title: Self-efficacy and pain catastrophizing in systemic lupus erythematosus: relationship to pain, stiffness, fatigue, and psychological distress.
abstract: OBJECTIVE
  To determine how self-efficacy for pain control and pain catastrophizing, both potentially modifiable pain coping cognitions, are related to pain, stiffness, fatigue, and psychological distress in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  We conducted a cross-sectional study of patients with SLE who completed measures of pain coping cognitions (i.e., self-efficacy for pain control, pain catastrophizing), symptom ratings (i.e., pain, stiffness, fatigue), and psychological distress.
  
  
  RESULTS
  Correlational analyses revealed that self-efficacy for pain control and pain catastrophizing were associated with the patients' physical symptom reports and psychological distress. After controlling for age, race, and disease activity, patients with lower levels of self-efficacy for pain control reported much higher levels of pain, stiffness, and fatigue. Patients with higher levels of pain catastrophizing reported much lower positive mood. SLE activity as assessed by the rheumatologist was not associated with physical symptoms, psychological distress, self-efficacy for pain control, or pain catastrophizing.
  
  
  CONCLUSIONS
  These results suggest that pain coping cognitions (i.e., either self-efficacy for pain control or pain catastrophizing) are significantly related to physical symptoms and psychological distress in patients with SLE. This finding is important because the results of studies from other samples of patients with persistent pain conditions have shown that these pain coping variables can be modified using psychological interventions, and that such treatment-related changes in pain cognitions are related to improved patient outcomes.
authors.affiliation: Duke University Medical Center, Durham, North Carolina, USA. tamara.somers@duke.edu
authors.forename: Tamara J
authors.initials: TJ
authors.lastname: Somers
authors.forename: Preethi C
authors.initials: PC
authors.lastname: Kurakula
authors.forename: Lisa
authors.initials: L
authors.lastname: Criscione-Schreiber
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Megan E B
authors.initials: ME
authors.lastname: Clowse
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D058443:Catastrophization; D003071:Cognition; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000503:physiopathology*; D009657:North Carolina; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D020377:Self Efficacy; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology