Personal meaning as a predictor of psychological well-being over time in individuals receiving HIV-related mental health services.

OBJECTIVE: This study examined the utility of personal meaning as a resilience variable in predicting psychological well-being over time in individuals enrolled in an HIV-related mental health services program. It was hypothesized that meaning assessed at the time of enrollment for mental health services would significantly predict well-being at the 3-month follow-up visit. A secondary hypothesis was that meaning would predict well-being in a model that also included social support as a predictor variable. METHOD: Participants completed self-report measures of psychological well-being, personal meaning and social support at the time of their initial mental health services visit. Well-being was measured again at the time of the 3-month follow-up visit. Regression methods were used for statistical analysis. RESULTS: Personal meaning assessed at the baseline visit was predictive of psychological well-being assessed at the 3-month follow-up visit when baseline well-being was controlled. Additionally, social support mediated the association between personal meaning and psychological well-being at the 3-month follow-up visit. CONCLUSIONS: Assessing personal meaning as a resilience variable in this clinical psychiatric sample of individuals enrolled in an HIV mental health services program was useful in predicting psychological well-being over time.

Psychological well-being in persons receiving HIV-related mental health services: the role of personal meaning in a stress and coping model.

OBJECTIVE: This investigation examined the association of personal meaning to psychological well-being in adults living with HIV/AIDS receiving mental health services. Personal meaning refers to a framework for delineating the purposes and goals that make life worth living and for evaluating the degree to which these purposes and goals are being fulfilled. Personal meaning was hypothesized to be positively associated with psychological well-being and to contribute independently to the variance in psychological well-being over and above social support, dispositional optimism and coping behavior. METHOD: With the use of a cross-sectional design, a set of self-report measures were completed by 132 adults living with HIV disease at the time of their initial mental health services evaluation. Data were analyzed using correlation and regression techniques. RESULTS: Personal meaning was positively associated with psychological well-being, although it did not contribute significantly to the variance in well-being over and above social support, optimism and coping behavior in a multifactorial regression model. Post hoc analysis showed partial mediation by optimism of the association between personal meaning and well-being. CONCLUSIONS: Personal meaning should be considered along with other psychological and behavioral coping factors in understanding and intervening clinically with individuals living with HIV disease and co-occurring psychiatric concerns.

Adherence to antiretroviral medication regimens: a test of a psychosocial model.

OBJECTIVE: The primary aim of this study was to test a psychosocial model of medication adherence among people taking antiretroviral medications. This model was based primarily on social cognitive theory and included personal (self-efficacy, outcome expectancy, stigma, depression, and spirituality), social (social support, difficult life circumstances), and provider (patient satisfaction and decision-making) variables. DESIGN: The data for this analysis were obtained from the parent study, which was a randomized controlled trial (Get Busy Living) designed to evaluate an intervention to foster medication adherence. Factor analysis was used to develop the constructs for the model, and structural equation modeling was used to test the model. Only baseline data were used in this cross sectional analysis. METHODS: Participants were recruited from a HIV/AIDS clinic in Atlanta, GA. Prior to group assignment, participants were asked to complete a questionnaire that included assessment of the study variables. Results A total of 236 participants were included in the analysis. The mean age of the participants was 41 years; the majority were male, and most were African-American. In the final model, self-efficacy and depression demonstrated direct associations with adherence; whereas stigma, patient satisfaction, and social support were indirectly related to adherence through their association with either self-efficacy or depression. CONCLUSION: These findings provide evidence to reinforce the belief that medication-taking behaviors are affected by a complex set of interactions among psychosocial variables and provide direction for adherence interventions.