Contact: Gail Ironson, MD, PhD
For Release: March 7, 2019
Patients in the middle range of HIV illness who work through the heated emotions sparked by life trauma, often shifting to less fraught feelings, are twice as likely to be alive up to 17 years later as equally ill people with HIV who do little or no emotional processing, a leading HIV researcher will report today.
“They get beyond their initial emotion from trauma, and when it’s processed in most cases it becomes less painful. For example, they may move from being terrified to being sad,” says Gail Ironson, MD, PhD, professor of psychology and psychiatry at University of Miami. She’ll report on the novel study at the American Psychosomatic Society meeting in Vancouver. Ironson studied those in the mid-range of HIV illness on the hunch that psychological factors might be less likely to affect survival for the barely ill or those with advanced disease.
To start, 167 participants were asked to write about the most traumatic event that happened to them. They also filled out questionnaires and had interviews on stress and coping with HIV, along with providing blood samples. Everything but the writing was repeated every six months for up to 17 years.
At the study’s end, 35% of the people had died. Everyone’s initial essay about trauma was coded for the amount of positive and negative emotions expressed, cognitive (mental) processing of the trauma and emotional working through of it. Only emotional processing was linked to the chances of surviving. The more words they wrote that reflected emotional processing, the more likely they were to still be alive, Ironson reports. Those in the top half for this type of emotional shift were twice as likely to have survived as those in the lower half. This held true even taking account of medical factors related to survival.
The findings are important for several reasons, she says. HIV patients often grapple with trauma, so how they cope can make a big impact on their health. But when they receive therapy, it tends to focus on the cognitive—problem-solving, reframing challenges and putting them in perspective. “A lot of people ‘get it’ intellectually. But this suggests you’ll gain more traction in extending life with emotional work,” Ironson notes. For example, HIV patients may learn from peers in groups that their diagnosis isn’t a death sentence, and this can dial down their trauma.
Why should this matter for survival? Trauma can trigger stress hormone surges that hinder the immune system, which might make HIV patients more vulnerable to infections and cancer, she suggests. Heavy stress also can endanger the heart. Traumatized patients also may be less likely to eat well and take their medication. “It takes a lot of emotional and physical energy to repress things that are really bothering you rather than working them through,” says Ironson.
Her advice for the HIV-positive: “You want to make sure that you’re paying attention to how your emotions are changing and how you’re dealing with them.”
The American Psychosomatic Society (APS) (www.psychosomatic.org), founded in 1943, is an international multidisciplinary academic society that organizes an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the APS is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”