Associations Among Resilience, Posttraumatic Growth, Anxiety, and Depression and Their Prediction From Stress in Newly Diagnosed People Living With HIV

Abstract

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Receiving an HIV diagnosis is a stressful life event with mental health consequences. People living with HIV (PLWH) report levels of anxiety and depression much higher than the general population (Chaudhury, Bakhla, & Saini, 2016), but positive mental health outcomes such as resilience and posttraumatic growth (PTG) have also been reported in this population (Murphy & Hevey, 2013). Resilience has been conceptualized in numerous ways (e.g., as a protective factor, as a process, as an outcome), but to some authors it is best defined as an outcome of positive adaptation in the face of adversity (e.g., Zautra, Hall, & Murray, 2010). It is the maintenance of a relatively stable trajectory of healthy functioning following exposure to a potential trauma (in this case, an HIV diagnosis), thus involving the return to pretrauma functioning levels (Bonanno, 2004). PTG, for its part, involves not just a return to pretrauma levels of functioning but an actual improvement (Tedeschi & Calhoun, 1996), and so it implies learning and growing after adversities. Although it has been established that these negative and positive outcomes coexist after an adverse event (Vera Poseck, Carbelo Baquero, & Vecina Jim enez, 2006), little is understood about their relationships with one another (Scali et al., 2012). Additionally, perceived stress has been identified as an important variable that impacts mental health. It has been associated with lower levels of resilience and greater anxiety, depression, and PTG in a variety of populations (Bonanno, Galea, Bucciarelli, & Vlahov, 2007; Chaudhury et al., 2016; Helgeson, Reynolds, & Tomich, 2006; Remor, 2006; Westphal & Bonanno, 2007), although data regarding PLWH is sometimes limited or nonexistent, especially with regard to resilience outcomes and PTG. In this brief report, we addressed these subjects by studying the relationships among anxiety, depression, resilience, and PTGinthe context of HIV diagnosis, specifically in newly diagnosed Spanish-speaking PLWH from Spain and Latin America. We also looked at how peri-diagnosis levels of perceived stress might explain the development of anxiety, depression, resilience, and PTG 6 months later. Additionally, we explored possible differences in levels of anxiety, depression, resilience, and PTG by sociodemographic variables.