THE ASSOCIATION BETWEEN TRAUMA AND QUALITY OF LIFE IN SLE.
Bibliographic record
Abstract
PV233 / #350 Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes Background/Purpose In SLE, early childhood trauma and adverse childhood experiences have been associated with chronic pain, fatigue, depression, self-reported flares and incident SLE. In this study we evaluated the frequency and impact of abusive and non-abusive trauma on quality of life in SLE. Methods This study involved adult SLE patients (2012 SLICC or 2019 ACR/EULAR criteria) from August 2023 to April 2024. Patients completed the LupusPRO; FACIT-fatigue scale; PROMIS measures for pain intensity, pain interference, self-efficacy, and psychological stress; and the Trauma History Screen. Additional trauma questions regarding emotional abuse and pregnancy loss or abortion were added. Abusive trauma was defined as physical, sexual, and emotional trauma as an adult or child. Patients were divided into 3 groups: abusive trauma, non-abusive trauma, and no trauma. Differences across groups were analyzed by Fisher’s exact test or ANOVA. Results In this cohort of 262 SLE patients (92% female, mean age 44 years, mean disease duration 15 years, 60% self-reported Black), the vast majority experienced at least 1 traumatic event (85%) with almost half suffering abusive trauma. Trauma was more common among women, with abusive trauma occurring almost exclusively in women. Education attainment was similar across groups, however a greater number of patients with abusive trauma had an annual income less than $50,000. There was a progressive increase in fatigue, pain intensity, and pain interference across the 3 groups with the highest scores in those with abusive trauma (Table 1). More than half of patients with abusive trauma reported moderate to severe levels of fatigue, pain intensity and interference in social and daily activities. Likewise, patients with trauma reported significantly more psychological stress and lower self-efficacy for managing symptoms and medications than those without trauma. When evaluating the relationship of trauma across LupusPRO, patients with abusive trauma had lower scores for sleep, physical and emotional health, pain, fatigue, cognition, body image, effects from lupus medications indicating worse health-related quality of life in these domains (Figure 1). Finally, scores for coping, desires and goals, and support system were worse in patients with abusive trauma. Table 1. Influence of trauma on pain, fatigue, self-efficacy and stress Figure 1. Influence of trauma on LupusPRO health and non-health related quality of life Conclusions Many patients with lupus have suffered trauma, including abusive trauma, throughout their lives and experience reduced quality of life across multiple health and non-health domains. Further, the data suggest that abusive trauma can impact the burden and severity of lupus symptoms as well the ability to manage symptoms and medications. Incorporating a trauma-informed approach to care may therefore be important in developing and delivering treatment to improve quality of life in SLE.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".