Affective Well-Being, Rumination, and Positive Reappraisal among People Living with HIV: A Measurement-Burst Diary Study

Abstract

Background: Changes of affective well-being are usually analysed either as longitudinal processes or as daily fluctuations. We used a three-burst diary study to combine these perspectives. Method: The participants were 211 patients with a diagnosis of HIV infection. In three bursts with 6-month intervals, they completed an online diary for five consecutive days, which gives 15 days of measurements. They evaluate affective well-being (positive and negative affect), stress associated with a central hassle, and coping (rumination and positive reappraisal). Results: Higher daily stress coupled with higher rumination was related to lower well-being. For positive reappraisal, the picture was more complex. First, its interaction with daily stress had an effect on negative, but not on positive, affect. Second, this effect was significant only at the first burst. Conclusions: These results suggest a stable debilitating effect of daily rumination, but a limited and diminishing beneficial effect of daily positive reappraisal among people living with HIV. As such, they do not confirm the view that positive reappraisal sustains affective well-being during chronic health conditions. This may inform stress management interventions for PLWH, which are now increasingly taking the form of mobile applications, adapted to the daily lives of patients in their natural environment.