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The Relation Between Emotional Dysregulation and Anxiety and Depressive Symptoms, Pain-Related Anxiety, and HIV-Symptom Distress Among Adults with HIV/AIDS

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Abstract

The current study investigated the relations between emotional dysregulation and anxiety and depressive symptoms, pain-related anxiety, and HIV-symptom distress among individuals living with HIV/AIDS. This research is important in its explanatory value regarding the unique effects of emotional dysregulation as it relates to psychological and disease-specific distress given high rates of distress specific to HIV infection (e.g. medicatin side-effects, stigma). Participants included 164 adults (17.1 % female, Mage = 48.40, SD = 9.57) with HIV/AIDS. Results indicated that emotional dysregulation was significantly and positively related to anxiety and depressive symptoms, pain-related anxiety, and HIV-symptom distress. All emotional dyregulation effects were evidenced above and beyond the variance accounted for by demographic and HIV-specific characteristics, and the main effects of anxiety sensitivity and distress intolerance. Findings are discussed in terms of the importance of emotional dysregulation in negative affective experiences within the HIV/AIDS population.

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Notes

  1. Post hoc analyses examining the effects of the DERS-subscales on all criterion variables were run but did not yield consistent, significant results and thus were not included in the present article. Future work would do well to examine sub-facets of emotional dysregulation to identify particular explanatory components of most relevance to psychological distress and HIV-symptom specific distress among the HIV/AIDS population. These supplementary analyses can be obtained upon request from Charles P. Brandt.

References

  • Abelson, R. P. (1985). A variance explanation paradox: When a little is a lot. Psychological Bulletin, 97(1), 129–133. doi:10.1037/0033-2909.97.1.129.

    Google Scholar 

  • Anestis, M. D., Bagge, C. L., Tull, M. T., & Joiner, T. E. (2011). Clarifying the role of emotion dysregulation in the interpersonal-psychological theory of suicidal behavior in an undergraduate sample. Journal of Psychiatric Research, 45(5), 603–611. doi:10.1016/j.jpsychires.2010.10.013.

    Article  PubMed  Google Scholar 

  • Berger, B. E., Ferrans, C. E., & Lashley, F. R. (2001). Measuring stigma in people with HIV: psychometric assessment of the HIV Stigma Scale. Research in Nursing & Health, 24(6), 518–529. doi:10.1002/nur.10011.

    Article  Google Scholar 

  • Blashill, A. J., Perry, N., & Safren, S. A. (2011). Mental health: a focus on stress, coping, and mental illness as it relates to treatment retention, adherence, and other health outcomes. Current HIV/AIDS Reports, 8(4), 215–222. doi:10.1007/s11904-011-0089-1.

    Article  PubMed  Google Scholar 

  • Bonn-Miller, M. O., Vujanovic, A. A., & Zvolensky, M. J. (2008). Emotional dysregulation: association with coping-oriented marijuana use motives among current marijuana users. Substance Use & Misuse, 43(11), 1653–1665. doi:10.1080/10826080802241292.

    Article  Google Scholar 

  • Bunn, J. Y., Solomon, S. E., Miller, C., & Forehand, R. (2007). Measurement of stigma in people with HIV: a reexamination of the HIV stigma scale. AIDS Education and Prevention, 19(3), 198–208. doi:10.1521/aeap. 2007.19.3.198.

    Article  PubMed  Google Scholar 

  • Capron, D. W., Gonzalez, A., Parent, J., Zvolensky, M. J., & Schmidt, N. B. (2012). Suicidality and anxiety sensitivity in adults with HIV. AIDS Patient Care and STDs, 26(5), 298–303. doi:10.1089/apc.2011.0429.

    Article  PubMed  Google Scholar 

  • Carver, C. S., Lawrence, J. W., & Scheier, M. F. (1996). A control-process perspective on the origins of affect. In L. L. Martin & A. Tesser (Eds.), Striving and feeling: Interactions among goals, affect, and self-regulation (pp. 11–52). Hillsdale: Lawrence Erlbaum Associates, Inc.

    Google Scholar 

  • Center for Disease Control and Prevention. HIV surveillance report, 2009; vol. 21. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Published February 2011. Accessed [May, 2012].

  • Chandra, P. S., Ravi, V. V., Desai, A. A., & Subbakrishna, D. K. (1998). Anxiety and depression among HIV-infected heterosexuals- a report from India. Journal of Psychosomatic Research, 45(5), 401–409. doi:10.1016/S0022-3999(98)00028-2.

