Identifying and describing feelings and psychological flexibility predict mental health in men with HIV
Early detection screening programmes have been well established for a variety of cancer types. More recently, anal cytological screening for anal cancer has been recommended (New York State Department of Public Health AIDS Institute, 2007). Population rates of anal cancer are 1.6 per 100,000 (Darragh & Winkler, 2011). However, men who have sex with men (MSM) and are HIV infected have considerably higher rates, estimated at between 42 and 137 per 100,000 (Darragh & Winkler, 2011). The psychological impact of cancer screening has been demonstrated in many different programmes and typically includes increased anxiety, reduced quality of life (QOL) and increased health vigilance (Brett, Bankhead, Henderson, Watson, & Austoker, 2005; Gray et al., 2006; McNaughton-Collins et al., 2004). Strategies for reducing these effects involve clear communication in written and verbal forms about the procedures and results (Wilkinson, Jones, & McBride, 1990; Wilson & Hines, 2000). Another way to reduce the negative effects of screening may be to develop an individual's strengths (e.g., ability to identify and describe feelings and psychological flexibility [PF]) to enhance their coping ability. There are numerous theories that have the potential to explain how an individual copes with health threat. Our study focuses on the two individual characteristics: the difficulty in identifying and describing feelings (DIDF; Bagby, Parker, & Taylor, 1994) and PF. Difficulties in identifying and describing feelings are major components of alexithymia (Bagby et al., 1994). Psychological flexibility is 'the ability to contact the present moment more fully as a conscious human being, and to change or persist in behavior when doing so serves valued ends' (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). Both DIDF and PF have been shown to explain differences in psychological functioning (Berrocal, Pennato, & Bernini, 2009; Gloster, Klotsche, Chaker, Hummel, & Hoyer, 2011), physical well-being (McCracken & Zhao-O'Brien, 2010; Saharinen et al., 2008) and QOL outcomes (Hayes et al., 2006; Modestin, Furrer, & Malti, 2004).
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