Psychological distress among HIV+ adolescents in the REACH study: Effects of life stress, social support, and coping

Purpose: To investigate the effects of life events, social support, and cop ing on anxiety and depression among human immunodeficiency virus (HIV)-infe cted adolescents. It was hypothesized that higher levels of stressful event s would be associated with higher levels of anxiety and depression, but tha t this association would be moderated by satisfaction with social support a nd by adaptive coping. Methods: HIV-infected adolescents from 16 locations in 13 U.S. cities (N = 230, median age 16.09 years, standard deviation 1.2, range 13-19; 77% femal es) were recruited into the Reaching for Excellence in Adolescent Care and Health (REACH) project. REACH is the first large-scale disease progression study of HIV+ adolescents infected through sexual behavior or injection dru g use. The adolescent assessment was conducted by audio-computer assisted s elf-interview. Least squares regressions were used to test hypotheses. Results: Life events with high impact were associated with higher levels of depression and anxiety. Frequently reported events included: being prescri bed medications (74%), family financial problems (61%), and parental alcoho l abuse (20%). Contrary to expectations, the buffering hypotheses of social support and adaptive coping were not supported. Satisfaction with social s upport and adaptive coping methods, were both associated directly with lowe r levels of depression, but no association was detected between these two m easures and anxiety. Conclusions: Although life event distress was directly associated with psyc hological distress,neither social support nor adaptive coping seemed to mod erate this association. However, both satisfaction with support and adaptiv e coping were associated directly with depression in HIV-infected adolescen ts. (C) Society for Adolescent Medicine, 2000.