    Article  PubMed  Google Scholar 

  • Chandra, P. S., Deepthivarma, S. S., Jairam, K. R., & Thomas, T. (2003). Relationship of psychological morbidity and quality of life to illness-related disclosure among HIV-infected persons. Journal of Psychosomatic Research, 54(3), 199–203. doi:10.1016/S0022-3999(02)00567-6.

    Article  PubMed  Google Scholar 

  • Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Mahwah: Erlbaum.

    Google Scholar 

  • Daughters, S. B., Magidson, J. F., Schuster, R. M., & Safren, S. A. (2010). ACT HEALTHY: a combined cognitive-behavioral depression and medication adherence treatment for HIV-infected substance users. Cognitive and Behavioral Practice, 17(3), 309–321. doi:10.1016/j.cbpra.2009.12.003.

    Article  PubMed  Google Scholar 

  • Dowshen, N., Binns, H. J., & Garofalo, R. (2009). Experiences of HIV-related stigma among young men who have sex with men. AIDS Patient Care and STDs, 23(5), 371–376. doi:10.1089/apc.2008.0256.

    Article  PubMed  Google Scholar 

  • Els, C., Boshoff, W., Scott, C., Strydom, W., Joubert, G., & Van Der Ryst, E. (1999). Psychiatric co-morbidity in South African HIV/AIDS patients. South African Journal of Medicine, 89(9), 992–995.

    Google Scholar 

  • Ferrando, S. J., & Freyberg, Z. (2008). Treatment of depression in HIV positive individuals: a critical review. International Review of Psychiatry, 20(1), 61–71. doi:10.1080/09540260701862060.

    Article  PubMed  Google Scholar 

  • Golub, S. A., Tomassilli, J. C., & Parsons, J. T. (2009). Partner serostatus and disclosure stigma: implications for physical and mental health outcomes among HIV-positive adults. AIDS and Behavior, 13(6), 1233–1240. doi:10.1007/s10461-008-9466-1.

    Article  PubMed  Google Scholar 

  • Gonzalez, A., Zvolensky, M. J., Vujanovic, A. A., Leyro, T. M., & Marshall, E. C. (2008). An evaluation of anxiety sensitivity, emotional dysregulation, and negative affectivity among daily cigarette smokers: relation to smoking motives and barriers to quitting. Journal of Psychiatric Research, 43, 138–147. doi:10.1016/j.jpsychires.2008.03.002.

    Article  PubMed  Google Scholar 

  • Gonzalez, A., Solomon, S. E., Zvolensky, M. J., & Miller, C. T. (2009). The interaction of mindful-based attention and awareness and disengagement coping with HIV/AIDS-related stigma in regard to concurrent anxiety and depressive symptoms among adults with HIV/AIDS. Journal of Health Psychology, 14(3), 403–413. doi:10.1177/1359105309102193.

    Article  PubMed  Google Scholar 

  • Gonzalez, A., Zvolensky, M. J., Solomon, S. E., & Miller, C. T. (2010). Exploration of the relevance of anxiety sensitivity among adults living with HIV/AIDS for understanding anxiety vulnerability. Journal of Health Psychology, 15(1), 138–146. doi:10.1177/1359105309344898.

    Article  PubMed  Google Scholar 

  • Gonzalez, A., Zvolensky, M. J., Parent, J., Grover, K. W., & Hickey, M. (2012). HIV symptom distress and anxiety sensitivity in relation to panic, social anxiety, and depression symptoms among HIV + adults. AIDS Patient Care and STDs, 26(3), 156–164. doi:10.1089/apc.2011.0309.

    Article  PubMed  Google Scholar 

  • Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. doi:10.1023/B:JOBA.0000007455.08539.94.

    Article  Google Scholar 

  • Gratz, K. L., & Tull, M. T. (2010). The relationship between emotion dysregulation and deliberate self-harm among inpatients with substance use disorders. Cognitive Therapy and Research, 34(6), 544–553. doi:10.1007/s10608-009-9268-4.

    Article  PubMed  Google Scholar 

  • Gross, J. J. (1998). The emerging field of emotion regulation: an integrative review. Review of General Psychology, 2(3), 271–299. doi:10.1037/1089-2680.2.3.271.

    Article  Google Scholar 

  • Hirsch, M. S., Conway, B., D’Aquila, R. T., Johson, V. A., Brun-Vezinet, F., Clotet, B., et al. (1998). Antiretroviral drug resistance testing in adults with HIV infection: implications for clinical management. International AIDS Society—USA Panel. JAMA, 279(24).

