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Most studies predicting the effects of prayer on health have examined intercessory prayer (prayers by others who often don't know you), yet most people pray for their own health and the health of others who they know. Our study, conducted in Miami, USA, differentiated praying for self, known others, and unknown others in people living with HIV, a virus with clearly defined biological markers of progression, enabling control for initial CD4-count and viral load. Only praying for known others predicted greater survival. People with HIV who prayed for known others were twice as likely to survive over 17 years compared to those who did not.

This study explicated associations between trauma-related cognitions and condomless sex, examining avoidance coping style and behavior (i.e., substance use) as intermediate variables, among a group disproportionately affected by both trauma and HIV. Two hundred and ninety HIV-negative MSM with a history of childhood sexual abuse (CSA) completed a cross-sectional psychosocial battery. Trauma-related cognitions were positively associated with more acts of condomless sex. Indirect associations on condomless sex were driven by avoidance coping, but not substance use. Findings indicate a need to address trauma-related cognitions and avoidance coping within interventions for reducing HIV risk among MSM with a history of CSA.

Objectives. To examine the effects of within-neighborhood and neighboring characteristics on discrimination, stigma, mental health, and HIV outcomes among Black women living with HIV (BWLWH). Methods. A total of 151 BWLWH in a southeastern US city provided baseline data (October 2019‒January 2020) on experienced microaggressions and discrimination (race-, gender-, sexual orientation-, or HIV-related), mental health (e.g., depression, posttraumatic stress disorder), and HIV outcomes (e.g., viral load, antiretroviral therapy adherence). Neighborhood characteristics by census tract were gathered from the American Community Survey and the National Center for Charitable Statistics. Spatial econometrics guided the identification strategy, and we used the maximum likelihood technique to estimate relationships between a number of predictors and outcomes. Results. Within-neighborhood and neighboring characteristics (employment, education, crime, income, number of religious organizations, and low-income housing) were significantly related to intersectional stigma, discrimination, mental health, HIV viral load, and medication adherence. Conclusions. Policy, research, and interventions for BWLWH need to address the role of neighborhood characteristics to improve quality of life and HIV outcomes. (Am J Public Health. 2022;112(S4):S433–S443. https://doi.org/10.2105/AJPH.2021.306675 )

Verbal learning deficits are common among sexually traumatized women who have not been formally diagnosed with posttraumatic stress disorder (PTSD). Aberrant resting-state functional connectivity (rsFC) of the amygdala and hippocampus are implicated in PTSD and verbal memory impairment. We tested rsFC between bilateral dentate gyrus (DG) and both centromedial (CM) and basolateral (BL) nuclei of the amygdala as statistical mediators for the effect of sexual trauma-related symptom severity on delayed verbal recall performance in 63 older women (age: 60-85 years) undiagnosed with PTSD. Participant data were drawn from the NKI-Rockland Study. Individuals completed a 10-min resting-state scan, Rey Auditory Verbal Learning Test (RAVLT), and the Sexual Abuse Trauma Index (SATI) from the Trauma Symptom Checklist. Z-scores indicating rsFC of DG with BL and CM amygdala seeds were evaluated in two separate mediation models. Higher SATI scores were associated with lower RAVLT after controlling for age, β = -.23, 95% CI [.48, .03], p = .039. This effect was negated upon adding a negative path from SATI to rsFC of left DG and right CM, β = -.29, 95% CI [-.52, -.02], p = .022, and a positive path from that seed pair to RAVLT List A recall, β = .28, 95% CI [.03, 0.48], p = .015. Chi-square fit indices supported partial mediation by this seed pair, p = .762. In the absence of PTSD sexual trauma symptoms partially relate to verbal learning deficits as a function of aberrant rsFC between left hippocampus DG and right amygdala CM nuclei.

