***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To examine whether ( a ) Living in the Face of Trauma ( LIFT ) , a group intervention to address coping with HIV and childhood sexual abuse ( CSA ) , significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention ; and ( b ) reductions in avoidant coping over time mediated reductions in traumatic stress . METHOD In a r and omized controlled trial , 247 participants completed measures of  traumatic stress and avoidant coping  at pre- and post intervention , and at 4- , 8- , and 12-month follow-ups . Latent growth curve modeling examined changes over the 5 time points ; st and ardized path coefficients provide estimates of effects . RESULTS As compared with the support intervention , the coping intervention led to a reduction in traumatic stress over time ( b = -.20 , p < .02 ) . Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention ( b = -.22 , p < .05 ) . Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress ( b = 1.45 , p < .001 ) , and the direct effect of the intervention on traumatic stress was no longer significant ( b = .04 , ns ) , suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress . CONCLUSIONS The LIFT intervention significantly reduced traumatic stress over time , and changes in avoidant coping strategies mediated this effect , suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA Objective This r and omized clinical trial was design ed to compare the effects of a theory-based coping effectiveness training ( CET ) intervention with an active informational control ( HIV-Info ) condition and a waiting-list control ( WLC ) condition on psychological distress and positive mood in HIV-seropositive gay men . Material s and Methods The authors recruited 149 self-identified gay or bisexual men who were 21 to 60 years of age , reported depressed mood , and had CD4 levels of 200 to 700 cells/mm3 .  CET and HIV-Info participants attended 10 90-minute group sessions during the 3-month intervention phase and six maintenance sessions over the remainder of the year . Participants were assessed at baseline and at 3 , 6 , and 12 months . Data were collected 1992 to 1994 , before the introduction of HAART . Analyses were based on the 128 participants who completed the 3-month assessment . Results After the 3-month intervention phase , when compared with HIV-Info , CET participants showed significantly greater decreases in perceived stress and burnout , and regression analyses indicated that significant increases in coping self-efficacy mediated the improvements in perceived stress and burnout . Compared with WLC , CET participants also showed significantly greater decreases in anxiety , and regression analyses indicated that significant increases in positive states of mind mediated the improvements in anxiety . Significant treatment group differences for positive morale were maintained at 6 and 12 months . In addition , optimism continued to increase in the CET and HIV-Info treatment groups during the maintenance phase . Conclusions CET can be an effective strategy for managing psychological distress and improving positive psychological states in patients confronting chronic illness Psychoneuroimmunology is a framework for mind-body practice and research that combines cutting-edge scientific exploration with holistic philosophy to appreciate and underst and stress responses . The rapidly growing research literature provides a foundation for building an integrative stress management model with the potential to positively influence the stress-disease relationship and , ultimately , health outcomes . This article introduces a novel tai chi intervention and provides quantitative and qualitative data from a r and omized clinical trial indicating its effects on psychosocial variables in individuals living with various stages of HIV disease To determine whether MBSR groups would help gay men living with HIV improve psychosocial functioning and increase mindfulness compared to treatment-as-usual ( TAU ) . Methods : 117 participants were r and omized 2:1 to MBSR or TAU . No new psychosocial or psychopharmacological interventions were initiated within 2 months of baseline . St and ardized question naires were administered pre- , postintervention and at 6 months . An intent-to-treat analysis found significant benefits of MBSR : at post-intervention and 6 months follow up , MBSR participants had significantly lower avoidance in IES and higher positive affect compared to controls . MBSR participants developed more mindfulness as measured by the Toronto Mindfulness Scale ( TMS ) including both TMS subscales , curiosity and decentering , at 8-week and 6 months . For the sample as a whole , increase in mindfulness was significantly correlated with reduction in avoidance , higher positive affect and improvement in depression at 6 months . MBSR has specific and clinical ly meaningful effects in this population Objectives : To examine the effect of a 15-session coping group intervention compared with a 15-session therapeutic support group intervention among HIV-positive men and women with a history of childhood sexual abuse ( CSA ) on sexual transmission risk behavior . Design : A r and omized controlled behavioral intervention trial with 12-month follow-up . Methods : A diverse sample of 247 HIV-positive men and women with histories of CSA was r and omized to 1 of 2 time-matched group intervention conditions . Sexual behavior was assessed at baseline ; immediately after the intervention ; and at 4- , 8- , and 12-month follow-up periods ( 5 assessment s ) . Changes in frequency of unprotected anal and vaginal intercourse by intervention condition were examined using generalized linear mixed models for all partners , and specifically for HIV-negative or serostatus unknown partners . Results : Participants in the HIV and trauma coping intervention condition decreased their frequency of unprotected sexual intercourse more than participants in the support intervention condition for all partners ( P < 0.001 ; d = 0.38 , 0.32 , and 0.38 at the 4- , 8- , and 12-month follow-up periods , respectively ) and for HIV-negative and serostatus unknown partners ( P < 0.001 ; d = 0.48 , 0.39 , and 0.04 at the 4- , 8- , and 12-month follow-up periods , respectively ) . Conclusion : A group intervention to address coping with HIV and CSA can be effective in reducing transmission risk behavior among HIV-positive men and women with histories of sexual trauma 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 r and omly 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 aim ed 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 OBJECTIVE We tested the effects of a 10-week group-based cognitive-behavioral stress management/expressive-supportive therapy intervention ( CBSM+ ) and a time-matched individual psychoeducational condition for 330 women with AIDS reporting moderate to poor baseline quality of life ( QOL ) .  