Abstract
Operating from a theoretical model comprising life stressors, social support, and coping style as variables (SSC model) accounting for significant proportions of the variance in psychological distress, specific immune system measures, and clinical health status in HIV-infected individuals, this dissertation investigated coping behavior and associations of coping with psychological distress and immune function in a controlled bereavement support group intervention for 172 bereaved HIV seropositive and seronegative gay or bisexual men. Subjects were assessed pre- and postintervention ten weeks later, and separate grief and mood disturbance measures were used. Immune measures were a number of CD4 cells, natural killer cell cytotoxicity, and lymphocyte proliferative response to PHA. The first hypothesis, which predicted that the intervention changed bereavement-specific, situationally-framed coping, was not supported. Potential explanations for nonsignificance were that, first, data reduction needs required the use of composites to form active coping and disengagement/denial variables and, second, tests of composite subscales were not conducted and may have yielded significant effects. Disengagement/denial and an emotion-focused coping strategy, venting, showed significant time-dependent declines, but only venting continued to show a significant decline when controlling for other relevant variables.Exploratory analyses showed that participation in the intervention, increases in active coping, and decreases in disengagement/denial coping were associated with decreases in distressed mood and grief. HIV seropositive status was significantly associated with increases in distressed mood, but not grief. Changes in immune parameters were not reliably associated with changes in coping, but increments in CD4 cell count were associated with lower levels of negative background stressors. Higher levels of grief were associated with decrements in NKCC%.The second hypothesis posited that a baseline measure of dispositional coping style would be significantly related to Time 2 psychological distress and immune function. The hypothesis was not supported by analyses, which indicated that the coping style variable, a composite composed of both coping and noncoping measures, was confounded with distress and had modest correlations with other dispositional coping variables. As such, the hypothesized role for dispositional coping style was not rigorously tested, but a proposed reconfiguration of the variable would permit a better test.Despite nonsignificant findings for the main hypotheses, exploratory analyses yielded findings that may inform the ongoing research endeavors of the larger study upon which this dissertation was based, as well as future studies examining the complex interplay of grief, depressed mood, immune function, and bereavement in HIV disease.