  • Justice, A., Holmes, W., Gifford, A., Rabeneck, L., Zackin, R., Sinclair, G., Weissman, S., et al. (2001). Development and validation of a self-completed HIV symptom index. Journal of Clinical Epidemiology, 54(12, Supplement 1), S77–S90. doi:10.1016/S0895-4356(01)00449-8.

    Article  PubMed  Google Scholar 

  • Kashdan, T. B., Zvolensky, M. J., & McLeish, A. C. (2008). Anxiety sensitivity and affect regulatory strategies: individual and interactive risk factors for anxiety-related symptoms. Journal of Anxiety Disorders, 22(3), 429–440. doi:10.1016/j.janxdis.2007.03.011.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Berglund, P. B., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. doi:10.1001/archpsyc.62.6.593.

    Article  PubMed  Google Scholar 

  • Leserman, J., Ironson, G., O’Cleirigh, C., Fordiani, J. M., & Balbin, E. (2008). Stressful life events and adherence in HIV. AIDS Patient Care and STDs, 22(5), 403–411. doi:10.1089/apc.2007.0175.

    Article  PubMed  Google Scholar 

  • Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. Diagnosis and treatment of mental disorders. New York: Guilford Press.

    Google Scholar 

  • Lorenz, K. A., Cunningham, W. E., Spritzer, K. L., & Hays, R. D. (2006). Changes in symptoms and health-related quality of life in a nationally representative sample of adults in treatment for HIV. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 15(6), 951–958. doi:10.1007/s11136-005-6010-x.

    Article  Google Scholar 

  • Low-Beer, S. S., Chan, K. K., Wood, E. E., Yip, B. B., Montaner, J. G., O’Shaughnessy, M. O., & Hogg, R. S. (2000). Health related quality of life among persons with HIV after the use of protease inhibitors. Quality of Life Research: An International Journal of Quality of Life Aspects Of Treatment, Care, & Rehabilitation, 9(8), 941–949. doi:10.1023/A:1008985728271.

    Article  Google Scholar 

  • McCracken, L. M., Zayfert, C., & Gross, R. T. (1992). The pain anxiety symptoms scale: development and validation of a scale to measure fear of pain. Pain, 50(1), 67–73. doi:10.1016/0304-3959(92)90113-P.

    Article  PubMed  Google Scholar 

  • O’Cleirigh, C., Ironson, G., & Smits, J. A. J. (2007). Does distress tolerance moderate the impact of major life events on psychosocial variables and behaviors important in the management of HIV? Behavior Therapy, 38(3), 314–323. doi:10.1016/j.beth.2006.11.001.

    Article  PubMed  Google Scholar 

  • O'Cleirigh, C., Hart, T. A., & James, C. A. (2008). HIV and anxiety. In M. J. Zvolensky, J. J. Smits, M. J. Zvolensky, & J. J. Smits (Eds.), Anxiety in health behaviors and physical illness (pp. 317–340). New York: Springer Science + Business Media.

    Google Scholar 

  • Paterson, D. L., Swindells, S., Mohr, J., Brester, M., Vergis, E. N., Squier, C., Wagener, M. M., & Singh, N. (2000). Adherence to protease inhibitor therapy and outcomes in patients with HIV Infection. Annals of Internal Medicine, 133(1), 21.

    Article  PubMed  Google Scholar 

  • Perretta, P., Nisita, C., Zaccagnini, E., & Lorenzetti, C. (1996). Psychopathology in 90 consecutive human immunodeficiency virus-seropositive and acquired immune deficiency syndrome patients with mostly intravenous drug use history. Comprehensive Psychiatry, 37(4), 267–277. doi:10.1016/S0010-440X(96)90006-1.

    Article  PubMed  Google Scholar 

  • Rabkin, J. G. (2008). HIV and depression: 2008 review and update. Current HIV/AIDS Reports, 5, 163–171. doi:10.1007/s11904-008-0025-1.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., Vujanovic, A. A., & Zvolensky, M. J. (2010). Emotional dysregulation: concurrent relation to sexual problems among trauma-exposed adult cigarette smokers. Journal of Sex & Marital Therapy, 36(2), 137–153. doi:10.1080/00926230903554545.

    Article  Google Scholar 

  • Sewell, M. C., Goggin, K. J., Rabkin, J. G., Ferrando, S. J., McElhiney, M. C., & Evans, S. (2000). Anxiety syndromes and symptoms among men with AIDS: a longitudinal controlled study. Psychosomatics: Journal of Consultation Liaison Psychiatry, 41(4), 294–300. doi:10.1176/appi.psy.41.4.294.

