title: Stress and Depression in Relation to Functional Health Behaviors in African American Patients with Systemic Lupus Erythematosus.
abstract: OBJECTIVE
  While increased psychological distress in SLE has been clinically and empirically reported, the relationship between emotional distress, treatment adherence, and disease activity are complex and even more unclear in African American lupus patients. In an effort to elucidate this phenomenon in these patients, this exploratory study aimed to investigate relationships between stress, depression, and various health behaviors in this group.
  
  
  METHODS
  Thirty patients invited to participate in this study were African American systemic lupus erythematosus (SLE) patients attending rheumatology clinics at the Medical University of South Carolina (MUSC). This study was part of a larger interventional pilot study, the Balancing Lupus Experiences with Stress Strategies (BLESS) study, that included a comprehensive battery of psychosocial, quality of life, and behavior change measures.
  
  
  RESULTS
  When looking at the association between anxiety/stress and functionality, levels of reported stress had strong effects upon functionality, especially between health distress and functionality. When looking at the association between depressive symptoms and functionality, depressive symptoms had moderate effects upon social/role limitations and nights spent in the hospital.
  
  
  CONCLUSIONS
  Not only did the larger pilot project demonstrate significant reductions in stress and depression as a result of workshop participation; this nested study also showed that those improvements were positively associated with improved health behaviors. These results could have implications for developing interventions to improve disease experience and quality of life in SLE patients with stress and depression.
authors.affiliation: Institute for Partnerships to Eliminate Health Disparities, University of South Carolina; Columbia, SC, USA.
authors.forename: Edith M
authors.initials: EM
authors.lastname: Williams
authors.affiliation: Office of Public Health Practice, University of South Carolina; Columbia, SC, USA.
authors.forename: Larisa
authors.initials: L
authors.lastname: Bruner
authors.affiliation: Institutional Assessment and Compliance, University of South Carolina; Columbia, SC, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Penfield
authors.affiliation: Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina; Charleston, SC, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Kamen
authors.affiliation: Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina; Charleston, SC, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Oates
keywords: Coping; Depression; Health behaviors; Psychological distress; Stress; Systemic lupus erythematosus