Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Being Yourself and Mental Health: Goal Motives, Positive Affect and Self-Acceptance Protect People with HIV from Depressive Symptoms

  • 182 Accesses

Abstract

Depression is a major problem for many people living with HIV. In general population-based studies, it was found that characteristics of personal goals, positive affect, and self-acceptance were associated negatively with depression, but almost no studies have investigated their role in HIV infection-related depression. This study examines a prospective model where autonomy and perceived progress in personal goals are positively associated with self-acceptance and positive affect, and these variables, over time, are negatively associated with depressive symptoms. Participants (N = 70) responded first to measures of autonomy, progress in personal goals, perceptions of self-acceptance, and positive affect, and 4 months later, they completed measures of depression. Personal goals variables were observed to be differentially associated with well-being variables: whereas personal goals autonomy was directly associated with both well-being variables, progress in personal goals was directly associated with positive affect and indirectly with self-acceptance, through its association with positive affect. Longitudinally, both self-acceptance and positive affect were associated with depression, the former directly, and the latter indirectly, through its association with self-acceptance. Self-acceptance is revealed as an important predictor of depression in PLWH. Results are discussed in terms of the contributions of hedonic and eudaimonic well-being to the relief of depressive symptoms.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2

References

  1. Allport, G. W. (1961). Pattern and growth in personality. New York, NY: Holt, Rinehart, & Winston.

  2. Belkin, G. S., Fleishman, J. A., Stein, M. D., Piette, J., & Mor, V. (1992). Physical symptoms and depressive symptoms among individuals with HIV infection. Psychosomatics: Journal of Consultation and Liaison Psychiatry,33(4), 416–427. https://doi.org/10.1016/s0033-3182(92)71946-x.

  3. Bing, E. G., Burnam, M., Longshore, D., et al. (2001). Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry,58(8), 721–728. https://doi.org/10.1001/archpsyc.58.8.721.

  4. Boyraz, G., & Waits, J. B. (2015). Reciprocal associations among self-focused attention, self-acceptance, and empathy: A two-wave panel study. Personality and Individual Differences,74, 84–89. https://doi.org/10.1016/j.paid.2014.09.042.

  5. Carver, C. S., Johnson, S. L., Joormann, J., & Scheier, M. F. (2015). An evolving view of the structure of self-regulation. In G. H. E. Gendolla, M. Tops, & S. L. Koole (Eds.), Handbook of biobehavioral approaches to self-regulation. (pp. 9–23). https://doi.org/10.1007/978-1-4939-1236-0_2.

  6. Carver, C. S., & Scheier, M. F. (1990). Origins and functions of positive and negative affect: A control process view. Psychological Review,97(1), 19–35. https://doi.org/10.1037/0033-295X.97.1.19.

  7. Chaudoir, S. R., Norton, W. E., Earnshaw, V. A., Moneyham, L., Mugavero, M. J., & Hiers, K. M. (2012). Coping with HIV stigma: Do proactive coping and spiritual peace buffer the effect of stigma on depression? AIDS and Behavior, 16(8), 2382–2391. https://doi.org/10.1007/s10461-011-0039-3.

  8. Chin, W. W. (2010). How to write up and report PLS analyses. In V. Esposito Vinzi, W. W. Chin, J. Henseler, & H. Wang (Eds.), Handbook of partial least squares: Concepts, methods and applications (pp. 665–689). New York, NY: Springer.

  9. Cohen, J. (1992). A power primer. Psychological Bulletin,112(1), 155–159. https://doi.org/10.1037/0033-2909.112.1.155.

  10. Díaz, D., Rodriguez-Carvajal, R., Blanco, A., Moreno-Jiménez, B., Gallardo, I., Valle, C., et al. (2006). Adaptación española de las escalas de bienestar psicológico de Ryff [Spanish adaptation of Ryff’s Psychological Well-Being Scales]. Psicothema,18(3), 572–577. https://doi.org/10.1037/t04262-000.

  11. Diener, E., Lucas, R. E., & Oishi, S. (2005). Subjective well-being. The science of happiness and life satisfaction. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 63–73). Oxford: Oxford University Press.

  12. Dunbar, H. T., Mueller, C. W., Medina, C., & Wolf, T. (1998). Psychological and spiritual growth in women living with HIV. Social Work,43(2), 144–154. https://doi.org/10.1093/sw/43.2.144.

