Lupus-Related Damage, Social Support, and Depression: An Exploratory Study Open Access

Abstract

African American women are disproportionately diagnosed with Systemic Lupus Erythematosus (SLE); however, very few studies focus specifically on this population. The purpose of this study is to understand the relationship between lupus-related organ damage and depression in African American women and to understand how emotional support influences this relationship. For this mixed-methods study, 437 participants from Year 3 of the Georgians Organized Against Lupus (GOAL) cohort study were analyzed using correlations, linear regressions, and ANOVAs. Qualitative interviews were also conducted with 15 GOAL participants to further explore the role of emotional support for lupus patients. The results of this study demonstrated that there is a significant, positive association between lupus-related organ damage and depression (r=0.163, p=0.001). Furthermore, the results demonstrated that emotional support does not serve as a mediating or moderating variable but depression is significantly associated with level of emotional support (F=17.574, p<0.001). Also, the relationship between lupus-related organ damage and depression gets weaker with more support, except in those who always receive the support they need. The results of the qualitative interviews identified some emotional challenges of lupus being relying on other people, not being able to do "normal things", and changes in abilities since pre-lupus diagnosis. Participants also mentioned their family and friends' understanding of lupus being an important factor in their level of support and also how having lupus affects their level of emotional support. The results of the qualitative interviews help to understand the results of the quantitative survey data. Those with the most serious health problems have the greatest visible need for support and assistance and may receive more support as a result. However, their need may be so great that it is not possible for them to always receive the support they need or, perhaps, those who always receive the support they need are protected from high levels of damage. Overall, these findings highlight the importance of monitoring depressive symptoms in lupus patients and developing interventions aiming to increase emotional support available to lupus patients.

Table of Contents

Introduction. 1

Literature Review. 5

Methods. 17

Results. 21

Discussion. 35

References. 42

Appendix A: Interview Guide. 49

Appendix B: Codebook. 51

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Systemic Lupus Erythematosus Depression Emotional Support
Committee Chair / Thesis Advisor	Thompson, Nancy J, Emory University
Committee Members	Drenkard, Cristina M, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs Hospital or other health care provider

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