Author
Rachel S. Lee
Other affiliations: Beth Israel Medical Center
Bio: Rachel S. Lee is an academic researcher from Yale University. The author has contributed to research in topics: Acquired immunodeficiency syndrome (AIDS) & Coping (psychology). The author has an hindex of 5, co-authored 5 publications receiving 675 citations. Previous affiliations of Rachel S. Lee include Beth Israel Medical Center.
Papers
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TL;DR: In this article, the authors examined internalized stigma among HIV-positive men and women (N = 268) in Milwaukee and Madison, Wisconsin, and New York City, and found that participants with high internalized HIV stigma had been diagnosed with HIV more recently, their families were less accepting of their illness, they were less likely to ever have attended an HIV support group, and they knew fewer people with HIV.
Abstract: HIV is recognized as a highly stigmatized disease; however, there has been a lack of research on the internalization of this stigma by seropositive people. This study examined internalized stigma among HIV-positive men and women (N = 268) in Milwaukee and Madison, Wisconsin, and New York City. The majority of the sample experienced internalized stigma related to their HIV status. Individuals who experienced high internalized HIV stigma (IHS) had been diagnosed with HIV more recently, their families were less accepting of their illness, they were less likely to ever have attended an HIV support group, and they knew fewer people with HIV. Individuals with high IHS also worried more about spreading their infection to others. Heterosexuals and participants from Wisconsin experienced higher levels of IHS. Hierarchical regression analyses showed that IHS contributed significantly to levels of depression, anxiety, and hopelessness after controlling for the effects of key behavioral and psychosocial variables.
486 citations
TL;DR: Three myosins function in a hierarchal, complementary manner to accomplish cytokinesis, with Myo2 and Myo51 taking the lead during contractile ring assembly and Myp2 making the greatest contribution to constriction.
82 citations
TL;DR: This bereavement group aimed at improving coping with grief also had a positive impact on health-related quality of life among HIV+ men and women, and suggests that cognitive-behavioral interventions may have a broad impact on both emotional and physical health.
Abstract: Background: AIDS-related bereavement is a severe life stressor that may be particularly distressing to persons themselves infected with HIV. Increasing evidence suggests that psychological health is associated with disease progression, HIV-related symptoms, and mortality. Purpose: This study assessed change in health-related quality of life among HIV+ persons following a group intervention for coping with AIDS-related loss. Methods: The sample included 235 HIV+ men and women of diverse ethnicities and sexual orientations who had experienced an AIDS-related loss within the previous 2 years. Participants were randomly assigned to a 12-week cognitive-behavioral bereavement coping group intervention or offered individual psychotherapy upon request. Quality of life was assessed at baseline and 2 weeks after the intervention. Results: Participants in the group intervention demonstrated improvements in general health-related and HIV-specific quality of life, while those in the comparison remained the same or deteriorated. Effect sizes indicated that the majority of change occurred in women. Conclusion: This bereavement group aimed at improving coping with grief also had a positive impact on health-related quality of life among HIV+ men and women, and suggests that cognitive-behavioral interventions may have a broad impact on both emotional and physical health.
74 citations
TL;DR: A 31-item measure that assesses HIV and sexual abuse-related shame, and the impact of shame on HIV-related health behaviors is presented, using eight well-established HIV specific and general psychosocial criterion measures.
Abstract: Shame has been shown to predict sexual HIV transmission risk behavior, medication non-adherence, symptomatic HIV or AIDS, and symptoms of depression and PTSD. However, there remains a dearth of tools to measure the specific constructs of HIV-related and sexual abuse-related shame. To ameliorate this gap, we present a 31-item measure that assesses HIV and sexual abuse-related shame, and the impact of shame on HIV-related health behaviors. A diverse sample of 271 HIV-positive men and women who were sexually abused as children completed the HIV and Abuse Related Shame Inventory (HARSI) among other measures. An exploratory factor analysis supported the retention of three-factors, explaining 56.7% of the sample variance. These internally consistent factors showed good test–retest reliability, and sound convergent and divergent validity using eight well-established HIV specific and general psychosocial criterion measures. Unlike stigma or discrimination, shame is potentially alterable through individually-focused interventions, making the measurement of shame clinically meaningful.
39 citations
TL;DR: Gains observed were modest, but are considered meaningful in the context of stressors encountered by this disenfranchised sample, which was diverse with respect to race, sexual orientation, and psychiatric comorbidity.
Abstract: The association between sexual abuse and HIV risk is well documented, yet little empirical data exists on treatment approaches integrating the psychological impact of sexual abuse and HIV disease. This study examined the clinical significance of change on sexual-trauma-related stress following a coping group intervention study among 28 women and men with HIV-AIDS and a history of childhood sexual abuse. More than 75% of participants showed improvement on 1 or more subscales of the Trauma Symptom Inventory, with the majority of improvements within domains related to trauma symptoms and behavioral difficulties. Most observed gains were modest, but are considered meaningful in the context of stressors encountered by this disenfranchised sample, which was diverse with respect to race, sexual orientation, and psychiatric comorbidity. These preliminary findings support the need for the conduct of research trials to identify mental health and secondary prevention intervention models that can assist those with HIV–AIDS who have experienced childhood sexual abuse.
36 citations
Cited by
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TL;DR: In this article, the relation between bereavement and physical and mental health was examined and the effectiveness of psychological intervention programs was assessed, focusing on high-risk people and those with complicated grief or bereavement-related depression and stress disorders.
1,271 citations
Book•
01 Nov 2009
TL;DR: It is tested whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system.
Abstract: We test whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system. In T. L. Scheid T. N. Brown (Eds.), A handbook for the study of mental health: Social contexts, theories. Find 9780521567633 A Handbook for the Study of Mental Health : Social Contexts, Theories, and Systems by Horwitz et al at over 30 bookstores. Buy, rent. A review of mental health problems in fathers following the birth of a child. for the study of mental health:Social contexts, theories, and systems (2nd ed., pp.
842 citations
TL;DR: An urgent need for social reform to reduce AIDS stigmas and the design of interventions to assist people living with HIV/AIDS to adjust and adapt to the social conditions of AIDS in South Africa is indicated.
659 citations
TL;DR: The task model has been modified to account for new thinking and research findings in the field, including meaning making, resilience, and continuing bonds, and the vital distinction between grief and trauma.
618 citations
TL;DR: Stigma is associated with psychological adjustment and adherence difficulties and is experienced more commonly among people who disclose their HIV status to a broad range of social contacts and should be addressed in stress management, health promotion, and medication adherence interventions for HIV-positive people.
Abstract: HIV-related stigmatization remains a potent stressor for HIV-positive people. This study examined the relationships among stigma-related experiences and depression, medication adherence, serostatus disclosure, and sexual risk among 221 HIV-positive men and women. In bivariate analyses that controlled for background characteristics, stigma was associated with depressive symptoms, receiving recent psychiatric care, and greater HIV-related symptoms. Stigma was also associated with poorer adherence and more frequent serostatus disclosure to people other than sexual partners, but showed no association to sexual risk behavior. In a multivariate analysis that controlled for all correlates, depression, poor adherence, and serostatus disclosure remained as independent correlates of stigma-related experiences. Findings confirm that stigma is associated with psychological adjustment and adherence difficulties and is experienced more commonly among people who disclose their HIV status to a broad range of social contacts. Stigma should be addressed in stress management, health promotion, and medication adherence interventions for HIV-positive people.
584 citations