Individual and Socioecological Resilience in Childhood-Onset Systemic Lupus Erythematosus: Associations With Patient Characteristics and Psychosocial Patient-Reported Outcomes
Bibliographic record
Abstract
Objective This study investigates individual and socioecological resilience and its relationship with sociodemographic and disease characteristics, as well as psychosocial patient-reported outcome measures (PROMs) in childhood-onset systemic lupus erythematosus (cSLE). Methods We conducted a cross-sectional study of patients with cSLE, ages 11-22 years, at a Canadian tertiary center from October 2021 to July 2024. The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) assessed individual resilience. The Child and Youth Resilience Measure–Revised (CYRM-R) assessed socioecological resilience. Linear regression models examined associations between resilience with sociodemographic (eg, health literacy, adverse childhood experiences [ACEs]) and disease factors (eg, age of onset, duration, disease activity). Pearson correlations determined relationships between resilience and patient-reported depressive and anxiety symptoms, executive functioning, pain interference, and fatigue. Results Of 49 participants, the mean score for individual psychological resilience was 26.0 (SD 7.1; CD-RISC-10), and the mean score for socioecological resilience was 73.4 (SD 9.1; CYRM-R). Higher resilience on CD-RISC-10 (β 0.99, 95% CI 0.45-1.55, P < 0.01) and CYRM-R (β 0.84, 95% CI 0.13-1.55, P = 0.02) was associated with better health literacy on the communication subscale. Lower CYRM-R scores were associated with higher number of ACEs (β −1.02, 95% CI −1.88 to −0.17; P = 0.02). For PROMs, lower scores for both individual and socioecological resilience correlated with worse depressive symptoms ( r −0.44, P = 0.003 for CD-RISC-10; r −0.55, P = 0.001 for CYRM-R) and executive functioning ( r −0.49, P = 0.002 for CD-RISC-10; r −0.56, P = 0.002 for CYRM-R). Conclusion Greater resilience was associated with fewer ACEs and better health-related communication, patient-reported mental health, and executive functioning. Findings highlight the importance of fostering resilience to improve outcomes in youth with cSLE.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".