  13. Edmondson, O. J. H., & MacLeod, A. K. (2015). Psychological well-being and anticipated positive personal events: Their relationship to depression. Clinical Psychology & Psychotherapy,22(5), 418–425. https://doi.org/10.1002/cpp.1911.

  14. Emlet, C. A., Tozay, S., & Raveis, V. H. (2011). “I’m not going to die from the AIDS”: Resilience in aging with HIV disease. The Gerontologist,51(1), 101–111. https://doi.org/10.1093/geront/gnq060.

  15. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavioral Research Methods,39(2), 175–191. https://doi.org/10.3758/BF03193146.

  16. Fava, G. A., Cosci, F., Guidi, J., & Tomba, E. (2017). Well-being therapy in depression: New insights into the role of psychological well-being in the clinical process. Depression and Anxiety,34, 801–808. https://doi.org/10.1002/da.22629.

  17. Ford, B. Q., & Mauss, I. B. (2014). The paradoxical effects of pursuing positive emotion: When and why wanting to feel happy backfires. In J. Gruber & J. T. Moskowitz (Eds.), Positive emotion: Integrating the light sides and dark sides (pp. 363–382). New York, NY: Oxford University Press.

  18. Fornell, C., & Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and statistics. Journal of Marketing Research,18(3), 328–388. https://doi.org/10.2307/3151312.

  19. Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist,56(3), 218–226. https://doi.org/10.1037/0003-066X.56.3.218.

  20. Fredrickson, B. L. (2004). The broaden-and-build theory of positive emotions. Philosophical Transactions of the Royal Society B: Biological Sciences,359(1449), 1367–1378. https://doi.org/10.1098/rstb.2004.1512.

  21. Fredrickson, B. L. (2016). The eudaimonics of positive emotions. In J. Vittersø (Ed.), Handbook of eudaimonic well-being (pp. 183–190). Cham: Springer. https://doi.org/10.1007/978-3-319-42445-3_12.

  22. Fumaz, C. R., Munoz-Moreno, J. A., Ballesteros, A. L., Paredes, R., Ferrer, M. J., Salas, A., et al. (2007). Influence of the type of pegylated interferon on the onset of depressive and neuropsychiatric symptoms in HIV-HCV coinfected patients. AIDS Care,19(1), 138–145. https://doi.org/10.1080/09540120600645539.

  23. Fuster, M. J., Gil de Montes, L., Toledo, J., & Jaen, A. (2014). Evolution of HIV-related stigma in Spain between 2008 and 2012. AIDS Care,26(supl 1), S41. https://doi.org/10.1080/09540121.2014.906557.

  24. Geisser, S. (1974). A predictive approach to the random effects model. Biometrika,61, 101–107. https://doi.org/10.1093/biomet/61.1.101.

  25. Gonzalez, J. S., Penedo, F. J., Llabre, M. M., Durán, R. E., Antoni, M. H., Schneiderman, N., et al. (2007). Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence. Annals of Behavioral Medicine,34(1), 46–55. https://doi.org/10.1007/BF02879920.

  26. Grant, F., Guille, C., & Sen, S. (2013). Well-being and the risk of depression under stress. PLoS ONE,8, 1–6. https://doi.org/10.1371/journal.pone.0067395.

  27. Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2017). A primer on partial least squares structural equations modeling (PLS-SEM) (2nd ed.). Los Angeles, CA: Sage.

  28. Hammen, C. (2005). Stress and depression. Annual Review of Clinical Psychology,1, 293–319. https://doi.org/10.1146/annurev.clinpsy.1.102803.143938.

  29. Harding, K. A., Hudson, M. R., & Mezulis, A. (2014). Cognitive mechanisms linking low trait positive affect to depressive symptoms: A prospective diary study. Cognition and Emotion,28(8), 1502–1511. https://doi.org/10.1080/02699931.2014.889661.

  30. Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science,43(1), 115–135. https://doi.org/10.1007/s11747-014-0403-8.

  31. Herrero, J., & Gracia, E. (2007). Una medida breve de la sintomatología depresiva (CESD-7) [A brief measure of depressive symptomatology (CESD-7)]. Salud Mental,30(5), 40–46.

  32. Huta, V., & Ryan, R. M. (2010). Pursuing pleasure or virtue: The differential and overlapping well-being benefits of hedonic and eudaimonic motives. Journal of Happiness Studies,11(6), 735. https://doi.org/10.3758/BF03193146.

