nach oben

International Journal of Behavioral Medicine

Erschienen in:

23.11.2016

Psychological Distress Mediates the Effect of Alexithymia on 2-Year Change in HIV Viral Load

verfasst von: Roger C. McIntosh, Gail Ironson, Michael Antoni, Betty Lai, Mahendra Kumar, Mary Ann Fletcher, Neil Schneiderman

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Individuals with trait alexithymia (AL) display poor cognitive assimilation of thoughts, feelings, and emotions. This may result in the persistence of stress, anxiety, and depressive disorders. The cumulative effect of this psychological distress is also linked clinical markers of human immunodeficiency virus (HIV) disease progression. This study examines the indirect effect of AL on HIV viral load as a function of baseline levels and change in psychological distress.

Methods

N = 123 HIV positive adults aged 37.9 ± 9.2 years provided blood samples for HIV-1 viral RNA and CD4 T lymphocytes along with self-reported stress, anxiety, and depression every 6 months for 2 years. A second-order conditional latent growth model was used to represent baseline and 2-year change in cumulative levels of psychological distress and to test the indirect effect of baseline levels of trait AL on change in HIV-1 viral load through this latent measure.

Results

AL was associated with baseline and latent change in psychological distress. Furthermore, baseline psychological distress predicted 2-year change in HIV-1 viral RNA after controlling for viral load at baseline. Altogether, trait AL had a significant indirect effect on change in viral load (β = 0.16, p = 0.03) as a function of baseline levels of distress.

Conclusion

Identification and communication of thoughts, feelings, and emotions are important for long-term psychological adaptation in HIV. Greater psychological distress, in turn, allows for persistence of peripheral viral replication.

Goetz RR, Remien RH. Axis I psychiatric symptoms associated with HIV infection and personality disorder. Am J Psychiatry. 1995;1(52):551.

Bing EG, Burnam MA, Longshore D, Fleishman JA, Sherbourne CD, London AS, et al. Psychiatric disorders and drug use among human immunodeficiency virus–infected adults in the United States. Arch Gen Psychiatry. 2001;58(8):721–8.PubMedCrossRef

Asch SM, Kilbourne AM, Gifford AL, Burnam MA, Turner B, Shapiro MF, et al. Underdiagnosis of depression in HIV. J Gen Intern Med. 2003;18(6):450–60.PubMedPubMedCentralCrossRef

Israelski D, Prentiss D, Lubega S, Balmas G, Garcia P, Muhammad M, et al. Psychiatric co-morbidity in vulnerable populations receiving primary care for HIV/AIDS. AIDS Care. 2007;19(2):220–5.PubMedCrossRef

Rabkin JG. HIV and depression: 2008 review and update. Curr HIV/AIDS Rep. 2008;5(4):163–71.PubMedCrossRef

Ironson GH, O’Cleirigh C, Schneiderman N, Weiss A, Costa Jr PT. Personality and HIV disease progression: role of NEO-PI-R openness, extraversion, and profiles of engagement. Psychosom Med. 2008;70(2):245.PubMedPubMedCentralCrossRef

John OP, Gross JJ. Healthy and unhealthy emotion regulation: personality processes, individual differences, and life span development. J Pers. 2004;72(6):1301–34.PubMedCrossRef

Gross JJ, Muñoz RF. Emotion regulation and mental health. Clin Psychol Sci Pract. 1995;2(2):151–64.CrossRef

Taylor GJ, Bagby RM, Luminet O. Assessment of alexithymia: self-report and observer-rated measures. The Handbook of Emotional Intelligence. 2000;301–19.

10.

Taylor GJ, Bagby RM, Ryan DP, Parker JD, Doody KF, Keefe P. Criterion validity of the Toronto Alexithymia Scale. Psychosom Med. 1988;50(5):500–9.PubMedCrossRef

11.

Lumley MA, Stettner L, Wehmer F. How are alexithymia and physical illness linked? A review and critique of pathways. J Psychosom Res. 1996;41(6):505–18.PubMedCrossRef

12.

Parruti G, Vadini F, Sozio F, Mazzott E, Ursini T, Polill E, et al. Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. PLoS ONE. 2013;8(1):e54555.PubMedPubMedCentralCrossRef

13.