Posttraumatic stress disorder (PTSD) symptoms may interfere with gay, bisexual and other men who have sex with men's (MSM) ability to engage in safe sex practices. An indirect relationship with dissociation may help to elucidate the relationship between PTSD symptom severity and condomless sex among MSM with childhood sexual abuse (CSA) histories. These relationships have not previously been examined in this group, which has a unique vulnerability for HIV acquisition. A cross-sectional sample of MSM with histories of CSA (N=290) was recruited at study sites in Boston, MA, and Miami, FL. Participants had a mean age of 37.95 years (SD=11.68), 22% were African American and 29.4% identified as Latino. The sample reported a mean of 10.47 (SD=4.38) lifetime PTSD symptoms and 26.4% met the clinical threshold for dissociation. Logistic regression models (adjusted for age, education, and substance use disorder) were used to assess indirect effects of dissociation on the relationship between lifetime PTSD symptoms and condomless anal/vaginal sex episodes with serodiscordant or unknown status partners in the past 3 months. Dissociation accounted for the association between lifetime PTSD symptom severity and condomless sex episodes. The Sobel test (Sobel = 2.04, p= .042; CI 95% bias-corrected bootstrap) suggested significant indirect effects for dissociation. Dissociation among MSM with CSA histories may compromise accurate appraisals of sexual risk and safety and increase vulnerability for HIV acquisition. Further research is warranted to address HIV prevention in the context of PTSD symptom severity to improve the mental health of MSM and increase the effectiveness of HIV prevention interventions.

Previous research has highlighted both psychological and structural risk factors as correlates of condomless anal sex, a key pathway to HIV acquisition in men who have sex with men (MSM). Fewer studies have focused on positive psychobehavioral factors, which may be associated with more consistent condom use. This study hypothesized that positive psychobehavioral factors would be associated with more frequent condom use over and above psychological and structural risk factors. MSM with histories of childhood sexual abuse in Boston, MA and Miami, FL (N = 108) completed cross-sectional assessments of psychosocial, structural, and positive psychobehavioral factors. These factors were entered simultaneously in a linear regression model to examine their association with frequency of condomless sex. More recent seroadaptive behavior (B = 0.323, 95% CI = 0.055–0.590, p = .019) and receipt of government benefits to supplement income (B = 0.892, 95% CI = 0.171–1.612, p = .016) were independently associated with higher frequency of condomless sex over and above all other psychosocial, structural, and positive psychobehavioral factors. R2 for the final model was 0.270. Ancillary analyses including participants taking and adherent to biomedical HIV prevention suggested an association between higher distress tolerance and lower frequency of condomless sex. Positive psychobehavioral factors may potentially lower risk for HIV in high-risk MSM; however, left unaddressed, structural disadvantage is a potent influence which may limit potential benefits.

OBJECTIVE The primary purpose of this study was to determine whether meaning in life predicts survival in people living with HIV (PLWH) over 17 years. This study also examined whether interviewer- and transcript-rated meanings predict survival equivalently. A third purpose of the study was to investigate whether meaning in life adds to the prediction of survival over positive emotional expression. METHODS A diverse sample of people with HIV (n = 177) completed an interview on stress and coping at baseline and were followed up for survival up to 17 years. Meaning was measured by interviewer rating of four items (meaningful purpose, unfinished business, finding new meaning, and meaningful activities). Transcript-rated meaning was assessed by two independent raters. Cox proportional hazards regression was used to determine whether meaning predicted survival over 17 years. RESULTS Meaning in life predicted significantly greater survival, adjusting for biomedical and sociodemographic variables whether assessed by interviewer or by transcript raters. Hazard ratios suggest that the effect is moderate to large (2.66-3.45 for top versus bottom third; 2.05-2.49 for top versus bottom half). Significance was maintained after adjusting for positive emotion. CONCLUSIONS Meaning assessed by interview (by both interviewer and transcript ratings) predicted greater survival over 17 years in PLWH and did so above positive emotion. This adds to a literature that is primarily based on self-report questionnaires. Meaning may have beneficial effects for both psychological and physical health in PLWH.

Black women living with HIV (BWLWH) in the U.S. face microaggressions based on race, gender, HIV-status, and sexual orientation. We examined changes in daily microaggressions and related distress among 143 BWLWH in Miami, FL. Microaggression-related distress increased from 52% at baseline/October, peaked at 70% during the holidays (November/December), declined to 55% in March when COVID-19 social distancing began, and peaked to 83% in June/July 2020 during widespread Black Lives Matters protests. Baseline viral suppression was associated with lower microaggressions across the 9-months. Microaggression-related distress may change due to social context and research is needed on microaggressions and viral load overtime.Las mujeres de raza negra que viven con el VIH (MNVV) en los EE. UU. enfrentan microagresiones basadas en la raza, el género, el estado serológico del VIH y la orientación sexual. Examinamos los cambios en las microagresiones diarias y el estrés relacionado entre 143 MNVV en Miami, FL. El estrés relacionado con la microagresión aumentó del 52% en la línea de base/octubre, alcanzó un máximo del 70% durante las vacaciones (noviembre/diciembre), disminuyó al 55% en marzo cuando comenzó el distanciamiento social por el COVID-19 y alcanzó un máximo del 83% en junio/julio de 2020 durante las protestas generalizadas de Black Lives Matters. La supresión viral inicial se asoció con menores microagresiones durante los 9 meses. El estrés relacionada con la microagresión puede cambiar debido al contexto social y se necesitan investigaciones sobre las microagresiones y la carga viral con el tiempo.

