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. 2021 Jan;73(1):55-64.
doi: 10.1002/acr.24440. Epub 2020 Dec 4.

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

Jameson K Hirsch  1 , Heather R Altier  1 , Martin Offenbächer  2 , Loren Toussaint  3 , Niko Kohls  4 , Fuschia M Sirois  5
Affiliations

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

Jameson K Hirsch et al. Arthritis Care Res (Hoboken). 2021 Jan.

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 self-forgiveness may improve mental and physical health in patients with rheumatic and musculoskeletal disease.

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References

    1. MacfarlaneGJ, KronischC, DeanLE, AtzeniF, HäuserW, FlußE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis2017;76:318-28.
    1. KhallafMK, AlSerganyMA, El-SaadanyHM, Abo El-HawaMA, AhmedRA. Assessment of fatigue and functional impairment in patients with rheumatic diseases. Egypt Rheumatol2020;42:51-6.
    1. MarchiL, MarzettiF, OrrùG, LemmettiS, MiccoliM, CiacchiniR, et al. Alexithymia and psychological distress in patients with fibromyalgia and rheumatic disease. Front Psychol2019;10:1735.
    1. HwangMC, LeeMJ, GenslerLS, WardMM, BrownMA, EisenS, et al. Longitudinal associations between depressive symptoms and clinical factors in ankylosing spondylitis patients: analysis from an observational cohort. Rheumatol Int2020;40:1053-61.
    1. Galvez-SánchezCM, MontoroCI, DuschekS, delPasoGA. Pain catastrophizing mediates the negative influence of pain and trait-anxiety on health-related quality of life in fibromyalgia. Qual Life Res2020;29:1871-81.

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