Coping and psychological adjustment in adolescents with vertically acquired HIV

Abstract

Children with vertically acquired HIV face the challenges of adolescence in addition to the demands of coping with their illness. The relationship between coping and psychological adjustment has been widely studied in adults and children with chronic diseases but it is poorly understood in adolescents with HIV. This study aimed to identify whether a UK sample of adolescents with vertically acquired HIV had poor psychological adjustment and to clarify the relationship between coping and psychological adjustment in this sample. Thirty adolescents with vertically acquired HIV (aged 11-17) filled in questionnaires of coping and psychological adjustment and a correlational design was used to determine if specific coping styles were related to quality of psychological adjustment. Results showed that younger children had lower levels of psychological adjustment than older adolescents, although as a group the adolescents scored within normal ranges. Psychological adjustment was significantly related to two coping styles, Ventilating feelings and Being humorous. Exploratory analysis examined the extent of HIV disclosure in this sample and the degree of satisfaction felt about the nature of communication about the diagnosis. The results showed that participants had few confidants but were satisfied with the nature of communication about their status. The level of satisfaction was not related to adjustment. On the basis of the results, potential clinical implications for adolescents with vertically acquired HIV who might be struggling not only with the challenging demands of adolescence but also with their illness are discussed. The need to adopt a developmental approach to coping and psychological adjustment is emphasized.

The changing epidemiology of the global paediatric HIV epidemic: keeping track of perinatally HIV‐infected adolescents

“…Data from the French CO10 cohort showed that school performance was comparable to national statistics [79]. However, Swiss and UK studies have illustrated that coping with HIV was an ongoing challenge for PHIVA as they became older, and that inconsistent disclosure and poor psychological adjustment had a negative impact on long-term adherence [80, 81]. As mentioned above, a very important issue that needs to be addressed is how to continue to follow these youth as they transition to adult care, especially given that a number of the findings to date regarding hyperlipidemia, bone density, and the impact of mental health and other central nervous system disorders may not be fully expressed until later in adulthood.…”

Disclosure of HIV status to children in resource‐limited settings: a systematic review

“…Furthermore, many studies to date have utilized cross-sectional designs and cannot adequately assess the impact of disclosure on clinical or psychosocial characteristics [6]. Other studies suggest that HIV-infected children who know their status may be better able to seek social support, have improved coping skills [11,22] and practice safer sexual practices to prevent secondary transmission [23,24]. …”

Annual Research Review: Mental health and resilience in HIV/AIDS‐affected children – a review of the literature and recommendations for future research

“…Only three studies on HIV‐infected children assessed the prevalence of psychological distress with respect to a comparison sample. In two (Moss, Bose, Wolters, & Brouwers, 1998; Sopena, Evangeli, Dodge, & Melvin, 2010), levels of mental health problems and resilience among HIV‐infected children were compared with published national norms in the U.S. and U.K. (respectively); no significant differences were found in either case. The third study (conducted in the U.S.) used a control/comparison design to assess adaptive outcomes and levels of emotional and behavioral problems among 403 children and adolescents (age 6–19 at study initiation) at varying stages of disease progression (four groups based on CD4 counts were created from the sample to account for disease progression, including a nonaffected control group) (Nichols et al., 2000).…”