Testing the vulnerability and scar model of the relationship between self-concept, social support and anxiety symptoms among children of HIV-infected parents in China: A 3-year longitudinal study.

BACKGROUND

Mental illness is a great concern among children of HIV-infected parents (COHIP), who are at their crucial stage of psychosocial development. It has been shown that self-concept (SC) and social support (SS) are important correlates of anxiety symptoms (AS), however, nature of the causality remained unclear.

METHODS

A 3-year longitudinal study was conducted in rural Central China, where many people were infected with HIV through unhygienic blood donation. A total of 195 COHIP (mean age: 12.6 years, 49.2% male) completed the baseline assessment and were followed for three years. Cross-lagged structural equation modeling analyses were used to test competing theoretical models: vulnerability model (low SC/SS contributes to AS), scar model (AS erodes SC/SS) and reciprocity model (low SC/SS and AS predict each other).

RESULTS

At each wave, 104 (53.3%) and 67 (41.6%) participants presented with anxiety disorders respectively. Nested-model comparison supported the superiority of scar models wherein AS significantly predicted subsequent low SC (β=-0.24, p=0.013) and SS (β=-0.31, p= 0.033), controlling for synchronous and autoregressive effects of all measures. The most parsimonious multivariate model that included significant relations was finally identified with a good model fit.

LIMITATIONS: Findings might be subject to reporting bias; and could not inform the temporal relationship between SC and SS.

CONCLUSION

Prevalence of anxiety was high among Chinese COHIP. The present study provides empirical evidence for scarring effects of AS; thus, highlighted the importance of identifying and treating COHIP's anxiety to mitigate long-term negative impacts on their psychosocial development.