McIntosh RC, Ironson G, Antoni M, Kumar M, Fletcher MA, Schneiderman N. Alexithymia is linked to neurocognitive, psychological, neuroendocrine, and immune dysfunction in persons living with HIV. Brain Behav Immun. 2014;36:165–75.PubMedCrossRef

14.

Hintikka J, Honkalampi K, Lehtonen J, Viinamäki H. Are alexithymia and depression distinct or overlapping constructs? A study in a general population. Compr Psychiatry. 2001;42(3):234–9.PubMedCrossRef

15.

Berthoz S, Consoli S, Perez-Diaz F, Jouvent R. Alexithymia and anxiety: compounded relationships? A psychometric study. Eur Psychiatry. 1999;14(7):372–8.PubMedCrossRef

16.

Parker JD, Bagby RM, Taylor GJ. Alexithymia and depression: distinct or overlapping constructs? Compr Psychiatry. 1991;32(5):387–94.PubMedCrossRef

17.

Honkalampi K, Saarinen P, Hintikka J, Virtanen V, Viinamäki H. Factors associated with alexithymia in patients suffering from depression. Psychother Psychosom. 1999;68(5):270–5.PubMedCrossRef

18.

Marchesi C, Brusamonti E, Maggini C. Are alexithymia, depression, and anxiety distinct constructs in affective disorders? J Psychosom Res. 2000;49(1):43–9.PubMedCrossRef

19.

Picardi A, Toni A, Caroppo E. Stability of alexithymia and its relationships with the ‘big five’ factors, temperament, character, and attachment style. Psychother Psychosom. 2005;74(6):371–8.PubMedCrossRef

20.

Luminet O, Rokbani L, Ogez D, Jadoulle V. An evaluation of the absolute and relative stability of alexithymia in women with breast cancer. J Psychosom Res. 2007;62(6):641–8.PubMedCrossRef

21.

Tolmunen T, Heliste M, Lehto SM, Hintikka J, Honkalampi K, Kauhanen J. Stability of alexithymia in the general population: an 11-year follow-up. Compr Psychiatry. 2011;52(5):536–41.PubMedCrossRef

22.

Spek V, Nyklíček I, Cuijpers P, Pop V. Alexithymia and cognitive behaviour therapy outcome for subthreshold depression. Acta Psychiatr Scand. 2008;118(2):164–7.PubMedCrossRef

23.

De Gucht V, Heiser W. Alexithymia and somatisation: a quantitative review of the literature. J Psychosom Res. 2003;54(5):425–34.PubMedCrossRef

24.

Lumley MA, Tomakowsky J, Torosian T. The relationship of alexithymia to subjective and biomedical measures of disease. Psychosomatics. 1997;38(5):497–502.PubMedCrossRef

25.

Martin JB, Pihl R. Influence of alexithymic characteristics on physiological and subjective stress responses in normal individuals. Psychother Psychosom. 1986;45(2):66–77.PubMedCrossRef

26.

Newton TL, Contrada RJ. Alexithymia and repression: contrasting emotion-focused coping styles. Psychosom Med. 1994;56(5):457–62.PubMedCrossRef

27.

Martínez-Sánchez F, Ortiz-Soria B, Ato-García M. Subjective and autonomic stress responses in alexithymia. Psicothema. 2001;13(1):57–62.

28.

Kohn PM, Gurevich M, Pickering DI, Macdonald JE. Alexithymia, reactivity, and the adverse impact of hassles-based stress. Personal Individ Differ. 1994;16(6):805–12.CrossRef

29.

Martin JB, Pihl R. The stress-alexithymia hypothesis: theoretical and empirical considerations. Psychother Psychosom. 1985;43(4):169–76.PubMedCrossRef

30.

Lumley MA. Alexithymia, emotional disclosure, and health: a program of research. J Pers. 2004;72(6):1271–300.PubMedCrossRef

31.

Evans DL, Leserman J, Perkins DO, Stern RA, Murphy C, Zheng B, et al. Severe life stress as a predictor of early disease progression in HIV infection. Am J Psychiatr. 1997;154(5):630–4.PubMedCrossRef

32.

Leserman J, Petitto JM, Perkins DO, Folds JD, Golden RN, Evans DL. Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virus–infected men: a 2-year follow-up study. Arch Gen Psychiatry. 1997;54(3):279.PubMedCrossRef

33.

Leserman J, Jackson ED, Petitto JM, Golden RN, Silva SG, Perkins DO, et al. Progression to AIDS: the effects of stress, depressive symptoms, and social support. Psychosom Med. 1999;61(3):397–406.PubMedCrossRef

34.

