Effectiveness of mindfulness-based Stress reduction (MBSR) on anxiety, depression and post-traumatic stress disorder symptoms in patients with HIV/ AIDS

Authors

1 Department of clinical Psychology, Faulty of Psychology and Educational Sciences, University of Kharazmi, Tehran, Iran

2 Department of clinical Psychology, Faulty of Psychology and Educational Sciences, Islamic Azad University, Science and Research Branch, Tehran, Iran

3 Department of Psychology and Education of Exceptional Children, Faculty of Psychology and Educational Sciences University of Allameh Tabatabaei, Tehran, Iran

4 Department of guidance and counseling psychology, Faulty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran

Abstract

AbstractIntroduction: Mindfulness plays an important role in improving psychological functions of chronic patients. Therefore the aim of this study was investigate the effectiveness of mindfulness-based stress reduction (MBSR) on symptoms of anxiety, depression and post-traumatic stress in patients with HIV/ AIDS.Method: This was an experimental design with pre-test, post-test along with follow-up group. Using convenience sampling 30 HIV/ AIDS patients were selected. They were randomly assigned into two groups of experiment and control. The experimental group underwent mindfulness-based stress reduction therapy within two months.  The scores of Beck Beck Depression Inventory-II (BDI-II) , Beck Anxiety Inventory (BAI)  and Impact of Event Scale - Revised (IES-R), were collected from the two groups in pre-test, post-test and in a two-month follow up. Data were analyzed using mixed analysis of variance test. Results: Results in the post-test and follow up indicated that MBSR in experimental group, significantly reduced symptoms of post-traumatic stress disorder  (P˂0.05), anxiety (P˂0.05) and depression (P˂0.05) in HIV/ AIDS patients.Conclusion: Results of this study revealed the effectiveness of mindfulness-based stress reduction on psychological functions in patients with HIV. According to these results and the mechanism of its effectiveness, this therapy can have good therapeutic implications.Keywords: mindfulness based stress reduction, anxiety, depression, post-traumatic stress, HIV/AIDS.

Keywords


References

1.    UNAIDS. The global report AIDS epidemic, 2013. http://www.unaids.org/en/media/unaids/contentassets/ documents/epidemiology. Accessed on 10th December. 2013.

2.                          UNAIDS. Global HIV/AIDS Response, epidemic update and health sector program towards universal access. http://www.unaids.org/en/media/unaids/contentassets/ documents/unaidspublication/2011. 2011.

3.    Watkins CC, Treisman GJ. Cognitive impairment in patients with AIDS - prevalence and severity. HIV/AIDS (Auckland, NZ). 2015;7:35-47. PubMed PMID: 25678819. Pubmed Central PMCID: PMC4319681. Epub 2015/02/14. eng.

4.    Christo PP. [Cognitive alterations associated with HIV-1 infection and AIDS]. Revista da Associacao Medica Brasileira (1992). 2010 Mar-Apr;56(2):242-7. PubMed PMID: 20499003. Epub 2010/05/26. Alteracoes cognitivas na infeccao pelo HIV e Aids. por.

5.    Thom RGM. HAART and Mind. Common Mental Disorders in People Living with HIV/AIDS. South Africa: Reach Publishers; 2012

6.    Ogden J. Health Psychology: A Textbook Edition tRe, editor. landan, uk: open university press; 2012.

7.    Clucas C, Sibley E, Harding R, Liu L, Catalan J, Sherr L. A systematic review of interventions for anxiety in people with HIV. Psychology, health & medicine. 2011 Oct;16(5):528-47. PubMed PMID: 21777090. Epub 2011/07/23. eng.

8.    Jonsson  G, Davies N, Freeman C, Joska J, Pahad S, Thom R, et al. Guident Management of mental health disordersin HIV-positive patientsby the Southern African HIV Clinicians Society

S Afr J HIV Med. 2013;14(4):155-65.

9.    Yunusa MA, Njoku CH, Obembe A. Self-reported adherence to treatment: a study of socioeconomic factors and psychiatric morbidity among male and female patients with HIV infection in Sokoto, Nigeria. Running title: Treatment adherence, socioeconomic factors and psychiatric morbidity in HIV patients. Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria. 2014 Jan-Mar;23(1):33-9. PubMed PMID: 24946452. Epub 2014/06/21. eng.

