Positive Psychological Factors and Impairment in Rheumatic and Musculoskeletal Disease: Do Psychopathology and Sleep Quality Explain the Linkage?

Abstract

Objective. Little is known about potential mechanisms of action linking protective positive psychological variables and functional disability in patients with rheumatic and musculoskeletal disease. The present study was undertaken to examine symptoms of psychopathology, including stress, depression, anxiety, and sleep quality, as serial mediators of the association between gratitude, self-compassion, self-forgiveness, and functional impairment. Methods. We assessed risk and protective factors for functional disability in patients with fibromyalgia (FM), osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) who were recruited from an Austrian health care facility. Respondents completed online surveys, including the Gratitude Questionnaire 6-item form, the Self-Compassion Scale short form, the Self-Forgiveness and Forgiveness of Others Index, the Perceived Stress Scale 4, the Patient Health Questionnaire 2, the 2-item Generalized Anxiety Disorder Scale, the Sleep Condition Indicator, and the Health Assessment Questionnaire. Bivariate and serial mediation analyses were conducted. Results. For our sample of 1,218 patients (52% female, n = 632; AS [37%], OA [34%], RA [14%], and FM [24%]), stress, depression, and anxiety, in parallel as first-order mediators, and sleep quality as a second-order mediator, explained the association between positive psychological variables and functional disability. Conclusion. Positive psychological factors exert a beneficial downstream effect on mental well-being, sleep health, and health-related functional impairment. Therapeutic promotion of gratitude, self-compassion, and selfforgiveness may improve mental and physical health in patients with rheumatic and musculoskeletal disease.

Osteoarthritis and Depression Update: 2023-Can the Stress and Coping Model Help?

“…6. Applying positive psychology approaches [gratitude, self-compassion, and self-forgiveness, cognitive restructuring] alongside efforts to foster empowerment [61,64].…”

The Effect of Sleep on Metabolism, Musculoskeletal Disease, and Mortality in the General US Population: Analysis of Results From the National Health and Nutrition Examination Survey

“…Many meta-analyses have shown that short and long sleep durations are associated with all-cause mortality [2][3][4]. Moreover, sleep may improve musculoskeletal disease at the psychological level [5][6][7][8]. It has also been reported that sleep duration is associated with obesity and diabetes [9][10][11].…”

Editorial: Psychological impact and quality of life in rheumatic and musculoskeletal diseases

“…Rheumatic diseases are generally characterized by a chronic course that both affects patients' physical, mental, and social function and significantly impacts their caregivers and family members, resulting in low health-related quality of life (QoL) as well as psychological problems ( 1 , 2 ). For this reason, over the last decade, health related QoL has become an evolving field of research; and data from the literature increasingly highlight the relationship between disease activity/damage and the ability to work and psychological wellbeing.…”