title: Psychological vulnerability predicts increases in depressive symptoms in individuals with rheumatoid arthritis.
abstract: BACKGROUND
  Efficient measures are needed to identify individuals at risk for depression to optimize intervention efforts that can enhance health-related outcomes.
  
  
  OBJECTIVE
  The purpose of this study was to examine the effectiveness of the six-item Psychological Vulnerability Scale (PVS) as a predictor of depressive symptoms and change in depressive symptoms while controlling for two established predictors of depression-arthritis helplessness (AHI) and functional impairment (FI).
  
  
  METHODS
  Data from 125 patients with rheumatoid arthritis (73% women) were used in hierarchical regression analyses to examine whether the PVS could be used to predict unique variance in depressive symptoms (Center for Epidemiological Studies-Depression [CES-D]) cross sectionally (N = 125) and change in depressive symptoms (N = 93).
  
  
  RESULTS
  The three-predictor cross-sectional model was highly significant, F(3, 121) = 25.6; p < .001, explaining 39% of the variance in CES-D scores assessed at the same point in time. Controlling for both AHI and FI, the PVS explained an additional 9.3% of the variance in CES-D scores. To examine changes in CES-D scores over a 1-year period, CES-D scores at the later time were regressed on CES-D scores from a year earlier. On the next two steps, AHI, FI, and PVS scores assessed a year earlier were entered into the model. The full model predicted 56% of the variance in depressive symptoms, F(4, 88) = 27.7, p < .001, with the PVS accounting for a unique 5.6% of the variance in change in CES-D scores.
  
  
  CONCLUSIONS
  Because of its brevity, the PVS can be an efficient screening tool for individuals at risk for depression. More research is needed to substantiate the value of the PVS for identifying individuals who could benefit from interventions designed to prevent depression.
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN 37240, USA. vaughn.sinclair@vanderbilt.edu
authors.forename: Vaughn G
authors.initials: VG
authors.lastname: Sinclair
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations