{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:52:01Z","timestamp":1791535921723,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to examine the factors associated with psychological resilience in Sj\u00f6gren's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study included 83 patients (F\/M: 79\/4). Hyposalivation was observed in 41%, while Schirmer's test positivity was observed in 84.3% of patients. Scores of the Brief Resilience Scale, self\u2010reported general health, self\u2010reported oral health, EULAR Sj\u00f6gren's Syndrome Patient Reported Index (ESSPRI), and physician global assessment for disease activity were noted. A mediation analysis was performed to examine the relationships among these variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Lower BRS scores were associated with Schirmer's test positivity and reduced salivary flow rate, higher scores of ESSPRI, physician and patient global assessments of disease activity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the simple mediation analysis, a lower BRS score as the dependent variable was directly associated with a higher physician\u2010assessed global disease activity as the independent variable and indirectly associated with the higher ESSPRI score as a mediator variable (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Since ocular dryness, lower salivary flow rates, physician global assessment of disease activity, and ESSPRI reflecting patient\u2010reported symptom severity were identified as key contributors to lower levels of psychological resilience in Sj\u00f6gren's disease, these measures may offer clinicians valuable guidance for tailoring more effective, patient\u2010centered integrated multidisciplinary care strategies for patients with SjD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70530","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:30:14Z","timestamp":1791534614000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Factors Associated With Psychological Resilience in Sj\u00f6gren's Disease"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-7745","authenticated-orcid":false,"given":"Berceste","family":"Polat Akmansoy","sequence":"first","affiliation":[{"name":"Faculty of Dentistry, Department of Oral and Maxillofacial Radiology Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4766-5662","authenticated-orcid":false,"given":"Nur","family":"Sisman Kitapci","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Department of Health Management Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0260-8085","authenticated-orcid":false,"given":"\u00d6m\u00fcr","family":"Mumcu","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Department of Periodontology Yeditepe University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8673-4061","authenticated-orcid":false,"given":"Fatma B\u00fc\u015fra","family":"Sari","sequence":"additional","affiliation":[{"name":"Institute of Health Sciences, Department of Health Management Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9542-9018","authenticated-orcid":false,"given":"\u015e\u00fckr\u00fc Can","family":"Akmansoy","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Department of Prosthodontics Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7119-0882","authenticated-orcid":false,"given":"Esra","family":"Sevimli","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, Department of Health Management Istanbul Arel University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6016-0140","authenticated-orcid":false,"given":"Ayseg\u00fcl","family":"Avcu","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Internal Medicine, Division of Rheumatology Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4087-6667","authenticated-orcid":false,"given":"Mustafa","family":"Erdogan","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Internal Medicine, Division of Rheumatology Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9588-8898","authenticated-orcid":false,"given":"Umit","family":"Karacayli","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Department of Oral and Maxillofacial Surgery Health Sciences University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1857-8719","authenticated-orcid":false,"given":"Meral","family":"Yay","sequence":"additional","affiliation":[{"name":"Faculty of Science and Literature, Department of Statistics Mimar Sinan Fine Arts University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5930-1973","authenticated-orcid":false,"given":"Farida","family":"Fortune","sequence":"additional","affiliation":[{"name":"Barts and The London School of Medicine and Dentistry, Centre of Immunobiology and Regenerative Medicine Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2862-0562","authenticated-orcid":false,"given":"Nevsun","family":"Inanc","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Internal Medicine, Division of Rheumatology Marmara University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2280-2931","authenticated-orcid":false,"given":"Gonca","family":"Mumcu","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Department of Oral and Maxillofacial Radiology Istanbul Okan University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/rir\u20102024\u20100004"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010024\u201002312\u20104"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.78918"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12940"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/000163501750266684"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239442"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1186\/s12903-021-01970-w","article-title":"Influence of Socioeconomic Status on Oral Disease Burden: A Population\u2010Based Study","volume":"21","author":"De Lucena E. H. G.","year":"2021","journal-title":"BMC Oral Health"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/mnqiy9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780197778586.001.0001","volume-title":"Health