A path model of the effects of spirituality on depressive symptoms and 24-h urinary-free cortisol in HIV-positive persons.

The present investigation examined the associations among spirituality, positive reappraisal coping, and benefit finding as they relate to depressive symptoms and 24-h urinary-free-cortisol output. Following an initial screening appointment, 264 human-immunodeficiency-virus-positive men and women on highly active antiretroviral therapy provided 24-h urine samples and completed a battery of psychosocial measures. Spirituality was associated with higher positive reappraisal coping and greater benefit finding. Benefit finding and positive reappraisal coping scores were, in turn, both related to lower depressive symptoms. Finally, we determined that benefit finding was uniquely predictive of decreased 24-h urinary-free cortisol output. Positive reappraisal coping and benefit finding may co-mediate the effect of spirituality on depressive symptoms, and benefit finding may uniquely explain the effect of spirituality on 24-h cortisol output.