The mediational role of helplessness in psychological outcomes in systemic lupus erythematosus

Mills, Sarah D.; Azizoddin, Desiree R.; Gholizadeh, Shadi; Racaza, Geraldine Z.; Nicassio, Perry M.

doi:10.1177/0961203317751046

Cited by 9 publications

(12 citation statements)

References 17 publications

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“…Depression and anxiety are frequently observed in rheumatoid arthritis or lupus erythematosus patients. [32][33][34][35] The current health crisis brought about by the quick spread of the SARS-Cov2 virus is a challenge to everyone's physical and mental health. In a pandemic such as this, fear increases anxiety and stress levels in healthy individuals and intensifies the symptoms of those with pre-existing psychiatric disorders.…”

Section: Discussionmentioning

confidence: 99%

“…The calculation of scores was based on previous studies. 14,15,22 The total depression subscale was divided into normal (0-9), mild depression (10)(11)(12), moderate depression (13)(14)(15)(16)(17)(18)(19)(20), severe depression (21-27) and extremely severe depression symptoms (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). The total anxiety subscale score was divided into normal (0-6), mild anxiety (7-9), moderate anxiety (10)(11)(12)(13)(14), severe anxiety (15)(16)(17)(18)(19) and extremely severe anxiety symptoms (20-42).…”

Section: Measures and Outcomesmentioning

confidence: 99%

“…The total anxiety subscale score was divided into normal (0-6), mild anxiety (7-9), moderate anxiety (10)(11)(12)(13)(14), severe anxiety (15)(16)(17)(18)(19) and extremely severe anxiety symptoms (20-42). The total stress subscale score was divided into normal (0-10), mild stress (11)(12)(13)(14)(15)(16)(17)(18), moderate stress (19)(20)(21)(22)(23)(24)(25)(26), severe stress (27-34) and extremely severe stress (35)(36)(37)(38)(39)(40)(41)(42).…”

Section: Measures and Outcomesmentioning

confidence: 99%

“…[25][26][27][28] The 22-item IES-R questionnaire was composed of three subscales that measured mean avoidance, intrusion and hyperarousal. The total IES-R score was multiplied by two and interpreted as normal (0-23), mild psychological impact (24-32), moderate psychological impact (33)(34)(35)(36) and severe psychological impact (>37). Both the DASS-21 and IES-R tools have been previously used for their psychometric properties in research related to the COVID-19 outbreak.…”

Section: Measures and Outcomesmentioning

confidence: 99%

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<p>Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus</p>

Tee¹,

Salido²,

Reyes³

et al. 2020

OARRR

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Background: Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are perceived to be more vulnerable to worse COVID-19 infection outcome. Furthermore, severe shortage in hydroxychloroquine supply was experienced. Objective: We presented the psychological responses of Filipino SLE and RA patients to the COVID-19 pandemic and shortage of hydroxychloroquine supply. Methods: A total of 512 completed online surveys from SLE and RA patients were gathered from May 19 to 26, 2020. The online survey collected data on socio-demographics, health status, contact history, health service utilization, use of hydroxychloroquine, COVID-19 knowledge and concerns, precautionary measures, information needs, the validated Impact of Events Scale-Revised (IES-R) and Depression, Anxiety and Stress Scales (DASS-21) ratings. Results: The psychological impact of COVID-19 outbreak was at least moderate in 20%. The mean IES-R score was higher among SLE (22.34, SD=14.39) than RA (18.85, SD=13.24) patients. Stress, anxiety and depression were moderate to severe in 12.3%, 38.7%, and 27.7% of respondents. The mean stress subscale score was 10.11 (SD=7.95), mean anxiety subscale score was 6.79 (SD=6.57) and mean depression subscale score was 9.03 (SD=8.77). The risk factors for adverse mental health during the COVID-19 pandemic include the presence of comorbidity of hypertension and asthma; being a healthcare worker; and presence of specific symptoms of myalgia, cough, breathing difficulty, dizziness and sore throat. The protective factors for mental health during the pandemic include satisfaction with available health information and wearing of face masks. Conclusion: In the third month of the pandemic in the Philippines, 20% of the respondents with lupus and RA experienced moderate to severe psychological impact. There was moderate to severe anxiety in 38.7% and moderate to severe depression in 27%. Identification of factors that affect mental health in lupus and RA is useful in implementation of effective psychological support strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Measures and Outcomesmentioning