    Article  Google Scholar 

  • Simons, J. S., & Gaher, R. M. (2005). The distress tolerance scale: development and validation of a self-report measure. Motivation and Emotion, 29(2), 83–102. doi:10.1007/s11031-005-7955-3.

    Article  Google Scholar 

  • Sullivan, L. E., Goulet, J. L., Justice, A. C., & Fielin, D. A. (2011). Alcohol consumption and depressive symptoms over time: a longitudinal study of patients with and without HIV infection. Drug and Alcohol Dependence, 117(2–3), 158–163. doi:10.1016/j.drugalcdep. 2011.01.014.

    Article  PubMed  Google Scholar 

  • Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., Abramowitz, J. S., et al. (2007). Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19(2), 176–188. doi:10.1037/1040-3590.19.2.176.

    Article  PubMed  Google Scholar 

  • Thompson, R. A. (1994). Emotion regulation: a theme in search of definition. Monographs of the Society for Research in Child Development, 59(2–3), 25–52. doi:10.2307/1166137. 250–283.

    Article  PubMed  Google Scholar 

  • Tsao, J. C. I., Dobalian, A., Moreau, C., & Dobalian, K. (2004). Stability of anxiety and depression in a national sample of adults with human immunodeficiency virus. The Journal of Nervous and Mental Disease, 192(2), 111–118. doi:10.1097/01.nmd.0000110282.61088.cc.

    Article  PubMed  Google Scholar 

  • Tull, M. T., Rodman, S. A., & Roemer, L. (2008). An examination of the fear of bodily sensations and body hypervigilance as predictors of emotion regulation difficulties among individuals with a recent history of uncued panic attacks. Journal of Anxiety Disorders, 22(4), 750–760. doi:10.1016/j.janxdis.2007.08.001.

    Article  PubMed  Google Scholar 

  • Tull, M. T., Stipelman, B. A., Salters-Pedneault, K., & Gratz, K. L. (2009). An examination of recent non-clinical panic attacks, panic disorder, anxiety sensitivity, and emotion regulation difficulties in the prediction of generalized anxiety disorder in an analogue sample. Journal of Anxiety Disorders, 23(2), 275–282. doi:10.1016/j.janxdis.2008.08.002.

    Article  PubMed  Google Scholar 

  • Vujanovic, A. A., Zvolensky, M. J., & Bernstein, A. (2008). The interactive effects of anxiety sensitivity and emotion dysregulation in predicting anxiety-related cognitive and affective symptoms. Cognitive Therapy and Research, 32(6), 803–817. doi:10.1007/s10608-007-9148-8.

    Article  Google Scholar 

  • Watson, D., Weber, K., Assenheimer, J. S., Clark, L. A., Strauss, M. E., & McCormick, R. A. (1995). Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. Journal of Abnormal Psychology, 104(1), 3–14. doi:10.1037/0021-843X.10.

    Article  PubMed  Google Scholar 

  • Williams, P., Narciso, L., Browne, G., Roberts, J., Weir, R., & Gafni, A. (2005). The prevalence, correlates, and costs of depression in people living with HIV/AIDS in Ontario: implications for service directions. AIDS Education and Prevention, 17(2), 119–130. doi:10.1521/aeap. 17.3.119.62903.

    Article  PubMed  Google Scholar 

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Acknowledgment

This project was funded by a McNeil Prevention and Community Psychology grant awarded to Dr. Gonzalez and a University of Vermont Undergraduate Research Endeavors Competitive Award granted to Justin Parent. We would like to thank Mr. Parent for his work in data management and Michael Hickey and Village Care in New York City for their recruitment efforts.

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Authors and Affiliations

  1. Department of Psychology, University of Houston, Houston, TX, USA

    Charles P. Brandt & Michael J. Zvolensky

  2. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Adam Gonzalez

  3. Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, USA

    Adam Gonzalez

  4. Department of Psychology, University of Vermont, Burlington, VT, USA

    Kristin W. Grover

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  1. Charles P. Brandt
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  2. Adam Gonzalez
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  4. Michael J. Zvolensky
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Correspondence to Charles P. Brandt.

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Brandt, C.P., Gonzalez, A., Grover, K.W. et al. The Relation Between Emotional Dysregulation and Anxiety and Depressive Symptoms, Pain-Related Anxiety, and HIV-Symptom Distress Among Adults with HIV/AIDS. J Psychopathol Behav Assess 35, 197–204 (2013). https://doi.org/10.1007/s10862-012-9329-y

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