Data Extravaganza Presentation - 7 minutes International Positive Psychology Association 7th IPPA World Congress 2021

Psychopathology, sleep quality, and disability in rheumatic and musculoskeletal disease: Positive psychological traits as protective factors (#82)

Heather Altier, M.A. 1 , Jameson Hirsch, Ph.D. 1 , Martin Offenbächer, M.D., M.P.H. 2 , Loren Toussaint, Ph.D. 3 , Niko Kohls, Ph.D. 4 , Fuschia Sirois, Ph.D. 5
  1. East Tennessee State University, Johnson City, TN, United States
  2. Gastein Healing Gallery, Bad Gastein-Böckstein, Austria
  3. Department of Psychology, Luther College, Decorah, IA, USA
  4. Division of Integrative Health Promotion, Coburg University of Applied Science, Coburg, Germany
  5. Department of Psychology, University of Sheffield, Sheffield, UK

Background

Stress, anxiety, and depression are prevalent among persons with rheumatic and musculoskeletal diseases (RMD), including ankylosing spondylitis, osteoarthritis, and fibromyalgia1, and impair sleep quality2. Yet, to the extent that persons with RMD foster gratitude (i.e., appreciating positive circumstances), self-compassion (i.e., self-kindness, mindfulness, and common humanity), and self-forgiveness (i.e., self-reconciliation upon admitting wrongdoing), functional impairment may be lessened via improvements in psychopathology3 and sleep4 (e.g., reduced rumination and pain catastrophizing).5,6

Hypotheses/Research Questions

We hypothesized that greater gratitude, self-compassion, and self-forgiveness would be independently related to less stress, anxiety, and depression, in parallel, and, in turn, to better sleep quality and functionality.

Sample Characteristics and Sample Size

Our sample (n=1,218) of patients with RMD, including diagnoses of ankylosing spondylitis (37%; n=434), osteoarthritis (34%; n=404), fibromyalgia (24%; n=278), and rheumatoid arthritis (14%; n=159), were primarily female (52%; n=632) and middle-aged (M=58 years; SD=11). Approximately 55% (n=673) had comorbid conditions.

Design

Participants were recruited in-person from an Austrian health facility and completed self-report measures. Bivariate correlations and serial multiple mediation regressions were conducted in R, covarying age and sex.

Results

All variables were related in expected directions (p<.01) in bivariate analyses. In multivariate analyses, positive psychological traits were related to lower stress, anxiety, and depression and, in turn, to better sleep and less impairment (gratitude: a1234d123b1234=-.012[-.015, -.008], t=-6.691; self-compassion: a1234d123b1234=-.182[-.215, -.152], t=-11.322; self-forgiveness: a1234d123b1234=-.090[-.109, -.072], t=-9.627). Each positive psychological trait explained approximately 25% of the total variance in impairment. 

Scientific Contribution

Supporting hypotheses, gratitude, self-compassion, and self-forgiveness were associated with improved functionality, and psychopathology and sleep quality were mediators; that is, self-soothing positive psychological characteristics are related to improvements in both psychological and physiological health among RMD patients. Therapeutically promoting positive psychological traits (e.g., mindfulness; gratitude diaries)7,8 and reducing psychopathology and sleep problems (e.g., cognitive behavioral therapy)9,10 may improve functionality in this population.

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  • Keywords: Health and Medicine, Positive emotions