  33. Jahoda, M. (1958). Current concepts in positive mental health. New York, NY: Basic Books. https://doi.org/10.1037/11258-000.

  34. Jané-Llopis, E., & Anderson, P. (2005). Mental health promotion and mental disorder prevention. A policy for Europe. Nijmegen: Radboud University Nijmegen.

  35. Kashdan, T. B., Biswas-Diener, R., & King, L. A. (2008). Reconsidering happiness: The costs of distinguishing between hedonics and eudaimonia. The Journal of Positive Psychology,3(4), 219–233. https://doi.org/10.1080/17439760802303044.

  36. Keyes, C. L. M. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior,43(2), 207–222. https://doi.org/10.2307/3090197.

  37. Keyes, C. L. M., Dhingra, S. S., & Simoes, E. J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health,100(12), 2366–2371. https://doi.org/10.2105/AJPH.2010.192245.

  38. King, L. A., Hicks, J. A., Krull, J. L., & Del Gaiso, A. K. (2006). Positive affect and the experience of meaning in life. Journal of Personality and Social Psychology,90(1), 179–196. https://doi.org/10.1037/0022-3514.90.1.179.

  39. Lamers, S. M. A., Westerhof, G. J., Glas, C. A. W., & Bohlmeijer, E. T. (2015). The bidirectional relation between positive mental health and psychopathology in a longitudinal representative panel study. The Journal of Positive Psychology,10(6), 553–560. https://doi.org/10.1080/17439760.2015.1015156.

  40. Leserman, J. (2003). HIV disease progression: Depression, stress, and possible mechanisms. Biological Psychiatry,54(3), 295–306. https://doi.org/10.1016/S0006-3223(03)00323-8.

  41. Maslow, A. H. (1968). Toward a psychology of being. New York, NY: Van Nostrand. https://doi.org/10.1037/10793-000.

  42. Miquelon, P., & Vallerand, R. J. (2006). Goal motives, well-being, and physical health: Happiness and self-realization as psychological resources under challenge. Motivation and Emotion,30, 259–272. https://doi.org/10.1007/s11031-006-9043-8.

  43. Miquelon, P., & Vallerand, R. J. (2008). Goal motives, well-being, and physical health: An integrative model. Canadian Psychology,49(3), 241–249. https://doi.org/10.1037/a0012759.

  44. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd edn). McGraw-Hill.

  45. Rabkin, J. G. (2008). HIV and depression: 2008 review and update. Current HIV/AIDS Reports,5(4), 163–171. https://doi.org/10.1007/s11904-008-0025-1.

  46. Radloff, C. S. (1977). The CES-D scale: A new self-report depression scale for research in the general population. Applied Psychological Measurement,1(3), 385–401. https://doi.org/10.1177/014662167700100306.

  47. Ringle, C. M., Wende, S., & Becker, J. M. (2015). SmartPLS 3. Bönningstedt, Germany. Retrieved from http://www.smartpls.com: SmartPLS. Accessed 12 March 2017.

  48. Risch, A. K., Taeger, S., Brüdern, J., & Stangier, U. (2013). Psychological well-being in remitted patients with recurrent depression. Psychotherapy and Psychosomatics,82(6), 404–405. https://doi.org/10.1159/000351808.

  49. Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology,21(2), 95–103. https://doi.org/10.1037/0022-006X.60.6.827.

  50. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships, as developed in the client-centered framework. In S. Koch (Ed.), Psychology: A study of a science (pp. 184–256). New York, NY: McGraw-Hill.

  51. Ryan, R. M., & Deci, E. L. (2000). The darker and brighter sides of human existence: Basic psychological needs as a unifying concept. Psychological Inquiry,11(4), 319–338. https://doi.org/10.1207/S15327965PLI1104_03.

  52. Ryan, R. M., Huta, V., & Deci, E. L. (2008). Living well: A self-determination theory perspective on eudaimonia. Journal of Happiness Studies,9(1), 139–170. https://doi.org/10.1007/s10902-006-9023-4.

  53. Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology,57(6), 1069–1081. https://doi.org/10.1037/0022-3514.57.6.1069.

  54. Ryff, C. D. (2014). Psychological well-being revisited: Advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics,83(1), 10–28. https://doi.org/10.1159/000353263.

  55. Ryff, C. D., Singer, B. H., & Love, G. D. (2004). Positive health: Connecting well-being with biology. Philosophical Transactions of the Royal Society of London B Biological Sciences,359(1449), 1383–1394.

