Posttraumatic stress disorder and posttraumatic growth in HIV-infected patients – the role of coping strategies
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Institute of Psychology, University of Lodz, Lodz, Poland
District Psychological and Pedagogical Outpatients Clinic, Piotrków Trybunalski, Poland
Submission date: 2016-07-03
Final revision date: 2016-09-08
Acceptance date: 2016-10-01
Online publication date: 2017-07-07
Publication date: 2017-06-07
Health Psychology Report 2017;5(4):323–332
The purpose of the research was to establish the role of coping strategies in the occurrence of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in HIV-infected individuals.

Participants and procedure
The study was conducted on 25 female and 39 male patients with HIV+ status and applied three questionnaires based on the self-report method. PTSD was assessed with the Impact of Event Scale-Revised (IES-R), PTG with the Posttraumatic Growth Inventory (PTGI), and the Brief version of Coping Orientations to Problems Experienced (Mini-Cope) was used for assessing coping strategies.

The data showed that half of the examined HIV+ group express a high intensity of PTSD symptoms and a majority of subjects have a medium or high intensity of PTG. Significant relationships were revealed between avoidance-focused strategies and the negative effects of HIV infection. Surprisingly, active coping strategy positively correlated with overall results of the IES-R and was found to be a predictor of PTSD symptoms. The seeking emotional support strategy was positively correlated with PTG and was considered as the leading predictor of overall PTG. The turning to religion strategy and acceptance were also positively correlated with posttraumatic growth.

Avoidance-focused strategies foster PTSD symptoms, while emotion-focused strategies seem to lead to posttraumatic growth.
AIDS National Center in Poland. (2012). Sytuacja epidemiologiczna HIV w Polsce na koniec 2012 [HIV epidemiology in Poland for 2012]. Available from: www.aids.gov.pl.
Breet, E., Kagee, A., & Seedat, S. (2014). HIV-related stigma and symptoms of posttraumatic stress disorder and depression in HIV individuals. Does social support play a mediating or moderating role? AIDS Care, 26, 947–951.
Bussel, V., & Naus, M. (2010). A longitudinal investigation of coping and posttraumatic growth in breast cancer survivors. Journal of Psychosocial Oncology, 28, 61–78.
Cann, A., Calhoun, L. G., Tedeschi, R. G., Triplett, K. N., Vishnevsky, T., & Lindstrom, C. M. (2011). Assessing posttraumatic cognitive processes: the Event Related Rumination Inventory. Anxiety, Stress & Coping, 24, 137–156.
Carver, C. (1997). You want to measure coping but your protocol’s too long: consider the brief COPE. International Journal of Behavioral Medicine, 4, 92–100.
Cohen, M. H., Fabri, M., Cai, X., Shi, Q., Hoover, D. R., Binagwaho, A., Culhane, M. A., Mukanyonga, H., Karegeya, D. K., & Anastos, K. (2009). Prevalence and predictors of posttraumatic stress disorder and depression in HIV-infected and at-risk Rwandan women. Journal of Womens Health, 18, 1783–1791.
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.
Hallam, W., & Morris, R. (2013). Post-traumatic growth in stroke carers: A comparison of theories. British Journal of Health Psychology, 19, 619–635. doi: 10.1111 /bjhp.12064.
Helgeson, V., Reynolds, K., & Tomich, P. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74, 797–816.
Heszen, I. (2012). Problemy zdrowotne i radzenie sobie z nimi – od zaprzeczania do emocji pozytywnych [Health problems and coping with them – from denial to positive emotions]. In N. Ogińska-Bulik & J. Miniszewska (eds.), Zdrowie w cyklu życia człowieka [Health in man’s life cycle] (pp. 181–197). Łódź: University Press.
Israelski, D. M., Prentiss, D. E., Lebega, S., Balmas, G., Garcia, P., Muhammad, M., Cummings, S., & Koopman, C. (2007). Psychiatric co-morbidity in vulnerable populations receiving primary care for HIV/AIDS. Aids Care, 19, 220–225.
