Background/Purpose: Psychological resilience – an individuals capacity to adapt in the face of stressors and recover after adverse events – has been linked to a number of outcome measures impacting patient functioning and well-being among populations living with chronic illness. To date, no research has been conducted into the resilience of children and adolescents with JIA. This study aims to define the level of resilience observed among JIA patients to better characterize this psychological feature in the population using a validated psychometric tool.

Methods: Participants between the ages of 10 and 17 with an established diagnosis of JIA were recruited from an outpatient pediatric rheumatology clinic to complete a series of questionnaires including the Connor-Davidson Resilience Scale (CD-RISC-25) and the Pain and Symptom Assessment Tool (PSAT). Participants parents were additionally requested to complete their own CD-RISC-25 and provide information regarding recent participant educational achievement and psychiatric health history. Study staff conducted chart review to confirm participants JIA subtype, duration of disease since diagnosis, treatment status, and physical exam findings on the date of study participation. The Pearson correlation coefficient was calculated to detect relationships between CD-RISC-25 scores and other parametric measures collected. Welchs t-test was applied for comparison of CD-RISC-25 scores between subgroups of participants.

Results: Among 52 participants enrolled in the study, CD-RISC-25 scores ranged from 39 to 100 (out of 100 possible points) with a mean of 75.42. Scores on the PSAT consistent with a diagnosis of juvenile FM were present in 13% of the population surveyed, but there was no statistically significant difference between CD-RISC-25 scores among participants with and without evidence of FM (t = -1.85, p-value = 0.11). CD-RISC-25 scores also did not differ to a statistically significant degree between participants with and without a history of depression or anxiety (t = -0.26, p-value = 0.80). There was no statistically significant correlation detected between CD-RISC-25 score and age at time of JIA diagnosis (r = 0.75, p-value = 0.46), time since JIA diagnosis (r = -0.48, p-value = 0.63), or parental CD-RISC-25 score (r = 0.46, p-value = 0.65).

Conclusion: A convenience sample from a single ambulatory care clinic demonstrated a broad range of psychological resilience levels among JIA patients. No relationships were identified between resilience and duration of disease, age at diagnosis, parental resilience, or a reported history of anxiety or depression. The trend identified in the comparison of resilience among JIA patients with and without clinical features of juvenile FM is compelling and suggests that this preliminary study was not sufficiently powered to capture such a relationship given the relatively low rate of participants reporting features of FM within the data collected. Further study is warranted to determine whether resilience among JIA patients relates to the presence of comorbid juvenile FM or to functional outcomes observed in that patient population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/preliminary-results-from-a-survey-of-psychological-resilience-among-jia-patients/