confidence: 99%

Section: Measures and Outcomesmentioning

confidence: 99%

Section: Measures and Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

<p>Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus</p>

Tee¹,

Salido²,

Reyes³

et al. 2020

OARRR

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“…The origin of fatigue in SLE is believed to be multifactorial and multidimensional. Identified factors associated with fatigue in SLE include stress (11,12), pain (7,12–15), poor sleep (13,16,17), depression (15,16,18–20), reduced levels of exercise (7,13), helplessness (7,13,20,21), abnormal illness behavior (7,13), and poor perceived social support (13,15). The association of fatigue with disease activity in SLE remains controversial, with some studies showing a positive correlation (7,16–18,22) and others with no significant association (4,13,15).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Study of Fatigue, Stress, and Depression: Role of Reduction in Stress Toward Improvement in Fatigue

Azizoddin

Jolly

Arora

et al. 2020

Arthritis Care & Research

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Objective Fatigue is common among individuals with systemic lupus erythematosus (SLE), but the causes are not well understood. Our objective was to examine perceived stress and depressive symptoms as predictors of fatigue in SLE. Methods Data from 2 years of the Lupus Outcomes Study (n = 650 patients), obtained through annual structured interviews, were used. Fatigue was measured with the Short Form 36 (SF‐36) vitality scale along with a variety of self‐report measures of disease, depression, and stress. Multivariate linear regression models examined predictors of changes in fatigue. Model 1 tested the association of time 1 (T1) depression with time 2 (T2) fatigue; model 2 added T1 perceived stress to model 1, and final models added T1‐to‐T2 decrease in stress. All analyses controlled for T1 fatigue, age, sex, self‐report of fibromyalgia, pain, and SLE duration, activity, and damage. Results Mean ± SD age was 51 ± 12 years, 92% of participants were women, and 68% were white. The mean ± SD SF‐36 fatigue score was 55 ± 24. T1 depression significantly predicted T2 fatigue. When T1 stress was added, stress (β = 1.7 [95% confidence interval (95% CI) 1.1, 2.2]; P < 0.0001) significantly predicted T2 fatigue, but depression was no longer significant. The addition of T1‐to‐T2 decrease in stress was associated with a clinically meaningful decline in fatigue (β = –11.8 [95% CI –15.6, –8.9]; P < 0.0001). Conclusion While depressive symptoms initially predicted subsequent fatigue, the effects were mediated by stress. A decrease in stress, in addition, was associated with a clinically meaningful decrease in fatigue. These results suggest that perceived stress plays an important role in SLE fatigue and may be an important focus of interventions for fatigue.

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Psychometric validation of the Arthritis Helplessness Index in systemic lupus erythematosus

Gholizadeh

Azizoddin

Mills

et al. 2018

Lupus

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Objective Helplessness is a relevant construct in systemic lupus erythematosus (SLE), an unpredictable chronic illness with no known cure characterized by relapsing and remitting features. However, no measure of helplessness has been validated in this population. The present study examined the structural validity, reliability, and convergent validity of the Arthritis Helplessness Index, a measure initially developed for rheumatoid arthritis populations, in a sample of patients with SLE. Methods Patients with SLE ( N = 136) receiving medical care at a private hospital completed the Arthritis Helplessness Index and other self-report measures. The structural validity of the Arthritis Helplessness Index was examined using confirmatory factor analysis. Internal consistency reliability was evaluated with Cronbach's coefficient alpha. Pearson product-moment correlations were used to examine convergent validity with measures of depression, anxiety and mastery. Results The five-item Arthritis Helplessness Index-Helplessness measure demonstrated a tenable factor structure (comparative fit index 0.98, root mean square error of approximation 0.06, standardized root mean residual 0.04). Internal consistency reliability was fair (α = 0.69). Convergent validity was evidenced by significant correlations with measures of depression, anxiety and mastery. Conclusion The five-item Arthritis Helplessness Index-Helplessness scale can confidently be used as a measure of helplessness in SLE.

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The mediational role of helplessness in psychological outcomes in systemic lupus erythematosus

Cited by 9 publications

References 17 publications

<p>Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus</p>

<p>Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus</p>

Longitudinal Study of Fatigue, Stress, and Depression: Role of Reduction in Stress Toward Improvement in Fatigue

Psychometric validation of the Arthritis Helplessness Index in systemic lupus erythematosus

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