How mental health relates to everyday stress, rumination, trauma and interoception in women living with HIV: A factor analytic study

Abstract

Mental health symptoms tend to correlate with one another within individuals. An exploratory factor analysis was performed on responses to five questionnaires related to depression, anxiety, trauma and perceived stress to determine which items related most highly to a common underlying construct in women with HIV (n = 35). Individual responses were further analyzed with respect to ruminations, which are repetitive thoughts about the self and with respect to interoception, which involves cognitive awareness of bodily states. Scores for ruminative thoughts were highly correlated with those for trauma-related thoughts (r = 0.77), perceived stress (r = 0.64), and symptoms of depression (r = 0.75). Items of mental health loaded highly and consistently onto one factor that accounted for 66% of the variance in the data. The principal factor accounted for 94% of the variance in measures of rumination, 87% for depression, 75% for trauma and stress, and 73% for anxiety. Women who endorsed greater numbers of maladaptive symptoms related to mental health (indicated by elevated factor scores) reported a decreased ability to sense and trust their bodily sensations and regulate thoughts and feelings related to these sensations. The general mental health factor did not relate to actual interoceptive awareness, as measured with a heartbeat tracking task. These results reveal a common and measurable mental health factor related to repetitive and body-related thoughts in people who are experiencing the everyday stress of living with a chronic disease.