A diathesis-stress approach to post-traumatic stress disorder symptoms associated with an HIV diagnosis: Implications for medication non-adherence
Introduction. We fit a diathesis-stress model with childhood trauma and neuroticism as predictors of depressive and HIV-related PTSD symptomatology in a sample of HIV+ Latino men who have sex with men (MSM). We then examined the impact of depressive and HIV-related PTSD symptomatology on medication adherence. We hypothesized the primary stressor from the diathesis-stress model to be symptoms of dissociation at the time of being diagnosed with HIV. Method. We sampled 149 Latino adult MSM living with HIV at a local HIV treatment clinic in El Paso, Texas. We administered all surveys in paper-and-pencil form, with viral loads and CD4 cell counts extracted from medical charts. Specifically, data were collected on self-reported histories of childhood abuse, trait levels of neuroticism, acculturation to non-Latino culture, accumulated life stressors, depression, HIV and non HIV-related post-traumatic stress symptoms, resilience, functional impairment and medication adherence. All participants were interviewed in either English or Spanish and paid $30 for their participation. Interviews lasted approximately two hours. Results. We observed high levels of childhood sexual abuse (22%) and trauma overall, as well as high rates of mild-to-moderate symptoms of depression (30%). Self-reported medication adherence was high across all measures. We found support for our hypothesized path model as a test of the theoretical structure proposed by the diathesis-stress model. All fit indices were indicative of good model fit. In addition, we found support for the diathesis-stress interaction with dissociation symptoms at the time of diagnosis moderating the relationship between childhood trauma and HIV-related PTSD symptoms. As hypothesized, our regression analyses revealed depression to be negatively correlated with adherence. PTSD symptoms related to HIV were positively associated with adherence, the opposite direction of that hypothesized. Conclusion. The diathesis-stress framework adequately models the relationship among childhood trauma, current levels of psychological distress, and the stress of being diagnosed with HIV. Furthermore, psychological distress is negatively associated with adherence and overall quality of life. Implications for interventions are discussed.
Sauceda, John Andrew, "A diathesis-stress approach to post-traumatic stress disorder symptoms associated with an HIV diagnosis: Implications for medication non-adherence" (2013). ETD Collection for University of Texas, El Paso. AAI3565937.