10.   Celesia BM, Nigro L, Pinzone MR, Coco C, La Rosa R, Bisicchia F, et al. High prevalence of undiagnosed anxiety symptoms among HIV-positive individuals on cART: a cross-sectional study. European review for medical and pharmacological sciences. 2013;17(15):2040-6. PubMed PMID: 23884824. Epub 2013/07/26. eng.

11.                                                         Shacham E, Morgan J, Önen NF, Taniguchi T, Overton ET. Screening Anxiety in the HIV Clinic. AIDS and behavior. 2012;16(8):2407-13. PubMed PMID: PMC3623696.

12.                                                  Illa L, Benejam G, Lage O, Friedman L, Major-Wilson H, Maturo D, et al. Prevalence of PTSD Symptoms in Adolescents Living with HIV. Journal of Adolescent Health.46(2):S47.

13.         Sherr L, Clucas C, Harding R, Sibley E, Catalan J. HIV and depression--a systematic review of interventions. Psychology, health & medicine. 2011 Oct;16(5):493-527. PubMed PMID: 21809936. Epub 2011/08/04. eng.

14.   Moradi AR, Herlihy J, Yasseri G, Shahraray M, Turner S, Dalgleish T. Specificity of episodic and semantic aspects of autobiographical memory in relation to symptoms of posttraumatic stress disorder (PTSD). Acta Psychologica. 2008 3//;127(3):645-53.

15.   Wright M. J, Woo E, Barclay T.R, Hinkin CH. The functional impact of HIV-associated neuropsychological decline. In R. Paul, N. Sactor, K. Tashima, & V. Valcour (Eds.). HIV and the Brain: New Challenges in the Modern Era. ew York: N, NY: Humana Press; 2009.

16.   Lowther K, Selman L, Harding R, Higginson IJ. Experience of persistent psychological symptoms and perceived stigma among people with HIV on antiretroviral therapy (ART): a systematic review. International journal of nursing studies. 2014 Aug;51(8):1171-89. PubMed PMID: 24602830. Epub 2014/03/08. eng.

17.   Lu SH, Tang XP, Deng XL, Chen WL, Hu RX. [Relationship between psychological distress and T lymphocyte in HIV/AIDS patients]. Zhonghua shi yan he lin chuang bing du xue za zhi = Zhonghua shiyan he linchuang bingduxue zazhi = Chinese journal of experimental and clinical virology. 2009 Feb;23(1):23-5. PubMed PMID: 19799009. Epub 2009/10/06. chi.

18.   Kabat‐Zinn J. Mindfulness‐based interventions in context: past, present, and future. Clin Psychol sinc &Pract. 2003;10(2):144-56.

19.   Abbott RA, Whear R, Rodgers LR, Bethel A, Thompson Coon J, Kuyken W, et al. Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomised controlled trials. Journal of psychosomatic research. 2014 5//;76(5):341-51.

20.   Yang Y, Liu Y-H, Zhang H-F, Liu J-Y. Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapies on people living with HIV: A systematic review and meta-analysis. International Journal of Nursing Sciences. 2015.

21.                   Goldin PR, Gross JJ. Effects of Mindfulness-Based Stress Reduction (MBSR) on Emotion Regulation in Social Anxiety Disorder. Emotion (Washington, DC). 2010;10(1):83-91. PubMed PMID: PMC4203918.

22.   Lawrence M, Booth J, Mercer S, Crawford E. A systematic review of the benefits of mindfulness-based interventions following transient ischemic attack and stroke. International journal of stroke : official journal of the International Stroke Society. 2013 Aug;8(6):465-74. PubMed PMID: 23879751. Epub 2013/07/25. eng.

23.   Palta P, Page G, Piferi RL, Gill JM, Hayat MJ, Connolly AB, et al. Evaluation of a mindfulness-based intervention program to decrease blood pressure in low-income African-American older adults. Journal of urban health : bulletin of the New York Academy of Medicine. 2012 Apr;89(2):308-16. PubMed PMID: 22302233. Pubmed Central PMCID: PMC3324609. Epub 2012/02/04. eng.

