The effects of an individualised cognitive-behavioral and electromyographic feedback intervention on HIV-seropositive patients.
- Authors: Messinis, Lambros
- Date: 2012-08-16
- Subjects: AIDS (Disease) - Patients - Mental health , AIDS (Disease) - Psychological aspects , Exercise therapy - Psychological aspects
- Type: Thesis
- Identifier: uj:2596 , http://hdl.handle.net/10210/6045
- Description: Ph.D. , The Acquired Immunodeficiency Syndrome (AIDS) has taken on pandemic proportions world wide, providing the health care system with the greatest challenge since its existence. At present, infection with the Human Immunodeficiency virus (HIV) is incurable, fatal and dangerously contagious influencing the health of the public as well as exerting profound effects on political, social and economic circumstances of the world. The challenge was and still is, to develop an effective treatment method for Human Immunodeficiency Virus (HIV) infection and /or Clinical AIDS. Up to the present time no effective treatment method has been found, as the retroviral agents typically only cause a temporary inhibition of the progression of the HIV and not a permanent cessation of the activity of the virus. In the absence of any pharmacological treatment, behavioral interventions and in particular biopsychosocial interventions utilizing cognitive-behavioral therapy and ergometric aerobic exercise take on particular importance as adjunctive treatment methods, especially during the asymptomatic and early symptomatic HIV, (CDC stages 2 and 3 and WR stages 2-4 A), but non-Clinical AIDS stages. Adding Electromyographic-feedback assisted relaxation training to the above therapeutic modalities increased the likelihood of addressing specific physiological variables associated with HIV-seropositivity, and served as a direct operant intervention in indirectly enhancing immune system functioning, through psychophysiological mechanisms or by means of the relaxation effect which it produces. In South-Africa the HIV\ AIDS situation is further compounded by a number of social and economic factors in a society expressing rapid political changes against a background of apartheid. Herein, issues of poverty, violence, proper medical care for HIV sufferers, especially in the rural areas where antiviral medications and other health services are not easily accessible, inadequate housing and unemployment place even greater burdens on the already under-served HIV sufferer. With the above aspects in mind and considering the seriousness of the AIDS pandemic in South-Africa as well as the absence of effective pharmacological agents in curing this disease, an 8-week combined biopsychosocial treatment intervention utilizing individualised cognitive-behavioral therapy, aerobic exercise and Electromyographic-feedback assisted relaxation training was developed. The objective of this research was to determine whether the combined biopsychosocial treatment intervention that had been developed would serve as a successful adjunctive treatment method to the present pharmacological treatments, especially during the asymptomatic and early symptomatic stages of HIV-infection where the apparent sluggishness of immunological functioning may be most amenable to interventions that enhance effector functions and communication between CD4 T-lymphocytes, CD8 T-lymphocytes, macrophages and B cells via increases in lymphokine production. The intervention further aimed to decrease depression, physiological tension and anxiety and fatigue levels, as well as increase vigor-activity levels important in the overall health status of HIV-seropositive patients. The intervention was implemented on a group of South- African asymptomatic and early symptomatic (CDC stages 2 and 3 and WR stages 2-4 A) HIV- seropositives. The results of the research revealed no statistically significant between-group differences in any of the cellular immune measurements. Clinically and statistically significant withingroup differences were however found in baseline to post-test measures of total lymphocyte counts in subjects of the experimental group. Statistically significant between-group differences were also found in the tension-anxiety, depression-dejection, fatigue-inertia and vigor-activity levels of experimental subjects as compared to control group subjects. The study further found that subjects who recorded lower depression and tension-anxiety levels at baseline and post-intervention phases had higher CD4 -T lymphocyte counts and therefore, increased resistance to HIV-related infections and diseases. The study also revealed significant within-group differences in terms of the baseline to post-test relaxation effect of the EMG-feedback assisted relaxation training, as well as clinically significant within-group increases in the CD4-T lymphocyte counts of experimental subjects who experienced this relaxation effect.
