Helping people with HIV to feel emotionally happy could help to improve their physical symptoms, new research suggests.
A study found that when individuals recently diagnosed with HIV were coached to practice skills to help them experience positive emotions, the result was less HIV in their blood and lower antidepressant use.
Coaching included focussing on positive events, through popular diaries called gratitude journals.
The researchers, from Northwestern Medicine, said the findings could pave the way for new intervention treatments for people in the initial stages of adjustment to any serious chronic illness.
Commenting on the findings, lead author Judith Moskowitz said: “Even in the midst of this stressful experience of testing positive for HIV, coaching people to feel happy, calm and satisfied - what we call positive affect - appears to influence important health outcomes.”
For the study, which was based in San Francisco, 80 participants (primarily men) were taught a set of eight skills over five weekly sessions to help them experience more positive emotions. Another 79 participants were in the control group, meaning they were not taught the skills.
Moskowitz and colleagues designed the tools based on evidence showing these particular skills increase positive emotions. Some of the skills included:
1) Recognising a positive event each day
2) Savouring that positive event and logging it in a journal or telling someone about it
3) Starting a daily gratitude journal
4) Listing a personal strength each day and noting how you used this strength recently
5) Setting an attainable goal each day and noting your progress
6) Reporting a relatively minor stressor each day, then listing ways in which the event can be positively reappraised. This can lead to increased positive affect in the face of stress
7) Understanding small acts of kindness can have a big impact on positive emotion and practicing a small act of kindness each day
8) Practicing mindfulness with a daily 10-minute breathing exercise, concentrating on the breath.
Fifteen months after the interventions, 91% of the intervention group had a suppressed viral load (meaning less of the HIV virus in their blood) compared to 76% of the control group.
The researchers noted that in addition to the potential benefit of a lower viral load on the infected person, there may be public health benefits.
“From a public health perspective, that is potentially huge for prevention of HIV,” Moskowitz said.
“HIV is less likely to be transmitted with a low viral load. To have a difference like that is amazing.”
The reduced viral load could be because of a stronger immune system, Moskowitz said, which has previously been linked to positive emotion.
The positive emotion intervention also improved mental health. At baseline, about 17% of the control group and intervention group reported being on antidepressants.
Fifteen months later, the intervention group was still at 17% but the control group’s antidepressant use rose to 35%.
“The group that learned coping skills did not increase antidepressant use, whereas overall the control group increased its antidepressant use,” Moskowitz said.
In addition, the intervention group was significantly less likely to have repeating, intrusive thoughts about HIV.
The paper was published in the Journal of Consulting and Clinical Psychology.
