Patterns of Coping Among Persons with HIV Infection

Configurations, Correlates, and Change

Published in: American Journal of Community Psychology, v. 32, no. 102, Sep. 2003, p. 187-204

Posted on RAND.org on January 01, 2003

by John Fleishman, Cathy D. Sherbourne, Paul Cleary, Albert W. Wu, Stephen Crystal, Ron D. Hays

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This study examines coping in response to HIV infection, using longitudinal data from a nationally representative sample (n = 2,864) of HIV-infected persons. We investigated configurations of coping responses, the correlates of configuration membership, the stability of coping configurations, and the relationship of coping to emotional well-being. Four coping configurations emerged from cluster analyses: relatively frequent use of blame-withdrawal coping, frequent use of distancing, frequent active-approach coping, and infrequent use of all three coping strategies (passive copers). Passive copers had few symptoms, high levels of physical functioning, and high emotional well-being; blame-withdrawal copers had the opposite pattern. Of those completing a second interview 1 year after baseline, 46% had the same coping configuration. Increases in the number of HIV-related symptoms raised the probability of blame-withdrawal coping at follow-up, whereas decreases raised the probability of passive coping. Infrequent use of coping responses at baseline was related to greater emotional well-being 1 year later. This result, in conjunction with the high levels of emotional well-being in the passive cluster, suggests that high levels of distress can induce blame-withdrawal coping whereas coping efforts are minimal when social support and emotional well-being are high. Results highlight issues in ascertaining the causal direction between coping and psychological outcomes, as well as in specifying the nature of stressful situations with which people are coping.

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