Table 4

Association of perceived stress (Perceived Stress Scale) with stressful events (Life Events Inventory) and positive and negative psychosocial factors, by ACEs*, in models with and without adjustment

Full sample (n=180)No ACEs (n=111)ACEs (n=69)
Perceived Stress Scale,
mean±SD
4.7±3.14.5±3.05.2±3.2
Beta (95% CI)P valueBeta (95% CI)P valueBeta (95% CI)P value
Model 1
Life Events Inventory0.24 (0.08 to 0.39)0.0030.19 (–0.14 to 0.42)0.110.25 (0.02 to 0.47)0.033
 Model R20.050.020.07
Model 2
Life Events Inventory0.18 (0.05 to 0.30)0.0060.05 (−0.13 to 0.23)0.620.31 (0.11 to 0.51)0.003
Positive psychosocial factor score†−0.61 (−0.92 to –0.29)0.0002−0.56 (–0.94 to –0.19)0.004−0.85 (–1.47 to –0.23)0.008
PROMIS social isolation0.22 (0.15 to 0.28)<0.00010.24 (0.16 to 0.32)<0.00010.17 (0.06 to 0.28)0.003
 Model R20.440.430.45
Model 3
Life Events Inventory0.20 (0.08 to 0.33)0.00180.07 (–0.12 to 0.27)0.540.37 (0.15 to 0.58)0.0011
Positive psychosocial factor score†−0.62 (−0.67 to –0.24)0.0003−0.67 (1.07 to –0.27)0.00131.01 (−1.72 to –0.310.0056
PROMIS social isolation0.19 (0.13 to 0.26)<0.00010.22 (0.14 to 0.31)<0.00010.19 (−0.04 to 0.21)0.17
 Model R20.510.520.61
  • Model 1: includes Life Events Inventory only. Model 2: includes Life Events Inventory, positive psychosocial factor score and PROMIS social isolation T-score. Model 3: includes Life Events Inventory; positive psychosocial factor score; PROMIS social isolation T-score and age, gender, disease duration, education ≤high school, income ≤125% of the US federal poverty level, race and ethnicity, number of comorbidities, BILD score ≥2, glucocorticoid use (≥7.5 mg/day) and PHQ score ≥10.

  • *Childhood trauma by ACE questionnaire scores ≥2.

  • †First eigenvalue from principal component analysis of resilience, emotional support and self-efficacy scores.

  • ACEs, adverse childhood experiences; BILD, Brief Index of Lupus Damage; PHQ, Patient Health Questionnaire; PROMIS, Patient-Reported Outcomes Measurement Information System.