Abstract
The relations among cognitive processing of stressful emotional material, mood, and immune functioning were examined in 30 asymptomatic gay men during the stress of HIV-1 seropositivity notification. We administered the Impact of Event Scale, and immunological and mood data were collected 5 weeks before, 1 week after, and 5 weeks after notification of HIV-1 seropositivity. Consistent elevations of avoidance or intrusion levels during the study period did not predict distress at 5 weeks postdiagnosis; rather, increased levels of both avoidance and intrusion over the study period were related to significantly greater anxiety, depression, and total mood disturbance by the end of the study. Increased intrusion, but not avoidance, during the period from study entry to 1-week postdiagnosis was related to higher levels of distress 1 week after HIV serostatus notification. In contrast, in the weeks following serostatus notification, increased avoidance predicted worse mood outcomes. Increased avoidance over the 10-week study period significantly predicted poorer proliferative response to pokeweed mitogen as well as trends toward lower T-helper-inducer lymphocyte (CD4+) percentages. Increased intrusion over this time period significantly predicted lower CD4+ percentages, controlling statistically for baselines. Mood change during the 10-week study did not mediate effects of cognitive processing on immune function. Mood changes may work jointly with cognitive processing to influence some immune outcomes. As increases in avoidant and intrusion processing may reflect difficulties in working through the trauma of HIV seropositivity notification, the current findings suggest the importance of thorough cognitive processing of traumatic medical information in this population for subsequent adjustment and immune functioning.