Four symptoms of posttraumatic stress (PTSS: intrusion, avoidance, alterations in arousal and reactivity, and negative alterations in cognitions and mood) were put forth by theAdult patients with colorectal cancer (Confirmatory factor analysis revealed good fit of the four-symptom model of PTSS for caregivers at all three times and for patients at T2. Factor loadings of the four symptoms were high, ranging from .47-.97 and .62-.96 among patients and caregivers, respectively.Findings extend the application of the four posttraumatic stress symptoms to patients with chronic major medical illness (cancer) and their family caregivers. Assessment and treatment of subclinical, yet substantial psychological distress precipitated by major medical illness like cancer are warranted. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

BACKGROUND: Life instability may be an important factor for HIV-related care outcomes in older adults living with HIV (OALWH). This study examined the degree to which an 11-item life instability index (LII) composed of individual- and community-level indicators was associated with HIV-related care outcomes—viral load, antiretroviral (ART) medication adherence, rates of detectable viral load, and HIV care appointment non-adherence among OALWH in the Miami area. METHODS: Six hundred twenty-three OALWH completed an interviewer-administered assessment (English or Spanish), which was matched with medical record data. RESULTS: Participants reported about six LII indicators each (M = 6.08, SD = 1.44). Greater index scores were associated with worse self-reported ART adherence (b = − 1.14, p = 0.03), lower observed appointment adherence (b = 0.02, p < 0.01), higher viral load (b = 0.09, p = 0.02), and greater odds of viral detection (OR = 1.22, p = 0.01). Regarding health behaviors, life instability was significantly associated with increased illicit substance use among participants and not associated with depression or anxiety. The association of life instability to ART adherence remained significant (although attenuated) when controlling for the significant effects of substance use (b = − 0.40, BSTP [− 0.87, − 0.09]). CONCLUSION: This present study is the first to examine an additive life instability index and its association with HIV-related behavioral and biomedical health outcomes among a population of OALWH. Greater indicators of life instability among OALWH may lead to poorer HIV-related health outcomes above and beyond the net of the effects of depression, anxiety, and substance use.

Men who have sex with men (MSM) are at high risk for physical and mental health conditions and are often discussed in the health literature as “at risk” versus “at promise”. However, there is an ongoing need to examine factors that place MSM “at promise” for optimal well-being. This manuscript examines correlates of resilience, the ability to “bounce back” and function adaptively after adversities, among MSM. One hundred and five MSM with a history of childhood sexual abuse, who were enrolled in a randomized control trial were recruited for a supplemental study assessing resilience and other psychosocial factors. Participants completed measures assessing resilient trait and coping (i.e. “I am able to adapt” and “I tend to bounce back”), symptoms of trauma, trauma-related thoughts, and distress tolerance (ability to regulate unpleasant feelings). Findings from multivariable linear regressions controlling for covariates (age, education, race/ethnicity, and income) indicated that higher resilience was associated with (a) lower trauma scores on re-experiencing severity (b = −1.41, SE = .53, p = .01) and avoidance severity (b = −1.61, SE = .67, p = .02), (b) lower post traumatic cognitions (b = −11.39, SE = 5.08, p = .03) especially negative cognitions about the self (b = −.44, SE = .16, p = .007), and (c) higher distress tolerance (b = .26, SE = .10, p = .01). Our preliminary findings suggest that resilient coping/traits are important to research after childhood sexual abuse among MSM, potentially assess in clinical settings, and address in interventions.

Interrelationships among HIV-associated neurocognitive dysfunction, avoidant coping, cognitively-oriented coping, and psychological distress were examined using structural equation modeling in an ethnically diverse sample of 209 adults predominantly in the mid-range of illness. Global neurocognitive deficits, assessed with the HIV-dementia scale, were associated with higher levels of avoidant coping, lower levels of cognitive coping, and a higher avoidant/cognitive coping ratio, which were each in turn associated with higher psychological distress measured by a latent factor comprising symptoms of depression, anxiety, and HIV-related distressing thoughts. There were significant indirect effects through avoidant coping and a higher avoidant/cognitive coping ratio. Results suggest the presence of HIV-associated neurocognitive deficits may interfere with the utilization of cognitive-based coping strategies and increase reliance on more maladaptive strategies, which in turn may translate to elevated reports of psychological distress. Findings may help inform interventions aimed at reducing avoidant coping and psychological distress, two factors associated with accelerated HIV disease progression.

