title: The relationship of daily mood and stressful events to symptoms in juvenile rheumatic disease.
abstract: OBJECTIVE
  The purpose of this study was 3-fold: 1) to assess the feasibility of a daily diary for use with children with juvenile rheumatic disease (JRD), 2) to describe daily variation in mood, stressful events, and symptoms in children with JRD, and 3) to examine the extent to which daily mood and daily stressful events predict daily symptoms in children with JRD.
  
  
  METHODS
  Twelve children with JRD completed a daily booklet for 7 days. The daily booklet included measures of daily mood, daily stressful events, daily symptoms, and daily function. The children also completed a visual analog scale for pain and the Children's Depression Inventory.
  
  
  RESULTS
  Subjects showed good compliance with scheduled completion and return of the daily diaries. Results indicated that children with JRD showed variability in daily mood, frequency of daily stressful events, and daily symptoms across days. Multilevel fixed effects models showed that more negative daily mood and more daily stressful events significantly predicted increased reports of fatigue, stiffness, and cutting back on daily activities. Negative daily mood also correlated with increases in daily reported pain.
  
  
  CONCLUSIONS
  These results indicate that daily diary research is both feasible and potentially informative in children with JRD. Our data emphasize the need for further investigation into the role of daily mood and daily stressful events on disease course in JRD.
authors.affiliation: Department of Pediatrics, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Schanberg
authors.forename: M J
authors.initials: MJ
authors.lastname: Sandstrom
authors.forename: K
authors.initials: K
authors.lastname: Starr
authors.forename: K M
authors.initials: KM
authors.lastname: Gil
authors.forename: J C
authors.initials: JC
authors.lastname: Lefebvre
authors.forename: F J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: G
authors.initials: G
authors.lastname: Affleck
authors.forename: H
authors.initials: H
authors.lastname: Tennen
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000339:Affect; D001171:Arthritis, Juvenile / Q000523:psychology*; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008499:Medical Records / Q000592:standards*; D013315:Stress, Psychological / Q000523:psychology*