Cited by 125Psychological Well-being and Life SatisfactionOptimism, Hope, and Well-beingMindfulness and Compassion Interventions

The DOI matches its Crossref record; 101 of the 101 references it cites were found in a registry or an index; none of the 68 sources its claims cite is checked for support yet.

A positive affect intervention for people experiencing health-related stress: Development and non-randomized pilot test

Open access

Abstract

In this article we present background, theoretical rationale, and pilot data on the development of an intervention designed to increase positive affect in people living with serious health-related stress. This proof-of-concept study demonstrated that a multiple-component positive affect intervention is feasible and acceptable for people newly diagnosed with HIV. Retention in the intervention and adherence to home practice were high. Participants reported significant increases in positive affect and significant decreases in negative affect. This positive affect intervention can serve as a template for programs to be developed to help people experiencing health-related and other types of life stress.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This proof-of-concept paper describes the development and non-randomized pilot test of a multiple-component positive affect intervention for people newly diagnosed with HIV. The intervention was feasible and acceptable, with high retention and home-practice adherence, and participants showed significant increases in positive affect and decreases in negative affect.

Key findings

  • Retention was high: 9 of 11 participants completed the entire 10-week study (81.8% retention). Home-practice adherence averaged 5.4 days per week across weeks and tasks, ranging from 4.1 days/week for mindful breath awareness to 6.6 days/week for personal strengths.
  • From pre-intervention to the first follow-up, positive affect increased by a mean of 3.9 points (p = .016) and negative affect decreased by 5.1 points (p = .016), compared with changes of +1.2 and −0.35, respectively, in a no-treatment historical comparison dataset. Pre-intervention to second follow-up effect sizes were Cohen’s d = 1.14 for positive affect and 1.98 for negative affect.
  • Overall mindfulness did not change significantly, but the nonreactivity subscale increased significantly at immediate post-intervention, while the nonjudgment subscale dropped significantly at the second follow-up. At 4-week follow-up, 6 of 9 participants reported practicing at least one skill daily; the most frequently practiced skill was noting positive events (2–3 times per week), and the least frequent was informal mindfulness (just under once per week).
  • Acceptability ratings were high: average likelihood of recommending the program to a friend was 8.6 out of 10, and to someone just testing positive for HIV was 9.5 out of 10 (7 of 9 participants said 10).

Methods

  • The intervention was based on revised Stress and Coping Theory and Broaden-and-Build theory and taught 8 skills across 5 weekly one-on-one sessions lasting approximately 45–60 minutes, with home practice and a workbook.
  • The pilot enrolled 11 people newly diagnosed with HIV within the previous 4 months (actual range 1–14; average 8.5 weeks prior to screening, range 3–15 weeks). Nine were men, two were women; average age was 38. Participants were recruited through HIV clinics and community sites in the San Francisco Bay Area between October and December 2007.
  • Positive and negative affect were assessed with a modified Differential Emotions Scale at week 1, one week after intervention completion, and by phone four weeks later; mindfulness was assessed with items from the Five Factor Mindfulness Scale. Main analyses used paired t-tests, with a no-treatment historical comparison group from a prior observational study in the same lab.

Limitations

  • The paper states that this was a formative, proof-of-concept pilot with no control group and a small sample; it also states that future work should examine which intervention components are most effective and for whom, analyze which types of positive affect change, and explore group or self-administered formats.
  • The text makes evident that the design was non-randomized, the comparison was a historical no-treatment dataset rather than a randomized control, and complete post-intervention data were available for only n = 9 participants.
  • The text also makes evident reliance on self-report measures, a short follow-up period, and a sample that was predominantly men, which limits generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/1359105311425275

Cites

101 of 101 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

44 Not checked yet · 29 Own result · 4 Own method · 3 No basis given · 2 Own interpretation

Verify all 68 references — free account

Show all 53 claims

  • It may state two separate claims as one. 18
  • Probably not a substantial claim. 11
  • The quote only partly states this claim. 2
29 of 29
  • The paper relies on this without support.

    There are few empirically-supported programs that explicitly focus on skills for producing positive affect.

    “but there are few empirically-supported programs that explicitly focus on skills for producing positive affect.”
  • The paper relies on this without support.

    None of the existing depression interventions for people living with HIV has targeted those newly diagnosed with HIV.

    “none has targeted those who were newly diagnosed with HIV”
  • The paper relies on this without support.

    None of the existing depression interventions for people living with HIV has explicitly targeted positive affect.

    “none has explicitly targeted positive affect.”
  • The paper relies on this without support.

    The historical comparison group represents the affective trajectory participants would likely have followed without any intervention.

    “representing the affective trajectory our participants would likely have followed without any intervention.”
  • The authors state this as an assumption.

    Teaching both formal and informal mindfulness early in the intervention would allow participants to better retain and practice the other skills.

    “It was our belief that by teaching both formal mindfulness (meditation) and informal mindfulness (mindfulness of the events of daily life) early in the intervention, participants could utilize this skill to better retain and practice the other skills.”
  • The paper relies on this without support.

    High levels of stress, distress, and depression are documented in people living with serious physical illness.

    “given the high levels of stress, distress, and depression documented in people living with serious physical illness”
  • The paper relies on this without support.

    The intervention does not require that a package of skills be practiced together to maximize beneficial effects.

    “the intervention does not consist of a package of skills that must be practiced together to maximize the beneficial effects.”
7 of 7

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Citations

Cites

Show all 99 references

Research works printed but not linked: 4

  1. Emmons RA, 1986, Paper presented at the American Psychological Association
  2. Fordyce MW, 1981, The Psychology of Happiness: Fourteen Fundamentals
  3. Moskowitz JT, 2008, Paper presented at the American Psychosomatic Society
  4. Ostrow DG, 1989, AIDS Education & Prevention, 1, 1

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Metadata

Authors
Moskowitz, J. T., Hult, J. R., Duncan, L. G., Cohn, M. A., Maurer, S., Bussolari, C., & Acree, M.
Affiliations
  • University of California, San Francisco (US)
  • University of San Francisco (US)
Venue
Journal of Health Psychology
Published
2011-10-21
Volume
17
Issue
5
Pages
676-692
ISSN
  • 1359-1053 (ISSN-L)
  • 1461-7277
OpenAlex
W2007094862
Cited by
125
References
99
Citations by year
2026: 1 · 2025: 3 · 2024: 12 · 2023: 7 · 2022: 8 · 2021: 7 · 2020: 15 · 2019: 8 · 2018: 11 · 2017: 19 · 2016: 5 · 2015: 10 · 2014: 8 · 2013: 7 · 2012: 3
FWCI
7.86
Type
journal article
Language
en
Open access
Locations
  • Journal of Health Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • University of California, San Francisco
  • National Institute of Mental Health (K24MH093225)
  • National Center for Research Resources (UL1RR024131)
  • National Institute on Minority Health and Health Disparities (L60 MD003696)
  • National Center for Complementary and Integrative Health (K01AT005270, K01 AT005720)
Topics
  • Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
  • Social Sciences › Psychology › Applied Psychology › Optimism, Hope, and Well-being
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords
positive affect, health stress, HIV diagnosis, feasibility, acceptability, intervention retention, negative affect, life events
MeSH terms
Adaptation, Psychological, Adult, Affect, Chronic Disease, Feasibility Studies, Female, HIV Seropositivity, Humans, Male, Models, Theoretical, Pilot Projects, San Francisco, Stress, Psychological

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