The impact of receiving an HIV diagnosis and cognitive processing on psychological distress and posttraumatic growth

Abstract

This study examined human immunodeficiency virus (HIV) as a traumatic stressor, intrusive and deliberate cognitive processing, psychological distress, and posttraumatic growth. One-hundred twelve participants completed interviews on posttraumatic stress disorder (PTSD) Criterion A, Rumination Scale-Revised, Impact of Event Scale, and the Posttraumatic Growth Inventory; relationships were modeled using path analysis. Model 1 attempted to replicate prior empirical research, Model 2 attempted to empirically replicate part of the posttraumatic growth theoretical model, and Model 3 attempted to empirically replicate an integrated model of posttraumatic growth and traumatic stress theories. Model 3 had good fit with study data. Results suggest shared and separate pathways from traumatic stressor to psychological distress and posttraumatic growth, with pathways mediated by cognitive processing. Implications of findings are discussed.

Figures

Figure 1

Path analysis examining Model 1, based on previous research findings (Taku et al., 2008), hypothesizing a direct path from past deliberate cognitive processing and indirect paths through current cognitive processing and psychological distress to posttraumatic growth. Curved double-arrow lines represent hypothesized covariances, straight single-arrow lines represent hypothesized paths, *** p < .001. Variance in outcomes explained by the model: psychological distress R2 = .66, posttraumatic growth R2 = .00.

Figure 2

Path analysis examining Model 2, based on part of Calhoun and Tedeschi’s (2006) model, hypothesizing indirect paths from traumatic stressors through past intrusive and current deliberate cognitive processing and psychological distress to posttraumatic growth. Dashed curved double-arrow lines represent covariances added based on modification indices, straight single-arrow lines represent hypothesized paths,* p < .05, ** p < .01, *** p < .001. Variance in predictors and outcomes explained by the model: past intrusive cognitive processing R2 = .25, current deliberate cognitive processing R2 = .26, psychological distress R2 = .07, posttraumatic growth R2 = .01.

Figure 3

Path analysis examining an integrated model of posttraumatic growth, synthesizing cognitive trauma theories and post-traumatic growth theory (Model 3), hypothesizing direct paths from past intrusive and current deliberate cognitive processing, and multiple indirect paths from the traumatic stressor through past and current cognitive processing, and psychological distress to post-traumatic growth. Straight lines represent hypothesized paths that remained in the final model, long dashed lines represent paths added to the final model based on modification indices, and short dashed lines represent hypothesized paths removed from the final model, * p < .05, ** p < .01, ** p < .001. Variance in predictors and outcomes explained by the model: past intrusive cognitive processing R2 = .24, past deliberate cognitive processing R2 = .39, current intrusive cognitive processing R2 = .35, current deliberate cognitive processing R2 = .70, psychological distress R2 = .62, posttraumatic growth R2 = .18.