Human immunodeficiency virus (HIV) is one of the leading causes of disability and mortality noted by existence of more than 76.1 infected people and 35 million deaths. A reduction of mortality rate associated with the success of antiretroviral therapy (ART) has-been observed. However, the disease still has a strong Impact on the lives of people living with aids, mainly due to stigma and prejudice, psychiatric disorders such as depression, changes in marital relationships such as abandonment of the partner, and difficulties in keeping and reintegrating into the job market with consequent Possible financial problems that may negatively influence ART adherence and so developing coping strategies is necessary to reduce the psychological suffering of people living with aids, arising from all the difficulties related to this disease.
The goal of an individual and human society is to stay healthy, live a life full of happiness, and ultimately maintain wellbeing throughout his life. Well-being is a concept that has subjective and objective components. The subjective component of wellbeing (as expressed by each individual) is referred to as „Quality of life (QOL).
HIV Coping strategies
Coping means to invest one’s own conscious effort, to solve personal and interpersonal problems, in order to try to master, minimize or tolerate stress and conflict. The psychological coping mechanisms are commonly termed coping strategies or coping skills. The term coping generally refers to adaptive (constructive) coping strategies, that is, strategies which reduce stress. In contrast, other coping strategies may be coined as maladaptive, if they increase stress.
Types of HIV Coping Strategies
HIV Appraisal-focused coping strategies
Appraisal-focused (adaptive cognitive) strategies occur when the person modifies the way they think, for example: employing denial, or distancing oneself from the problem. People may alter the way they think about a problem by altering their goals and values, such as by seeing the humor in a situation: “some have suggested that humor may play a greater role as a stress moderator among women than men”.
HIV Adaptive behavioral coping strategies
People using problem-focused strategies try to deal with the cause of their problem. They do this by finding out information on the problem and learning new skills to manage the problem. Problem-focused coping is aimed at changing or eliminating the source of the stress. Taking control, information seeking, and evaluating the pros and cons. However, problem-focused coping may not be necessarily adaptive, especially in the uncontrollable case that one cannot make the problem go away.
HIV Emotion-focused coping strategies
Emotion-focused strategies involve:
Emotion-focused coping is a mechanism to alleviate distress by minimizing, reducing, or preventing, the emotional components of a stressor. This mechanism can be applied through a variety of ways, such as:
The focus of this coping mechanism is to change the meaning of the stressor or transfer attention away from it. For example, reappraising tries to find a more positive meaning of the cause of the stress in order to reduce the emotional component of the stressor. Avoidance of the emotional distress will distract from the negative feelings associated with the stressor. Emotion-focused coping is well suited for stressors that seem uncontrollable (ex. a terminal illness diagnosis, or the loss of a loved one).Some mechanisms of emotion focused coping, such as distancing or avoidance, can have alleviating outcomes for a short period of time, however they can be detrimental when used over an extended period. Positive emotion-focused mechanisms, such as seeking social support, and positive re-appraisal, are associated with beneficial outcomes. Emotional approach coping is one form of emotion-focused coping in which emotional expression and processing is used to adaptively manage a response to a stressor. Other examples include relaxation training through deep breathing, meditation, yoga, music and art therapy, and aromatherapy, as well as grounding, which uses physical sensations or mental distractions to refocus from the stressor to present.
Reactive and proactive coping
Most coping is reactive in that the coping is in response to stressors. Anticipating and reacting to a future stressor is known as proactive coping or future-oriented coping. Anticipation is when one reduces the stress of some difficult challenge by anticipating what it will be like and preparing for how one is going to cope with it.
Social coping
Social coping recognizes that individuals are bedded within a social environment, which can be stressful, but also is the source of coping resources, such as seeking social support from others.
Humor
Humor used as a positive coping strategy may have useful benefits in relation to mental health and well-being. By having a humorous outlook on life, stressful experiences can be and are often minimized. This coping method corresponds with positive emotional states and is known to be an indicator of mental health. Physiological processes are also influenced within the exercise of humor. For example, laughing may reduce muscle tension, increase the flow of oxygen to the blood, exercise the cardiovascular region, and produce endorphins in the body. Using humor in coping while processing through feelings can vary depending on life circumstance and individual humor styles. In regards to grief and loss in life occurrences, it has been found that genuine laughs/smiles when speaking about the loss predicted later adjustment and evoked more positive responses from other people. A person of the deceased family member may resort to making jokes of when the deceased person used to give unwanted “wet willies” (term used for when a person sticks their finger inside their mouth then inserts the finger into another person’s ear) to any unwilling participant. A person might also find comedic relief with others around irrational possible outcomes for the deceased funeral service. It is also possible that humor would be used by people to feel a sense of control over a more powerless situation and used as way to temporarily escape a feeling of helplessness. Exercised humor can be a sign of positive adjustment as well as drawing support and interaction from others around the loss.
Maladaptive coping or non-coping
Whereas adaptive coping strategies improve functioning, a maladaptive coping technique (also termed non-coping) will just reduce symptoms while maintaining or strengthening the stressor. Maladaptive techniques are only effective as a short-term rather than long-term coping process.
Examples of maladaptive behavior strategies include dissociation, sensitization, safety behaviors, anxious avoidance, rationalization and escape (including self-medication).
These coping strategies interfere with the person’s ability to unlearn, or break apart, the paired association between the situation and the associated anxiety symptoms. These are maladaptive strategies as they serve to maintain the disorder.
Dissociation
The ability of the mind to separate and compartmentalize thoughts, memories, and emotions. This is often associated with post-traumatic stress syndrome.
Sensitization
When a person seeks to learn about, rehearse, and/or anticipate fearful events in a protective effort to prevent these events from occurring in the first place.
Safety behaviors are demonstrated when individuals with anxiety disorders come to rely on something, or someone, as a means of coping with their excessive anxiety.
Rationalization
The practice of attempting to use reasoning to minimize the severity of an incident, or avoid approaching it in ways that could cause psychological trauma or stress. It most commonly manifests in the form of making excuses for the behavior of the person engaging in the rationalization, or others involved in the situation the person is attempting to rationalize.
Anxious avoidance
When a person avoids anxiety provoking situations by all means. This is the most common method. Escape is closely related to avoidance. This technique is often demonstrated by people who experience panic attacks or have phobias. These people want to flee the situation at the first sign of anxiety.
Further examples
Further examples of coping strategies include emotional or instrumental support, self-distraction, denial, substance use, self-blame, behavioral disengagement and the use of drugs or alcohol.
Many people think that meditation “not only calms our emotions, but…makes us feel more ‘together’”, as too can “the kind of prayer in which you’re trying to achieve an inner quietness and peace”.
Low-effort syndrome
Also known as low-effort coping refers to the coping responses of a person refusing to work hard. For example, a student at school may learn to put in only minimal effort as they believe if they put in effort it could unveil their flaws.
