A randomized, controlled trial of mindfulness-based stress reduction in HIV infection.

Objective: Evidence links depression and stress to more rapid progression of HIV-1 disease. We conducted a randomized controlled trial to test whether an intervention aimed at improving stress management and emotion regulation, mindfulness-based stress reduction (MBSR), would improve immunological (i.e.

Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV.

Objective: We conducted a randomized controlled trial to determine whether IRISS (Intervention for those Recently Informed of their Seropositive Status), a positive affect skills intervention, improved positive emotion, psychological health, physical health, and health behaviors in people newly diagnosed with HIV.

Method: One-hundred and fifty-nine participants who had received an HIV diagnosis in the past 3 months were randomized to a 5-session, in-person, individually delivered positive affect skills intervention or an attention-matched control condition.

Results: For the primary outcome of past-day positive affect, the group difference in change from baseline over time did not reach statistical significance (p = .

Assessment of stress and self-efficacy for the NIH Toolbox for Neurological and Behavioral Function.

Background And Objectives: The NIH Toolbox for Neurological and Behavioral Function assessment battery contains measures in the domains of cognitive function, motor function, sensory function, and emotional health. It was designed for use in epidemiological and clinical trials health-related research.

Design: This paper describes the first phase of instrument development for the stress and self-efficacy subdomain of emotional health.

Positive Affect in the Midst of Distress: Implications for Role Functioning.

Stress has been shown to deplete the self-regulation resources hypothesized to facilitate effective role functioning. However, recent research suggests that positive affect may help to replenish these vital self-regulation resources. Based on revised Stress and Coping theory and the Broaden-and-Build theory of positive emotion, three studies provide evidence of the potential adaptive function of positive affect in the performance of roles for participants experiencing stress.

Stress, coping, and hope.

Hope is discussed in many literatures and from many perspectives. In this essay hope is discussed from the vantage of psychology and stress and coping theory. Hope and psychological stress share a number of formal properties: both are contextual, meaning-based, and dynamic, and both affect well-being in difficult circumstances.

Applying principles from complex systems to studying the efficacy of CAM therapies.

In October 2007, a National Center for Complementary and Alternative Medicine (NCCAM)-sponsored workshop, entitled "Applying Principles from Complex Systems to Studying the Efficacy of CAM Therapies," was held at Georgetown University in Washington, DC. Over a 2-day period, the workshop engaged a small group of experts from the fields of complementary and alternative medicine (CAM) research and complexity science to discuss and examine ways in which complexity science can be applied to CAM research. After didactic presentations and small-group discussions, a number of salient themes and ideas emerged.

Filming the family: a documentary film to educate clinicians about family caregivers of patients with brain tumors.

The objective of this paper is to evaluate the educational value of a documentary film about family caregiving for patients with brain tumors. The method used in this study is a pre-post survey among neurosurgeons, neuro-oncologist, and other clinician viewers. Viewers evaluated the film highly and reported an intention to change their practice as a result of watching the film.

End of living: maintaining a lifeworld during terminal illness.

The narrative responses of 32 people with AIDS or cancer with survival prognoses of 6 months to a year to monthly interview questions about their daily lives were analysed with a team-based qualitative methodology. Two groups emerged: (a) a Maintained Lifeworld Group characterised by one or more of the following: continued engagement with family, friends, and community; the ability to relinquish untenable goals and substitute new, realistic ones; engagement in spirituality and a spiritual practice; and, (b) a Lifeworld Interrupted Group characterised by one or more of the following: relocation just before or during the study, cognitive impairment, commitment to untenable goals, ongoing substance abuse. Understanding how people with a terminal illness can maintain a lifeworld and experience well-being while also managing the physical challenges of their illness could help inform the support offered by professional and family caregivers to improve care recipients' quality of life.

Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres.

Understanding the malleable determinants of cellular aging is critical to understanding human longevity. Telomeres may provide a pathway for exploring this question. Telomeres are the protective caps at the ends of chromosomes.

Mediators of childhood sexual abuse and high-risk sex among men-who-have-sex-with-men.

Objective: Mediators of childhood sexual abuse (CSA) and HIV risk behavior were examined for men-who-have-sex-with-men (MSM).

Method: Data from a dual frame survey of urban MSM (N=1078) provided prevalence estimates of CSA, and a test of two latent variable models (defined by partner type) of CSA-risk behavior mediators.

Results: A 20% prevalence of CSA was reported.

Depression, distress and positive mood in late-stage cancer: a longitudinal study.

Objectives: To determine whether new-onset clinical depression emerges over time, and whether positive and negative mood levels change among patients with terminal cancer.

Methods: In this two-site study, 58 cancer patients seen at least twice were interviewed monthly until death or study termination. Major measures included the Patient Health Questionnaire-9, Holland System of Beliefs Inventory, and Positive and Negative Affect Schedule.

The case for positive emotions in the stress process.

For many decades, the stress process was described primarily in terms of negative emotions. However, robust evidence that positive emotions co-occurred with negative emotions during intensely stressful situations suggested the need to consider the possible roles of positive emotions in the stress process. About 10 years ago, these possibilities were incorporated into a revision of stress and coping theory (Folkman, 1997).

