title: The health education for lupus study:  a randomized controlled cognitive-behavioral intervention targeting psychosocial adjustment and quality of life in adolescent females with systemic lupus erythematosus.
abstract: BACKGROUND
  To examine in a randomize controlled feasibility clinical trial the efficacy of a cognitive-behavioral intervention designed to manage pain, enhance disease adjustment and adaptation and improve quality of life among female adolescents with systemic lupus erythematosus.
  
  
  METHODS
  Female adolescents (n = 53) ranging in age from 12 to 18 years were randomly assigned to 1 of 3 groups including a cognitive-behavioral intervention, an education-only arm and a no-contact control group. Participants were assessed at baseline, postintervention and at 3- and 6-month intervals after completion of the intervention.
  
  
  RESULTS
  No significant differences were revealed among the 3 treatment arms for any of the dependent measures at any of the assessment points. For the mediator variables, a posthoc secondary analysis did reveal increases in coping skills from baseline to postintervention among the participants in the cognitive-behavioral intervention group compared with both the no-contact control group and the education-only group.
  
  
  CONCLUSIONS
  Although no differences were detected in the primary outcome, a possible effect on coping of female adolescents with systemic lupus erythematosus was detected in this feasibility study. Whether the impact of training in the area of coping was of sufficient magnitude to generalize to other areas of functioning, such as adjustment and adaptation, is unclear. Future phase III randomized trials will be needed to assess additional coping models and to evaluate the dose of training and its influence on pain management, adjustment and health-related quality of life.
authors.affiliation: Department of Psychology, Wayne State University, Detroit, MI 48202, USA. rtbrown@wayne.edu
authors.forename: Ronald T
authors.initials: RT
authors.lastname: Brown
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Shaftman
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Tilley
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Anthony
authors.forename: Mary C
authors.initials: MC
authors.lastname: Kral
authors.forename: Bonnie
authors.initials: B
authors.lastname: Maxson
authors.forename: Laura
authors.initials: L
authors.lastname: Mee
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Bonner
authors.forename: Larry B
authors.initials: LB
authors.lastname: Vogler
authors.forename: Laura E
authors.initials: LE
authors.lastname: Schanberg
authors.forename: Mark A
authors.initials: MA
authors.lastname: Connelly
authors.forename: Janelle L
authors.initials: JL
authors.lastname: Wagner
authors.forename: Richard M
authors.initials: RM
authors.lastname: Silver
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Nietert
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000523:psychology / Q000628:therapy*; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D011788:Quality of Life; D012917:Social Adjustment; D016896:Treatment Outcome