with latent variables. New York, NY: Wiley.

    Book  Google Scholar 

  • Broadbent, E., Ellis, C. J., Thomas, J., Gamble, G., & Petrie, K. J. (2009). Can an illness perception intervention reduce illness anxiety in spouses of myocardial infarction patients? A randomized controlled trial. Journal of Psychosomatic Research, 67, 11–15. doi:10.1016/j.jpsychores.2008.11.006

    Article  PubMed  Google Scholar 

  • Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The brief illness perception questionnaire. Journal of Psychosomatic Research, 60, 631–637. doi:10.1016/j.jpsychores.2005.10.020

    Article  PubMed  Google Scholar 

  • Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.

    Article  CAS  PubMed  Google Scholar 

  • Chesney, M. A. (2000). Factors affecting adherence to antiretroviral therapy. Clinical Infectious Diseases, 30, S171–S176. doi:10.1086/313849

    Article  PubMed  Google Scholar 

  • Chesney, M. A., Ickovics, J., Hecht, F. M., Sikipa, G., & Rabkin, J. (1998). Adherence: A necessity for successful HIV combination therapy. AIDS, 13, S271–S278.

    Google Scholar 

  • Cole, S. W. (2008). Psychosocial influences on HIV-1 disease progression: Neural, endocrine, and virologic mechanisms. Psychosomatic Medicine, 70, 562–568. doi:10.1097/PSY.0b013e3181773bbd

    Article  PubMed  Google Scholar 

  • Crowley, S. L., & Fan, X. (1997). Structural equation modeling: Basic concepts and applications in personality assessment research. Journal of Personality Assessment, 68, 508–531.

    Article  CAS  PubMed  Google Scholar 

  • Culver, J. L., Arena, P. L., Antoni, M. H., & Carver, C. S. (2002). Coping and distress among women under treatment for early stage breast cancer: Comparing African Americans, Hispanics and non-Hispanic whites. Psycho-Oncology, 11, 495–504. doi:10.1002/pon.615

    Article  PubMed  Google Scholar 

  • Devins, G. M. (1994). Illness intrusiveness and the psychosocial impact of lifestyle disruptions in chronic life-threatening disease. Advances in Renal Replacement Therapy, 1, 251–263.

    CAS  PubMed  Google Scholar 

  • Devins, G. M., Armstrong, S. J., Mandin, H., Paul, L. C., Hons, R. B., Burgess, E. D., & Buckle, S. (1990). Recurrent pain, illness intrusiveness, and quality of life in end-stage renal disease. Pain, 42, 279–285.

    Article  CAS  PubMed  Google Scholar 

  • Gauchet, A., Tarquinio, C., & Fischer, G. (2007). Psychosocial predictors of medication adherence among persons living with HIV. International Journal of Behavioral Medicine, 14, 141–150.

    Article  PubMed  Google Scholar 

  • Hallas, C. N., Wray, J., Andreou, P., & Banner, N. R. (2011). Depression and perceptions about heart failure predict quality of life in patients with advanced heart failure. Heart & Lung: The Journal of Acute and Critical Care, 40, 111–121. doi:10.1016/j.hrtlng.2009.12.008

    Article  Google Scholar 

  • Horne, R., Buick, D., Fisher, M., Leake, H., Cooper, V., & Weinman, J. (2004). Doubts about necessity and concerns about adverse effects: Identifying the types of beliefs that are associated with non-adherence to HAART. International Journal of STD and AIDS, 15, 38–44. doi:10.1258/095646204322637245

    Article  PubMed  Google Scholar 

  • Horne, R., Cooper, V., Gellaitry, G., Date, H. L., & Fisher, M. (2007). Patients’ perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: The utility of the necessity-concerns framework. JAIDS Journal of Acquired Immune Deficiency Syndromes, 45, 334–341. doi:10.1097/QAI.1090b1013e31806910e31806913

    Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55.

