This study evaluated the effects of a behavioral stress-management program on anxiety, mood, self-esteem, and T-cell count in a group of HIV-positive men who were asymptomatic except for T-cell counts below 400. The program consisted of 20 biweekly sessions of progressive muscle relaxation and electromyograph biofeedback-assisted relaxation training, meditation, and hypnosis. Ten subjects were randomly assigned to either a treatment group or a no-treatment control group, and the 2 groups were compared on pre- to posttreatment changes in the dependent measures. Analysis showed that, compared with the no-treatment group, the treatment group showed significant improvement on all the dependent measures, which was maintained at a 1-mo. follow-up. Since stress is known to compromise the immune system, these results suggest that stress management to reduce arousal of the nervous system and anxiety would be an appropriate component of a treatment regimen for HIV infection.
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References
1.
ArnetzB. B.WassermanJ.PetriniB.BrennerS. O.LeviL.EnerothP.SalovaaraH.HjelmR.SalovaaraL.TheorellT.PettersonI. L. (1987) Immune function in unemployed women. Psychosomatic Medicine, 49, 3–12.
2.
BachJ. F.DuvalD.DardenneM.SalomonJ. C.TurszT.FournierC. (1975) The effects of steroids on T cells. Transplantation Proceedings, 7, 25–30.
3.
BarberT. X. (1984) Hypnosis, deep relaxation, and active relaxation: Data, theory, and clinical applications. In WoolfolkR. L.LehrerP. M. (Eds.), Principles and practice of stress management. New York: Guilford. Pp. 142–187.
4.
BasmajianJ. V. (1979) Muscles alive: Their functions revealed by electromyography. (4th ed.) Baltimore, MD: Williams & Wilkins.
5.
BernsteinD. A.BorkovekT. D. (1973) Progressive relaxation training. Champaign, IL: Research Press.
6.
BesedovskyH. O.Del ReyA.SorkinE.Da PradaM.KellerH. H. (1979) Immunoregulation mediated by the sympathetic nervous system. Cell Immunology, 48, 346–355.
7.
BorkovekT. D.GraysonJ. B.CooperK. M. (1978) Treatment of general tension: Subjective and physiological effects of progressive relaxation. Journal of Consulting and Clinical Psychology, 46, 518–528.
8.
BudzynskiT. H.StoyvaJ. M. (1984) Biofeedback methods in the treatment of anxiety and stress. In WoolfolkR. L.LehrerP. M. (Eds.), Principles and practice of stress management. New York: Guilford. Pp. 188–219.
9.
BullochK.MooreR. Y. (1981) Innervation of the thymus gland by brain stem and spinal cord in mouse and rat. American Journal of Anatomy, 162, 157–166.
10.
CarringtonP. (1984) Modern forms of meditation. In WoolfolkR. L.LehrerP. M. (Eds.), Principles and practice of stress management. New York: Guilford. Pp. 108–141.
CraryB.BorysenkoM.SutherlandD. C.KutzI.BorysenkoJ.BensonH. (1983) Decrease in mitogen responsiveness of mononuclear cells from peripheral blood after epinephrine administration in humans. Journal of Immunology, 130, 694–697.
13.
DantonW. G.MayJ. R.LynnE. J. (1984) Psychological and physiological effects of relaxation and nitrous oxide training. Psychological Reports, 55, 311–322.
14.
DavidsonD. M.WinchesterM. A.TaylorC. B.AldermanE. A.IngelsN. B. (1979) Effects of relaxation therapy on cardiac performance and sympathetic activity in patients with organic heart disease. Psychosomatic Medicine, 41, 303–309.
15.
DimsdaleJ. E.MossJ. (1980) Plasma catecholamines in stress and exercise. Journal of the American Medical Association, 243, 340–342.
16.
DorianB.GarfinkelP.BrownG.ShoreA.GladmanD.KeystoneE. (1982) Aberrations in lymphocyte subpopulations and function during psychological stress. Clinical and Experimental Immunology, 50, 132–138.
17.
FauciA. S. (1978) Mechanisms of the immunosuppressive and anti-inflammatory effects of glucocorticosteroids. Journal of Immunopharmacology, 9, 1–25.
18.
GlasserL.HicksM. J.LindenbergR. E. (1981) The effects of in vivo dexamethasone on lymphocyte subpopulations: Differential response of EAhu rosette-forming cells. Clinical Immunology and Immunopathology, 18, 22–31.
19.
