Abstract
The level of emotional distress and the impact of stress and personal resources on distress were examined among 149 youths aged 14–23 who tested seropositive for the human immunodeficiency virus (HIV+). These HIV+ females and males (the males were predominantly gay and bisexual) were relatively healthy (M T cells=516; 17% T cells >200; 3.8 physical symptoms in the previous three months) and reported levels of emotional distress and self-esteem similar to uninfected adolescents. Youths experienced about three stressful life events in the previous three months, primarily death/illness of friends and violent crimes. Youths were less likely to utilize self destructive, avoidant, and depressed coping styles in contrast to taking positive actions. Social support from parents, friends, and romantic partners was high, but these support persons often engaged in sexual and substance use risk acts. Controlling for youths’ physical health status, increased emotional distress was associated with significantly lower self-esteem, higher stress, and negative coping styles. Social support did not mediate emotional distress among HIV+ youths.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Goldsmith M: Invisible epidemic now becoming visible as HIV/AIDS pandemic reaches adolescents.Journal of the American Medical Association. 1993,270:16–19.
Baker R: Board of Ed’s AIDS Council doesn’t want (kids to know).Village Voice.5 April 1994, 11–14.
Rotheram-Borus MJ, Koopman C: Adolescents. In Stuber M (ed),Children and AIDS (Vol. 19). Washington, DC: American Psychiatric Press, 1991, 45–66.
Gayle HD, D’Angelo LJ: Epidemiology of acquired immunodeficiency syndrome and human immunodeficiency virus infection in adolescents.Pediatric Infectious Disease Journal. 1991,10(4): 322–328.
D’Angelo L, Brown R, English A, Hein K, Remafedi G: HIV infection and AIDS in adolescents: A position paper of the Society for Adolescent Medicine.Journal of Adolescent Health. 1994,75(5): 427–434.
Futterman D, Hein K, Reuben N, Dell R, Shaffer N: Human immunodeficiency virus-infected adolescents: The first 50 patients in a New York City program.Pediatrics. 1993,91(4):730–735.
Futterman D, Rogers A, D’Angelo L, Levin L: Transmission dynamics and clinical status of HIV + youth. Society of Adolescent Medicine. Vancouver, Canada: May, 1995.
Hein K, Dell R, Futterman D, Rotheram-Borus MJ, Shaffer N: Comparison of HIV+ and HIV- adolescents: Risk factors and psychosocial determinants.Pediatrics. 1995,95(1):96–104.
Folkman S: Coping across the life span: Theoretical issues. In Cummings EM, Greene AL, Karraker KH (eds),Life-Span Developmental Psychology: Perspectives on Stress and Coping. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1991, 3–19.
Folkman S: Psychosocial effects of HIV infection. In Goldberger L, Breznitz S (eds),Handbook of Stress: Theoretical and Clinical Aspects (2nd Ed.). New York: Free Press, 1993, 658–681.
Folkman S, Lazarus RS: Coping and emotion. In Monat A, Lazarus RS (eds),Stress and Coping: An Anthology (3rd Ed.). New York: Columbia University Press, 1991, 207–227.
Selye H: History of the stress concept. In Goldberger L, Breznitz S (eds),Handbook of Stress: Theoretical and Clinical Aspects (2nd Ed.). New York: Free Press, 1993, 7–17.
Chuang HT, Devins GM, Hunsley J, Gill MJ: Psychosocial distress and well-being among gay and bisexual men with human immunodeficiency virus infection.American Journal of Psychiatry. 1989,146(7):876–880.
Donlou JN, Wolcott DL, Gottlieb MS, Landsverk J: Psychosocial aspects of AIDS and AIDS-related complex: A pilot study.Journal of Psychosocial Oncology. 1985,5(2):39–55.
Centers for Disease Control and Prevention:Facts about Adolescents and HIV/AIDS, CDC National AIDS Clearinghouse No. 289. Rockville, MD: Centers for Disease Control and Prevention, 1994.
Rogers A, Futterman D, D’Angelo L, Levin L: Factors affecting antiretroviral treatment in HIV+ youth. Society of Adolescent Medicine. Vancouver, Canada: March, 1995.
Remafedi G: Adolescent homosexuality: Psychosocial and medical implications.Pediatrics. 1987,79:331–337.
Rotheram-Borus MJ, Rosario M, Van Rossem R, Reid H, Gillis JR: Prevalence, course, and predictors of multiple problem behaviors among gay and bisexual male adolescents.Developmental Psychology. 1995,31(l):75–85.
