Abstract
Background
People living with non-radiographic axial spondyloarthritis (nr-axSpA) often suffer poor psychological health. Social support has been identified as one way to enhance psychological well-being, yet little research has examined the relationship between quality of support provided by important others and indicators of well-being in people living with nr-axSpA. Thus, the aim of this study is to examine whether important other autonomy support predicts symptoms of subjective vitality, depression and anxiety and test if this relationship is mediated by the three innate basic psychological needs (autonomy - a sense of ownership and volition over actions and behaviours; competence - feeling effective and capable of achieving valued outcomes; relatedness - experiencing closeness and genuine connection, with valued others) as specified by Self Determination Theory (SDT).
Methods
Sixty three participants living with nr-axSpA (M Age = 43.16 years; SD = 11.17; female = 58.73%) were recruited from a specialist rheumatology hospital via the Bath Spondyloarthritis Biobank. Spinal mobility was assessed using the Bath Ankylosing Spondylitis Metrology Index (M = 1.83; SD = 1.2; range = 5). Questionnaires measuring important other autonomy support, basic psychological need satisfaction, subjective vitality, depression severity and anxiety severity were completed. Mediation analyses were conducted via three linear regressions and bootstrapping for subjective vitality, anxiety and depressive symptoms.
Results
Important other autonomy support was significantly and positively related to subjective vitality (β = .32, p = .01), and significantly and negatively related to symptoms of depression (β = -.32, p = .02) and anxiety (β = -.31, p = .03). Important other autonomy support also demonstrated a significant positive relationship with basic psychological need satisfaction (β = .27, p <.05). Basic psychological need satisfaction had a significant positive relationship with subjective vitality (β = .58, p < .01; R2 = .37) and a significant negative relationship with depressive symptoms (β = -.57, p < .01; R2 = .35) and anxiety (β = -.50, p <.01; R2 = .30). Assessment of the indirect effects revealed that basic psychological need satisfaction did not mediate the relationships between important other autonomy support and subjective vitality (b = .15, 95% BC CI -.04, .34), depressive symptoms (b = -.06, 95% BC CI -.16, .01) and anxiety (b = -.08, 95% BC CI -.19, .03).
Conclusion
Both important other autonomy support and basic psychological needs were significantly related to psychological well-being. Yet, basic psychological need satisfaction did not mediate the relationships between important other autonomy support with subjective vitality, depressive symptoms and anxiety. Healthcare interventions could help important others to improve the quality of their support and try to increase a sense of autonomy, competence and relatedness satisfaction in people living with nr-axSpA to enhance the psychological well-being of people living with nr-axSpA.
Disclosures
T.A. Ingram None. P.C. Rouse None. M. Standage None. E. Reilly None. R. Sengupta None.
Effects of perceived autonomy support from social agents on motivation and engagement of Chinese primary school students: Psychological need satisfaction as mediator