Resilience may curb negative effects of feeling socially isolated: Study

Scleroderma patients who feel socially isolated report more life dissatisfaction by Andrea Lobo, PhD | April 2, 2024

People with scleroderma who feel more socially isolated are more likely to report being dissatisfied with life, but this association is partially attenuated in those who show more resilience, according to a recent study.

Resilience refers to the ability to adapt to and recover from challenging life experiences, such as living with a chronic disease.

These findings suggest that more adaptive coping may help protect against the negative effects of perceived social isolation, and “support the promotion of social connection and resilience to enhance life satisfaction in people with [scleroderma],” researchers wrote.

The study, “Resilience partially mediates the association between perceived social isolation and life satisfaction in people with systemic sclerosis,” was published in the Journal of Scleroderma and Related Disorders.

Scleroderma, or systemic sclerosis (SSc), is an autoimmune disease characterized by the accumulation of scar tissue in the skin and potentially several internal organs, including the heart, kidney, lungs, and gastrointestinal tract.

Scleroderma-related changes may lead to mental health issues
​SSc-related physical changes and limitations, and the uncertainties about disease progression may lead to mental health issues, such as anxiety and depression, and feelings of social isolation. Therefore, assessing a patient’s well-being is an important part of disease management.

In studies of other chronic disorders, resilience was found to help patients address daily life stressors and functional limitations, and improve their social functioning.

However, “examination of life satisfaction in the SSc population remains limited … [and] no known study has investigated the mediating role of resilience in the relationship between perceived social isolation and life satisfaction in people with SSc,” the researchers wrote.

To know more, researchers in the U.S. analyzed baseline (at the beginning of a study) data from the RENEW clinical trial (NCT04908943), in which patients were randomly assigned to a 12-week online intervention to help them manage energy and symptoms, or to no intervention. RENEW stands for Resilience-building Energy management to Enhance Well-being.
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The study included 163 participants, who were mainly women (93.9%), white (85.3%), married (66.7%), and with a college or higher degree (59%). Nearly half of the patients had diffuse cutaneous SSc, and 57% were within five years of their SSc diagnosis.

Half of patients report being dissatisfied with their lives
​Their mean life satisfaction, assessed using the Satisfaction with Life Scale, indicated a mean score of 19.4, with about half of the patients dissatisfied with their lives. The test measures the patient’s agreement with five sentences, such as “My life is mostly in line with my ideal” and “The conditions of my life are excellent.” The individual items are then combined for a total score that varies from 5 (extremely dissatisfied) to 35 (extremely satisfied).

Resilience was assessed using a self-reported questionnaire designed to evaluate adaptability, self-efficacy (related to self-confidence and one’s belief in their capacity to do tasks and succeed), emotional regulation, optimism, and ability to maintain focus under stress. The mean score was 26.1 (scale maximum was 40, with higher scores representing more resilience).

Results also showed moderate to severe loneliness in 15% of the patients, with a perceived social isolation score of 52. On this scale, scores higher than 60 reflected greater social isolation, and scores up to 60 reflected less social isolation.

Perceived social isolation was negatively correlated with life satisfaction, meaning that participants who perceived being more social isolated reported poorer life satisfaction. Also, patients who reported being more resilient were also more satisfied with life and felt less socially isolated.

‘Resilience may act as a protective mediator’“
Results suggest resilience may act as a protective mediator, counteracting the negative influence of perceived social isolation on life satisfaction,” the researchers wrote.

Moreover, having a college degree or higher, being married, having less pain and fatigue, and having fewer depressive symptoms, were all associated with higher satisfaction with life. No statistically significant differences in life satisfaction were found comparing SSc subtypes.

“These findings advocate for a holistic approach to the care and support of individuals with SSc, emphasizing the importance of addressing both perceived social isolation and resilience to improve overall well-being,” the researchers concluded.
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“To ensure the generalizability of findings to the broader SSc population, future studies should include a more diverse sample, including more male and racial and ethnic minority participants,” they noted.