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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. [ABSTRACT FROM AUTHOR]

Background: Numerous studies conducted within the USA demonstrate higher levels of benefit finding in ethnic minority individuals compared to nonminority individuals living with chronic disease. Purpose: As benefit finding may be a salient buffer for the effects of stress, the current study examined the association between perceived stress and benefit finding in human immunodeficiency virus (HIV)+ men who have sex with men (MSM) living in the southeast USA and investigated whether ethnicity was a moderator of this relationship. We hypothesized that benefit finding would be greater in ethnic minority MSM than in white MSM and that ethnic minority MSM with high levels of stress would experience greater benefit finding than their white MSM counterparts. Method: The current study utilized baseline (T1) and 3-month follow-up (T2) data drawn from a previous trial of a psychosocial intervention in HIV+ MSM. Participants were 130 HIV+ MSM; 52 % were white and 48 % belonged to minority ethnic groups (African-American, Caribbean-American, Hispanic). Results: Analyses revealed that benefit finding was greater in ethnic minority MSM at baseline; however, this difference became nonsignificant when age, education level, highly active antiretroviral therapy adherence, and CD4 count were added to the model. Moderated regression analyses revealed a significant interaction between T1 perceived stress and ethnicity in predicting T2 benefit finding, such that higher levels of T1 perceived stress predicted lower levels of T2 benefit finding in ethnic minority MSM only. This association was independent of intervention group assignment. Conclusion: The current study's results highlight potential differences in the relationship between stress and benefit finding processes in white and ethnic minority HIV+ MSM. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular reactivity has been examined as a risk marker or factor in the pathogenesis of hypertension or cardiovascular disease, but few have examined the relationship with the metabolic syndrome. Purpose: We examined whether cardiovascular reactivity to laboratory stress is associated with individual cardiometabolic risk factors and their co-occurrence. A significant positive relationship was hypothesized for both individual and clustered risk factors in their cross-sectional associations with reactivity to multiple stressors. Methods: A sample of 144, 15-17-year-old adolescents (74 % boys) largely from ethnic minority groups (54 % Hispanic White, 26 % Black) were identified at annual blood pressure (BP) screening (39 % with elevated BP) at high schools in Miami, Florida, USA. Participants completed the evaluated speaking, mirror star tracing, and cold pressor tasks, as well as cardiometabolic risk factor blood sampling. Participants were classified into metabolic syndrome criterion groups (0, 1, 2, or ≥3 criteria) based on American Heart Association adult criteria. Results: Multiple regression analyses with individual metabolic syndrome variables demonstrated that diastolic (D)BP reactivity during the mirror star tracing task accounted for 1.3 %, 3.8 %, and 5.1 % of the respective variances in casual systolic BP, waist circumference, and triglycerides ( ps < 0.05). In multinomial logistic regression models, increased DBP reactivity during mirror star tracing and cold pressor tasks, and decreased HR reactivity during the cold pressor, were associated with greater likelihood of risk factor co-occurrence (ranging from 8.3 % to 15.8 %). Conclusions: Findings indicate that autonomic reactivity to the mirror star tracing and cold pressor tasks, but not the evaluated speaking task, is associated with risk factor co-occurrence, and reactivity may be a clinical prognosticator of cardiometabolic disease risk. [ABSTRACT FROM AUTHOR]

Background: Health Locus of Control (HLOC) has been related to a number of psychosocial and medical variables in previous research in HIV. However, there is little information about its relationship to disease status, or about the Doctors subscale (DHLOC), in this population. Purpose: The main purpose of the present study was to determine whether HLOC beliefs were related to 'healthy survival with AIDS' status, and to do so with the DHLOC subscale in addition to the other HLOC subscales. Method: Two HIV-positive groups, healthy survivors (HS; n = 70) who had experienced an asymptomatic period of ≥9 months despite low CD4 cells (<50) without the aid of protease inhibitors and a matched control group (MC; n = 70) of individuals in the mid-range of disease progression were compared on the HLOC scales. Several factors were examined as potential mediators. Results: The HS group had significantly higher DHLOC and lower Internal HLOC (IHLOC) than the MC group. Both DHLOC and IHLOC contributed unique variance in relationship to HS status. These findings were not due to group differences in age, gender, ethnicity, income, education, sexual orientation, or HIV viral load. Conclusions: HLOC may contribute to the particular psychosocial profile of this relatively 'rare' group of HIV-positive individuals who remained asymptomatic despite very low CD4 cells. Higher DHLOC and lower IHLOC beliefs may be adaptive for HIV-positive individuals at an advanced stage of disease progression, and therefore modifying HLOC beliefs may be a worthwhile focus of future interventions. [ABSTRACT FROM AUTHOR]

Focuses on the concepts of behavioral medicine. Definition of behavioral medicine; Emphasis of the International Society of Behavioral Medicine on original reports with quality research; Provision of the integration of biomedical and behavioral investigation.