Individual change in depression, perceived control, and immune functioning in persons living with AIDS
The present study examined the degree to which perceived control, attributional style, and depression predicted change in the physical and immune system functioning of persons living with AIDS. Forty-two persons diagnosed with HIV-1 Associated Dementia participating in a Randomized Trial for AIDS Dementia Care at the Rivington House skilled nursing facility in lower Manhattan took part in the study. Participants were interviewed over 4 assessment times during the course of the study, allowing for a longitudinal analysis of change using traditional regression-based techniques and growth curve modeling. Results indicated that perceived vicarious control over symptoms at the beginning of the study was positively related to CES-D depression scores at endpoint and follow-up. Forced-entry regression analyses revealed that midpoint CES-D depression scores significantly predicted symptom severity ratings at endpoint and follow-up. Higher depression levels were related to increasing symptom severity ratings. Results from the growth curve analysis demonstrated that midpoint CES-D scores were associated with initial symptom severity ratings, and that summary vicarious control beliefs were associated with a reduction in the symptom severity and viral load growth trajectories over time. As such, vicarious control beliefs had a beneficial impact on health status over time, confirming Rothbaum et al.'s (1982) theory that vicarious control is an adaptive means of coping with threatening events in chronically ill populations. In particular, an association with doctors and nurses appears to improve the psychological and physical functioning of AIDS patients residing in a nursing home. In addition, the relationship between depression and symptom severity ratings supports the psychoneuroimmunology literature (Cohen & Herbert, 1993). In particular, midpoint depression levels predicted endpoint and follow-up symptom severity ratings, as well as were related to initial symptom severity ratings at baseline in the growth curve model. These findings underscore how psychological traits and behavior can affect the health status of persons with AIDS. Future research into the quality of life of persons living with AIDS should examine depression and perceived control as potentially important psychological characteristics contributing to physical functioning and adaptation.
Zaleski, Ellen Howze, "Individual change in depression, perceived control, and immune functioning in persons living with AIDS" (1999). ETD Collection for Fordham University. AAI9955976.