Illness behavior, emotional stress and psychosocial factors among asymptomatic HIV-infected patients

Background: Over the last years the way in which patients with chronic physical illness respond to their illness (illness behavior) has been explored by several studies. This study sought to examine characteristics of illness behavior and to investigate the association between illness behavior and psychosocial and clinical variables among asymptomatic HIV-infected subjects. Methods: Seventy-three asymptomatic HIV+ outpatients completed self-report questionnaires to evaluate illness behavior (Illness Behavior Questionnaire), psychological stress symptoms (Brief Symptom Inventory), personality variables (External Locus of Control and Courtauld Emotional Control Scales) and social support (Social Provision Scale). Results: Psychological morbidity (‘caseness’ = 34%) was associated with a pattern of illness behaviour characterized by conviction of disease progression, irritability, dysphoria, psychological perception of illness and low denial. Individual capacity to express emotions, adequate levels of social support and low levels of depression, as well as clinical variables (high number of CD4+ cells, recent notification of HIV infection and nonintravenous drug use category) influenced a more adaptive illness behaviour. Conclusions: Psychosocial variables resulted to influence the tendency to interpret illness in a nonadaptive way in asymptomatic HIV-infected subjects. Such variables merit to be routinely examined within the doctor-patient relationship in AIDS clinics

Coping styles and psychosocial-related variables an HIV-infected patients

The study examined the relationship between coping and psychosocial variables (psychological stress symptoms, locus of control, emotional repression, and social support) among 108 human immunodeficiency virus (HIV)-infected patients. The authors administered several tests, including one that measures fighting spirit and degree of hopelessness, to assess each patient’s individual coping style. The patients who were adjusting well to their HIV-positive status tended to have a higher level of fighting spirit and lower degree of hopelessness than those patients who were not adjusting well to their HIV-positive status. A coping style based on incapacity to face and confront HIV infection was associated with symptoms of psychological stress, repression of anger, external locus of control, and low social support in the latter group. These patients showed symptoms indicating maladjustment to HIV infection (43% of the sample) and differed from the “noncases” (the well-adjusted patients) in that the former group reported inadequate coping responses (lower fighting spirit and higher hopelessness, fatalistic attitude, and anxious preoccupation) and poorer social support, and had a greater tendency to repress anger and express sadness. The data support the hypothesis that coping with HIV infection is a complex phenomenon involving multiple and interacting variables. Interventions aimed at improving the coping style for many HIV patients are needed