Previous analysis of the data that are used in this study reveal that compared to people who self-identify as religious and spiritual, spiritual only, and neither religious nor spiritual, s...

There is considerable debate about the distinction between being religious and being spiritual. It is time to move beyond this issue to an examination of the health-related implications of ...

Approximately 1% to 2% of women suffer from posttraumatic stress disorder (PTSD) following childbirth, with obstetric emergencies being a key risk factor for birth-related PTSD. The current study augmented prolonged exposure (PE) with cognitive behavioral therapy (CBT) to treat symptoms of PTSD, anxiety, depression, panic disorder, and agoraphobia in a 28-year-old married Hispanic female following a life-threatening case of postpartum preeclampsia. To target distressing symptoms and reach treatment goals, the patient engaged in two preparatory sessions, 12 active PE sessions, and five supplementary CBT sessions. Posttreatment assessment indicated a significant reduction of anxiety and depressive symptoms. Panic attacks reduced in frequency and severity, and by the end of treatment, the patient no longer met criteria for PTSD, major depressive disorder (MDD), or agoraphobia. In the case of postpartum PTSD, CBT can augment PE treatment to reduce symptomatology.

There is growing evidence that a sense of meaning in life may emerge, in part, from the social relationships that people maintain. But it is not clear how the relationship between social ties and a sense of meaning might arise. The purpose of this study is to see if meaning in life is associated with three socially focused virtues: compassion, forgiveness of others, and providing social support to others. In the process, an effort is made to see if these social virtues arise from social relationships in religious institutions. Two main findings emerge from a recent nationwide survey. First, people who are more compassionate, more forgiving, and who help others more often have a stronger sense of meaning in life. Second, individuals who receive more spiritual support from fellow church members are more likely to adopt these social virtues. The theoretical basis of these relationships is discussed.

This study addresses two issues. The first is to identify the aspects of religious life that are associated with benevolent images of God including denominational affiliation (Conservative Christia...

For patients diagnosed with chronic illness, attitude towards treatment may play an important role in health and survival. For example, negative attitudes towards treatment have been related to poorer adherence to treatment recommendations and prescribed medication across a range of chronic illnesses. In addition, prior research has shown that attitude towards treatment assessed through a psychiatric interview predicted survival at 1 year after bone marrow transplantation with great accuracy ( 90%).The purpose of this study was to determine the relationship between a self-report attitude to a treatment measure that operationalized a psychiatric interview, and survival over 17 years in a sample of people living with HIV (PLWH).Participants (N = 177) who were in the mid-range of HIV illness at baseline (CD4s 150 to 500, no prior AIDS-defining clinical symptom) were administered the Montreal-Miami Attitude to Treatment (MMAT-20/HIV) scale and followed longitudinally to determine survival at 17 years.The Montreal-Miami Attitude to Treatment (MMAT-20/HIV) scale is a 20-item self-report questionnaire designed to survey multiple factors that contribute to an overall psychological construct of the treatment process.The MMAT-20/HIV predicted survival over 17 years controlling for biomedical (baseline CD4, viral load, antiretroviral medications, age) and psychosocial (race, education, antiretroviral medications) variables. Those in the top half on the MMAT-20/HIV were almost twice as likely to survive than those in the lower half. Scores on the MMAT-20/HIV were significantly but modestly correlated with adherence (r = .20, p .05), but adherence was not a mediator of the relationship between the MMAT-20/HIV and survival.An individual's attitude towards the treatment process predicted survival, raising the possibility that optimal clinical management would include ways to probe these attitudes and intervene where possible. The ease of administering the MMAT-20 and adaptability to other illnesses could facilitate this endeavor.