Zorrilla EP, McKay JR, Luborsky L, Schmidt K. Relation of stressors and depressive symptoms to clinical progression of viral illness. Am J Psychiatry. 1996.

35.

Kemeny ME, Dean L. Effects of AIDS-related bereavement of HIV progression among New York City gay men. AIDS Educ Prev. 1995.

36.

Solano L, Costa M, Salvati S, Coda R, Aiuti F, Mezzaroma I, et al. Psychosocial factors and clinical evolution in HIV-1 infection: a longitudinal study. J Psychosom Res. 1993;37(1):39–51.PubMedCrossRef

37.

Ironson G, Friedman A, Klimas N, Antoni M, Fletcher MA, LaPerriere A, et al. Distress, denial, and low adherence to behavioral interventions predict faster disease progression in gay men infected with human immunodeficiency virus. Int J Behav Med. 1994;1(1):90–105.PubMedCrossRef

38.

Kimerling R, Armistead L, Forehand R. Victimization experiences and HIV infection in women: associations with serostatus, psychological symptoms, and health status. J Trauma Stress. 1999;12(1):41–58.PubMedCrossRef

39.

Leserman J, Petitto J, Gu H, Gaynes B, Barroso J, Golden R, et al. Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors. Psychol Med. 2002;32(6):1059–73.PubMedCrossRef

40.

Leserman J. HIV disease progression: depression, stress, and possible mechanisms. Biol Psychiatry. 2003;54(3):295–306.PubMedCrossRef

41.

Leserman J. Role of depression, stress, and trauma in HIV disease progression. Psychosom Med. 2008;70(5):539–45.PubMedCrossRef

42.

Chida Y, Vedhara K. Adverse psychosocial factors predict poorer prognosis in HIV disease: a meta-analytic review of prospective investigations. Brain Behav Immun. 2009;23(4):434–45.PubMedCrossRef

43.

44.

Motivala SJ, Hurwitz BE, Llabre MM, Klimas NG, Fletcher MA, Antoni MH, et al. Psychological distress is associated with decreased memory helper T-cell and B-cell counts in pre-AIDS HIV seropositive men and women but only in those with low viral load. Psychosom Med. 2003;65(4):627–35.PubMedCrossRef

45.

Greeson JM, Hurwitz BE, Llabre MM, Schneiderman N, Penedo FJ, Klimas NG. Psychological distress, killer lymphocytes and disease severity in HIV/AIDS. Brain Behav Immun. 2008;22(6):901–11.PubMedCrossRef

46.

McIntosh RC, Hurwitz BE, Antoni M, Gonzalez A, Seay J, Schneiderman N. The ABCs of trait anger, psychological distress, and disease severity in HIV. Ann Behav Med. 2014;49(3):420–33.CrossRef

47.

Li F, Duncan TE, Duncan SC, Acock A. Latent growth modeling of longitudinal data: a finite growth mixture modeling approach. Struct Equ Model. 2001;8(4):493–530.CrossRef

48.

Hancock GR, Kuo W-L, Lawrence FR. An illustration of second-order latent growth models. Struct Equ Model. 2001;8(3):470–89.CrossRef

49.

Sayer AG, Cumsille PE. Second-order latent growth models. 2001.

50.

Ironson G, O’Cleirigh C, Fletcher MA, Laurenceau JP, Balbin E, Klimas N, et al. Psychosocial factors predict CD4 and viral load change in men and women with human immunodeficiency virus in the era of highly active antiretroviral treatment. Psychosom Med. 2005;67(6):1013–21.PubMedPubMedCentralCrossRef

51.

Ironson G, Balbin E, Stuetzle R, Fletcher MA, O’Cleirigh C, Laurenceau J, et al. Dispositional optimism and the mechanisms by which it predicts slower disease progression in HIV: proactive behavior, avoidant coping, and depression. Int J Behav Med. 2005;12(2):86–97.PubMedPubMedCentralCrossRef

52.

Ironson G, Balbin E, Stieren E, Detz K, Fletcher MA, Schneiderman N, et al. Perceived stress and norepinephrine predict the effectiveness of response to protease inhibitors in HIV. Int J Behav Med. 2008;15(3):221–6.PubMedPubMedCentralCrossRef

53.

