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Pain, social support and depressive symptoms in patients with rheumatoid arthritis: testing the stress-buffering hypothesis

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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.

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Acknowledgements

The authors would like to thank Norman Bartsch and Simone Hertig for their valuable help in patient recruitment and data extraction as well as all patients who participated in the study.

Funding

There was no funding obtained for this study.

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Authors and Affiliations

  1. Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany

    Susanne Brandstetter, Gertraud Riedelbeck, Mark Steinmann, Julika Loss & Christian Apfelbacher

  2. Department of Rheumatology and Clinical Immunology, Asklepios Medical Center Bad Abbach, Bad Abbach, Germany

    Boris Ehrenstein

Authors
  1. Susanne Brandstetter
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  2. Gertraud Riedelbeck
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  3. Mark Steinmann
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  4. Boris Ehrenstein
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  5. Julika Loss
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  6. Christian Apfelbacher
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Corresponding author

Correspondence to Susanne Brandstetter.

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The authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Brandstetter, S., Riedelbeck, G., Steinmann, M. et al. Pain, social support and depressive symptoms in patients with rheumatoid arthritis: testing the stress-buffering hypothesis. Rheumatol Int 37, 931–936 (2017). https://doi.org/10.1007/s00296-017-3651-3

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  • DOI: https://doi.org/10.1007/s00296-017-3651-3

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