Objective To determine whether brief treatments provide psychological relief after traumatic events in low-resource communities. Method Participants (n = 105) who had experienced a traumatic event within the past 6 months were randomly assigned to 1 of 3 4-session treatments: individual eye movement desensitization and reprocessing (EMDR), group-administered stress management with a trauma focus (SMT), or group-administered psychological first aid (PFA). Measures administered pretreatment and at 1-, 3-, and 6-month posttreatment included posttraumatic stress disorder (PTSD) symptoms, posttraumatic cognitions (PTCI), and depressive symptoms (BDI). Results The 3 treatment groups all showed significant declines in PTSD, PTCI, and BDI symptoms over time with large prepost effect sizes (median 1-month: 0.96, 3-month: 1.38, 6-month: 1.10). However, the treatment groups showed significantly different rates of decline, with the EMDR group showing the fastest declines-interaction PTCI: F(1, 237) = 5.85, p = .016; depression:, F(1, 239) = 4.90, p = .028-followed by the SMT and then PFA group. While there were significant differences between the EMDR and PFA groups at the 1- and 3-month follow-ups, there were no significant differences in any of the 3 outcome measures at the 6-month follow-up, nor were there significant differences between groups on PTSD symptoms, F(1, 239) = 2.30, p = .131. Conclusion This study provides preliminary evidence that any of these 3 approaches may be useful in low-resource community settings. Because it gives the quickest relief, EMDR is the preferred approach, followed by SMT, due its ease of administration. PFA provides a reasonable alternative. Where possible, booster sessions should be planned. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Interventions addressing syndemics and ART adherence are needed for individuals with uncontrolled HIV and psychosocial problems. Twenty-seven participants with detectable HIV plasma viral load (PVL) or recent STI participated in an open trial of transdiagnostic adherence counseling and cognitive behavioral therapy. Outcomes were collected at baseline, 4-, and 8-months. Log PVL improved from baseline to 4-month (γ = − 1.13, 95% CI − 1.72, − 0.55, p

Self-medication theory posits that some trauma survivors use alcohol to cope with posttraumatic stress disorder (PTSD) symptoms, but the role of negative posttraumatic cognitions in this relationship is not well defined. We examined associations among PTSD symptoms, posttraumatic cognitions, and alcohol intoxication frequency in 290 men who have sex with men (MSM), who reported a history of childhood sexual abuse (CSA). Using a bootstrap approach, we examined the indirect effects of PTSD symptoms on alcohol intoxication frequency through posttraumatic cognitions regarding the self, world, and self-blame. In separate regression models, higher levels of PTSD symptoms and posttraumatic cognitions were each associated with more frequent intoxication, accounting for 2.6% and 5.2% of the variance above demographics, respectively. When examined simultaneously, posttraumatic cognitions remained significantly correlated with intoxication frequency whereas PTSD symptoms did not. Men reporting elevated posttraumatic cognitions faced increased odds for current alcohol dependence, odds ratio (OR) = 2.19, 95% CI [1.13, 4.22], compared with men reporting low posttraumatic cognitions, independent of current PTSD diagnosis. A higher level of PTSD symptom severity was indirectly associated with more frequent alcohol intoxication through cognitions about the self and world; the indirect to total effect ratios were 0.74 and 0.35, respectively. Negative posttraumatic cognitions pertaining to individuals' self-perceptions and appraisals of the world as dangerous may play a role in self-medication with alcohol among MSM with a history of CSA. Interventions targeting these cognitions may offer potential for reducing alcohol misuse in this population, with possible broader implications for HIV-infection risk.

Objective: The burden of sleep disturbance and depressive symptomology is high for persons living with HIV and particularly so for women. While cognitive behavioral stress management (CBSM) is shown to reduce symptoms of depression and 24-hr urinary free cortisol output (CORT) in HIV+ men, less is known about the effects of CBSM on mood and concomitant sleep disturbance in HIV+ women. The study aim is to model longitudinal change in sleep disturbance, depressive symptomology, and CORT for HIV+ women exposed to a 12-week CBSM intervention or control condition. Methods: Self-reported sleep quality and depressive symptomology, along with CORT, was collected from surveys at baseline and approximately every three months thereafter for nine months from 130 HIV+ women (Mage = 38.44, SD = 7.73). The data was used to specify a parallel process latent growth model with CORT as a time-varying covariate. Results: The model showed acceptable fit. There was a linear decline in sleep disturbance (β = −0.32, p

The purpose of this study is to see if the use of religious coping responses is associated with alcohol intake. In addition, tests are conducted to see if the relationship between religion and alco...

