Psychology Ph.D. Dissertations


The Association between Acceptance and Health for Individuals who are HIV-Positive

Date of Award


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)



First Advisor

William O'Brien (Committee Chair)

Second Advisor

Robert Carels (Committee Member)

Third Advisor

Steve Jex (Committee Member)

Fourth Advisor

Pamela Bechtel (Committee Member)


Given the increase in number of individuals infected with HIV and the prevalence of stressors and mental health problems among these persons, researchers continue to examine which appraisals and coping responses may be related to better mental health and physical health for HIV populations. Research shows that negative appraisals and avoidance coping are consistently associated with less adaptive functioning. As an alternative, acceptance may be a type of appraisal that precludes the need to engage in coping strategies, especially non-adaptive coping strategies (e.g., avoidance coping). Acceptance refers to the willingness to experience thoughts, feelings, and physical symptoms without engaging in efforts to avoid or control them. Furthermore, research demonstrates that higher levels of acceptance are associated with better functioning for persons living with chronic illnesses. However, the role of acceptance has yet to be empirically examined within HIV-positive populations. Therefore, the aim of the present study is to evaluate the relationships between acceptance, negative appraisals (i.e., threat appraisals), avoidance coping, psychological health (i.e., depression, quality of life, perceived functioning), medication adherence, and physical health (i.e., immune functioning).

Analyses were conducted to examine both direct relationships and mediated relationships. Results indicated that levels of acceptance were related to better mental health. However, acceptance was not significantly associated with medication adherence, and medication adherence did not mediate the relationships between acceptance and mental health. Results also indicated that threat appraisals were associated with worse mental health, threat appraisals were related to some types of avoidance coping, and avoidance coping mediated the relationship between threat appraisals and depression. Overall, the present study suggests that acceptance and threat appraisals are important variables that impact mental health for those who are living with HIV and experiencing difficulties adjusting to the illness.