- Full Text:
- Authors: Messinis, Lambros
- Date: 2012-08-16
- Subjects: AIDS (Disease) - Patients - Mental health , AIDS (Disease) - Psychological aspects , Exercise therapy - Psychological aspects
- Type: Thesis
- Identifier: uj:2596 , http://hdl.handle.net/10210/6045
- Description: Ph.D. , The Acquired Immunodeficiency Syndrome (AIDS) has taken on pandemic proportions world wide, providing the health care system with the greatest challenge since its existence. At present, infection with the Human Immunodeficiency virus (HIV) is incurable, fatal and dangerously contagious influencing the health of the public as well as exerting profound effects on political, social and economic circumstances of the world. The challenge was and still is, to develop an effective treatment method for Human Immunodeficiency Virus (HIV) infection and /or Clinical AIDS. Up to the present time no effective treatment method has been found, as the retroviral agents typically only cause a temporary inhibition of the progression of the HIV and not a permanent cessation of the activity of the virus. In the absence of any pharmacological treatment, behavioral interventions and in particular biopsychosocial interventions utilizing cognitive-behavioral therapy and ergometric aerobic exercise take on particular importance as adjunctive treatment methods, especially during the asymptomatic and early symptomatic HIV, (CDC stages 2 and 3 and WR stages 2-4 A), but non-Clinical AIDS stages. Adding Electromyographic-feedback assisted relaxation training to the above therapeutic modalities increased the likelihood of addressing specific physiological variables associated with HIV-seropositivity, and served as a direct operant intervention in indirectly enhancing immune system functioning, through psychophysiological mechanisms or by means of the relaxation effect which it produces. In South-Africa the HIV\ AIDS situation is further compounded by a number of social and economic factors in a society expressing rapid political changes against a background of apartheid. Herein, issues of poverty, violence, proper medical care for HIV sufferers, especially in the rural areas where antiviral medications and other health services are not easily accessible, inadequate housing and unemployment place even greater burdens on the already under-served HIV sufferer. With the above aspects in mind and considering the seriousness of the AIDS pandemic in South-Africa as well as the absence of effective pharmacological agents in curing this disease, an 8-week combined biopsychosocial treatment intervention utilizing individualised cognitive-behavioral therapy, aerobic exercise and Electromyographic-feedback assisted relaxation training was developed. The objective of this research was to determine whether the combined biopsychosocial treatment intervention that had been developed would serve as a successful adjunctive treatment method to the present pharmacological treatments, especially during the asymptomatic and early symptomatic stages of HIV-infection where the apparent sluggishness of immunological functioning may be most amenable to interventions that enhance effector functions and communication between CD4 T-lymphocytes, CD8 T-lymphocytes, macrophages and B cells via increases in lymphokine production. The intervention further aimed to decrease depression, physiological tension and anxiety and fatigue levels, as well as increase vigor-activity levels important in the overall health status of HIV-seropositive patients. The intervention was implemented on a group of South- African asymptomatic and early symptomatic (CDC stages 2 and 3 and WR stages 2-4 A) HIV- seropositives. The results of the research revealed no statistically significant between-group differences in any of the cellular immune measurements. Clinically and statistically significant withingroup differences were however found in baseline to post-test measures of total lymphocyte counts in subjects of the experimental group. Statistically significant between-group differences were also found in the tension-anxiety, depression-dejection, fatigue-inertia and vigor-activity levels of experimental subjects as compared to control group subjects. The study further found that subjects who recorded lower depression and tension-anxiety levels at baseline and post-intervention phases had higher CD4 -T lymphocyte counts and therefore, increased resistance to HIV-related infections and diseases. The study also revealed significant within-group differences in terms of the baseline to post-test relaxation effect of the EMG-feedback assisted relaxation training, as well as clinically significant within-group increases in the CD4-T lymphocyte counts of experimental subjects who experienced this relaxation effect.
