Older adults' perspective on the therapeutic alliance and a meta-analytic review of emotional support and depression in adults with rheumatoid arthritis

  • Amy Millar

Student thesis: Doctoral ThesisDoctorate in Clinical Psychology


Objective: Biopsychosocial models of adjustment to chronic illness indicate that social support should be strongly associated with depression; however, this is not consistently evident within the literature. This review and meta-analysis aimed to test the strength of association between emotional support (as a distinct social support concept) and depressive symptomatology in an adult rheumatoid arthritis (RA) population. Design: A systematic literature review of four databases identified 14 studies (77 = 1416) which met full inclusion criteria. A random-effects meta-analysis was conducted using effect sizes (Pearson’s r) of associations between emotional support and depressive symptomatology. Subgroup analyses contrasted the effects of measures of perceived availability of emotional support with those of satisfaction with emotional support. Results: A moderate effect size for the relationship between emotional support and depression was revealed (r = -0.30 [95% Cl = -0.45, -0.14; p
Date of AwardDec 2019
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorPauline Adair (Supervisor)


  • social support
  • depression
  • rheumatoid arthritis
  • meta-analysis

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