Juczyński, Z., & Ogińska-Bulik, N. (2009a). Pomiar zaburzeń po stresie traumatycznym – polska wersja zrewidowanej Skali Wpływu Zdarzeń [Measurement of post-traumatic stress disorder – Polish version of Impact Event Scale-Revised]. Psychiatria, 6, 15–25.
Juczyński, Z., & Ogińska-Bulik, N. (2009b). Narzędzia pomiaru stresu i radzenia sobie ze stresem [Measurement tools of stress and coping with stress]. Warszawa: Pracownia Testów Psychologicznych.
Lawrence, J. W., & Fauerbach, J. A. (2003). Personality, coping, chronic stress, social support and PTSD symptoms among adults burn survivors: a path analysis. Journal of Burn Care & Rehabilitation, 24, 63–72.
Lelorain, S., Tessier, P., Florin, A., & Bonnaud-Antignac, A. (2012). Posttraumatic growth in long term breast cancer survivors: relation to coping, social support and cognitive processing. Journal of Health Psychology, 17, 627–639.
Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17, 11–21.
Mahmoudi, M., Dehdari, T., Shojaeezadeh, D., & Abbasian, L. (2015). Coping with stress strategies in HIV-infected Iranian patients. Journal of the Association of Nurses in AIDS Care, 26, 464–471.
Martinez, A., Israelski D., Walker, C., & Koopman, C. (2002). Posttraumatic stress disorder in women attending human immunodeficiency virus outpatient clinics. AIDS Patient Care STDS, 16, 283–291.
Milam, J. E. (2004). Posttraumatic growth among HIV/AIDS patients. Journal of Applied Social Psychology, 34, 2353–2376.
Milam, J. E. (2006). Posttraumatic growth and HIV disease progression. Journal of Consulting & Clinical Psychology, 74, 817–827.
Morris, B., Shakespeare-Finch, J., & Scott, J. (2007). Coping process and dimensions of posttraumatic growth. Australasian Journal of Disaster and Trauma Studies, 1, 1–12.
Nightingale, V. R., Sher, T. G., & Hansen, N. B. (2013). The impact of receiving an HIV diagnosis and cognitive processing on psychological distress and posttraumatic growth. Journal of Traumatic Stress, 23, 452–460.
Ogińska-Bulik, N. (2014). Rola strategii radzenia sobie ze stresem w rozwoju po traumie u ratowników medycznych [The role of coping strategies in posttraumatic growth in medical rescue workers]. Medycyna Pracy, 65, 209–217.
Ogińska-Bulik, N. (2016). Ruminacje a negatywne i pozytywne skutki traumy u zakażonych HIV [Rumination and negative and positive effects of trauma in HIV-infected]. Psychiatria, 13, 8–16.
Ogińska-Bulik, N., & Juczyński, Z. (2010). Rozwój potraumatyczny – charakterystyka i pomiar [Posttraumatic growth – characteristic and measurement]. Psychiatria, 7, 129–142.
Ogińska-Bulik, N., & Langer, I. (2007). Osobowość typu D i strategie radzenia sobie ze stresem a nasilenie objawów PTSD w grupie strażaków [Type D personality, coping with stress and intensity of PTSD symptoms in firefighters]. Medycyna Pracy, 58, 307–316.
Olley, B. O., Zeier, M. D., Seedat, S., & Stein, D. J. (2005). Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa. AIDS Care, 17, 550–557. doi: 10.1080/09540120412331319741.
Park, C. L., Aldwin, C. M., Fenster, J. R., & Snyder, L. B. (2008). Pathways to posttraumatic growth versus posttraumatic stress: coping and emotional reactions following the September 11, 2001 terrorist attacks. American Journal of Orthopsychiatry, 78, 300–312.
Peterson, K., Togun, T., Klis, S., Menten, J., & Colebunders, R. (2012). Depression and posttraumatic stress disorder among HIV-infected Gambians on antiretroviral therapy. AIDS Patients Care STDs, 26, 589–596.
Pooley, J. A., Cohen, L., O’Connor, M., & Taylor, M. (2013). Posttraumatic stress and posttraumatic growth and their relationship to coping and self-efficacy in Northwest Australian cyclone communities. Psychological. Trauma: Theory, Research, Practice, and Policy, 5, 392–399.