Behavior Change and Treatment Adherence: Evidence\u2010Based Guidelines for Improving Healthcare","author":"DiMatteo M. R.","year":"2025"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2019.e02064"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2018.12.005"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13061057"},{"key":"e_1_2_11_14_1","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression\u2010Based Approach","author":"Hayes A. F.","year":"2017"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.brat.2016.11.001","article-title":"Regression\u2010Based Statistical Mediation and Moderation Analysis in Clinical Research: Observations, Recommendations, and Implementation","volume":"98","author":"Hayes A. F.","year":"2017","journal-title":"Behaviour Research and Therapy"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12579"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010022\u201008501\u20105"},{"issue":"1","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.coms.2013.09.003","article-title":"Salivary Gland Dysfunction and Xerostomia in Sj\u00f6gren's Syndrome","volume":"26","author":"Jensen S. B.","year":"2014","journal-title":"Oral and Maxillofacial Surgery Clinics of North America"},{"issue":"1","key":"e_1_2_11_19_1","first-page":"7","article-title":"Periodontal Risk Assessment (PRA) for Patients in Supportive Periodontal Therapy (SPT)","volume":"1","author":"Lang N. P.","year":"2003","journal-title":"Oral Health & Preventive Dentistry"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2015.03.010"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2008.0353"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10238\u2010021\u201000728\u20106"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/froh.2021.767568"},{"issue":"3","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1111\/idh.12491","article-title":"Are Oral Hygiene Instructions With Aid of Plaque\u2010Disclosing Methods Effective in Improving Self\u2010Performed Dental Plaque Control? A Systematic Review of Randomized Controlled Trials","volume":"19","author":"Oliveira L. M.","year":"2021","journal-title":"International Journal of Dental Hygiene"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472\u20106890\u20105\u20104"},{"issue":"9","key":"e_1_2_11_26_1","first-page":"661","article-title":"The Global Burden of Oral Diseases and Risks to Oral Health","volume":"83","author":"Petersen P. E.","year":"2005","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.2014.44"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010021\u201004899\u2010z"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102019\u2010216114"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345231218903"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2017.12.012"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2014.10.004"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.143743"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102013\u2010204615"},{"issue":"6","key":"e_1_2_11_35_1","doi-asserted-by":"crossref","DOI":"10.1111\/eos.13022","article-title":"Psychological Resilience in Patients With Primary Sj\u00f6gren's Syndrome: Effect of Involvement of Major Salivary and Lacrimal Glands","volume":"132","author":"Sevimli E.","year":"2024","journal-title":"European Journal of Oral Sciences"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39859"},{"issue":"1","key":"e_1_2_11_37_1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s12903-020-01169-5","article-title":"Chemosensory Dysfunction, Oral Disorders and Oral Health\u2010Related Quality of Life in Patients With Primary Sj\u00f6gren's Syndrome: Comparative Cross\u2010Sectional Study","volume":"20","author":"\u0160ijan Gobelji\u0107 M.","year":"2020","journal-title":"BMC Oral Health"},{"issue":"1","key":"e_1_2_11_38_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3109\/00016356408993968","article-title":"Periodontal Disease in Pregnancy II. Correlation Between Oral Hygiene and Periodontal Condition","volume":"22","author":"Silness J.","year":"1964","journal-title":"Acta Odontologica Scandinavica"},{"issue":"3","key":"e_1_2_11_39_1","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1080\/10705500802222972","article-title":"The Brief Resilience Scale: Assessing the Ability to Bounce Back","volume":"15","author":"Smith B. W.","year":"2008","journal-title":"International Journal of Behavioral Medicine"},{"key":"e_1_2_11_40_1","first-page":"167","volume-title":"Resilience in Children, Adolescents, and Adults: Translating Research Into Practice","author":"Smith B. W.","year":"2012"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010024\u201004224\u20107"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.614653"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18052247"},{"issue":"3","key":"e_1_2_11_44_1","doi-asserted-by":"crossref","DOI":"10.3390\/medicina59030473","article-title":"Oral Health and Oral Health\u2010Related Quality of Life in Patients With Primary Sj\u00f6gren's Syndrome","volume":"59","author":"Vujovic S.","year":"2023","journal-title":"Medicina"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.190849"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.14620"}],"container-title":["Oral Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/odi.70530","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/odi.70530","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/odi.70530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:30:16Z","timestamp":1791534616000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/odi.70530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":45,"alternative-id":["10.1111\/odi.70530"],"URL":"https:\/\/doi.org\/10.1111\/odi.70530","archive":["Portico"],"relation":{},"ISSN":["1354-523X","1601-0825"],"issn-type":[{"value":"1354-523X","type":"print"},{"value":"1601-0825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]},"assertion":[{"value":"2025-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"odi.70530"}}