This proposal describes a comprehensive research project designed to prospectively pilot test the efficacy of prolonged exposure (PE) therapy at reducing symptoms of HIV-related posttraumatic stress disorder (PTSD) and increasing adherence to antiretroviral medication regimens in people living with HIV (PLWH). Recent studies examining the efficacy of cognitive behavioral interventions at increasing adherence to medications in PLWH have produced, at best, small effect sizes. Failure to address mental health issues in PLWH has been suggested as one explanation for the relatively small impact of these interventions. Previous research has found that symptoms of PTSD (particularly avoidance symptoms stemming from diagnosis/living with HIV) are positively related to non-adherence. PE has been found to be an effective treatment for PTSD; however, its efficacy at reducing PTSD symptoms in patients meeting criteria due to diagnosis with a life-threatening disease is unknown. Further, the extent to which decreasing symptoms of PTSD results in consequent reductions in non-adherence has not been examined. The proposed research will examine the efficacy of PE therapy at reducing HIV-related PTSD and non-adherence in 70 PLWH (20% female, 50% African-American, 50% Caucasian) with PTSD. Participants will be randomly assigned to either the 6-week, 12-session intervention or a weekly monitoring/wait list control group. Follow-up time points at post treatment and three and six months will consist of interviews and questionnaires designed to measure symptoms of HIV-related PTSD and co-morbid disorders. Further, medication adherence (via self-report and electronic monitoring) will also be measured. The proposed research will directly test the efficacy of PE at reducing symptoms of HIV-related PTSD and co-morbid disorders, and non-adherence, and will provide pilot data and effect sizes for a large-scale randomized, multi-site trial.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
1R34MH071201-01A1
Application #
6892560
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Gordon, Christopher M
Project Start
2005-01-01
Project End
2007-12-31
Budget Start
2005-01-01
Budget End
2005-12-31
Support Year
1
Fiscal Year
2005
Total Cost
$205,114
Indirect Cost
Name
Kent State University at Kent
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
041071101
City
Kent
State
OH
Country
United States
Zip Code
44242
Kobayashi, Ihori; Delahanty, Douglas L (2014) Awake/sleep cortisol levels and the development of posttraumatic stress disorder in injury patients with peritraumatic dissociation. Psychol Trauma 6:449-456
Kobayashi, Ihori; Delahanty, Douglas L (2013) Gender differences in subjective sleep after trauma and the development of posttraumatic stress disorder symptoms: a pilot study. J Trauma Stress 26:467-74
Pacella, Maria L; Armelie, Aaron; Boarts, Jessica et al. (2012) The impact of prolonged exposure on PTSD symptoms and associated psychopathology in people living with HIV: a randomized test of concept. AIDS Behav 16:1327-40
Kobayashi, Ihori; Sledjeski, Eve; Fallon Jr, William et al. (2011) Effects of early albuterol (salbutamol) administration on the development of posttraumatic stress symptoms. Psychiatry Res 185:296-8
Nugent, Nicole R; Sledjeski, Eve M; Christopher, Norman C et al. (2011) The influence of family environment on dissociation in pediatric injury patients. Clin Child Psychol Psychiatry 16:485-97
Nugent, Nicole R; Christopher, Norman C; Crow, John P et al. (2010) The efficacy of early propranolol administration at reducing PTSD symptoms in pediatric injury patients: a pilot study. J Trauma Stress 23:282-7
Pinna, Keri; Cremeans-Smith, Julie K; Greene, Kenneth et al. (2009) The impact of gender and hypothalamic pituitary adrenal activity on depressive symptoms following surgical stress. J Health Psychol 14:1095-104
Cremeans-Smith, Julie K; Boarts, Jessica M; Greene, Kenneth et al. (2009) Patients' reasons for electing to undergo total knee arthroplasty impact post-operative pain severity and range of motion. J Behav Med 32:223-33
Cremeans-Smith, Julie K; Soehlen, Steve; Greene, Kenneth et al. (2009) In-hospital levels of C-reactive protein and IL-6 predict post-operative depressive symptoms among patients undergoing total knee replacement surgery. Brain Behav Immun 23:1096-103
Boarts, Jessica M; Bogart, Laura M; Tabak, Melanie A et al. (2008) Relationship of race-, sexual orientation-, and HIV-related discrimination with adherence to HIV treatment: a pilot study. J Behav Med 31:445-51

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