Changes in mood and depressive symptoms and related change processes during cognitive-behavioral stress management in HIV-infected men

This study examined the effects of a cognitive-behavioral stress management (CBSM) intervention vs. a no-treatment control group in 100 HIV-infected gay men. CBSM participants showed significant decreases in mood disturbance and depressive symptoms as well as changes in coping, perceptions of social support, self-efficacy, and dysfunctional attitudes. Stepwise regression analyses were conducted to determine which of these changes were most important for reductions in mood disturbance and depressive symptoms. Although increases in self-efficacy emerged as a significant predictor of reduction in both mood disturbance and depressive symptoms, improvements in behavioral coping strategies were most closely tied to lowered overall mood disturbance whereas improvements in cognitive coping strategies and reduction in dysfunctional attitudes were more closely associated with decreases in depressive symptoms. These results support the use of multimodal CBSM interventions for HIV-infected men as a way to modify many different types of processes independently associated with different indicators of psychological adjustment.