WASHINGTON - New research finds that HIV-positive gay men who find meaning from the death of a partner or close friend to AIDS may have improved immune functioning and live longer than HIV-positive gay men who are less successful in coping with this type of loss. This research supports the notion that stressful life events can act as a catalyst for positive psychological changes, which may in turn have beneficial effects on physical health.
Researchers Julienne E. Bower, Ph.D., Margaret E. Kemeny, Ph.D., and Shelley E. Taylor, Ph.D., of the University of California, Los Angeles, and John L. Fahey, MD, of the University of California, Los Angeles, School of Medicine conducted the study, which will be published in the December issue of the American Psychological Association's (APA) Journal of Consulting and Clinical Psychology. The psychologists assessed cognitive processing and the discovery of meaning from bereavement interviews conducted with 40 HIV-positive men (mean age - 39.4) who had recently lost a close friend or partner to AIDS.
Cognitive processing was defined as "the process of actively thinking about a stressor [in this case, the bereavement], the thoughts and feelings it evokes, and its implications for one's life and future," while the discovery of meaning was defined as "a major shift in values, priorities, or perspectives in response to the loss." Among the statements that were coded as denoting discovery of meaning were those that expressed a greater appreciation for loved ones, a commitment to enjoying life, new personal growth goals and increased self-understanding. Immune status was evaluated by measuring the rate of decline of CD4 T cells (helper T cells), which have been closely tied to the disease progression among HIV-infected individuals. CD4 T cells were measured for up to three years after the loss, and mortality was assessed between four and nine years after the loss.
While high levels of cognitive processing were associated with a marginal decrease in the rate of helper T cell decline, discovery of meaning was associated with a significant decrease in the rate of helper T cell decline. In addition, discovery of meaning was also associated with a lower rate of AIDS-related mortality. Fifteen of the participants in the study died of AIDS-related causes. Only three of the men who died reported finding meaning from the death of their partner or close friend, whereas 13 of the 25 survivors found meaning from the loss. Discovery of meaning was not associated with a number of psychosocial or behavioral characteristics (such as number of HIV-related symptoms at the beginning of the follow-up period, cigarette smoking, alcohol consumption, or drug use), and remained a significant predictor of helper T cell status and AIDS-related mortality after controlling for use of AZT.
This study is the first to show an association between finding meaning from a loved one's death and mortality and the first to report an association between meaning and health that does not appear to be mediated by health behaviors or other confounding variables. The authors note that, "HIV-positive men who are prompted by the death of a loved one to make major shifts in their own values and priorities, emphasizing such things as close relationships, living each day to the fullest, and personal growth, may show physiological benefits, including a lower rate of mortality."
Since this study had a small sample size, the researchers note that their findings must be considered preliminary. However, this study adds to a growing body of psychological literature which recognizes that exposure to stress does not invariably end in depression or despair, but may also prompt a life-enhancing reevaluation of one's goals and priorities and a reexamination of one's sense of self.
"Our findings are intriguing because they suggest that individuals who discover a positive sense of meaning in their own lives following a traumatic event may show positive changes not only in psychological adjustment, but also in immune status and physical health," notes Dr. Bower, lead author of the study. "These results also suggest that in order to find meaning, it may be necessary to confront the reality of the stressor and deal with potentially painful thoughts and feelings about the experience."
Article: "Cognitive Processing, Discovery of Meaning, CD4 Decline, and AIDS-Related Mortality Among Bereaved HIV-Seropositive Men" Julienne E. Bower, Ph.D., Margaret E. Kemeny, Ph.D., and Shelley E. Taylor, Ph.D., University of California, Los Angeles, and John L. Fahey, MD, Los Angeles Multicenter AIDS Cohort Study and University of California, Los Angeles, School of Medicine in Journal of Consulting and Clinical Psychology, Vol. 66, No. 6.
(Full Text available from the APA Public Affairs Office or on the Internet at http://www.apa.org/journals/ccp.html )
Julienne E. Bower, Ph.D. can be reached at (310) 794-9383 or jbower@ucla.edu.
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