Taylor GJ, Ryan D, Bagby RM. Toward the development of a new self-report alexithymia scale. Psychother Psychosom. 1985;44(4):191–9.PubMedCrossRef

54.

Beck AT, Ward C, Mendelson M. Beck Depression Inventory (BDI). Arch Gen Psychiatry. 1961;4(6):561–71.PubMedCrossRef

55.

Spielberger CD. State‐trait anxiety inventory: Wiley Online Library. 2010.

56.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.PubMedCrossRef

57.

Chesney MA, Ickovics J, Chambers D, Gifford A, Neidig J, Zwickl B, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. AIDS Care. 2000;12(3):255–66.PubMedCrossRef

58.

Reynolds NR, Sun J, Nagaraja HN, Gifford AL, Wu AW, Chesney MA. Optimizing measurement of self-reported adherence with the ACTG adherence questionnaire: a cross-protocol analysis. J Acquir Immune Defic Syndr. 2007;46(4):402–9.PubMedCrossRef

59.

Markus KA. Principles and practice of structural equation modeling by Rex B. Kline. Struct Equ Model Multidiscip J. 2012;19(3):509–12.CrossRef

60.

Muthen L, Muthen B. MPlus 4.1. Los Angeles: Muthen & Muthen; 2006.

61.

McArdle JJ. Structural factor analysis experiments with incomplete data. Multivar Behav Res. 1994;29(4):409–54.CrossRef

62.

Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999;6(1):1–55.CrossRef

63.

Baron RM, Kenny DA. The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173.PubMedCrossRef

64.

Sobel ME. Asymptotic confidence intervals for indirect effects in structural equation models. Sociol Methodol. 1982;13(1982):290–312.CrossRef

65.

Ironson G, Hayward H. Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosom Med. 2008;70(5):546–54.PubMedPubMedCentralCrossRef

66.

Milam JE, Richardson JL, Marks G, Kemper CA, Mccutchan AJ. The roles of dispositional optimism and pessimism in HIV disease progression. Psychol Health. 2004;19(2):167–81.CrossRef

67.

Carrico AW, Riley ED, Johnson MO, Charlebois ED, Neilands TB, Remien RH, et al. Psychiatric risk factors for HIV disease progression: the role of inconsistent patterns of anti-retroviral therapy utilization. J Acquir Immune Defic Syndr. 2011;56(2):146. 1999.PubMedPubMedCentralCrossRef

68.

O’Cleirigh C, Ironson G, Weiss A, Costa Jr PT. Conscientiousness predicts disease progression (CD4 number and viral load) in people living with HIV. Health Psychol. 2007;26(4):473.PubMedCrossRef

69.

Penedo FJ, Gonzalez JS, Dahn JR, Antoni M, Malow R, Costa P, et al. Personality, quality of life and HAART adherence among men and women living with HIV/AIDS. J Psychosom Res. 2003;54(3):271–8.PubMedCrossRef

70.

Temoshok LR, Waldstein SR, Wald RL, Garzino-Demo A, Synowski SJ, Sun L, et al. Type C coping, alexithymia, and heart rate reactivity are associated independently and differentially with specific immune mechanisms linked to HIV progression. Brain Behav Immun. 2008;22(5):781–92.PubMedCrossRef

71.

Semple SJ, Patterson TL, Temoshok LR, McCutchan JA, Straits-Troster K, Chandler JA, et al. Identification of psychobiological stressors among HIV-positive women. Women Health. 2003;20(4):15–36.CrossRef

72.

Thompson SC, Nanni C, Levine A. The stressors and stress of being HIV-positive. AIDS Care. 1996;8(1):5–14.PubMedCrossRef

73.

Peterson JL, Folkman S, Bakeman R. Stress, coping, HIV status, psychosocial resources, and depressive mood in African American gay, bisexual, and heterosexual men. Am J Community Psychol. 1996;24(4):461–87.PubMedCrossRef

74.

McIntosh RC, Rosselli M. Stress and coping in women living with HIV: a meta-analytic review. AIDS Behav. 2012;16(8):2144–59.PubMedCrossRef

75.

Moskowitz JT, Hult JR, Bussolari C, Acree M. What works in coping with HIV? A meta-analysis with implications for coping with serious illness. Psychol Bull. 2009;135(1):121.PubMedCrossRef

76.

