Psychometric Validation of the Arthritis Helplessness Index in Systemic Lupus Erythematosus

Shadi Gholizadeh¹, Desiree R Azizoddin², Sarah D. Mills³, Geraldine Zamora Racaza⁴, Hi'Ilani Mary Kala'aukahi Potemra⁵, Daniel J. Wallace⁶, Michael Weisman⁷ and Perry M. Nicassio⁸, ¹SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, ²Department of Anesthesiology, Stanford University School of Medicine, Palo Alto, CA, ³Medicine, Lineberger Comprehensive Cancer Center University of North Carolina, Durham, NC, ⁴Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, ⁵University of California, Los Angeles, Los Angeles, CA, ⁶Geffen School of Medicine at UCLA, West Hollywood, CA, ⁷Harbor UCLA Medical Center, Los Angeles, CA, ⁸Cousins Center for PNI, UCLA, LA, CA

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: depression, patient outcomes and psychological status, SLE

Session Information

Date: Sunday, October 21, 2018

Session Title: Measures and Measurements of Healthcare Quality Poster – ARHP

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Helplessness is a relevant construct in systemic lupus erythematosus (SLE), an unpredictable chronic illness with no known cure characterized by relapsing and remitting features. However, no measure of helplessness has been validated in this population. The Arthritis Helplessness Index (AHI) is a 15-item self-report measure developed to assess perceptions of helplessness in coping with rheumatoid arthritis (RA). Since its development, the measure has been widely used across rheumatologic contexts and adapted into several variants. A single-factor total score, a bi-factor 7-item Internality and 5-item Helplessness version, and a 5-item Helplessness short-form have been proposed in the literature for RA patients. One potential challenge with using the AHI has been that multiple variants of the measure exist. Moreover, lack of a formal evaluation of the psychometric properties of the measure in SLE had precluded identification of the optimal form of the measure for this patient population. The present study examined the structural validity, reliability, and convergent validity of the Arthritis Helplessness Index in a sample of patients with SLE.

Methods: Patients with SLE (N = 136) receiving medical care at a private hospital completed the AHI and other self-report measures. The structural validity of the AHI was examined using confirmatory factor analysis. Internal consistency reliability was evaluated with Cronbach’s coefficient alpha. Pearson product-moment correlations were used to examine convergent validity with measures of depression, anxiety, and mastery.

Results: The five-item AHI-Helplessness measure demonstrated a tenable factor structure (CFI = 0.98, RMSEA = 0.06, SRMR = 0.04). Internal consistency reliability was fair (a = 0.69). Convergent validity was evidenced via significant correlations with measures of depression, anxiety, and mastery.

Conclusion: The results of the present study suggest that the 5-item AHI-Helplessness scale is a reliable and valid one-factor measure of helplessness for patients with SLE. Moreover, the results suggest that the 15-item AHI total score and 7-item AHI-Internality subscale should not be used in patients with SLE given the lack of structural validity.

Disclosure: S. Gholizadeh, None; D. R. Azizoddin, None; S. D. Mills, None; G. Z. Racaza, None; H. M. Kala'aukahi Potemra, None; D. J. Wallace, None; M. Weisman, None; P. M. Nicassio, None.

To cite this abstract in AMA style:

Gholizadeh S, Azizoddin DR, Mills SD, Racaza GZ, Kala'aukahi Potemra HM, Wallace DJ, Weisman M, Nicassio PM. Psychometric Validation of the Arthritis Helplessness Index in Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/psychometric-validation-of-the-arthritis-helplessness-index-in-systemic-lupus-erythematosus/. Accessed August 9, 2022.

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