Secondary Analysis of Helplessness, Depressive Symptoms, and Sleep Quality on Health Status: A Moderated Mediation Analysis

Terry A Cronan,1 Taylor L Skow,1 Lucy Ishkhanian,1 Melody Sadler,1 Kalila Wash,1 Angelina Van Dyne2 1Department of Psychology, San Diego State University, San Diego, CA, USA; 2San Diego State University/University of CA, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USACorrespondence: Terry A Cronan, Department of Psychology, 5500 Campanile Drive, San Diego, CA, 92182-4611, USA, Tel +1 (619) 594-4595, Email [email protected]: The objective of the study was to determine whether depressive symptoms mediated the association between helplessness and health status, and to assess whether sleep quality moderated this relationship for people with fibromyalgia (FM) in a moderated mediation model.Patients and Methods: The participants were 600 members of a health maintenance organization. The Arthritis Helplessness Index (AHI) was used to assess helplessness. The Center for Epidemiological Studies Depression Scale (CES-D) was used to measure symptoms of depression. Sleep quality was assessed using The Pittsburgh Sleep Quality Index (PSQI). Health Status was measured using the Quality of Well-Being Scale (QWB).Results: Depressive symptoms partially mediated the relationship between helplessness and health status. Sleep quality fully moderated the association between depressive symptoms and health status. However, worse sleep quality was associated with a weaker relationship between depressive symptoms and health status.Conclusion: The findings extend the literature by explaining the impact of helplessness on health status via depressive symptoms, and emphasize the importance of reducing feelings of helplessness and depression in people with FM. The results suggest that depressive symptoms may be more critical than addressing sleep quality problems in interventions designed for people with FM.Keywords: fibromyalgia, psychological health, quality of life, behavioral health