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Moderating role of self-efficacy on the associations of social support with depressive and anxiety symptoms in Chinese patients with rheumatoid arthritis

Authors Liu L, Xu N, Wang L

Received 16 March 2017

Accepted for publication 14 July 2017

Published 9 August 2017 Volume 2017:13 Pages 2141—2150

DOI https://doi.org/10.2147/NDT.S137233

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 3

Editor who approved publication: Professor Wai Kwong Tang


Li Liu,1 Neili Xu,2 Lie Wang1

1Department of Social Medicine, School of Public Health, China Medical University, 2Department of Rheumatology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China

Purpose: Rheumatoid arthritis (RA) is significantly associated with depression and anxiety. Social support and self-efficacy are the coping resources of psychological distress. However, little research is available on the interaction of social support and self-efficacy in RA patients. This study aimed to identify the prevalence of depressive and anxiety symptoms and to examine whether or not self-efficacy moderates the associations of social support with depressive and anxiety symptoms in Chinese RA patients.
Methods: A multicenter, cross-sectional study was conducted in northeast of China from December 2014 to January 2016. A total of 297 RA patients completed the Center for ­Epidemiologic Studies Depression Scale, Zung Self-Rating Anxiety Scale, Multidimensional Scale of Perceived Social Support and General Self-Efficacy Scale. The associations of social support, self-efficacy and social support × self-efficacy interaction with depressive and anxiety symptoms were examined by hierarchical regression analysis. If the interaction was statistically significant, simple slope analysis was conducted.
Results: The prevalence of depressive symptoms was 58.2%, while 47.5% RA patients had anxiety symptoms. Social support and social support × self-efficacy interaction were significantly associated with depressive symptoms. Social support, self-efficacy and their interaction were significantly associated with anxiety symptoms. The association between social support and depressive symptoms was gradually reduced in the low (1 standard deviation [SD] below the mean, B=–0.614, β=–0.876, P<0.001), mean (B=–0.395, β=–0.563, P<0.001) and high (1 SD above the mean, B=–0.176, β=–0.251, P=0.002) groups of self-efficacy. For anxiety symptoms, the association was also gradually reduced in the low (B=–0.527, β=–0.774, P<0.001), mean (B=–0.288, β=–423, P<0.001) and high (B=–0.049, β=–0.071, P=0.447) groups of self-efficacy.
Conclusion: There was a high prevalence of depressive and anxiety symptoms in Chinese RA patients. Self-efficacy could attenuate the associations of social support with depressive and anxiety symptoms. Adequate social support and self-efficacy intervention should be provided to alleviate psychological distress.

Keywords: self-efficacy, social support, psychological distress, moderating role, rheumatoid arthritis

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