Prati, G., & Pietrantoni, L. (2009). Optimism, social support and coping strategies contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14, 364–388.
Rajandram, R. K., Jenewein, J., McGrath, C., & Zwahlen, R. A. (2011). Coping processes relevant to posttraumatic growth: an evidence-based review. Support Care Cancer, 19, 583–589.
Rzeszutek, M., Oniszczenko, W., & Firląg-Burkacka, E. (2012). Temperament traits, coping style and trauma symptoms in HIV men and women. AIDS Care, 24, 1150–1154.
Rzeszutek, M., Oniszczenko, W., & Firląg-Burkacka, E. (2016). Gender differences in posttraumatic stress symptoms and the level of posttraumatic growth among Polish sample of HIV-positive individuals. AIDS Care, 28, 1411–1415. doi: 10.1080/09540121.2016.1182615.
Schmidt, S., Blank, T., Bellizzi, K., & Park, C. (2012). The relationship of coping strategies, social support, and attachment style with posttraumatic growth in cancer survivors. Journal of Health Psychology, 17, 1033–1040.
Schroevers, M. J., Helgeson, V. S., Sanderman, R., & Ranchor, A. V. (2010). Type of social support matters for prediction of posttraumatic growth among cancer patients. Psychooncology, 19, 46–53.
Schweitzer, A., Mizwa, M. B., & Ross, M. W. (2010). Psychosocial aspects of HIV/AIDS: adults. In Baylor International Pediatric AIDS Initiative and Baylor College of Medicine (eds.), HIV Curriculum for the Health Professional (pp. 334–349). Baylor College of Medicine.
Scrignaro, M., Barni, S., & Magrin, M. E. (2011). The combined contribution of social support and coping strategies in predicting post-traumatic growth: a longitudinal study on cancer patients. Psychooncology, 20, 823–831. doi: 10.1002/pon1782.
Sears, S. R., Stanton, A. L., & Danoff-Burg, S. (2003). The yellow brick road and the emerald city: benefit finding, positive reappraisal coping, and posttraumatic growth in women with early-stage breast cancer. Health Psychology, 22, 487–496.
Sherr, L., Nagra, N., Kulubya, G., Catalan, J., Clucas, C., & Harding, R. (2011). HIV infection associated post-traumatic stress disorder and post-traumatic growth – A systematic review. Psychology, Health & Medicine, 16, 612–629.
Street, A. E., Gibson, L. E., & Holohan, D. R. (2005). Impact of childhood traumatic events, trauma-related guilt, and avoidant coping strategies on PTSD symptoms in female survivors of domestic violence. Journal of Traumatic Stress, 18, 245–252.
Taylor, S. E., & Armor, D. A. (1996). Positive illusions and coping with adversity. Journal of Personality, 64, 873–898.
Tedeschi, R. G., & Calhoun, L. G. (1996). The Post-Traumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455–471.
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–8.
Tedstone, J. E., & Tarrier, N. (2003). Posttraumatic stress disorder following medical illness and treatment. Clinical Psychology Review, 23, 409–448.
Thornton, A. A., & Perez, M. A. (2006). Posttraumatic growth in prostate cancer survivors and their partners. Psychooncology, 15, 285–296.
UNAIDS – Joint United Nations Programme on HIV/AIDS. Global report epidemiology slides. (2013). Available from: http://www.unaids.org/en/dataa....
Updegraff, J. A., Taylor, S. E., Kemeny, M. E., & Wyatt, G. E. (2002). Positive and negative effects of HIV infection in women with low socioeconomic resources. Personality and Social Psychology Bulletin, 28, 382–394.
Weiss, D., & Marmar, C. (1997). The Impact of Event Scale – Revised. In J. Wilson & T. Keane (eds.), Assessing psychological trauma and PTSD: A handbook for practitioners (pp. 399–411). New York: Guilford Press.
Widows, M. R., Jacobsen, P. B., Booth-Jones, M., & Fields, K. K. (2005). Predictors of posttraumatic growth following bone marrow transplantation for cancer. Health Psychology, 24, 266–273.