Forgiveness and state-trait anger: Correlates of depression in persons living with HIV

Background The effects of living with HIV are not only physical, but also emotional. Major depressive disorder rates are almost twice as high in persons living with HIV (PLH) (Kraaij et al., 2008). PLH may become angry at themselves for contracting HIV, which can lead to increased depression (Luutonen, 2007). Forgiveness can function as a coping strategy to decrease depression (Ysseldyk, Matheson, & Anisman, 2009). Against a theoretical framework of Lazarus and Folkman's cognitive theory of stress and coping (1984), we hypothesized that increased anger and decreased forgiveness is associated with increased depression in HIV+ individuals. Methods Our cross-sectional, correlational study examined data collected from 119 PLH (50% male, 50.8% heterosexual, 69.2% African-American, 24.2% European American, 6.6% other). Participants on average were 46.8 (SD=8.9, ranging 23-66) years of age, who completed the State-Trait Anger Expression Inventory (Speilberger, 1983), Heartland Forgiveness Scale (Thompson et al., 2005; á=.92), and Center for Epidemiologic Studies Depression Scale (Radloff, 1977; á= .76-.92). Our sample reported a high state anger level (Mean= 21.1, SD=7.24), moderate forgiveness level (Mean= 87.22, SD=17.02), and high depression level (Mean= 40.1, SD=11.5). Results A multiple hierarchical regression analysis found that PLHs reporting higher levels of state anger (â=.34, t=2.9 p<.005), and lower levels of forgiveness (â= -.23, t= -2.0 p<.045), also reported higher levels of depression, accounting for 30% of its variance (adjusted R square =.30, F (8, 110)=5.78, p<.001). Conclusion Our findings suggest that public health programs addressing depression in PLH should incorporate forgiveness and state anger in their design.