Rotheram-Borus MJ, Hunter J, Rosario M: Suicidal behavior and gay-related stress among gay and bisexual male adolescents.Journal of Adolescent Research. 1994,9(4):498–508.
Remafedi G, Farrow J, Deisher R: Risk factors for attempted suicide in gay and bisexual youth.Pediatrics. 1991,87(6):869–876.
Rubenstein JL, Heeren T, Housman D, Rubin C, Stechler G: Suicidal behavior in “normal” adolescents: Risk and protective factors.American Journal of Orthopsychiatry. 1989,59:59–71.
Roberts RE, Andrews JA, Lewinsohn PM, Hops H: Assessment of depression in adolescents using the Center for Epidemiologic Studies Depression Scale.Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1990,2(2): 122–128.
Bukstein OG, Brent DA, Kaminer Y: Comorbidity of substance abuse and other psychiatric disorders in adolescents.American Journal of Psychiatry. 1989,146(9): 131–1141.
Garrison CZ, Jackson KL, Marsteller F, McKeown R, Addy C: A longitudinal study of depressive symptomatology in young adolescents.Journal of the American Academy of Child and Adolescent Psychiatry. 1990,29(4):581–585.
Roberts RE, Sobhan M: Symptoms of depression in adolescence: A comparison of Anglo, African, and Hispanic Americans.Journal of Youth and Adolescence. 1992,21:639–651.
Bowler S, Sheon AR, D’Angelo LJ, Vermund SH: HIV and AIDS among adolescents in the United States: Increasing risk in the 1990s.Journal of Adolescence. 1992,75:345–371.
Remafedi G: The health and psychosocial status of HlV-seropositive youth. Society of Adolescent Medicine. Vancouver, Canada: May, 1995.
Rotheram-Borus MJ, Koopman C, Rosario M: Developmentally tailoring prevention programs: Matching strategies to adolescents’ serostatus. In DiClemente RJ (ed),Adolescents and AIDS: A Generation in Jeopardy. Newbury Park, CA: Sage Publications, 1992, 212–229.
Ostrow DG, Monjan A, Joseph J, et al: HIV-related symptoms and psychological functioning in a cohort of homosexual men.American Journal of Psychiatry. 1989,146(6):737–742.
Compas BE: Stress and life events during childhood and adolescence.Clinical Psychology Review. 1987,7(3):275–302.
Coyne J, Downey G: Social factors and psychopathology: Stress, social support, and coping processes.Annual Review of Psychology. 1991,42:401–425.
Dohrenwend BP, Dohrenwend BS: Socioenvironmental factors, stress, and psychopathology.American Journal of Community Psychology. 1981,9(2): 128–164.
Blaney NT, Millon C, Morgan R, Eisdorfer C, Szapocznik J: Emotional distress, stress-related disruption, and coping among healthy HIV+ gay males.Psychology and Health. 1990,4:259–273.
Namir S, Wolcott DL, Fawzy FI, Alumbaugh MJ: Coping with AIDS: Psychological and health implications.Journal of Applied Social Psychology. 1987,77(3):309–328.
Wolcott DL, Namir S, Fawzy FI, Gottlieb MS, Mitsuyasu RT: Illness concerns, attitudes towards homosexuality, and social support in gay men with AIDS.General Hospital Psychiatry. 1986,8: 395–403.
Rotheram-Borus MJ, Rosario M, Koopman C: Minority youths at high risk: Gay males and runaways. In Gore S, Colton ME (eds),Adolescent Stress: Causes and Consequences. New York: Aldine de Gruyter, 1991, 181–200.
Nicholson WD, Long BC: Self-esteem, social support, internalized homophobia, and coping strategies of HIV + gay men.Journal of Consulting and Clinical Psychology. 1990,58(6):873–876.
Allgood-Merton B, Lewinsohn P, Hops H: Sex differences and adolescent depression.Journal of Abnormal Psychology. 1990,99(1): 55–63.
Brage D, Meredith W: A causal model of adolescent depression.Journal of Psychology. 1994,128(4):455–468.
Lazarus RS, Folkman S:Stress, Appraisal, and Coping. New York: Springer, 1984.
Compas BE, Orosan PG, Grant KE: Adolescent stress and coping: Implications for psychopathology during adolescence.Journal of Adolescence. 1993,76(3):331–349.
Wolf TM, Balson PM, Morse EV, et al: Relationship of coping style to affective state and perceived social support in asymptomatic and symptomatic HIV-infected persons: Implications for clinical management.Journal of Clinical Psychiatry. 1991,52:171–173.
