Psychology Ph.D. Dissertations

Acceptance and Commitment Therapy for Latinos Living with HIV/AIDS: A Pilot Randomized Control Outcome Study

Date of Award

2018

Document Type

Dissertation

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Psychology/Clinical

First Advisor

William O'Brien (Committee Chair)

Second Advisor

Eric Dubow (Committee Member)

Third Advisor

Howard Cromwell (Committee Member)

Fourth Advisor

George Bullerjahn (Other)

Abstract

HIV/AIDS continues to be a problematic disease that affects all ethnic groups. Latinos are likely to experience challenges associated with poor quality of life, HIV stigma, language, and cultural barriers. Latinos are also at risk of experiencing multi-layered stigma. Acceptance and Commitment Therapy (ACT) has been associated with improved health outcomes among diverse medical and psychiatric populations, including HIV. However, the potential benefits of a mindfulness based intervention have not been explored among Latinos with HIV. The primary goal of this study was to develop and empirically evaluate a brief ACT protocol tailored to HIV-positive Latino individuals living on the U.S./Mexico border with the goal of improving quality of life and reducing HIV stigma. Two separate sets of data are presented. Study 1 evaluated cross-sectional data on measures of acceptance, cognitive fusion, quality of life, viral load, and language among HIV-positive Latinos. Study 2 evaluated the feasibility of a one-day, three-hour ACT group to improve quality of life and reduce HIV stigma. There were three primary hypotheses for this study: a) acceptance would be positively associated with quality of life and lower HIV stigma and viral load; b) cognitive defusion would be positively associated with quality of life and lower reports of HIV stigma and viral load; and c) participants in the ACT group would report improved quality of life and reduced HIV stigma at posttreatment and follow-up assessments compared to pretreatment assessment and to participants attending an HIV education group. Correlational and regression analyses were conducted to evaluate associations among all study variables. Repeated measures ANOVA, nonparametric analyses, and single-subject analyses were conducted to evaluate treatment outcome data. Results were mixed and provide only partial support for study hypotheses. The ACT intervention was not helpful in reducing reports of HIV stigma or improving quality of life. Results from correlational analyses indicate that acceptance, mindfulness, and cognitive defusion were associated with better quality of life and reduced HIV stigma. Language was associated with higher quality of life and viral load, suggesting that low acculturation can be a protective factor for Latinos. Clinical implications and interpretation are discussed.

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