Application of the DSM-IV Criteria to the Experience of Living with AIDS
ABSTRACT A diagnosis with HIV is often considered traumatic. According to the DSM-IV-TR's criteria for PTSD, a traumatic event precipitates a set of reactions in an individual that includes avoidant behaviour, intrusive thoughts, and physiologic hyperarousal. However, persons diagnosed with HIV are typically concerned with events that will occur in the future such as physical decline and death, access to treatment, the welfare of dependants, and stigma and discrimination. Their concerns are thus future-oriented rather than anchored to a past traumatic event, which is the requirement of PTSD. This article argues that an HIV diagnosis may be inappropriately regarded as traumatic.
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ABSTRACT: A number of epidemiological studies have attempted to measure the prevalence of HIV-related posttraumatic stress disorder (PTSD) in sub-Saharan Africa. A systematic review of the literature identified eight relevant studies that put current estimates of the prevalence of HIV-related PTSD between 4.2% and 40%. Even the lower estimates suggest that PTSD in response to the trauma of being diagnosed and living with HIV is a significant mental health burden. However, a conceptual framework to advance our understanding of the prevalence and phenomenology of HIV-related PTSD is lacking. This article argues that the Ehlers & Clark (2000) cognitive model of PTSD provides a useful conceptual framework for understanding HIV-related PTSD in South Africa. The model emphasises the role of trauma appraisals in the development and maintenance of PTSD, which can also be usefully applied to some of the other psychological disorders associated with HIV infection. The model appears to fit some of the important research findings, and it offers insights into the relationships between HIV-related PTSD and other psychological disorders, HIV stigma, the high prevalence of non-HIV traumatic events, occasional problems with the delivery of antiretroviral drugs in the South African public health service, the unpredictable course of HIV illness, and the quality of HIV testing and counselling. Implications for individual treatment strategies and broader public health interventions are briefly discussed.African Journal of AIDS Research 06/2011; 10(2-2):139-148. DOI:10.2989/16085906.2011.593376 · 0.61 Impact Factor
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ABSTRACT: This cross-sectional study sought to determine the percentage of individuals who met criteria for lifetime PTSD and HIV-related PTSD among 85 recently diagnosed HIV-positive patients attending public health clinics in the Western Cape, South Africa. The PTSD module of the Composite International Diagnostic Interview (CIDI) was used to determine the percentage of those who met criteria for lifetime PTSD and HIV-related PTSD. The rate of lifetime PTSD and incidence of HIV-related PTSD was 54.1% (95% CI: 43.6-64.3%) and 40% (95% CI: 30.2-50.6%), respectively. Findings suggest that receiving an HIV-positive diagnosis and/or being HIV-positive may be considered a stressor that frequently results in HIV-related PTSD. Given the various barriers to efficient mental health interventions and services in South Africa, there are significant challenges that need to be addressed in order to ensure that the mental health of HIV-positive individuals is appropriately addressed.AIDS and Behavior 01/2009; 15(1):125-31. DOI:10.1007/s10461-008-9498-6 · 3.49 Impact Factor
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ABSTRACT: The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment.AIDS and Behavior 06/2011; 15(8):1870-8. DOI:10.1007/s10461-011-9980-4 · 3.49 Impact Factor