CHANGES IN COGNITIVE COPING SKILLS AND SOCIAL SUPPORT DURING COGNITIVE-BEHAVIORAL STRESS MANAGEMENT INTERVENTION AND DISTRESS OUTCOMES IN SYMPTOMATIC HUMAN-IMMUNODEFICIENCY-VIRUS (HIV)-SEROPOSITIVE GAY MEN

Objective: We have previously reported decreases in dysphoria, anxiety , and total mood disturbance in symptomatic HIV seropositive gay men a fter a 10-week cognitive behavioral stress management (CBSM) group int ervention. This structured intervention was designed a) to increase co gnitive and behavioral coping skills related to managing the distress of symptomatic HIV, and b) to increase social support among group memb ers. Here we examine the relative contribution of changes in coping sk ills and social support during the intervention period to reductions i n dysphoria, anxiety, and distress-related symptoms in this sample. Me thods: Participants were randomized to a 10-week CBSM group interventi on or to a wait-list control condition. Coping, social supports, and m ood were measured before and after the intervention period. Results: M embers of the CBSM group (N = 22) showed significant improvement in co gnitive coping strategies involving positive reframing and acceptance, and in social supports involving attachment, alliances, and guidance at the end of the 10-week CBSM program compared with controls (N = 18) who showed decrements in these coping abilities and no changes in soc ial support. Improved cognitive coping, specifically acceptance of the HIV infection, was strongly related to lower dysphoria, anxiety, and total mood disturbance in both conditions. Changes in social support a nd in cognitive coping skills seem to mediate the effects of the exper imental condition on the chan es in distress noted during the interven tion. Conclusions: These results suggest that cognitive coping and soc ial support factors can be modified by psychosocial interventions and may be important determinants of the changes in psychological well-bei ng and quality of life during symptomatic HIV infection that can be ac hieved through this form of intervention.