St. Lawrence JS, Brasfield TL, Jefferson KW, Allyene E, Shirley A: Social support as a factor in African-American adolescents’ sexual risk behavior.Journal of Adolescent Research. 1994,9(3): 292–310.
DiClemente RJ: The emergence of adolescents as a risk group for human immunodeficiency virus infection.Journal of Adolescent Research. 1990,5(1):7–17.
Rotheram-Borus MJ, Koopman C: HIV and adolescents.Journal of Primary Prevention. 1991,12(1):68–82.
Rotheram-Borus MJ, Murphy DA: High-risk adolescents: They can comply with health care and reduce health-risk behaviors. Society of Adolescent Medicine. Vancouver, Canada: March, 1995.
Gruen R, Calderwood M, Meyer-Bahlburg, H, Ehrhardt A: Psychosexual assessment in AIDS research. InAbstracts of the Fifth International Conference on AIDS. Ottawa, Ontario, Canada: 1989, 739.
Gwadz M, Rotheram-Borus MJ: Tracking high-risk adolescents longitudinally.AIDS Education and Prevention. 1992,4:69–82.
Derogatis LR:Brief Symptom Inventory: Administration, Scoring, and Procedures Manual. Minneapolis, MN: National Computer Systems, Inc., 1993.
Johnson JH, McCutcheon SM: Assessing life stress in older children and adolescents: Preliminary findings with the Life Events Checklist. In Sarason IG, Spielberger CD (eds),Stress and Anxiety (Vol. 7). New York: Wiley, 1980, 111–125.
Sarason IG, Johnson JH, Siegel JM: Assessing the impact of life changes. In Sarason IG, Spielberger CD (eds),Stress and Anxiety (Vol. 6). Washington, DC: Hemisphere Publishing Corporation, 1978, 131–149.
Rosenberg M:Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press, 1965.
Dixon WJ, Massey FJ:Introduction to Statistical Analysis (4th Ed.). New York: McGraw-Hill, 1983, 119–126.
Centers for Disease Control and Prevention:HIV/AIDS Surveillance Report: U.S. HIV and AIDS cases reported through June, 1994. Washington, DC: Department of Health and Human Services, 1994,6(l):5–27.
Bozzette SA, Kanouse DE, Berry S, Duan N: Health status and function with Zidovudine or Zalcitabine as initial therapy for AIDS: A randomized controlled trial.Journal of the American Medical Association. 1995,273(4):295–301.
Rotheram-Borus MJ, Phinney J: Ethnic behavior patterns as an aspect of identity. In Phinney J, Rotheram-Borus MJ (eds),Children’s Ethnic Socialization: Pluralism and Development. Fontana, CA: Sage Publications, 1987, 10–31.
Luna GC, Rotheram-Borus MJ:The significance of HIV infection in the lives of troubled gay and lesbian youths: Four case studies of precipitating life factors and subsequent adaptation. Unpublished manuscript, Department of Psychiatry, University of California, Los Angeles, 1996.
Petersen AC, Ding S: Improving coping behaviors during adolescence. Society for Research in Child Development. Indianapolis, IN: March, 1995.
Folkman S: Personal control and stress and coping processes: A theoretical analysis.Journal of Personality and Social Psychology. 1984,46(4):839–852.
Author information
Authors and Affiliations
Additional information
Preparation of this manuscript was supported in part by Grant R01 DA-07903 from the National Institute on Drug Abuse to the first author.
The authors also appreciate the contributions of Jeffrey M. Birnbaum, M.D., Brad Brusavich, Ph.D.; Jake Carpenter; Brenda Chabon, Ph.D.; Christina Christie, Ph.D.; Timothy R. Cline, Ph.D.; Al Cohall, M.D.; Lori Crawford, M.S.W.; Donna Futterman, Ph.D.; Marya Gwadz, M.A.; Darius Jatulis, M.A.; Michael Kennedy, M.A.; Michelle Kipke, Ph.D.; Kris Langabeer, B.A.; Linda Levin, M.D.; Sutherland Miller, Ph.D.; Barbara Otto, M.D.; Dennis Rahaman, Ron Reynolds, Ph.D.; Mavis Seehaus, M.A.; Arlene Schneir, Ph.D.; and Whitney Wright, Ph.D.
About this article
Cite this article
Rotheram-Borus, M.J., Murphy, D.A., Reid, H.M. et al. Correlates of emotional distress among HIV+ youths: Health status, stress, and personal resources. Ann Behav Med 18, 16–23 (1996). https://doi.org/10.1007/BF02903935
Issue Date:
DOI: https://doi.org/10.1007/BF02903935