Recurrent genital herpes: what helps adjustment?

Psychosocial adjustment to recurrent genital infections with herpes simplex virus (HSV) varies greatly among individuals. To identify the factors predictive of psychosocial adjustment to recurrent genital HSV infections, we analyzed data from interviews and psychological tests conducted with infected individuals. We found that avoidant coping strategies such as denial and social support from a counselor were negatively correlated with adjustment to genital HSV, whereas cognitive coping strategies and social support from one's spouse or lover were positively correlated with adjustment. We conclude that psychosocial adjustment to recurrent genital HSV infections might be facilitated by sharing one's diagnosis with supportive intimate others and avoiding denial as a defense mechanism.

The relationship among genital herpes simplex virus, stress, and social support.

Despite widespread popular belief in the activation of recurrent lesions in genital herpes simplex virus (HSV) by psychosocial stress, little empirical evidence supports that contention. This study retrospectively examined the role of stress in activation of HSV lesions as mediated by social support. Participants were 59 volunteers who had self-reported culture-positive genital HSV for at least 10 months. Measures of stress proneness (State-Trait Anxiety Inventory; STAI-Trait), recent stressful events (Schedule of Recent Events; SRE), and subjective appraisal of stress (global self-rating) were administered along with measures of general social support and herpes-specific social support. When retrospective reports of HSV symptoms were examined using a multiple-regression approach, duration of disease and amount of herpes-specific social support were found to be significant moderators of the relation between stress and number of HSV recurrences in the preceding 12 months. When duration of disease was short (less than 4 years), stress (SRE) and number of recurrences were positively associated; when disease duration was longer, there was no relationship. Similarly, at low levels of herpes-specific social support, a positive relation between stress (SRE) and number of recurrences was found. However, at higher levels of herpes-specific social support, no association was found. No relation was found between stress proneness (STAI-Trait) and HSV symptoms. However, subjective appraisal (global rating) of stress in the preceding 12 months was positively and significantly correlated with reported number of recurrences. Results are discussed in terms of their clinical implications.

Psychosocial aspects of genital herpes virus infection.

Genital herpes virus infection is one of the most prevalent and perhaps the most emotionally difficult of the sexually transmitted diseases. This article examines the current empirical and clinical understanding of the psychosocial aspects of the disease and proposes a framework for future investigation. Psychosocial issues of importance in the disease are discussed and responses characteristic of the psychosocial adjustment process are presented. Evidence of the role of stress and psychosocial factors is reviewed. Finally, a biopsychosocial research approach to the psychoneuroimmunological mechanisms of the disease is suggested as a way of understanding etiology and process.

Stress reduction treatment of severe recurrent genital herpes virus.

Four individuals with high-frequency recurrences of genital herpes virus of at least 2 years' duration were treated with two behavioral stress-reduction treatments. Subjects were given 10 weekly sessions of frontalis EMG biofeedback (2 subjects) or progressive muscle relaxation treatment (2 subjects). Presession and postsession frontalis EMG measures were recorded for all subjects across treatment. Outcome was measured by daily and weekly symptom charting mailed in weekly over 6 months, or by telephone interview after 6 months. Results demonstrated substantial improvement in reported symptoms with both treatments. Relaxation treatment resulted in a 66% and 100% reduction in frequency of recurrences. Frontalis EMG biofeedback resulted in a 72% and 7% reduction in frequency of recurrences. Follow-up at 1-year posttreatment showed that treatment effects were maintained by one subject, partially maintained by two, and reversed in one subject. The need for controlled investigation is emphasized.

Psychological aspects of multiple sclerosis and its treatment: toward a biopsychosocial perspective.

Multiple sclerosis (MS) is a chronic, progressive neurological disease that produces demyelination of the CNS nerve fibers. With onset most often in young adulthood, the disease produces a variety of neurological symptoms and follows an unpredictable course characterized by exacerbations and remissions. This article reviews the literature on psychological aspects of MS including early psychoanalytic studies and more current psychosocial research. Literature on the relationship between stress and symptoms, and the extent of cognitive impairment experienced is reviewed. A view of psychosocial adjustment to MS based upon an adaptive coping model, and a psychological treatment approach suited to the special needs of individuals with MS are discussed. Finally, a biopsychosocial research model is recommended due to the complex, interactive nature of MS and unique research difficulties it presents.

Fibrositis and psychologic disturbance.

Thirty patients with fibrositis and 2 control groups, one of rheumatoid arthritis patients and the other of arthritis patients with other than rheumatoid arthritis, were compared on the basis of the Minnesota Multiphasic Personality Inventory (MMPI) to assess the role of psychologic factors in fibrositis. Patients with fibrositis differed in both elevation and variability in their MMPI profiles, indicating that they were more psychologically disturbed than patients with rheumatoid or other types of arthritis. The fact that almost all of the fibrositis patients' MMPI scales were higher suggests that we might be dealing with a number of different psychologic disturbances that have stiffness and musculoskeletal pain as principal and common symptoms.

A personal adaptation group for burn injured hospital patients.

This article describes the first reported psychotherapeutic group for hospitalized burn patients. The rationale for the group is based upon an adaptive coping model. Issues typically dealt with in groups include feelings toward hospital staff, emotional reactions to treatments, and feelings concerning their burn injury. Body image and resultant self-esteem issues are a major theme. The importance of clinical services for burn injured patients and the involvement of mental health professionals in service delivery is emphasized.