Daily Events and Mood State Among Individuals Living With HIV: Examination of the Within-Persons Approach to Data Collection Using Daily Diary Methodology

Studies examining the link between stressful events and coping with HIV have relied on a between-persons approach focusing on how individuals differ on some characteristics. Although the between-subjects approach has yielded important information, our goal was to use a within-persons approach, making repeated measurements of the same persons over many days, to examine the impact of changing circumstances on the mood states of those with HIV. A second goal was to determine if asking participants to report their daily experiences via a computerized interactive voice system is a viable way to collect such information. This study collected a variety of trait measures for seven HIV patients and subsequently used a computerized telephone system to collect information regarding daily events and mood states over 21 consecutive days. Several daily measures, including self-esteem, optimism, and positive social interactions were significantly related to daily mood states. Trait measures, with the exception of symptom distress, were ineffective in predicting variations in daily mood states. It was concluded that a computerized telephone system is a viable means of collecting information from HIV patients on a daily basis and within-persons methodology may provide useful information about daily events affecting mood states beyond that generated by a between-persons approach. Keywords: coping; computerized interactive voice system; HIV patients; mood; optimism; self-esteem Understanding potential stressors and resources for living with HIV disease is important because these variables may affect daily mood states and psychological functioning. These in turn may affect the progression of HIV disease via biological and behavioral pathways, and even the effectiveness of highly active antiretroviral therapy (Leserman et al., 2000). Based on this perspective, our study examined how various psychological states and social interactions, measured on a daily basis, affect daily mood states. In the present article, the results and methodological limitations of prior quantitative studies linking HIV infection and psychological functioning will be briefly reviewed. These studies rely on a between-persons approach to data collection, examining how individuals who differ on some characteristic (e.g., severity of life stress, satisfaction with social support) cope with HIV. Using a daily diary study, it will be demonstrated how collecting data from HIV-positive persons based on a within-persons approach (involving repeated measurements on the same persons over many days) may increase our understanding of the link between everyday events and mood state for individuals with HIV and/or AIDS. Another goal of this study was to determine if collecting measures of everyday events using a computerized interactive voice system was a viable approach. BACKGROUND Within-Persons Versus the Between-Persons Approach to Data Collection The strategy in most quantitative studies regarding the link between stressful events and coping with HIV compares individuals who are in different life situations. These studies rely on a between-persons approach, focusing on how individuals who differ on predictor variables such as stressful life events (e.g., Nott & Vedhara, 1995), satisfaction with social support (Leserman et al., 2000), and perceived HIV-related stigma (Derlega, Winstead, Greene, Serovich & Elwood, 2002; Miles, Burchinal, Holditch-Davis, Wasilewski, & Christian, 1997) cope with HIV. The between-persons approach has provided valuable information about coping with HIV, but this approach has its theoretical and practical limitations (Bolger, Davis, & Rafaeli, 2003; Gable & Reis, 1999). The between-persons approach does not provide information about the reactions of the same individuals given daily changes and fluctuations in life circumstances (e.g., how someone reacts to interacting with others in positive or negative social contexts or how the same individual reacts to the ebb and flow of HIV- or medication-caused physical symptoms each day). …