Kopnisky KL, Stoff DM, Rausch DM. Workshop report: the effects of psychological variables on the progression of HIV-1 disease. Brain Behav Immun. 2004;18(3):246–61.PubMedCrossRef

77.

Antoni MH. Stress, coping, and health in HIV/AIDS. The Oxford Handbook of Stress, Health, and Coping. 2010:428.

78.

Cardena E. The domain of dissociation. 1994.

79.

Lipsanen T, Saarijärvi S, Lauerma H. Exploring the relations between depression, somatization, dissociation and alexithymia—overlapping or independent constructs? Psychopathology. 2004;37(4):200–6.PubMedCrossRef

80.

Grabe H-J, Rainermann S, Spitzer C, Gänsicke M, Freyberger H. The relationship between dimensions of alexithymia and dissociation. Psychother Psychosom. 2000;69(3):128–31.PubMedCrossRef

81.

Guilbaud O, Corcos M, Hjalmarsson L, Loas G, Jeammet P. Is there a psychoneuroimmunological pathway between alexithymia and immunity? Immune and physiological correlates of alexithymia. Biomed Pharmacother. 2003;57(7):292–5.PubMedCrossRef

82.

Bruni R, Serino F, Galluzzo S, Coppolino G, Cacciapaglia F, Vadacca M, et al. Alexithymia and neuroendocrine-immune response in patients with autoimmune diseases. Ann N Y Acad Sci. 2006;1069(1):208–11.PubMedCrossRef

83.

Bossu P, Salani F, Cacciari C, Picchetto L, Cao M, Bizzoni F, et al. Disease outcome, alexithymia and depression are differently associated with serum IL-18 levels in acute stroke. Curr Neurovasc Res. 2009;6(3):163–70.PubMedCrossRef

84.

Corcos M, Guilbaud O, Paterniti S, Curt F, Hjalmarsson L, Moussa M, et al. Correlation between serum levels of interleukin-4 and alexithymia scores in healthy female subjects: preliminary findings. Psychoneuroendocrinology. 2004;29(5):686–91.PubMedCrossRef

85.

Guilbaud O, Curt F, Perrin C, Chaouat G, Berthoz S, Dugré-Le Bigre C, et al. Decreased immune response in alexithymic women: a cross-sectional study. Biomed Pharmacother. 2009;63(4):297–304.PubMedCrossRef

86.

Uher T. Alexithymia and immune dysregulation: a critical review. Act Nerv Super. 2010;52(1):40–4.CrossRef

87.

Spitzer C, Brandl S, Rose H-J, Nauck M, Freyberger HJ. Gender-specific association of alexithymia and norepinephrine/cortisol ratios. A preliminary report. J Psychosom Res. 2005;59(2):73–6.PubMedCrossRef

88.

Henry JP, Haviland MG, Cummings MA, Anderson DL, Nelson JC, MacMurray JP, et al. Shared neuroendocrine patterns of post-traumatic stress disorder and alexithymia. Psychosom Med. 1992;54(4):407–15.PubMedCrossRef

89.

Härtwig EA, Aust S, Heuser I. HPA system activity in alexithymia: a cortisol awakening response study. Psychoneuroendocrinology. 2013;38(10):2121–6.CrossRef

90.

Connor RI, Ho DD. Human immunodeficiency virus type 1 variants with increased replicative capacity develop during the asymptomatic stage before disease progression. J Virol. 1994;68(7):4400–8.PubMedPubMedCentral

91.

Wei X, Ghosh SK, Taylor ME, Johnson VA, Emini EA, Deutsch P, et al. Viral dynamics in human immunodeficiency virus type 1 infection. Nature. 1995;373(6510):117–22.PubMedCrossRef

92.

Ho DD, Neumann AU, Perelson AS, Chen W, Leonard JM, Markowitz M. Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection. Nature. 1995;373(6510):123–6.PubMedCrossRef

93.

Connor RI, Mohri H, Cao Y, Ho DD. Increased viral burden and cytopathicity correlate temporally with CD4+ T-lymphocyte decline and clinical progression in human immunodeficiency virus type 1-infected individuals. J Virol. 1993;67(4):1772–7.PubMedPubMedCentral

94.

Leserman J, Petitto JM, Golden RN, Gaynes BN, Gu H, Perkins DO, et al. Impact of stressful life events, depression, social support, coping, and cortisol on progression to AIDS. Am J Psychiatr. 2000;157(8):1221–8.PubMedCrossRef

95.

