This 5-year renewal has 2 components. Study 1 will describe over time emotional distress, psychopathology, and dysfunctional behaviors among a cohort of HIV+ and HIV-adults. Subjects without AIDS and with history of parenteral drug use, males sex with males, and/or unprotected heterosexual intercourse with potentially HIV+ partners will have HIV testing with counseling, then be followed at 3 months, 6 months and every 6 months thereafter with repeated counseling and measures of: a) distress (e.g., anxiety, depression); b) psychopathology (e.g., current DSM-III-R Axis I); and c) HIV-related behaviors (e.g., unsafe sex). We will also assess: a) HIV-related stressors (e.g., physical symptoms, CD4, bereavement); b) resources (e.g., social support, hardiness); and c) vulnerabilities (e.g., lifetime Axis I, Axis II). Analyzed cohort will represent women and minorities and be comprised of an estimated 400 HIV+ and 486 HIV- subjects followed for at least 2 years during 11 years since study began. Structural modelling will examine for interactions within an explanatory model that hypothesizes HIV-related stressors will be associated with distress, current psychopathology and maladaptive behaviors as mediated by subjects' resources and vulnerabilities. Study 2 will test the differential effectiveness of standard counseling alone or an additional 6 weekly individual sessions of stress-prevention training. Subjects will be 80 HIV+ and 80 HIV- with levels of distress associated with psychopathology. The dependent variables will be multiple measures of emotional distress obtained before randomization, then 3 and 6 months later. Preliminary data support feasibility and scientific merit of both the prospective and intervention studies. Results will help characterize responses to AIDS epidemic, identify factors associated with psychiatric and behavioral dysfunction, and test potentially generalizable methods for reducing their emotional distress. The proposal will thereby address issues specifically targeted by NIMH RFAs.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH042277-08
Application #
3381476
Study Section
Psychobiological, Biological, and Neurosciences Subcommittee (MHAI)
Project Start
1986-09-30
Project End
1997-08-31
Budget Start
1993-09-01
Budget End
1994-08-31
Support Year
8
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Weill Medical College of Cornell University
Department
Type
Schools of Medicine
DUNS #
201373169
City
New York
State
NY
Country
United States
Zip Code
10065
Ferrando, Stephen J; Rabkin, Judith G; Lin, Shu-Hsing et al. (2005) Increase in body cell mass and decrease in wasting are associated with increasing potency of antiretroviral therapy for HIV infection. AIDS Patient Care STDS 19:216-23
Rabkin, Judith G; McElhiney, Martin; Ferrando, Stephen J et al. (2004) Predictors of employment of men with HIV/AIDS: a longitudinal study. Psychosom Med 66:72-8
Rabkin, J G; Ferrando, S J; Lin, S H et al. (2000) Psychological effects of HAART: a 2-year study. Psychosom Med 62:413-22
Evans, S; Ferrando, S J; Rabkin, J G et al. (2000) Health locus of control, distress, and utilization of protease inhibitors among HIV-positive men. J Psychosom Res 49:157-62
Goggin, K; Sewell, M; Ferrando, S et al. (2000) Plans to hasten death among gay men with HIV/AIDS: relationship to psychological adjustment. AIDS Care 12:125-36
Wagner, G J; Ferrando, S J; Rabkin, J G (2000) Psychological and physical health correlates of body cell mass depletion among HIV+ men. J Psychosom Res 49:55-7
Rabkin, J G; Ferrando, S J; van Gorp, W et al. (2000) Relationships among apathy, depression, and cognitive impairment in HIV/AIDS. J Neuropsychiatry Clin Neurosci 12:451-7
Sewell, M C; Goggin, K J; Rabkin, J G et al. (2000) Anxiety syndromes and symptoms among men with AIDS: a longitudinal controlled study. Psychosomatics 41:294-300
de Moore, G M; Hennessey, P; Kunz, N M et al. (2000) Kaposi's sarcoma: The Scarlet Letter of AIDS: the psychological effects of a skin disease. Psychosomatics 41:360-3
Ferrando, S J; Rabkin, J G; Poretsky, L (1999) Dehydroepiandrosterone sulfate (DHEAS) and testosterone: relation to HIV illness stage and progression over one year. J Acquir Immune Defic Syndr 22:146-54

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