The mediation effect of treatment fatigue in the association between memory and health-related quality of life in men with HIV who have sex with men.

Approximately half of all adults living with the Human Immunodeficiency Virus (HIV) experience cognitive alterations related to difficulties in treatment adherence and, therefore, to a significant decrease in quality of life. In this sense, new studies are needed to identify potential mediators related to treatment in this association, such as treatment fatigue. This fact is especially important in at specific groups of individuals with HIV, namely men with HIV who have sex with men (MSM). The objective of this study was to analyze the association between cognitive functioning, Health-Related Quality of Life (HRQoL), and treatment fatigue in MSM with HIV. A cross-sectional study was developed with a sample of 70 MSM, from the Infectious Diseases Unit of the General University Hospital of Alicante (Spain). Participants completed questionnaires related to sociodemographic data, HRQoL, and treatment fatigue in an initial phase; in a second phase, they were administered a computerized cognitive evaluation. Our results demonstrate a significant relationship between a lower cognitive performance in the memory domain and worse HRQoL. Mediation analysis has revealed the total mediation effect of treatment fatigue, specifically, the treatment cynicism domain, on this relationship. This mediation effect remained significant after controlling the sociodemographic and clinical HIV-related variables in the model. No significant mediation effects of the rest of evaluated cognitive domains (attention, perception, reasoning, or coordination) were found in this relationship. The results of this study highlight how MSM with a significant deterioration of memory are at greater risk of developing high levels of treatment fatigue, and, therefore, a lower adherence to the same and a significant deterioration in their HRQoL.

Lower cortisol response in high-resilient caregivers of people with autism: the role of anger.

Caring for an offspring with an autism spectrum disorder (ASD) has been related to high stress levels and health disturbances. However, a protective effect against these negative health outcomes has been described in high-resilient caregivers. In this context, the main aim of the present study was to assess the association between resilient coping and cortisol response to acute stress in caregivers of people with ASD. Furthermore, the study aimed to explore the mediating role of anger in this association. We exposed 40 caregivers of people with ASD to an acute psychosocial stressor in the laboratory. Salivary cortisol samples were obtained before, during, and after the stressor. Resilient coping, anger, and socio-demographic variables were also assessed. Resilient coping was negatively correlated with cortisol response. Specifically, cortisol release was lower in high-resilient than low-resilient caregivers. Anger was positively correlated with cortisol response, mediating the association with resilient coping. The observed associations of resilient coping and anger with cortisol response indicate that these variables may affect health outcomes, resilience being protective and anger harmful. Psychotherapeutic interventions focused on strengthening resilience and anger management could benefit caregivers, improving their health status and quality of life.

Lower cardiovascular reactivity to acute stress in informal caregivers of people with autism spectrum disorder than in non-caregivers: Implications for health outcomes.

Caring for offspring with autism spectrum disorder (ASD) is associated with chronic stress. Such a situation could alter body homeostasis, and in turn, physiological systems associated with the stress response and health, such as the autonomic nervous system. The primary aim of the present study was to compare the cardiovascular response with a set of mental tasks in parents of people with (n=34) and without (n=36) ASD. The secondary aim was to explore a potential relationship between cardiovascular response and self-reported health. Caregivers had lower sympathetic activity than non-caregivers, especially during the acute stress period. Higher sympathetic activity was related to more self-reported somatic symptoms in caregivers. Further, caregivers were found to have lower sympathetic reactivity to the stressor, probably due to an adaptation mechanism. Such adaptation could be extremely important for protecting the health of caregivers.

Sleep during the third trimester of pregnancy: the role of depression and anxiety.

Depression has been associated with sleep disturbances in pregnancy; however, no previous research has controlled the possible confounding effect of anxiety on this association. This study aims to analyze the effect of depression on sleep during the third trimester of pregnancy controlling for anxiety. The sample was composed by 143 depressed (n = 77) and non-depressed (n = 66) pregnant women who completed measures of depression, anxiety, and sleep. Differences between groups in sleep controlling for anxiety were found. Depressed pregnant women present higher number of nocturnal awakenings and spent more hours trying falling asleep during the night and the entire 24 h period. Present findings point out the effect of depression on sleep in late pregnancy, after controlling for anxiety.

Highly resilient coping entails better perceived health, high social support and low morning cortisol levels in parents of children with autism spectrum disorder.

The negative consequences of caring for people with developmental disabilities have been widely described. However, the ability to bounce back from the stress derived from care situations has been less studied. Those caregivers who have shown this ability are considered as resilient. This study aims to evaluate the relationship between resilience and self-reported health and cortisol awakening response (CAR) in a sample of caregivers of people with autism spectrum disorders (ASD). It also aims to evaluate the role of social support as a mediator in the association between resilience and health. Caregivers with higher resilience show better perceived health, lower morning cortisol levels, and less area under the curve with respect to ground (AUCg). Social support was positively related to resilience and mediated the relationship between resilience and perceived health. This mediating effect was not found in the association between resilience and CAR. Resilience could be a protective factor that modulates the negative consequences of chronic stress in the care context. Social support could be an important variable mediating the effects of resilience on health outcomes in caregivers. All these results must be considered when implementing effective psychological programs for helping caregivers.

Self-reported health and cortisol awakening response in parents of people with asperger syndrome: the role of trait anger and anxiety, coping and burden.

Caring for offspring with autism spectrum disorders entails high levels of stress for a long period of time and is associated with several types of health complaints. Few studies have focused on specific effects of particular disorders in the spectrum. This study was carried out with the aim of evaluating the global health of parents of people with Asperger syndrome (N = 53) compared to those of typically developing children (N = 54) through self-reported measures (medication consumption and somatic symptoms) and biological markers (cortisol awakening response [CAR]). Additionally, we analysed various psychological variables as potential predictors of caregiver health. We found that caregivers take more medication and have worse self-reported health than controls, but there were no significant differences in CAR between the groups. However, after controlling for negative affect, differences between groups in CAR reached significance. With regards to predictor variables, anxiety trait, cognitive-coping style, burden and anger temperament were significantly associated with caregiver's self-reported health. These findings underline the need to develop interventions that foster improvements in the health of caregivers, reduce their burden and enhance their quality of life.