Psychology and longevity

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HIV AND CANCER
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had recently lost a close friend or partner to AIDS were interviewed about how they made
sense of this death. These interviews were then classified according to whether the
individual had managed to find meaning in the death in line with Taylor’s cognitive
adaptation theory of coping (Taylor 1983) (see Chapter 3). An example of meaning
would be ‘What his death did was snap a certain value into my behaviour, which is
“Listen, you don’t know how long you’ve got. You’ve just lost another one. Spend more
time with the people that mean something to you”.’ The results showed that those who
had managed to find meaning maintained their levels of CD4 T-helper cells at follow-up,
where as those who did not find meaning showed a decline.
Research has also explored the link between how people cope with HIV and the
progression of their disease with a focus on type C coping style which reflects emotional
inexpression and a decreased recognition of needs and feelings. For example, Solano
et al. (2001, 2002) used CD4 cells as a measure of disease status and assessed baseline
coping and followed 200 patients up after 6 and 12 months. The results showed that type
C coping style predicted progression at follow-up suggesting that a form of coping which
relies upon a lack of emotional expression may exacerbate the course of HIV disease.
However, the results also showed that very high levels of emotional expression were
also detrimental. The authors conclude that working through emotions rather than
just releasing them may be the most protective coping strategy for people diagnosed as
HIV+. Therefore, both an individual’s behaviour and his or her psychological state
appear to relate to the progression from HIV to AIDS.
Psychology and longevity
Research has also examined the role of psychological factors in longevity following
infection with HIV. In particular, this has looked at the direct effects of beliefs and
behaviour on the state of immunosuppression of the individual (see Chapter 11 for a
discussion of PNI). In 1987, Solomon et al. studied 21 AIDS patients and examined their
health status and the relationship of this health status to predictive baseline psychological variables. At follow-up, they found that survival was predicted by their general
health status at baseline, their health behaviours, hardiness, social support, type C
behaviour (self-sacrificing, self-blaming, not emotionally expressive) and coping
strategies. In a further study, Solomon and Temoshok (1987) reported an additional
follow-up of AIDS patients. They argued that a positive outcome was predicted by perceived control over illness at baseline, social support, problem-solving, help-seeking
behaviour, low social desirability and the expression of anger and hostility. This study
indicated that type C behaviour was not related to longevity.
Reed et al. (1994) also examined the psychological state of 78 gay men who had
been diagnosed with AIDS in terms of their self-reported health status, psychological
adjustment and psychological responses to HIV, well-being, self-esteem and levels of
hopelessness. In addition, they completed measures of ‘realistic acceptance’, which
reflected statements such as ‘I tried to accept what might happen’, ‘I prepare for the
worst’ and ‘I go over in my mind what I say or do about this problem’. At follow-up,
the results showed that two-thirds of the men had died. However, survival was predicted by ‘realistic acceptance’ at baseline with those who showed greater acceptance
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