The study is one of the first to examine both the prevalence of life instability among older adults with HIV (OAWH) in a community clinic and its relationship to their mental health. OAWH (N=623) from a community medical clinic completed an interviewer-administered assessment (English/Spanish) which included an additive Life Instability Index (LII) composed of indicators at the individual (e.g. education, housing instability, employment status) and community (e.g. poverty, transportation) levels. Participants were a mean age of 60 years (SD = 5.90) with the majority identifying as Black-non-Hispanic (65.9%), cisgender male (60.8%), and heterosexual (80.6%). Participants reported an average of 6.08 destabilizing factors (SD = 1.44). In multiple linear regression analyses LII was significantly related to increased substance use among participants (b= 0.08, p < 0.01), but not with anxiety or depression. An LII is an innovative approach to assess the relationship between OAWH’s mental health and social determinants of health.

The purpose of this study is to see if a pantheistic view of God (i.e., God is all around us in nature), a theistic view of God (i.e., God is the creator of the universe who protects us), a...

Research indicates that people with strong social support networks tend to cope more effectively with stressful life events. This study aims to contribute to this literature in three ways. First, we assess spiritual social support that was received in religious institutions. Spiritual support is assistance that is provided with the explicit purpose of increasing the religious beliefs and behaviors of the recipient. Second, an effort was made to see if potential stress-moderating effects of spiritual support are more likely to arise among extraverts than among introverts. Third the data come from a recent nationwide survey (N = 1657). Statistical tests were performed to see if there is a three-way interaction between stress, spiritual support, and extraversion on anxiety. The findings indicate that strong spiritual support moderates the relationship between stress and anxiety, but only among highly extraverted study participants. In contrast, spiritual support tends to exacerbate the relationship between stress and anxiety among study participants with very low extraversion scores (i.e., introverts). The theoretical implications of these findings are discussed.

Although a good deal of research has assessed the positive effects that involvement in religion has on alcohol use, there is relatively little research on the negative aspects of religious life and alcohol problems.This study has two objectives. The first is to see if spiritual struggles are associated with problem drinking. The second is to see if the relationship between spiritual struggles and problem drinking is stronger for younger than for older adults.The data come from a recent nationwide survey of adults of all ages who reside in the United States (N = 2142).The study was conducted in 2014. Problem drinking is assessed with the CAGE questionnaire.The findings indicate that people who encounter more spiritual struggles are more likely to experience problem drinking. The relationship between spiritual struggles and problem drinking was stronger than the relationship between three other frequently used measures of religion and problem drinking (i.e., attendance at worship services, private prayer, and affiliation with Evangelical denominations). The results further reveal that spiritual struggles are associated with a greater risk of drinking problems among younger than among older individuals. Conclusions/Importance: Although many studies show that various facets of religion are associated with a lower risk of experiencing problems with alcohol the findings from the current study show that there are negative aspects of religious life that may be associated with a greater risk of having problems with alcohol.

The purpose of this study is to evaluate the relationship between spiritual struggles and levels of interleukin-6 (IL-6) with a subsample (N = 943) of participants who took part in a nationwide survey. This study, which was completed in 2014, was conducted in the United States. Spiritual struggles refer to difficulties that a person may encounter with his or her faith and include having a troubled relationship with God, encountering difficulties with religious others, and being unable to find a sense of ultimate meaning in life. Based on the notion that spiritual struggles may be associated with personal growth as well physical health problems, it was hypothesized that there is a nonlinear relationship between the two: levels of IL-6 will decline at relatively low levels of spiritual struggles, but levels of IL-6 will increase as spiritual struggles become more severe. The findings support this hypothesis and suggest there is a quadratic relationship between spiritual struggles and IL-6. The clinical implications of these findings are discussed.

Objective People dealing with serious mental illness frequently report turning to religion to help cope with the disorder. However, little is known about how religion impacts commitment to psychotherapy programs for people with schizophrenia and their caregivers. Method In a sample of 64 families enrolled in a culturally informed family treatment for schizophrenia that targets religiosity, we hypothesized that patients and caregivers who use high levels of adaptive religious coping and low levels of maladaptive religious coping, would be less likely to drop out of treatment than their counterparts. Results In line with hypotheses, results demonstrated that greater maladaptive religious coping was associated with fewer family therapy sessions attended. Contrary to expectations, greater adaptive religious coping was also associated with attending fewer family therapy sessions. Conclusion Results suggest that any type of religious coping may be associated with higher levels of attrition from family therapy. Perhaps spiritual/religious people are already getting support and guidance from their beliefs and practices that aid them in coping with mental illness. Results may also suggest that there is a "religiosity gap" in which religious individuals perceive a disconnect between their beliefs and the beliefs of their mental health providers. It is important to point out that in this study, of those who dropped out prematurely, nearly all did so before the religiosity segment of treatment even began. Modifying how family treatments are introduced early on in therapy to ensure they appear congruent with the beliefs and values of religious families may help to reduce attrition. (PsycINFO Database Record

