A third of HIV-positive gay men have post-traumatic stress disorder, UK investigators report in AIDS Patient Care and STDs. Events including starting treatment, HIV-related illness, and witnessing an HIV-related death were all linked to the development of symptoms associated with post-traumatic stress disorder. Emotional responses to such events - rather than actual physical threat - were associated with the development of symptoms of posttraumatic stress.
“A wide range of HIV-related events can be of traumatic intensity for some individuals”, comment the researchers.
Life-threatening illness is recognized as a possible stressor that can lead to the development of post-traumatic stress disorder. In the standard text book for the diagnosis of mental disorders (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Text Revision) this stress is defined as “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury or threat to the physical integrity of self and others”, with the individual’s emotional response involving “fear, helplessness, or horror.”
Investigators wished to see if a broad-range of HIV-related events were associated with the development of post-traumatic stress disorder. They hypothesized that experiencing one or more events would be linked with symptoms of post-traumatic stress, and that perceived threat and emotional distress would be associated with such symptoms. They also wished to see if shame-related emotions were associated with post-traumatic stress symptoms.
Overall, 33%of the sample met the diagnostic criteria for posttraumatic stress disorder.
Individuals living with HIV can experience long periods of good health and stability, note the investigators. However, they suggest that receiving bad test results or witnessing HIV-related illness and death could cause “intense fear, helplessness or horror” that can predict the development of symptoms of post-traumatic stress. They recommend that HIV doctors should be watchful for symptoms such as “reexperiencing the event, behavioural avoidance or emotional numbing.”
The investigators believe that their study adds to the literature that associates HIV with posttraumatic stress and that this is “primarily associated with fear, helplessness, or horror as opposed to shame, humiliation, or guilt.”
HIV-related posttraumatic stress disorder: investigating the traumatic events.
Anthony C. Theuninck, DClinPsychol, Nick Lake, DClinPsychol, and
Stuart Gibson, Ph.D
AIDS Patient Care and STDs, 24: 485-91, 2010. doi:10.1089/apc.2009.0231.
Link to AIDS PC and STDs abstract