- Full Text:
The effects of an anger-expressive cognitive-behavioural intervention programme on HIV-seropositive patients
- Authors: Lamb, Torsten Rainer
- Date: 2012-08-16
- Subjects: AIDS (Disease) , AIDS (Disease) - Epidemiology , AIDS (Disease) - Psychological aspects , AIDS (Disease) - Patients - Mental health , AIDS (Disease) - Patients - Research - South Africa , Behavior therapy , Group psychotherapy , Cognitive therapy , Psychometrics
- Type: Thesis
- Identifier: http://ujcontent.uj.ac.za8080/10210/382928 , uj:9573 , http://hdl.handle.net/10210/5997
- Description: D.Phil. , This thesis presents an intervention programme that aims to facilitate anger-expression and takes psychosocial and immunological variables into account. The present research argues that if the effects of the programme are validated, similar programmes may yield similar benefits for other participants in future intervention programmes in a South African context. The nature, course and effects of the HIV disease are described and include specific processes and mechanisms of influence in physical, mental and social terms. Biological processes that result from immunological deficiencies causing AIDS are analyzed and an explication of disease progression is offered. Psychological and social aspects related to immune-system deterioration carry implications for patients and influence their prognosis. The research was conducted in the context of a biopsychosocial conceptualization and was aimed at reducing levels of anger and helping establish recourses in the patients to manage infection and disease, as well as improve or at least retard decrements in immunological functioning. The goal of this intervention programme was to reduce levels of anger, anxiety, depression and social isolation. This would in turn increase the participant's personal sense of self-control, self-efficacy and self-esteem. Changes in these factors would help retard the overall HIV disease progression. An intervention programme was tailored to address the specific needs of HIV- infected patients. The group intervention was focused in such a way that relevant psychological, behavioural and social aspects were addressed. The programme borrowed and used aspects of different models and reformulated an intervention that would best address the specific needs of the participants. It was possible to isolate specific problems and focus the intervention on these specific areas, such as depression, anger, social isolation and hopelessness. For example, it was possible to take into account the participants' low self-efficacy and problems related to a lack of interpersonal coping skills and develop the participants' confidence and assertiveness (Antoni, 1991)
- Full Text:
- Authors: Lamb, Torsten Rainer
- Date: 2012-08-16
- Subjects: AIDS (Disease) , AIDS (Disease) - Epidemiology , AIDS (Disease) - Psychological aspects , AIDS (Disease) - Patients - Mental health , AIDS (Disease) - Patients - Research - South Africa , Behavior therapy , Group psychotherapy , Cognitive therapy , Psychometrics
- Type: Thesis
- Identifier: http://ujcontent.uj.ac.za8080/10210/382928 , uj:9573 , http://hdl.handle.net/10210/5997
- Description: D.Phil. , This thesis presents an intervention programme that aims to facilitate anger-expression and takes psychosocial and immunological variables into account. The present research argues that if the effects of the programme are validated, similar programmes may yield similar benefits for other participants in future intervention programmes in a South African context. The nature, course and effects of the HIV disease are described and include specific processes and mechanisms of influence in physical, mental and social terms. Biological processes that result from immunological deficiencies causing AIDS are analyzed and an explication of disease progression is offered. Psychological and social aspects related to immune-system deterioration carry implications for patients and influence their prognosis. The research was conducted in the context of a biopsychosocial conceptualization and was aimed at reducing levels of anger and helping establish recourses in the patients to manage infection and disease, as well as improve or at least retard decrements in immunological functioning. The goal of this intervention programme was to reduce levels of anger, anxiety, depression and social isolation. This would in turn increase the participant's personal sense of self-control, self-efficacy and self-esteem. Changes in these factors would help retard the overall HIV disease progression. An intervention programme was tailored to address the specific needs of HIV- infected patients. The group intervention was focused in such a way that relevant psychological, behavioural and social aspects were addressed. The programme borrowed and used aspects of different models and reformulated an intervention that would best address the specific needs of the participants. It was possible to isolate specific problems and focus the intervention on these specific areas, such as depression, anger, social isolation and hopelessness. For example, it was possible to take into account the participants' low self-efficacy and problems related to a lack of interpersonal coping skills and develop the participants' confidence and assertiveness (Antoni, 1991)