OBJECTIVE: The prevalence of clinically significant depressive symptoms is 3 times higher in people living with HIV (PLWH) than in the general population. While studies have shown that depression predicts worse course with HIV, few have investigated its relationship with mortality, and none have had a 17-year follow-up period and been conducted entirely during the time since the advent of protease inhibitors. METHODS: We followed a diverse sample of HIV positive people (n=177) in the mid-range of illness for a study on stress and coping. Participants were assessed every six months (for 12 years) via blood draw, questionnaires and interview. Depression was measured using the Beck Depression Inventory (BDI-I). The study began in March, 1997 and mortality was assessed in April, 2014. RESULTS: In the primary analysis depression, analyzed as a continuous variable, significantly predicted all-cause mortality (Hazard Ratio (HR) = 1.038, 95%CI = 1.008 – 1.068). With BDI scores dichotomized, the HR was 2.044 (95%CI = 1.176 - 3.550). Furthermore, this result was moderated by race and educational attainment such that depression only predicted worse survival for non-African Americans and those with a college education or above. CONCLUSIONS: Depression measured during the first year and a half predicted worse survival in a diverse sample of PLWH followed for 17 years after accounting for initial disease status, antiretroviral medications and age. More research is needed to identify psychological risk factors for long-term outcomes in African Americans and those who are not college educated. Interventions targeting depression may improve well-being and potentially also long-term survival in individuals with HIV.

This study examined the impact of a stressful death/divorce on psychological and immune outcomes in people with HIV. People with HIV with stressful death/divorce were examined from before the event to up to 12 months later ( n = 45); controls were assessed at similar intervals ( n = 112). Stressful deaths/divorces were associated with increased viral load and anxiety over time ( ps ≤ .014), but not CD4+ or depression. Increased use of religious coping after the stressful death/divorce was associated with slower increases in viral load ( p = .010). These data suggest people with HIV should consider the potentially elevated risk of transmission after such events and seek appropriate monitoring and care.

Research reveals that a number of different aspects of religious involvement are associated with happiness. However, researchers have yet to provide an overarching theoretical explanation for how multiple dimensions of religion might be associated with happiness. The purpose of this study is to develop and test a conceptual model that includes the following core hypotheses: (1) people who attend worship services more often tend to be more committed to their faith; (2) people who are more committed to their faith are more likely to be compassionate; (3) compassionate individuals are more likely to provide emotional support to significant others; and (4) people who provide support to others tend to be happier. Data from a recent nationwide survey in the United States (N = 3,010) provides support for each hypothesis. The theoretical implications of these finding are discussed.

A budding literature has shown the benefits of compassionate love on psychological well-being. Yet, much less is known on its relevance for health outcomes. The purpose of the present study is to examine the effects of compassionate love on survival among people living with HIV (PLWH). 177 PLWH at the mid-stage of illness participated in a longitudinal study of stress and coping. They completed questionnaires, interviews, and essays every 6 months. Three components (giving and receiving compassionate love, and compassionate love toward self) were rated using interview and essay transcripts. Giving compassionate love and compassionate love toward self predicted longer survival, even when controlling for substance use and social support. Only giving compassionate love remained a significant predictor when controlling for adherence. Being compassionate toward others as well as oneself may have survival benefits. Giving compassionate love appears to be more important than receiving.

Research on the locus of control construct conveys the impression that more control is always better. However, some studies suggest that very high levels of control are associated with negative outcomes. The purpose of this study was to see if this is true of religiously oriented feelings of control (i.e., God-mediated control). The outcome was antibody titers to the Epstein-Barr virus (EBV). The findings suggest that very high God-mediated control is associated with higher EBV values. However, this finding was only observed among young adults (age 18–40), but not among middle-aged (age 41–64), or older adults (aged 65 and older).