Cole SW, Korin YD, Fahey JL, Zack JA. Norepinephrine accelerates HIV replication via protein kinase A-dependent effects on cytokine production. J Immunol. 1998;161(2):610–6.PubMed

96.

Cole SW. Psychosocial influences on HIV-1 disease progression: neural, endocrine, and virologic mechanisms. Psychosom Med. 2008;70(5):562–8.PubMedCrossRef

97.

Cole SW, Naliboff BD, Kemeny ME, Griswold MP, Fahey JL, Zack JA. Impaired response to HAART in HIV-infected individuals with high autonomic nervous system activity. Proc Natl Acad Sci. 2001;98(22):12695–700.PubMedPubMedCentralCrossRef

98.

Singh N, Squier C, Sivek C, Wagener MM, Victor LY. Psychological stress and depression in older patients with intravenous drug use and human immunodeficiency virus infection: implications for intervention. Int J STD AIDS. 1997;8(4):251–5.PubMedCrossRef

99.

LeBlanc AJ. Aging with HIV/AIDS. Handbook of Sociology of Aging: Springer; 2011, p. 495–512.

100.

Ironson G, O’cleirigh C, Kumar M, Kaplan L, Balbin E, Kelsch C, et al. Psychosocial and neurohormonal predictors of HIV disease progression (CD4 cells and viral load): a 4 year prospective study. AIDS Behav. 2015;19(8):1388–97.PubMedPubMedCentralCrossRef

101.

Lumley MA, Tojek TM, Macklem DJ. Effects of written emotional disclosure among repressive and alexithymic people. 2002.

102.

Frisina PG, Borod JC, Lepore SJ. A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. J Nerv Ment Dis. 2004;192(9):629–34.PubMedCrossRef

103.

O’Cleirigh C, Ironson G, Antoni M, Fletcher MA, McGuffey L, Balbin E, et al. Emotional expression and depth processing of trauma and their relation to long-term survival in patients with HIV/AIDS. J Psychosom Res. 2003;54(3):225–35.PubMedCrossRef

104.

O’Cleirigh C, Ironson G, Fletcher MA, Schneiderman N. Written emotional disclosure and processing of trauma are associated with protected health status and immunity in people living with HIV/AIDS. Br J Health Psychol. 2008;13(1):81–4.PubMedPubMedCentralCrossRef

105.

McIntosh RC, Ironson G, Antoni M, Fletcher MA, Schneiderman N. Alexithymia, assertiveness and psychosocial functioning in HIV: implications for medication adherence and disease severity. AIDS Behav. 2015;1–14.

106.

Carpenter KM, Addis ME. Alexithymia, gender, and responses to depressive symptoms. Sex Roles. 2000;43(9–10):629–44.CrossRef

107.

Levant RF, Hall RJ, Williams CM, Hasan NT. Gender differences in alexithymia. Psychol Men Masculinity. 2009;10(3):190.CrossRef

108.

Kokkonen P, Karvonen JT, Veijola J, Läksy K, Jokelainen J, Järvelin M-R, et al. Prevalence and sociodemographic correlates of alexithymia in a population sample of young adults. Compr Psychiatry. 2001;42(6):471–6.PubMedCrossRef

109.

Mattila AK, Salminen JK, Nummi T, Joukamaa M. Age is strongly associated with alexithymia in the general population. J Psychosom Res. 2006;61(5):629–35.PubMedCrossRef

110.

Bangsberg DR, Perry S, Charlebois ED, Clark RA, Roberston M, Zolopa AR, et al. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS. 2001;15(9):1181–3.PubMedCrossRef

111.

Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, et al. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. AIDS. 2000;14(4):357–66.PubMedCrossRef

112.

Mannheimer S, Friedland G, Matts J, Child C, Chesney M. The consistency of adherence to antiretroviral therapy predicts biologic outcomes for human immunodeficiency virus–infected persons in clinical trials. Clin Infect Dis. 2002;34(8):1115–21.PubMedCrossRef

113.

Pillai R, Nair BS, Watson RR. AIDS, drugs of abuse and the immune system: a complex immunotoxicological network. Arch Toxicol. 1991;65(8):609–17.PubMedCrossRef

114.

Giannini AJ. Alexithymia, affective disorders and substance abuse: possible cross-relationships. Psychol Rep. 1996;78(3c):1389–90.PubMedCrossRef

115.