Socioeconomic differences in the effects of prayer on physical symptoms and quality of life.

The extent to which religiosity is related to well-being may differ as a function of race/ethnicity, education or income. We asked 155 caregivers to complete measures of religiosity, prayer, physical symptoms and quality of life. Lower education and, to a lesser extent, lower income were correlated with religiosity and prayer.

The prediction of bereavement outcome: development of an integrative risk factor framework.

We propose an integrative risk factor framework to enhance understanding of individual differences in adjustment to bereavement and to encourage more systematic analysis of factors contributing to bereavement outcome (e.g., examination of interactions between variables and establishing pathways in the adaptation process).

A validity and reliability study of the coping self-efficacy scale.

Objectives: Investigate the psychometric characteristics of the coping self-efficacy (CSE) scale, a 26-item measure of one's confidence in performing coping behaviors when faced with life challenges.

Design: Data came from two randomized clinical trials (N1=149, N2=199) evaluating a theory-based Coping Effectiveness Training (CET) intervention in reducing psychological distress and increasing positive mood in persons coping with chronic illness.

Methods: The 348 participants were HIV-seropositive men with depressed mood who have sex with men.

Caregiving time in sickle cell disease: psychological effects in maternal caregivers.

Background: Providing home care for a child with a chronic illness can be stressful for the family. The purpose of this paper is to examine patterns of caregiving and the associated psychological impact on maternal caregivers of children with sickle cell disease (SCD).

Procedure: Fourteen maternal caregivers of children with SCD were interviewed as part of a larger study of maternal caregivers of children with chronic illness.

The economic burden of home care for children with HIV and other chronic illnesses.

Objectives: We compared types, amounts, and costs of home care for children with HIV and chronic illnesses, controlling for the basic care needs of healthy children to determine the economic burden of caring for and home care of chronically ill children.

Methods: Caregivers of 97 HIV-positive children, 101 children with a chronic illness, and 102 healthy children were surveyed regarding amounts of paid and unpaid care provided. Caregiving value was determined according to national hourly earnings and a market replacement method.

Pediatric adherence: perspectives of mothers of children with HIV.

This study approached pediatric adherence practices from the perspective of mothers of children with HIV in the USA. The study aimed to articulate what is involved in the daily life experience of giving or supervising a child's HIV medication (i.e.

Resilience to loss in bereaved spouses, bereaved parents, and bereaved gay men.

Recent research has indicated that many people faced with highly aversive events suffer only minor, transient disruptions in functioning and retain a capacity for positive affect and experiences. This article reports 2 studies that replicate and extend these findings among bereaved parents, spouses, and caregivers of a chronically ill life partner using a range of self-report and objective measures of adjustment. Resilience was evidenced in half of each bereaved sample when compared with matched, nonbereaved counterparts and 36% of the caregiver sample in a more conservative, repeated-measures ipsative comparison.

Economic and psychologic costs for maternal caregivers of gastrostomy-dependent children.

Objective: To examine the economic and psychologic costs of care provided by maternal caregivers to children with gastrostomy tube (GT) feedings.

Study Design: We conducted a 3-site study of primary maternal caregivers of 101 chronically ill children, with (n = 50) and without (n = 51) enteral nutrition support by GT to determine the time spent providing technical care, nontechnical care, and health care management and to assess depressive mood and quality of life. Associated costs were determined.

Coping: pitfalls and promise.

Coping, defined as the thoughts and behaviors used to manage the internal and external demands of situations that are appraised as stressful, has been a focus of research in the social sciences for more than three decades. The dramatic proliferation of coping research has spawned healthy debate and criticism and offered insight into the question of why some individuals fare better than others do when encountering stress in their lives. We briefly review the history of contemporary coping research with adults.

Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group-based intervention.

Objective: This randomized clinical trial was designed to compare the effects of a theory-based coping effectiveness training (CET) intervention with an active informational control (HIV-Info) condition and a waiting-list control (WLC) condition on psychological distress and positive mood in HIV-seropositive gay men.

Materials And Methods: The authors recruited 149 self-identified gay or bisexual men who were 21 to 60 years of age, reported depressed mood, and had CD4 levels of 200 to 700 cells/mm(3). CET and HIV-Info participants attended 10 90-minute group sessions during the 3-month intervention phase and six maintenance sessions over the remainder of the year.

Couples therapy at end of life.

This study reports on a preliminary uncontrolled study of a treatment for couples in which one partner is diagnosed with a terminal illness. In this study nine couples, in which one partner was diagnosed with a terminal illness and had less than 18 months to live, were offered eight sessions of couples therapy. Follow-up data were available for six couples.

Do positive psychological states shed light on recovery from bereavement? Findings from a 3-year longitudinal study.

The purpose of the current study was to document the course and 1-month post-bereavement predictors of both positive and negative psychological states in bereaved gay male caregivers for 3 years following the death of their partners. The results show that although the patterns of post-bereavement depressive mood and positive psychological states were similar, some of their predictors differed. Given that the processes that produce positive psychological states are not the same as those that produce negative states, our findings support the inclusion of both positive and negative psychological states in studies of post-bereavement adjustment.