Research indicates that feeling grateful is associated with better physical health. However, most studies rely on self-reports of health. The purpose of this study is to see if feelings of gratitude in general as well as feeling grateful to God specifically are associated with a key biomarker of health – hemoglobin A1c (HbA1c). HbA1c is an indicator of blood sugar control. In the process of assessing the relationship between gratitude and HbA1c, an effort is made to see if the relationship between these measures and HbA1c vary by gender. Findings from a recent nationwide survey indicate that women are more likely than men to feel grateful in general and to feel grateful to God. The results further reveal stronger feelings of general gratitude are associated with lower levels of HbA1c. However, this relationship did not differ for men and women. In contrast, feeling grateful to God was associated with lower HbA1c, but this relationship emerged among women only.

Childhood sexual abuse (CSA) is associated with post-traumatic stress disorder (PTSD), which can be associated with condomless sex among men who have sex with men (MSM). However, the impact of moderating factors on the relationship between PTSD symptom severity and condomless sex is poorly understood. We examined whether PTSD symptom severity was associated with condomless sex among MSM with CSA histories, and whether substance dependence, self-esteem, and distress tolerance moderated that relationship (n = 288). Notably, no direct relationship between PTSD symptom severity and condomless sex was found. Adjusted models indicated that condomless sex was differentially impacted by PTSD symptom severity among those without substance dependence (ΔR2 = 0.03, p = 0.034) and, counterintuitively, those with high self-esteem (ΔR2 = 0.07, p = 0.005). PTSD symptom severity was associated with condomless sex across levels of distress tolerance. Findings indicate that substance use, self-esteem, and distress tolerance should be targeted in high-risk MSM with CSA even if they do not have PTSD.

Findings from a considerable number of studies suggest that a wide range of psychosocial factors are associated with sleep quality. However, it is surprising to find that very few studies assess the relationship between religion and sleep quality. The purpose of this study is to examine the relationship between three key measures of religion and sleep quality. The data are from a recent nationwide survey of adults of all ages (N = 1774). A conceptual model that contains the following core relationships was evaluated empirically: (1) people who go to church more frequently tend to receive more spiritual support from fellow church members (spiritual support is assistance that is provided with the explicit purpose of bolster the religious behaviors and beliefs of the recipient), (2) more spiritual support is associated with stronger God-mediated control beliefs (God-mediated control refers to the extent to which people believe God works with them to overcome challenges that arise in life), (3) people with a strong sense of God-mediated control will feel more hopeful about the future, and (4) individuals who are more hopeful will enjoy better quality sleep. Empirical support was found for each of these relationships.

A number of studies have examined religious transformations. But most of this work has been concerned with identifying different types of transformations and steps in the process of transformation. The current study was designed to examine the ways in which religious transformations may be associated with happiness. We take a novel approach toward the evaluation of this relationship. We argue that a religious transformation may be an important resource for coping with lifetime trauma. Two major findings emerge from our nationwide survey (N = 2,851). First, the data indicate that the magnitude of the relationship between lifetime trauma and happiness is reduced significantly for people who have had a religious transformation but not for those who have not had this type of religious experience. Second, the results reveal that the potential stress-related benefits of a religious transformation are more evident among younger adults than among middle-aged or older adults.

The purpose of this study is to address two issues. First, an effort is made to see if there are age differences in the prevalence of spiritual struggles. Second, tests are performed to see if age differences exist in the relationship between spiritual struggles and physical health. Data from a recent nationwide survey reveal that younger adults report that they encounter more spiritual struggles than either middle-aged or older adults. The findings further indicate that the negative relationship between spiritual struggles and health tends to become more pronounced at successively older ages.

Cardiovascular disease is a growing concern in HIV disease management and nearly 1 out of 3 persons living with the virus is hypertensive. Biobehavioral factors such as anger, hostility, and HPA axis reactivity are emperically linked to blood pressure regulation. Whether HPA axis or mood disturbance increases risk for hypertension remains unclear in HIV disease. The aim of this study was to determine whether 9-month change in angry/hostile mood predicts alterations in systolic (SBP) or diastolic blood pressure (DBP), and whether this change is mediated by 24-h urinary cortisol (CORT) output. Sixty-one HIV positive adults, aged 41.1 ± 8.6 years, assigned to the control condition of a stress management intervention provided blood samples, 24-h urine specimens, blood pressure in-office, and self-reported mood at baseline and a 9-month follow-up. CORT was tested as a mediator in two separate models controlling for baseline BP, CD4 count, HIV-1 viral load, protease inhibitor use, body mass index, smoking status, and family history of cardiometabolic disease. Increase in angry/hostile mood was associated with greater SBP (β = 0.33, CI 0.09, 0.56, p = 0.01) and DBP (β = 0.39, CI 0.16, 0.62, p