Reducing Stress in HIV-infected Youth Through Mindfulness Training

通过正念训练减轻艾滋病毒感染青少年的压力

• 批准号: 8122354
• 负责人: Erica Sibinga
• 金额: $ 20.1万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8122354
• 关键词: Accounting; Address; Adult; Affect; Age; Aggressive behavior; Anxiety; Attention; Award; Behavioral; Chronic Disease; Chronic stress; Cognitive; Development; Disease Progression; Dose; Exposure to; HIV; HIV Seropositivity; Health; Health education; Hostility; Instruction; Intervention; Life; Mediating; Meditation; Mental Depression; Mental Health; Moods; Morbidity - disease rate; Neuropsychology; Outcome; Participant; Phase; Pilot Projects; Population; Population Intervention; Poverty; Primary Health Care; Process; Programmed Instruction; Public Health; Quality of life; Randomized Controlled Trials; Recruitment Activity; Research; Research Activity; Risk; Site; Stress; Stress and Coping; Structure; Techniques; Therapeutic; Time; Training; Violence; Vulnerable Populations; Work; Youth; aged; base; coping; coping mechanism; design; follow-up; improved; inner city; interest; mindfulness; mindfulness meditation; mindfulness-based stress reduction; mortality; physical conditioning; programs; psychologic; psychological distress; public health relevance; response; skills; theories

DESCRIPTION (provided by applicant): HIV-infected urban youth are under significant and unavoidable stress due to living with HIV and circumstances of inner-city life. How these youth appraise and cope with stress can ameliorate its negative effects on their lives. Mindfulness-based stress reduction (MBSR) is a structured 8-week program of instruction in mindfulness meditation that has been shown to improve psychological and quality of life outcomes in adults with chronic diseases. Our pilot study of MBSR for HIV-infected and at-risk urban youth showed beneficial effects in psychological and interpersonal functioning, highlighting the promise of this intervention. A Phase II randomized controlled trial (RCT) of MBSR is the next step in evaluating whether MBSR is an effective means of reducing stress and improving health outcomes in this vulnerable population. The proposed research will address 2 specific aims: 1) to estimate the effect size of MBSR on psychological and interpersonal functioning among HIV-infected youth and 2) to determine if positive effects of MBSR on psychological and interpersonal functioning in HIV-infected youth are mediated by changes in appraisal and coping processes. To accomplish these aims, we will conduct a small RCT with HIV-infected urban youth, aged 15-20 years, of the MBSR vs. an attention control program. Assessments of psychological and interpersonal functioning will occur at baseline, program completion, and 3 month follow-up and include: mindfulness; perceived stress, threat appraisal, and coping; psychological functioning (depression, anxiety, hostility, and mood states); and interpersonal functioning (aggression and interpersonal skills). We expect MBSR to result in improved outcomes. The results of this pilot RCT will be used to develop a larger, multi-site RCT and R01 application to be submitted in year 3 of this application. Given the far-reaching effects of chronic stress on morbidity and mortality, identification of MBSR as a successful stress-reduction intervention for HIV-infected youth has widespread public health significance. Additionally, much MBSR research remains atheoretical and little work has examined potential mechanisms of action. With the burgeoning interest in mindfulness, research must explore its potential therapeutic mechanisms. This R21 proposal, grounded in theory on stress, coping, and neuropsychology, will be an important step in this direction. PUBLIC HEALTH RELEVANCE: Mindfulness-based stress reduction (MBSR) may be beneficial for HIV-infected youth. We will evaluate the MBSR program compared with an attention control among HIV- infected youth to estimate its effect and how it may be helpful.

描述（由申请人提供）：由于患有艾滋病毒和城市内部生活的情况，受艾滋病毒感染的城市青年处于巨大而不可避免的压力。这些青年评估和应对压力如何可以改善其对生活的负面影响。基于正念的压力减轻（MBSR）是一个结构化的8周正念冥想教学计划，已证明可以改善患有慢性疾病的成年人的心理和生活质量。我们针对艾滋病毒感染和高危城市青年的MBSR试点研究对心理和人际交往表现出了有益的作用，强调了这种干预的希望。 MBSR的II期随机对照试验（RCT）是评估MBSR是否是减轻压力和改善该脆弱人群健康结果的有效手段的下一步。拟议的研究将针对2个具体目的：1）估计MBSR对HIV感染的青年对心理和人际交往功能的影响和2）确定MBSR对艾滋病毒感染的青年对心理和人际关系功能的积极影响是否介导通过评估和应对过程的变化。为了实现这些目标，我们将与MBSR和注意力控制计划的15-20岁的HIV感染的城市青年进行小型RCT。心理和人际关系功能的评估将在基线，计划完成和3个月的随访中进行，包括：正念；感知压力，威胁评估和应对；心理功能（抑郁，焦虑，敌对和情绪状态）；以及人际关系功能（侵略性和人际交往能力）。我们预计MBSR会带来改善的结果。该试点RCT的结果将用于开发较大的多站点RCT和R01应用程序，将在本申请的第3年中提交。鉴于慢性压力对发病率和死亡率的影响很大，因此将MBSR鉴定为对HIV感染的青年的成功减少压力干预措施的鉴定具有广泛的公共健康意义。此外，许多MBSR研究仍然是理论上的，几乎没有工作研究了潜在的作用机理。随着对正念的兴趣，研究必须探索其潜在的治疗机制。这项R21提案以压力，应对和神经心理学理论为基础，将是朝这个方向迈出的重要一步。 公共卫生相关性：基于正念的压力减轻（MBSR）可能对感染HIV的青年有益。我们将评估MBSR计划与受HIV感染的青年的注意力控制相比，以估计其影响以及如何有所帮助。