The differential impact of PTSD and depression on HIV disease markers and adherence to HAART in people living with HIV
depression; social support; HIV; adherence; PTSD; Environmental & Occupational Health; Public; Biomedical Social Sciences; posttraumatic-stress-disorder; primary care; medication; drug-resistance; protease inhibitors; active antiretroviral therapy; CD4; cell count; outpatient clinics; viral load
Despite high rates of comorbidity, research has typically focused on the independent impact of posttraumatic stress disorder (PTSD) and depression symptoms in people living with HIV (PLWH). The present study examined the independent and comorbid influence of PTSD and depression symptoms on medication adherence, CD4 cell counts, and viral load, over the course of 3 months in 57 PLWH (82% men, 54% Caucasian, 44% African American) recruited from a clinic or social service agency. Both PTSD and depressive symptoms predicted lower subsequent adherence. However, only depressive symptoms predicted lower CD4 counts and presence of a detectable viral load. Participants reporting symptoms consistent with diagnostic levels of comorbid PTSD and depression were less likely to adhere to HAART and were more likely to have a detectable viral load. These results highlight the influences of PTSD and depression on adherence and HIV disease markers, and underscore the importance of examining comorbid symptomatology in PLWH.
Boarts J M; Sledjeski E M; Bogart L M; Delahanty D L
Aids and Behavior
2006
2006-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s10461-006-9069-7" target="_blank" rel="noreferrer noopener">10.1007/s10461-006-9069-7</a>
Alcohol Use Disorder History Moderates The Relationship Between Avoidance Coping And Posttraumatic Stress Symptoms
accident survivors; administered ptsd scale; alcohol use disorder; avoidance coping; cue reactivity; drug-use; follow-up; major depression; patients; posttraumatic stress disorder (PTSD); Psychology; sexual assault survivors; social support; structured clinical interview; Substance Abuse; substance use disorder; Substance Abuse
Avoidance coping (AVC) is common in individuals with posttraumatic stress disorder (PTSD) and in individuals with alcohol use disorder (AUD). Given that PTSD and AUD commonly co-occur, AVC may represent a risk factor for the development of comorbid posttraumatic stress and alcohol use. In this study, the relationship between AVC and PTSD symptoms (PTSS) was examined in individuals with versus without AUDs. Motor vehicle accident (MVA) victims were assessed 6 weeks postaccident for AUD history (i.e. diagnoses of current or past alcohol abuse or dependence) and AVC. PTSS were assessed 6 weeks and 6 months post-MVA. All analyses were conducted on the full sample of MVA victims as well as on the subset of participants who were legally intoxicated (blood alcohol concentration >= 0.08) during the accident. It was hypothesized that the relationship between AVC and PTSS would be stronger in those individuals with an AUD history and especially strong in the subset of individuals who were legally intoxicated during the MVA. Results were largely supportive of this hypothesis, even after controlling for in-hospital PTSS, gender, and current major depression. Early assessment of AUD history and avoidance coping may aid in detecting those at elevated risk for PTSD, and intervening to reduce AVC soon after trauma may help buffer the development of PTSD + AUD comorbidity.
Hruska B; Fallon W; Spoonster E; Sledjeski E M; Delahanty D L
Psychology of Addictive Behaviors
2011
2011-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/a0022439" target="_blank" rel="noreferrer noopener">10.1037/a0022439</a>