Haviland MG, Hendryx MS, Shaw DG, Henry JP. Alexithymia in women and men hospitalized for psychoactive substance dependence. Compr Psychiatry. 1994;35(2):124–8.PubMedCrossRef

116.

Lane RD, Weihs KL, Herring A, Hishaw A, Smith R. Affective agnosia: expansion of the alexithymia construct and a new opportunity to integrate and extend Freud’s legacy. Neurosci Biobehav Rev. 2015;55:594–611.PubMedCrossRef

117.

Ricciardi L, Demartini B, Fotopoulou A, Edwards MJ. Alexithymia in neurological disease: a review. J Neuropsychiatry Clin Neurosci. 2015:appi. neuropsych. 14070169.

118.

Lutgendorf SK, Antoni MH, Ironson G, Starr K, Costello N, Zuckerman M, et al. Changes in cognitive coping skills and social support during cognitive behavioral stress management intervention and distress outcomes in symptomatic human immunodeficiency virus (HIV)-seropositive gay men. Psychosom Med. 1998;60(2):204–14.PubMedCrossRef

119.

Antoni M, Cruess D, Wagner S, Lutgendorf S, Kumar M, Ironson G, et al. Cognitive behavioral stress management effects on anxiety, 24-hour urinary catecholamine output, and T-cytotoxic/suppressor cells over time among symptomatic HIV-infected gay men. J Consult Clin Psychol. 2000;68:31–45.PubMedCrossRef

120.

Antoni MH, Cruess S, Cruess DG, Kumar M, Lutgendorf S, Ironson G, et al. Cognitive-behavioral stress management reduces distress and 24-hour urinary free cortisol output among symptomatic HIV-infected gay men. Ann Behav Med. 2000;22(1):29–37.PubMedCrossRef

121.

Antoni MH, Carrico AW, Durán RE, Spitzer S, Penedo F, Ironson G, et al. Randomized clinical trial of cognitive behavioral stress management on human immunodeficiency virus viral load in gay men treated with highly active antiretroviral therapy. Psychosom Med. 2006;68(1):143–51.PubMedCrossRef

122.

Antoni MH, Pereira DB, Marion I, Ennis N, Andrasik MP, Rose R, et al. Stress management effects on perceived stress and cervical neoplasia in low-income HIV-infected women. J Psychosom Res. 2008;65(4):389–401.PubMedPubMedCentralCrossRef

123.

Antoni MH, Cruess DG, Klimas N, Carrico AW, Maher K, Cruess S, et al. Increases in a marker of immune system reconstitution are predated by decreases in 24-h urinary cortisol output and depressed mood during a 10-week stress management intervention in symptomatic HIV-infected men. J Psychosom Res. 2005;58(1):3–13.PubMedCrossRef

124.

Antoni MH, Cruess DG, Klimas N, Maher K, Cruess S, Kumar M, et al. Stress management and immune system reconstitution in symptomatic HIV-infected gay men over time: effects on transitional naïve T cells (CD4+ CD45RA+ CD29+). Am J Psychiatr. 2002;159(1):143–5.PubMedCrossRef

Titel: Psychological Distress Mediates the Effect of Alexithymia on 2-Year Change in HIV Viral Load
verfasst von: Roger C. McIntosh
Gail Ironson
Michael Antoni
Betty Lai
Mahendra Kumar
Mary Ann Fletcher
Neil Schneiderman
Publikationsdatum: 23.11.2016
Verlag: Springer US
Erschienen in: International Journal of Behavioral Medicine / Ausgabe 2/2017
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-016-9602-7

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2017

Classifying Fibromyalgia Syndrome as a Mental Disorder?—An Ambulatory Assessment Study

Psychometric Testing of the Chinese-Version Glover-Nilsson Smoking Behavioral Questionnaire (GN-SBQ-C) for the Identification of Nicotine Dependence in Adult Smokers in Taiwan

Influence of Depression and Hostility on Exercise Tolerance and Improvement in Patients with Coronary Heart Disease

The Key Role of Pain Catastrophizing in the Disability of Patients with Acute Back Pain

The Association Between Social Support, Body Mass Index and Increased Risk of Prediabetes: the Cardiovascular Risk in Young Finns Study

Psychometric Properties of the Arabic Version of the Drug Use Disorders Identification Test (DUDIT) in Clinical, Prison Inmate, and Student Samples