title: Pain, social support and depressive symptoms in patients with rheumatoid arthritis: testing the stress-buffering hypothesis.
abstract: This study investigated as to how social support influences health among people with rheumatoid arthritis (RA). We refer to the stress-buffering hypothesis of social support which suggests that the negative consequences of stressors on health outcomes can be buffered by social support. In this study, pain represents a stressor and depressive symptoms represent negative health outcomes. It was hypothesized that higher levels of social support should attenuate the association between pain and depression in RA. A cross-sectional study was conducted in 361 patients with RA. They completed questionnaires on social support, depression and perceived pain. Linear regression analysis was applied, with pain as the main explanatory variable, depression as a dependent variable, and an interaction term "social support × pain". Both pain and social support showed significant associations with depression, with more severe pain and lower social support going along with a higher depression score. However, the interaction term "social support × pain" was not significant, indicating that social support did not attenuate the association between pain and depression. Social support was inversely associated with the experience of depressive symptoms among people suffering from RA. However, it had no buffering effect in attenuating the postulated association between the stressor "pain" and the negative health outcomes assessed as depressive symptoms. The stress-buffering hypothesis of social support was not supported by data from this study among people suffering from RA.
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany. susanne.brandstetter@klinik.uni-regensburg.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Brandstetter
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.
authors.forename: Gertraud
authors.initials: G
authors.lastname: Riedelbeck
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Steinmann
authors.affiliation: Department of Rheumatology and Clinical Immunology, Asklepios Medical Center Bad Abbach, Bad Abbach, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Ehrenstein
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.
authors.forename: Julika
authors.initials: J
authors.lastname: Loss
authors.affiliation: Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Apfelbacher
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D008960:Models, Psychological; D058748:Pain Perception; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Depression; Rheumatoid arthritis; Social support; Stress-buffering hypothesis