Immunstatus bei HIV-Infizierten: Hat das Bewältigungsverhalten Einfluß?

Leiberich, Peter; Reiser, Jürgen; Harrer, Thomas; Wendler, Jörg; Engeter, Martina; Kalden, Joachim R.; Hahn, E. G.; Olbrich, Erhard

doi:10.1007/978-3-642-77018-0_6

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“…Whereas some evasive-regressive strategies could be useful in the first few weeks after diagnosis to gain a short term intrapsychic protection against the threats of that critical life event [17], they were counterproductive to a successful long-term adaptation. In particular, HIV-posi tive persons who dealt with their diagnosis in a depressive way and persisted in evasive-regressive strategies showed a reduced QL at all times of measurement, although they used cognitive-actional coping strategies as intensively as individuals with low distress and good QL.…”

Section: Discussionmentioning

confidence: 99%

“…Cognitive-actional coping is usually relied upon when situations can be influenced and changed (focussing on problems), whereas emotional-pal liative coping plays an adaptive function for situations and burdens that are perceived as inescapable and unal terable (focussing on emotions [16]). In addition, our group has found a pattern of evasive-regressive coping strategies such as avoidance, escapism and regression to infantile or mentally immature behavior units [17]. Find ings of other studies suggest that these strategies are relat ed to a deterioration of immune markers [18].…”

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confidence: 99%

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Longitudinal Development of Distress, Coping and Quality of Life in HIV-Positive Persons

Leiberich¹,

Engeter²,

Olbrich³

et al. 1997

Psychother Psychosom

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Background: Longitudinal study on burdens, quality of life and coping strategies of HIV-positive persons to identify patterns of successful adaptation to the demands of the infection. Methods: In a semiprospective multimodal approach, 61 HIV-positive persons in all stages of the infection attending an HIV ambulatorium were assessed by inventories (3 times) and by a half-standardized interview (baseline Tl focussing on first reactions after diagnosis, follow-up T3 1.5 years later). Subjects had a mean age of 35.3 years and 69% were male. Forty-four percent were infected via homosexual intercourse, 46% via intravenous needle sharing and 10% via heterosexual intercourse or an unknown source. Results: Global, psychic and familial distress decreased significantly from the first period after the diagnosis of HIV to the third time of measurement, while somatic complaints increased. Most test persons were able to deal effectively with the demands of the infection and showed a great degree of flexibility in their use of cognitive-actional and emotional-palliative strategies; they achieved a high quality of life. In contrast, highly distressed individuals, mainly drug users, tended to cope in an evasive-regressive way and reported a low quality of life. Correlations between ineffective coping strategies and low quality of life were found to be significant. Conclusions: After an initial phase of sorrow and lack of orientation regarding their future life, most HIV-positive persons deal effectively with the demands of the HIV infection and report a good quality of life. In contrast, HIV-positive persons with a high degree of distress and an evasive-regressive coping pattern need professional support, such as psychotherapy.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%