“…Some research has suggested that psychological disorders occur at higher rates in persons with SLE than in healthy individuals (Omdal, Husby, & Mellgren, 1995), and individuals with more active disease states are likely to experience greater psychological distress (Dobkin et al, 1998;Segui et al, 2000;Shorthall, Isenberg, & Newman, 1995;Tayer, Nicassio, Radojevic, & Krall, 1996;Ward et al, 1999). Psychological distress in turn may adversely impact other areas of functioning, including quality of life Buckhardt, Archenholtz, Mannerkorpi, & Bjelle, 1993), interpersonal relationships (Druley, Stephens, & Coyne, 1997;Fitzpatrick, Newman, Lamb, & Shipley, 1988), fatigue (McKinley, Ouellette, & Winkel, 1995;Wang, Gladman, & Urowitz, 1998), and pain (Tench, McCurdie, White, & D'Cruz, 2000;Wysenbeek, Leibovici, Weinberger, & Guedj, 1993).…”