24.   Nyklicek I, Mommersteeg PM, Van Beugen S, Ramakers C, Van Boxtel GJ. Mindfulness-based stress reduction and physiological activity during acute stress: a randomized controlled trial. Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2013 Oct;32(10):1110-3. PubMed PMID: 23527521. Epub 2013/03/27. eng.

25.   Zeidan F, Johnson SK, Diamond BJ, David Z, Goolkasian P. Mindfulness meditation improves cognition: evidence of brief mental training. Consciousness and cognition. 2010 Jun;19(2):597-605. PubMed PMID: 20363650. Epub 2010/04/07. eng.

26.   golaij s, moradi a, parhoon h. Comparing the performance of the people suffering from washing compulsion, checking compulsion and generalized anxiety disorders in the realm of autobiographical memory. Journal of Behavioral Sciences. 2014;8(3):1-2. eng %@ %[ 2014.

27.            Fata L, Birashk B, Atif Waheed M.K, Dobson K. By means of this scheme, the state of emotional and cognitive processing of emotional information hought and Behavior in Clinical Psychology. 2005;2:20-5. Persian.

28.   Kaviani H, Mousavi A.S. [Psychometric properties of the Persian version of Beck anxiety inventory (BAI). Medical journal of Tehran University of Medical Sciences. 2008;65(2):136-40. Persian.

29.   Moradi A, Salimi M, Fathi- Ashtiani A. Memory performance of war veterans with PTSD. Journal of Behavioral Sciences. 2011;4(4):5-6.

30.   Chaskalson M. The mindful workplace: developing resilient individuals and resonant organizations with MBSR: John Wiley & Sons; 2011.

31.   Goldin PR, Gross JJ. Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion. 2010 Feb;10(1):83-91. PubMed PMID: 20141305. Pubmed Central PMCID: PMC4203918. Epub 2010/02/10. eng.

32.   Sibinga EMS, Stewart M, Magyari T, Welsh CK, Hutton N, Ellen JM. Mindfulness-Based Stress Reduction for HIV-Infected Youth: A Pilot Study. EXPLORE: The Journal of Science and Healing. 2008 1//;4(1):36-7.

33.   Riley KE, Kalichman S. Mindfulness-based stress reduction for people living with HIV/AIDS: preliminary review of intervention trial methodologies and findings. Health psychology review. 2015;9(2):224-43. PubMed PMID: 26209210. Epub 2015/07/26. eng.

34.   Jam S, Imani A, Foroughi M, SeyedAlinaghi S, Emadi Koochak H, Mohraz M. The Effects of Mindfulness-Based Stress Reduction (MBSR) Program in Iranian HIV/AIDS Patients: A Pilot Study. Acta medica Iranica. 2010;48(2).

35.   Duncan LG, Moskowitz JT, Neilands TB, Dilworth SE, Hecht FM, Johnson MO. Mindfulness-based stress reduction for HIV treatment side effects: a randomized, wait-list controlled trial. Journal of pain and symptom management. 2012 Feb;43(2):161-71. PubMed PMID: 21925831. Pubmed Central PMCID: PMC3253947. Epub 2011/09/20. eng.

36.   Beak A.T, steer R.A, Brown G. k. Beck Depression Inventory for measuring depression. Arch Gen psychology. 1996;4:561-71.

37.                                                                           Brown K.W, Ryan R.M, Creswell J.D. mindfulness: theoretical foundations and evidence for its salutary effects. Psychological Inquiry. 2007;18(4):211-37.

38.                                                             Arch J.J, Craske M.G. Mechanisms of mindfulness: emotion regulation following a focused breathing induction. Behaviour research and therapy. 2006;44(12):1849-58.

39.   Kabat-Zinn J. Some reflections on the origins of MBSR, skillful means, and the trouble with maps. Contemporary Buddhism. 2011 (12):281-306.

40.   Campbell T, Rohleder P, Beadle S, O’Keefe T. Chapter 30 - Psychological Responses in People with HIV Infection: Considering the Challenges in the Fourth Decade of the Epidemic1. In: Watson RR, editor. Health of HIV Infected People. Boston: Academic Press; 2015. p. 551-72.