  56. Sandín, B., Chorot, P., Lostao, L., Joiner, T. E., Santed, M. A., & Valiente, R. M. (1999). Escalas PANAS de afecto positivo y negativo: Validación factorial y convergencia transcultural [PANAS Scales of Positive and Negative Affect: Factor validation and transcultural convergence]. Psicothema,11(1), 37–51.

  57. Sheldon, K. M. (2014). Becoming oneself: The central role of self-concordant goal selection. Personality and Social Psychology Review,18(4), 349–365. https://doi.org/10.1177/1088868314538549.

  58. Sheldon, K. M. (2016). Putting eudaimonia in its place. In J. Vittersø (Ed.), Handbook of eudaimonic well-being (pp. 531–541). Cham: Springer. https://doi.org/10.1007/978-3-319-42445-3_36.

  59. Sheldon, K. M., & Elliot, A. J. (1998). Not all personal goals are personal: Comparing autonomous and controlled reasons for goals as predictors of effort and attainment. Personality and Social Psychology Bulletin, 24(5), 546–557. https://doi.org/10.1177/0146167298245010.

  60. Sheldon, K. M., & Kasser, T. (1998). Pursuing personal goals: Skills enable progress, but not all progress is beneficial. Personality and Social Psychology Bulletin,24(12), 1319–1331. https://doi.org/10.1177/01461672982412006.

  61. Shrira, A., Palgi, Y., Wolf, J. J., Haber, Y., Goldray, O., Shacham-Shmueli, E., et al. (2011). The positivity ratio and functioning under stress. Stress and Health: Journal of the International Society for the Investigation of Stress,27(4), 265–271. https://doi.org/10.1002/smi.1349.

  62. Sueoka, K., Goulet, J. L., Fiellin, D. A., Rimland, D., Butt, A. A., Gibert, C., et al. (2010). Depression symptoms and treatment among HIV infected and uninfected veterans. AIDS and Behavior,14(2), 272–279. https://doi.org/10.1007/s10461-008-9428-7.

  63. Sumari-de Boer, I. M., Sprangers, M. A. G., Prins, J. M., & Nieuwkerk, P. T. (2012). HIV stigma and depressive symptoms are related to adherence and virological response to antiretroviral treatment among immigrant and indigenous HIV infected patients. AIDS and Behavior, 16(6), 1681–1689. https://doi.org/10.1007/s10461-011-0112-y.

  64. Vittersø, J. (2013). Feelings, meanings, and optimal functioning: Some distinctions between hedonic and eudaimonic well-being. In A. S. Waterman (Ed.), The best within us: Positive psychology perspectives on eudaimonia (pp. 39–55). Washington, DC: American Psychological Association.

  65. Warren-Jeanpiere, L., Dillaway, H., Hamilton, P., Young, M., & Goparaju, L. (2014). Taking it one day at a time: African American women aging with HIV and co-morbidities. AIDS Patient and Care and STDs,28(7), 372–380. https://doi.org/10.1089/apc.2014.0024.

  66. Watson, D. (2005). Positive affectivity. The disposition to experience pleasurable emotional states. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 106–118). New York, NY: Oxford University Press.

  67. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology,54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063.

  68. Wood, A. M., & Joseph, S. (2010). The absence of positive psychological (eudemonic) well-being as a risk factor for depression: A ten-year cohort study. Journal of Affective Disorders,122(3), 213–217. https://doi.org/10.1016/j.jad.2009.06.032.

  69. Zhao, X., Lynch, J. G., & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of Consumer Research,37(2), 197–206. https://doi.org/10.1086/651257.

Download references

Acknowledgements

The authors acknowledge the assistance received by Professor Joaquín Aldas-Manzano in methodological aspects of this paper.

Funding

Funding was provided by Fundación para la Investigación y la Prevención del Sida en España (Grant No. 18754/08).

Author information

Correspondence to Eneko Sansinenea.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sansinenea, E., Asla, N., Agirrezabal, A. et al. Being Yourself and Mental Health: Goal Motives, Positive Affect and Self-Acceptance Protect People with HIV from Depressive Symptoms. J Happiness Stud 21, 593–612 (2020). https://doi.org/10.1007/s10902-019-00098-7

Download citation

Keywords

  • Personal goals
  • Positive affect
  • Self-acceptance
  • Depression
  • HIV/aids