Depressive symptoms, self-esteem, HIV symptom management self-efficacy and self-compassion in people living with HIV

Abstract

The aims of this study were to examine differences in self-schemas between persons living with HIV/AIDS with and without depressive symptoms, and the degree to which these self-schemas predict depressive symptoms in this population. Self-schemas are beliefs about oneself and include self-esteem, HIV symptom management self-efficacy, and self-compassion. Beck’s cognitive theory of depression guided the analysis of data from a sample of 1766 PLHIV from the U.S. and Puerto Rico. Sixty-five percent of the sample reported depressive symptoms. These symptoms were significantly (p ≤ .05), negatively correlated with age (r= −.154), education (r= −.106), work status (r= −.132), income adequacy (r= −.204, self-esteem (r= −.617), HIV symptom self-efficacy (r=−.408) and self-kindness (r=−.284); they were significantly, positively correlated with gender (female/transgender) (r=.061), white or Hispanic race/ethnicity (r= .047) and self-judgment (r=.600). Fifty-one percent of the variance (F=177.530 (df=1524); p<.001) in depressive symptoms was predicted by the combination of age, education, work status, income adequacy, self-esteem, HIV symptom self-efficacy, and self-judgment. The strongest predictor of depressive symptoms was self-judgment. Results lend support to Beck’s theory that those with negative self-schemas are more vulnerable to depression and suggest that clinicians should evaluate PLHIV for negative self-schemas. Tailored interventions for the treatment of depressive symptoms in PLHIV should be tested and future studies should evaluate whether alterations in negative self-schemas are the mechanism of action of these interventions and establish causality in the treatment of depressive symptoms in PLHIV.

Effects of Problem-Solving Therapy and Clinical Case Management on Disability in Low-Income Older Adults

“…the belief in one’s ability to achieve personal goals) predicted changes in disability over time across conditions. These findings are consistent with studies in medically compromised but non-depressed populations, where assistance with negotiating complex health care systems and managing chronic illnesses results in better well-being, sense of self-efficacy, and overall functioning (59–61). Although case management does not explicitly address psychopathology, problem-solving, and self-efficacy, it is likely that when case managers address problems that feel overwhelming to depressed, disabled, low-income older adults, patients see that change is possible and learn the process of solving these problems by observing their case managers solve them.…”

Depression in HIV Infected Patients: a Review

“…Eller et al, for example, by recruiting a large sample of 1766 HIV-positive patients from the USA and Puerto Rico, have found depressive symptoms in 65 % of the subjects [37].…”

“…But the results of these studies, as well as their clinical implications, are currently widely discussed. For example, Eller et al have identified self-judgment as the strongest predictor of depressive symptoms, combined with poor self-esteem and HIV symptom self-efficacy [37].…”

Evaluation of Psychosocial Adjustment and Self-Esteem in Perinatally HIV-Infected Adolescents

“…The relationship between self-esteem and depressive symptoms has been documented in many studies involving patients and non-clinical populations [29][30][31]. The study in adults with HIV infection found an association between self-esteem and depressive symptoms [15]. Low self-esteem in adults with HIV infection [32] is usually due to rejection, loss of social identity, and the physical consequences of HIV disease.…”

“…Effects on physical, social and psychological well-being have involved negative feelings such as depression [14], distress and anxiety, which interfere with their self-esteem. Sixty-five percent of adults living with HIV/AIDS reported depressive symptoms which were significantly negatively correlated with their self-esteem [15]. Studies of self-esteem in children and adolescents generally focus on those with chronic illnesses [16] but have scarcely been reported in adolescents with HIV infection.…”