Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history
Objective Trauma history is associated with SLE onset and worse patient-reported outcomes; perceived stress is associated with greater SLE disease activity. Stress perceptions vary in response to life events and may be influenced by psychosocial factors. In an SLE cohort, we examined whether stressf...
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BMJ Publishing Group
2024-05-01
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| Series: | Lupus Science and Medicine |
| Online Access: | https://lupus.bmj.com/content/11/1/e001060.full |
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| author | Lindsey A Criswell Patricia P Katz Jinoos Yazdany Maria Dall'Era Caroline Gordon Stephanie Rush Laura Trupin Cristina Lanata Kamil E Barbour Sarah Patterson Kimberly Dequattro Kurt J Greenlund |
| author_facet | Lindsey A Criswell Patricia P Katz Jinoos Yazdany Maria Dall'Era Caroline Gordon Stephanie Rush Laura Trupin Cristina Lanata Kamil E Barbour Sarah Patterson Kimberly Dequattro Kurt J Greenlund |
| author_sort | Lindsey A Criswell |
| collection | DOAJ |
| description | Objective Trauma history is associated with SLE onset and worse patient-reported outcomes; perceived stress is associated with greater SLE disease activity. Stress perceptions vary in response to life events and may be influenced by psychosocial factors. In an SLE cohort, we examined whether stressful events associated with perceived stress, whether psychosocial factors affected perceived stress, and whether these relationships varied by prior trauma exposure.Methods This is a cross-sectional analysis of data from the California Lupus Epidemiology Study, an adult SLE cohort. Multivariable linear regression analyses controlling for age, gender, educational attainment, income, SLE damage, comorbid conditions, glucocorticoids ≥7.5 mg/day and depression examined associations of recent stressful events (Life Events Inventory) and positive (resilience, self-efficacy, emotional support) and negative (social isolation) psychosocial factors with perceived stress. Analyses were stratified by lifetime trauma history (Brief Trauma Questionnaire (BTQ)) and by adverse childhood experiences (ACEs) in a subset.Results Among 242 individuals with SLE, a greater number of recent stressful events was associated with greater perceived stress (beta (95% CI)=0.20 (0.07 to 0.33), p=0.003). Positive psychosocial factor score representing resilience, self-efficacy and emotional support was associated with lower perceived stress when accounting for number of stressful events (−0.67 (−0.94 to –0.40), p<0.0001); social isolation was associated with higher stress (0.20 (0.14 to 0.25), p<0.0001). In analyses stratified by BTQ trauma and ACEs, associations of psychosocial factors and perceived stress were similar between groups. However, the number of recent stressful events was significantly associated with perceived stress only for people with BTQ trauma (0.17 (0.05 to 0.29), p=0.0077) and ACEs (0.37 (0.15 to 0.58), p=0.0011).Conclusion Enhancing positive and lessening negative psychosocial factors may mitigate deleterious perceived stress, which may improve outcomes in SLE, even among individuals with a history of prior trauma who may be more vulnerable to recent stressful events. |
| format | Article |
| id | doaj-art-1a0bdcf4c7a44e81bd12d9aa190d527a |
| institution | OA Journals |
| issn | 2053-8790 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | BMJ Publishing Group |
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| series | Lupus Science and Medicine |
| spelling | doaj-art-1a0bdcf4c7a44e81bd12d9aa190d527a2025-08-20T02:13:31ZengBMJ Publishing GroupLupus Science and Medicine2053-87902024-05-0111110.1136/lupus-2023-001060Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma historyLindsey A Criswell0Patricia P Katz1Jinoos Yazdany2Maria Dall'Era3Caroline Gordon4Stephanie Rush5Laura Trupin6Cristina Lanata7Kamil E Barbour8Sarah Patterson9Kimberly Dequattro10Kurt J Greenlund11National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USAUniversity of California San Francisco, San Francisco, California, USADivision of Rheumatology, University of California San Francisco School of Medicine, San Francisco, California, USAUniversity of California San Francisco, San Francisco, California, USARheumatology Research Group, University of Birmingham, Birmingham, UKUniversity of California San Francisco, San Francisco, California, USAUniversity of California San Francisco, San Francisco, California, USANational Institutes of Health, Bethesda, Maryland, USADivision of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USAUniversity of California San Francisco, San Francisco, California, USAUniversity of Pennsylvania, Philadelphia, Pennsylvania, USADivision of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USAObjective Trauma history is associated with SLE onset and worse patient-reported outcomes; perceived stress is associated with greater SLE disease activity. Stress perceptions vary in response to life events and may be influenced by psychosocial factors. In an SLE cohort, we examined whether stressful events associated with perceived stress, whether psychosocial factors affected perceived stress, and whether these relationships varied by prior trauma exposure.Methods This is a cross-sectional analysis of data from the California Lupus Epidemiology Study, an adult SLE cohort. Multivariable linear regression analyses controlling for age, gender, educational attainment, income, SLE damage, comorbid conditions, glucocorticoids ≥7.5 mg/day and depression examined associations of recent stressful events (Life Events Inventory) and positive (resilience, self-efficacy, emotional support) and negative (social isolation) psychosocial factors with perceived stress. Analyses were stratified by lifetime trauma history (Brief Trauma Questionnaire (BTQ)) and by adverse childhood experiences (ACEs) in a subset.Results Among 242 individuals with SLE, a greater number of recent stressful events was associated with greater perceived stress (beta (95% CI)=0.20 (0.07 to 0.33), p=0.003). Positive psychosocial factor score representing resilience, self-efficacy and emotional support was associated with lower perceived stress when accounting for number of stressful events (−0.67 (−0.94 to –0.40), p<0.0001); social isolation was associated with higher stress (0.20 (0.14 to 0.25), p<0.0001). In analyses stratified by BTQ trauma and ACEs, associations of psychosocial factors and perceived stress were similar between groups. However, the number of recent stressful events was significantly associated with perceived stress only for people with BTQ trauma (0.17 (0.05 to 0.29), p=0.0077) and ACEs (0.37 (0.15 to 0.58), p=0.0011).Conclusion Enhancing positive and lessening negative psychosocial factors may mitigate deleterious perceived stress, which may improve outcomes in SLE, even among individuals with a history of prior trauma who may be more vulnerable to recent stressful events.https://lupus.bmj.com/content/11/1/e001060.full |
| spellingShingle | Lindsey A Criswell Patricia P Katz Jinoos Yazdany Maria Dall'Era Caroline Gordon Stephanie Rush Laura Trupin Cristina Lanata Kamil E Barbour Sarah Patterson Kimberly Dequattro Kurt J Greenlund Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history Lupus Science and Medicine |
| title | Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history |
| title_full | Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history |
| title_fullStr | Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history |
| title_full_unstemmed | Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history |
| title_short | Positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history |
| title_sort | positive psychosocial factors may protect against perceived stress in people with systemic lupus erythematosus with and without trauma history |
| url | https://lupus.bmj.com/content/11/1/e001060.full |
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