    Article  Google Scholar 

  • Ironson, G., Balbin, E., Stuetzle, R., Fletcher, M. A., O’Cleirigh, C., Laurenceau, J. P., & Solomon, G. (2005). Dispositional optimism and the mechanisms by which it predicts slower disease progression in HIV: Proactive behavior, avoidant coping, and depression. International Journal of Behavioral Medicine, 12, 86–97. doi:10.1207/s15327558ijbm1202_6

    Article  PubMed Central  PubMed  Google Scholar 

  • Johnson, M., & Folkman, S. (2004). Side effect and disease related symptom representations among HIV + adults on antiretroviral therapy. Psychology, Health & Medicine, 9, 139–148. doi:10.1080/13548500410001670672

    Article  Google Scholar 

  • Kiene, S. M., Simbayi, L. C., Abrams, A., Cloete, A., Tennen, H., & Fisher, J. D. (2008). High rates of unprotected sex occurring among HIV-positive individuals in a daily diary study in South Africa: The role of alcohol use. Journal of Acquired Immune Deficiency Syndrome, 49, 219–226. doi:10.1097/QAI.0b013e318184559f

    Article  Google Scholar 

  • Lazarus, R. S., & DeLongis, A. (1983). Psychological stress and coping in aging. American Psychologist, 38, 245–254.

    Article  CAS  PubMed  Google Scholar 

  • Leventhal, H., Leventhal, E. A., & Cameron, L. (2001). Representations, procedures, and affect in illness self-regulation: A perceptual-cognitive model. In A. S. Baum, T. A. Revenson, & J. E. Singer (Eds.), Handbook of health psychology (pp. 19–48). New York, NY: Erlbaum.

    Google Scholar 

  • Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. In S. Rachman (Ed.), Medical psychology (Vol. 2, pp. 7–30). New York: Pergamon Press.

    Google Scholar 

  • Leventhal, H., Nerenz, D. R., & Steele, D. (1984). Disease representations and coping with health threats. In S. J. Baum (Ed.), Handbook of psychology and health (pp. 219–252). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Magnusson, D. (2003). The person approach: Concepts, measurement models, and research strategy. New Directions for Child and Adolescent Development, 101, 3–23. doi:10.1002/cd.79

    Article  PubMed  Google Scholar 

  • McCorry, N. K., Dempster, M., Quinn, J., Hogg, A., Newell, J., Moore, M., & Kirk, S. J. (2013). Illness perception clusters at diagnosis predict psychological distress among women with breast cancer at 6 months post diagnosis. Psycho-oncology, 22, 692–698. doi:10.1002/pon.3054

    Article  PubMed  Google Scholar 

  • Miyazaki, Y., Bodenhorn, N., Zalaquett, C., & Ng, K. M. (2008). Factorial structure of Brief COPE for international students attending US colleges. College Student Journal, 42, 795–806.

    Google Scholar 

  • Mocroft, A., Ledergerber, B., Katlama, C., Kirk, O., Reiss, P., Monforte, A., & Lundgren, J. D. (2003). Decline in the AIDS and death rates in the EuroSIDA study: An observational study. The Lancet, 362, 22–29.

    Article  CAS  Google Scholar 

  • Moos, R. H., & Schaefer, J. A. (1993). Coping resources and processes: Current concepts and measures. In L. B. Goldberger & S. Breznitz (Eds.), Handbook of stress: Theoretical and clinical aspects (2nd ed., pp. 234–257). New York, NY: Free Press.

    Google Scholar 

  • Moskowitz, J. T., Hult, J. R., Bussolari, C., & Acree, M. (2009). What works in coping with HIV? A meta-analysis with implications for coping with serious illness. Psychological Bulletin, 135, 121–141. doi:10.1037/a0014210

    Article  PubMed  Google Scholar 

  • Moskowitz, J., & Wrubel, J. (2005). Coping with HIV as a chronic illness: A longitudinal analysis of illness appraisals. Psychology & Health, 20, 509–531. doi:10.1080/08870440412331337075

    Article  Google Scholar 

  • Mulder, C. L., Antoni, M. H., Duivenvoorden, H. J., Kauffmann, R. H., & Goodkin, K. (1995). Active confrontational coping predicts decreased clinical progression over a one-year period in HIV-infected homosexual men. Journal of Psychosomatic Research, 39, 957–965. doi:10.1016/0022-3999(95)00062-3

    Article  CAS  PubMed  Google Scholar 

  • Mulder, C. L., de Vroome, E. M., van Griensven, G. J., Antoni, M. H., & Sandfort, T. G. (1999). Avoidance as a predictor of the biological course of HIV infection over a 7-year period in gay men. Health Psychology, 18, 107–113.

    Article  CAS  PubMed  Google Scholar 

  • Murphy, E. L., Collier, A. C., Kalish, L. A., Assmann, S. F., Para, M. F., Flanigan, T. P., & Nemo, G. J. (2001). Highly active antiretroviral therapy decreases mortality and morbidity in patients with advanced HIV disease. Annals of Internal Medicine, 135, 17–26. doi:10.7326/0003-4819-135-1-200107030-00005

    Article  CAS  PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus users’ guide (7th ed.). Los Angeles, CA: Muthén & Muthén.

  • Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14, 535–569. doi:10.1080/10705510701575396

    Article  Google Scholar 

  • Pain, D., Miglioretti, M., & Angelino, E. (2007). Sviluppo della versione italiana del Brief-IPQ (Illness Perception Questionnaire, short version), strumento psicometrico per lo studio delle Rappresentazioni di malattia. Psicologia della Salute, 1, 81–90.

    Google Scholar 

  • Pakenham, K. I., & Rinaldis, M. (2001). The role of illness, resources, appraisal, and coping strategies in adjustment to HIV/AIDS: The direct and buffering effects. Journal of Behavioral Medicine, 24, 259–279.

    Article  CAS  PubMed  Google Scholar 

  • Pol, S., Artru, P., Thepot, V., Berthelot, P., & Nalpas, B. (1996). Improvement of the CD4 cell count after alcohol withdrawal in HIV-positive alcoholic patients. AIDS, 10, 1293–1294.

    Article  CAS  PubMed  Google Scholar 

  • Reynolds, N., Eller, L. S., Nicholas, P., Corless, I., Kirksey, K., Hamilton, M., & Wantland, D. (2009). HIV illness representation as a predictor of self-care management and health outcomes: A multi-site, cross-cultural study. AIDS and Behavior, 13, 258–267.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Roth, S., & Cohen, L. J. (1986). Approach, avoidance, and coping with stress. American Psychologist, 41, 813–819. doi:10.1037/0003-066X.41.7.813

    Article  CAS  PubMed  Google Scholar 

  • Scharloo, M., Kaptein, A. A., Weinman, J., Bergman, W., Vermeer, B. J., & Rooijmans, H. G. M. (2000). Patients’ illness perceptions and coping as predictors of functional status in psoriasis: A 1-year follow-up. British Journal of Dermatology, 142, 899–907. doi:10.1046/j.1365-2133.2000.03469.x

    Article  CAS  PubMed  Google Scholar 

  • Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8, 23–74.

    Google Scholar 

  • Skinner, E. A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: A review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129, 216–269. doi:10.1037/0033-2909.129.2.216

    Article  PubMed  Google Scholar 

  • Stanton, A. L., Revenson, T. A., & Tennen, H. (2007). Health psychology: Psychological adjustment to chronic disease. Annual Review of Psychology, 58, 565–592. doi:10.1146/annurev.psych.58.110405.085615

    Article  PubMed  Google Scholar 

  • Temoshok, L. R., Wald, R. L., Synowski, S., & Garzino-Demo, A. (2008). Coping as a multisystem construct associated with pathways mediating HIV-relevant immune function and disease progression. Psychosomatic Medicine, 70, 555–561. doi:10.1097/PSY.0b013e318177354f

    Article  PubMed  Google Scholar 

  • Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38, 1–10.

    Article  Google Scholar 

  • van der Veek, S. M., Kraaij, V., Van Koppen, W., Garnefski, N., & Joekes, K. (2007). Goal disturbance, cognitive coping and psychological distress in HIV-infected persons. Journal of Health Psychology, 12, 225–230. doi:10.1177/1359105307074249

    Article  PubMed  Google Scholar 

  • Vermunt, J. K. (2010). Latent class modeling with covariates: Two improved three-step approaches. Political Analysis, 18, 450–469. doi:10.1093/pan/mpq025

    Article  Google Scholar 

  • Weaver, K. E., Llabre, M. M., Duran, R. E., Antoni, M. H., Ironson, G., Penedo, F. J., & Schneiderman, N. (2005). A stress and coping model of medication adherence and viral load in HIV-positive men and women on highly active antiretroviral therapy (HAART). Health Psychology, 24, 385–392. doi:10.1037/0278-6133.24.4.385

    Article  PubMed  Google Scholar 

  • Zyrianova, Y., Kelly, B., Sheehan, J., McCarthy, C., & Dinan, T. (2011). The psychological impact of arthritis: The effects of illness perception and coping. Irish Journal of Medical Science, 180, 203–210. doi:10.1007/s11845-010-0522-2

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

A. Norcini Pala and P. Steca declare that they have no conflict of interest.

Human and animal rights and Informed Consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Norcini Pala, A., Steca, P. Illness perceptions and coping strategies among individuals diagnosed with HIV. J Behav Med 38, 620–631 (2015). https://doi.org/10.1007/s10865-015-9639-0

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