Higher resilience significantly attenuated the association between dyspnea and depressive symptoms among women with HIV (B=-0.52; 95% CI -0.71 to -0.33; p<0.001), as did social support.
Observational (n=447)
Do resilience and social support moderate the relationship between lung health indicators and depressive symptoms in women with HIV?
Resilience and social support attenuate the relationship between dyspnea and depressive symptoms in women with HIV.
Effect estimate: B=-0.52 (95% CI -0.71, -0.33)
p-value: p=<0.001
Abstract Rationale Women with HIV (WWH) experience accelerated lung function decline and a high burden of dyspnea, which is strongly associated with depressive symptoms. However, little is known about whether modifiable psychosocial protective factors can reduce this burden. Resilience and social support are promising modifiable factors, yet their moderating effects in the context of impaired lung health have not been examined among WWH. Purpose To determine whether resilience and social support moderate the relationship between lung health and depressive symptoms in WWH. Methods We conducted a secondary analysis using data from the Women’s Interagency HIV Study (WIHS). Participants included WWH who completed lung health and psychosocial assessments between April 2018 and September 2019. Lung health indicators included: 1) pulmonary function (post-bronchodilator Forced Expiratory Volume in one second FEV₁, Forced Vital Capacity FVC, and the FEV₁/FVC ratio); 2) dyspnea (Modified Medical Research Council mMRC Dyspnea Scale); and 3) self-reported chronic obstructive pulmonary disease (COPD) diagnosis. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Resilience was assessed using the Connor-Davidson Resilience Scale 10-item (CD-RISC-10), and social support using the Medical Outcomes Study Social Support Survey (MOS-SSS). Regression analyses were conducted to test whether resilience and social support moderated the relationship between lung health indicators and depressive symptoms, adjusting for demographic and clinical covariates. Results Among 447 WWH (mean age 50.6 years; 67.1% Black non-Hispanic; 38.7% current tobacco users), neither resilience nor social support moderated associations between FEV₁, FVC, or FEV₁/FVC and depressive symptoms. In contrast, resilience significantly moderated the association between dyspnea and depressive symptoms, such that higher resilience attenuated the relationship (B=-0.52, 95%CI: -0.71, -0.33; p0.001). Social support also moderated the association between dyspnea and depressive symptoms, although with a smaller effect size (B=-0.20, 95%CI: -0.29, -0.11; p0.001). No moderation was observed for self-reported COPD diagnosis. Conclusions Resilience and social support buffered the impact of dyspnea on depressive symptoms among WWH. Integrating strategies that strengthen psychosocial resources into pulmonary care may help reduce depressive symptom burden in those experiencing dyspnea. Future research should test behavioral interventions that enhance resilience and social support and examine whether they improve dyspnea, mental health, and engagement in lung health care among WWH. This abstract is funded by: NIH
Byun et al. (Fri,) conducted a observational in Women with HIV (n=447). Resilience and social support was evaluated on Moderation of the association between dyspnea and depressive symptoms by resilience (B=-0.52, 95% CI -0.71, -0.33, p=<0.001). Higher resilience significantly attenuated the association between dyspnea and depressive symptoms among women with HIV (B=-0.52; 95% CI -0.71 to -0.33; p<0.001), as did social support.