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The effects of a group-based cognitive behavioural intervention on mood change and interpersonal behaviour in HIV-positive persons
- Authors: Messini, Lambros
- Date: 2014-04-14
- Subjects: AIDS (Disease) - Patients - Mental health , AIDS (Disease) - South Africa - Psychological aspects , AIDS (Disease) - Treatment - South Africa
- Type: Thesis
- Identifier: uj:10603 , http://hdl.handle.net/10210/10126
- Description: M.A. (Psychology) , The Acquired Immunodeficiency Syndrome (AIDS) has become one of the major challenges that the health care system has had to face and will continue to present a significant health challenge well into the 21st century. Up to the present time no effective treatment method has been found as the retroviral agents typically only cause a temporary inhibition of the progression of the Human Immunodeficiency Virus (HlV) and not a permanent cessation of the activity ofthe virus. Psychosocial approaches to the management of HlV have been moderately successful, but more successful then the retroviral agents during the HIV but non Clinical stage. Considering the proportions of the HlV disease, there are few studies in South-Africa, that describe the therapeutic effects of a stress management package consisting of aerobic exercise, group-based cognitive behavioural therapy and relaxation training on mood state changes of asymptomatic and early symptomatic HIV sufferers. Psychological measures, like depression and anxiety have been found to be associated with lowered immune responsivity, thus enhancing the underlying immunodeficiency found in HlV/AIDS sufferers. Past research has also illustrated the benefits that may be derived from aerobic exercise on the physiological mechanisms of the body. The intention of this research, was therefore to further reinforce the positive effects of aerobic exercise by using a biopsychosocial approach in the treatment of HIV, leading to an overall improvement in the immunological status, depression and distress levels of HlV patients, as well as their ability to cope with the disease. The study took place within the context of a wider project, forming a component of the AIDS research conducted by Prof. E.Wolff (Rand Afrikaans University). The study assessed the relevance of this intervention for the South African Setting.
- Full Text:
- Authors: Messini, Lambros
- Date: 2014-04-14
- Subjects: AIDS (Disease) - Patients - Mental health , AIDS (Disease) - South Africa - Psychological aspects , AIDS (Disease) - Treatment - South Africa
- Type: Thesis
- Identifier: uj:10603 , http://hdl.handle.net/10210/10126
- Description: M.A. (Psychology) , The Acquired Immunodeficiency Syndrome (AIDS) has become one of the major challenges that the health care system has had to face and will continue to present a significant health challenge well into the 21st century. Up to the present time no effective treatment method has been found as the retroviral agents typically only cause a temporary inhibition of the progression of the Human Immunodeficiency Virus (HlV) and not a permanent cessation of the activity ofthe virus. Psychosocial approaches to the management of HlV have been moderately successful, but more successful then the retroviral agents during the HIV but non Clinical stage. Considering the proportions of the HlV disease, there are few studies in South-Africa, that describe the therapeutic effects of a stress management package consisting of aerobic exercise, group-based cognitive behavioural therapy and relaxation training on mood state changes of asymptomatic and early symptomatic HIV sufferers. Psychological measures, like depression and anxiety have been found to be associated with lowered immune responsivity, thus enhancing the underlying immunodeficiency found in HlV/AIDS sufferers. Past research has also illustrated the benefits that may be derived from aerobic exercise on the physiological mechanisms of the body. The intention of this research, was therefore to further reinforce the positive effects of aerobic exercise by using a biopsychosocial approach in the treatment of HIV, leading to an overall improvement in the immunological status, depression and distress levels of HlV patients, as well as their ability to cope with the disease. The study took place within the context of a wider project, forming a component of the AIDS research conducted by Prof. E.Wolff (Rand Afrikaans University). The study assessed the relevance of this intervention for the South African Setting.
- Full Text:
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