The goal of this study was to examine treatment effects on total QOL and 11 QOL domains from baseline to post-intervention follow-up . METHODS Participants were assessed at baseline , r and omized to a treatment condition ( individual psychoeducation condition n=180 , group-based CBSM+ condition n=150 ) , participated in the intervention for 10 weeks and assessed again within 4 weeks following the intervention .  QOL was measured using the Medical Outcomes Study -HIV-30 . RESULTS QOL scores increased over the course of both interventions for the total QOL score and three QOL domains : cognitive functioning , health distress and overall health perceptions . While women in the CBSM+ group condition showed a significant improvement in mental health QOL from pre- to post-intervention , women in the individual condition did not change . No changes were observed for energy/fatigue , health transition , single-item overall QOL , pain , physical well-being , role functioning or social functioning in either condition . CONCLUSION Results suggest that group-based CBSM+ and individual psychoeducational interventions are effective at improving certain aspects of QOL and that group-based CBSM+ may be particularly effective at increasing QOL related to mental health in this population of women with AIDS We design ed a r and omized controlled trial of a home based intervention to improve antiretroviral adherence and to assess the impact of depressive symptoms among people living with HIV in Hunan , China . At baseline , 110 subjects reported taking 90 % or less of prescribed medication . At 6 months , when the intervention ended , 56 % of subjects in the control and 87 % of subjects in the experimental group were adherent . This difference was maintained at 12 months . In multivariate analyses , controlling for baseline visual analogue adherence scale , stigma , social support , and Center for Epidemiological Studies Depression scale , the experimental group had a significantly higher proportion of people who were adherent ( p=0.009 ) . The high prevalence of significant depressive symptoms ( 67 % ) at baseline is of concern . It is of particular importance that future studies look at the types of depression likely to be seen in these patients and differentiate early between those likely to benefit from HIV-related support and those who will require additional depression-targeted interventions Numerous herpesvirus infections are associated with clinical ly relevant outcomes as well as an accelerated HIV replication rate and subsequent disease progression .  Stress management interventions mayimprovemarkersofcellularimmunecontroloverlatent herpesvirus infections and these changes appear to be mediated by perceptions of increased social support availability . We examined the effects ofagroup-based cognitive behavioral stress management ( CBSM ) intervention on distress , dysphoria , perceived socialsupport , and herpesvirus immunoglobulin G ( IgG ) antibody titers during the 6to 12 months following the intervention . Of those who were initially r and omized , 49 HIV-infected men were followed during the 6-to 12-month period after r and omization to either a 10-week CBSM intervention ( n=31 ) or amodified wait-list control condition ( n = 18 ) . Measures of distress , dysphoria , social support , and blood sample s for herpesvirus Ig Gtiters were taken at baseline , immediately following CBSM and at-6-to 12-month follow-up . Men in CBSM displayed maintenance of previously observed intervention effects on dysphoria , reliable alliance support , and herpesvirus IgG antibody titers ( i.e. , Epstein-Barr virus capsid antigen ; EBV-VCA ) . Intervention-related changes in EBV-VCA were unrelated to changes in lymphocyte subsets ( i.e. , CD4 + , CD8 + , and CD4+:CD8 + ) or changes in measures of dysphoria and social support during the investigation period . Data indicate that HIV-infected men participating in a CBS Mintervention maintain better psychosocial status and immunologic control of latent EBV infection up to 1 year after its conclusion OBJECTIVES Investigate the psychometric characteristics of the  coping self-efficacy ( CSE ) scale , a 26-item measure of one 's confidence in performing coping behaviors when faced with life challenges . DESIGN Data came from two r and omized clinical trials ( N1=149 , N2=199 ) evaluating a theory-based Coping Effectiveness Training ( CET ) intervention in reducing psychological distress and increasing positive mood in persons coping with chronic illness . METHODS The 348 participants were HIV-seropositive men with depressed mood who have sex with men . Participants were r and omly assigned to intervention and comparison conditions and assessed pre- and post-intervention . Outcome variables included the CSE scale , ways of coping , and measures of social support and psychological distress and well-being . RESULTS Exploratory ( EFA ) and confirmatory factor analyses ( CFA ) revealed a 13-item reduced form of the CSE scale with three factors : Use problem-focused coping ( 6 items , alpha=.91 ) , stop unpleasant emotions and thoughts ( 4 items , alpha=.91 ) , and get support from friends and family ( 3 items , alpha=.80 ) . Internal consistency and test-retest reliability are strong for all three factors . Concurrent validity analyses showed these factors assess self-efficacy for different types of coping . Predictive validity analyses showed that residualized change scores in using problem- and emotion-focused coping skills were predictive of reduced psychological distress and increased psychological well-being over time . CONCLUSIONS The CSE scale provides a measure of a person 's perceived ability to cope effectively with life challenges , as well as a way to assess changes in CSE over time in inter 
    Output:
    
Authors ' conclusions Group‐based psychosocial interventions may have a small effect on measures of depression , but the clinical importance of this is unclear .
More high quality evidence is needed to assess whether group psychosocial intervention  improve psychological well‐being in HIV positive adults