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[Preprint]. 2023 Apr 7:rs.3.rs-2758092.
doi: 10.21203/rs.3.rs-2758092/v1.

Socioeconomic Status, Reserve Capacity, and Depressive Symptoms Predict Pain in Rheumatoid Arthritis: An Examination of the Reserve Capacity Model

Desiree Azizoddin  1 , Richard Olmstead  2 , Kris-Ann Anderson  1 , Alanna E Hirz  3 , Michael R Irwin  2 , Shadi Gholizadeh  4 , Michael Weisman  5 , Mariko Ishimori  5 , Daniel Wallace  5 , Perry Nicassio  5
Affiliations

Socioeconomic Status, Reserve Capacity, and Depressive Symptoms Predict Pain in Rheumatoid Arthritis: An Examination of the Reserve Capacity Model

Desiree Azizoddin et al. Res Sq. .

Update in

Abstract

Background: Guided by the reserve capacity model, we examined the roles of socioeconomic status (SES), reserve capacity, and negative emotions as determinants of pain in patients with Rheumatoid Arthritis (RA).

Methods: The study used cross-sectional baseline data from 106 adults in a clinical trial comparing behavioral treatments for RA. Structural equation modeling evaluated the direct effects of SES, reserve capacity (helplessness, self-efficacy, social support) and negative emotions (stress and depressive symptoms) on pain, and the indirect effects of SES as mediated by reserve capacity and negative emotions.

Results: Results showed that low SES contributed to greater pain, through lower reserve capacity and higher negative emotions. Mediational analyses showed that reserve capacity and negative emotions partially mediated the effect of SES on pain.

Conclusions: The findings indicate that interventions that target negative emotions in patients with low SES may facilitate better pain control with RA.

Trial registration: clinicaltrials.gov NCT00072657; 02/2004.

Keywords: Depressive symptoms; Pain; Psychosocial factors; Rheumatoid arthritis; Socioeconomic factors.

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Conflict of interest statement

Competing interests: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Hypothesized direct and indirect effects of SES, reserve capacity, and negative emotions on Rheumatoid Arthritis pain.
Figure 2
Figure 2
Final structural model with standardized path coefficients and factor loadings of SES, reserve capacity, and negative emotions on Rheumatoid Arthritis pain. Notes. †pathway set to 1.0. Dashes lines indicate paths dropped from model. AHI = Arthritis Helplessness Index. PMS = Personal Mastery Scale. SPS = Social Provisions Scale. HDRS = Hamilton Depression Rating Scale. PSS = Perceived Stress Scale. PANAS Negative = Negative Affect scale of the Positive and Negative Affect Schedule. RADAR Total Joint = Rapid Assessment of Disease Activity in Rheumatology total joint score. Pain VAS = Pain visual analog scale. *p<.05; **p<.01; ***p<.001.
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