Using the Millon Behavioral Medicine Diagnostic (MBMD) to Evaluate the Need for Mental Health Services in Association with Biomarkers of Disease Status Among HIV Positive Men and Women

Abstract

Psychological distress states have been related to rate of disease progression among HIV-positive individuals. However, the measures that have been used in this research as well as the treatment context of the populations studied are highly variable, making it challenging for clinicians to incorporate such measures into screening batteries. The present study examined the association of two summary scales of the Millon Behavioral Medicine Diagnostic (MBMD; Millon et al., Millon Behavioral Medicine Diagnostic. NCS Assessments, Minneapolis, 2001), with markers of HIV disease status (CD4 and CD8 cell counts, viral load) among an ethnically diverse sample of 147 HIV-positive individuals (52 men who have sex with men, 34 men who have sex with women, and 51 women) who had recently initiated Highly Active Antiretroviral Therapy (HAART). After controlling for age and months since HIV diagnosis, we found that higher scores on the overall MBMD Psych Referral Summary Scale, reflecting a need for mental health treatment, were related to greater HIV viral load but did not relate to CD4 or CD8 cell counts. Subgroup analyses revealed that Psych Referral scores were related to greater HIV viral load only for the men who have sex with men (MSM) subgroup. These results suggest that the MBMD may help in identifying psychosocial characteristics associated with some markers of disease status in persons with HIV and perhaps may also be useful in identifying individual differences in response to treatment and eventual disease outcome.

Characterizing HIV Medication Adherence for Virologic Success Among Individuals Living With HIV/AIDS: Experience With the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Cohort

“…While our study does not explicitly evaluate the role of mental health status, the finding that individuals who were non-adherent were more likely to report both depression symptoms and substance use point toward the need to include the role of mental health and substance use and treatment in future studies on HIV medication adherence. This finding directly eludes to previous studies that have supported the need for comprehensive case management approaches including depression care for persons living with HIV/AIDS (Burbridge, Cruess, Antoni, & Meagher, 2011). …”

Assessment and Evaluation of Alcohol Use Disorder in Liver Transplant

“…Other measures such as the Substance Abuse Subtle Screening Inventory and broader personality assessments like the PAI (Personality Assessment Inventory), Minnesota Multiphasic Personality Inventory, and Millon Behavioral Medicine Diagnostic assess for AUD and factors such as mental illness which may perpetuate AUD. 38…”

Millon Behavioral Medicine Diagnostic

“…The MBMD also is useful with other clinical populations outside of rehabilitation settings. A study examining an HIV positive population provided ongoing support for the impact of psychological factors on physical health and treatment outcomes (Burbridge et al 2011). The MBMD has been effective in examining the psychological processes involved with treatment adherence.…”