Home / 2019 / Trajectory of change in anxiety sensitivity in relation to anxiety, depression, and quality of life among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy

Trajectory of change in anxiety sensitivity in relation to anxiety, depression, and quality of life among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy

Treatment of the Human Immunodeficiency Virus (HIV) and the progression to Acquired Immunodeficiency Syndrome (AIDS) has changed drastically over the past few decades. Indeed, HIV/AIDS has transitioned from a near “death sentence” into a chronic condition that can be managed. Due to treatment advances, people living with HIV/AIDS can live long and fulfilling lives. However, these individuals live with tremendous stresses associated with their chronic health condition. In addition to the symptoms associated with HIV/AIDS, these individuals face social judgment/stigma and numerous mental health conditions.

In particular, anxiety and depression are common among persons living with HIV/AIDS. These symptoms may come in the form of social anxiety stemming from the judgment/societal stigma of HIV/AIDS, post-traumatic stress symptoms due to high rates of trauma exposure experienced in this population, general worry relating to uncertainty about the future, or depression resulting from the difficulties and losses that these individuals face. Due to the various forms of anxiety/depression symptoms that can occur, new transdiagnostic (i.e., treatments that are effective across two or more traditional diagnostic categories) treatments have been developed to target the broad range of symptoms that can occur.

Furthermore, not only do these individuals experience mental health symptoms, they also experience reduced quality of life. That is, it is not just that individuals have negative symptoms that are unpleasant, but they also experience more broad deficits in their standards of health and happiness. Treatments for persons with HIV/AIDS should therefore be focused on improving the positives (i.e., improving quality of life) in addition to reducing the “negatives” (i.e., symptoms of anxiety/depression). Treating the life of the individual should improve their standard of living and not simply remove a negative (i.e., symptom).

Treating mental health among persons living with HIV/AIDS is important not only to improve their quality of life, but also to improve their health. Past work suggests that improving mental health among these individuals can have impacts on their HIV symptoms and their ability to manage their condition. Reducing depression/anxiety is associated with improved medication adherence. For HIV/AIDS, adhering to medications is key in making sure the condition is a chronic health problem and not a cause of early death as it once was. Our team recently developed a transdiagnostic cognitive behavioral treatment for anxiety among persons living with HIV/AIDS (HIV Anxiety Management/Reduction Therapy; HAMRT). Yet, we have not evaluated what factors may drive symptom change in this treatment.

Our current study evaluated how anxiety sensitivity (the tendency for individuals to fear physical sensations associated with anxiety) changes over the course of HAMRT and how changes in anxiety sensitivity related to changes in anxiety, depression, and quality of life. We found that anxiety sensitivity is reduced over the course of HAMRT and that changes in anxiety sensitivity correspond to changes in all three outcomes. This suggests that anxiety sensitivity may be a mechanism of change underlying changes in key outcomes, although more work is needed to evaluate whether anxiety sensitivity changes and then outcomes change, or whether they all change together. Taken together, a brief six-session treatment can yield meaningful changes in a vulnerable group of individuals. This treatment can be broadly applied to a number of mental health symptom domains and may offer promise in improving the quality of life of these individuals. This work is focused on not only extending the lives of persons with HIV/AIDS, but also making those lives markedly better.

Read the full paper: Paulus, D. J., Brandt, C. P., Lemaire, C., & Zvolensky, M. J. (in press). Trajectory of change in anxiety sensitivity in relation to anxiety, depression, and quality of life among persons living with HIV/AIDS following transdiagnostic cognitive-behavioral therapy. Cognitive Behaviour Therapy. doi: 10.1080/16506073.2019.1621929

Pictured: Daniel J. Paulus

Photo by: Josef Grunig

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