GoldsteinD. S.DionneR.SweetJ.GracelyR.BrewerH. B.GreggR.KeiserH. R. (1982) Circulatory, plasma catecholamine, Cortisol, lipid and psychological responses to a real-life stress (third molar extractions): Effects of diazepam sedation and of inclusion of epinephrine with local anesthetic. Psychosomatic Medicine, 44, 259–272.
20.
HaynesB. F.FauciA. S. (1978) The differential effects of in vivo hydrocortisone on the kinetics of subpopulations of human peripheral blood thymus-derived lymphocytes. Journal of Clinical Investigation, 61, 703–707.
21.
JacobsJ.IlariaG. (1989) Management of psychological distress: A hospital based “mutual aid” support group for HIV seropositive men. Paper presented at the Fifth International Conference on AIDS, Montreal.
22.
JacobsonE. (1970) Modern treatment of tense patients. Champaign, IL: Thomas.
23.
JosephJ. G.KesslerR. C.OstrowD.PhairJ.ChmielJ. (1988) Psychosocial predictors of symptom development in HIV-infected gay men. Paper presented at the Fourth International Conference on AIDS, Stockholm.
24.
KellyP. J. (1989) Evaluation of a meditation and hypnosis-based stress management program for men with HIV. Paper presented at the Fifth International Conference on AIDS, Montreal.
25.
KesslerR.JosephJ.OstrowD.PhairJ.ChmielJ. (1989) Psychosocial co-factors in illness onset among HIV positive men. Paper presented at the Fifth International Conference on AIDS, Montreal.
LaperriereA. R.AntoniM. H.SchneidermanN.IronsonG.KilmasN.CaralisP.FletcherM. A. (1990) Exercise intervention attenuates emotional distress and natural killer cell decrements following notification of positive serologic status for HIV-1. Biofeedback and Self-Regulation, 15, 229–242.
28.
LavalleeY. J.LamontagneY.PinardG.AnnableL.TerraultL. (1977) Effects of EMG feedback, diazepam and their combination on chronic anxiety. Journal of Psychosomatic Research, 21, 65–71.
LockeS. E.KrausL.LesermanJ.HurstM.HeiselS.WilliamsR. M. (1984) Life change stress, psychiatric symptoms, and natural killer cell activity. Psychosomatic Medicine, 46, 441–453.
31.
McClellandD. C.FloorE.DavidsonR. J.SaronC. (1980) Stressed power motivation, sympathetic activation, immune function and illness. Journal of Human Stress, 6, 11–19.
32.
McNairD. M.LorrM.DropplemanL. F. (1981) Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service.
33.
ParrilloJ. E.FauciA. S. (1979) Glucocorticosteroids and immune processes. Annual Review of Pharmacology and Toxicology, 19, 179–201.
34.
PatelC. (1984) Yogic therapy. In WoolfolkR. L.LehrerP. M. (Eds.), Principles and practice of stress management. New York: Guilford. Pp. 70–107.
35.
RiceK. M.BlanchardE. B.PurcellM. (1993) Biofeedback treatments of generalized anxiety disorder. Biofeedback and Self-Regulation, 18, 93–107.
36.
SaykinA. J.JanssenR.SprehnG.SpiraT.CannonL.KaplanJ.O'ConnorB.WatsonS.AllenR. (1989) Neuropsychological and psychosocial function in two cohorts of gay men: Relation to stage of HIV-1 infection. Paper presented at the Neurological and Neuropsychological Complications of HIV Infection Conference, Quebec City.
37.
SelyeH. (1936) The stress of life. New York: McGraw-Hill.
38.
SpielbergerC. D.GorsuchR. L.LusheneR. E. (1970) Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
39.
SundararamanS.SolomonS.TaraR.RajkumarS.SubhaM. (1989) Psychological sequelae of AIDS. Paper presented at the Fifth International Conference on AIDS, Montreal.
40.
TemoshokL. (1987) An intensive psychoimmunological study of long-surviving persons with AIDS. Paper presented at the Third International Conference on AIDS, Washington, DC.
41.
TemoshokL. (1989) Psychoneuroimmunologic relationships in men with ARC. Paper presented at the Fifth International Conference on AIDS, Montreal.
42.
WilliamsJ. M.PetersonR. G.SheaP. A.SchmedtjeJ. F.BauerD. C.FeltenD. L. (1981) Sympathetic innervation of murine thymus and spleen: Evidence for a functional link between the nervous and immune systems. Brain Research Bulletin, 6, 83–94.
