"My Body Is a Ticking Time Bomb": Associations of Body Mindsets with Psychological Distress in People with Chronic Kidney Disease.

Background: This study investigated the association between body mindsets-established, but mutable beliefs a person holds about their body-with psychological distress in people with chronic kidney disease (CKD).

Methods: A cross-sectional, mixed methods survey was conducted in people with CKD at various stages of treatment. Participants completed the Patient Health Questionnaire-4 (PHQ-4) to capture distress, the Body Mindset Inventory (BMI), and qualitative free-text responses elaborating on their mindsets. Hierarchical regression models explored associations of body mindsets with psychological distress, controlling for demographic variables, treatment modalities, and comorbidities.

Results: Two hundred and thirty-two adults with CKD (62% female) completed the survey; 27.6% were receiving dialysis and 34.7% had received a kidney transplant. Those who more strongly endorsed the mindset that their Body is an Adversary reported greater psychological distress, while those who more strongly endorsed the mindsets that their Body is Capable or their Body is Responsive reported less psychological distress. Together, all three mindsets explained 12% unique variance in psychological distress, even after accounting for demographic factors, treatment modalities, and comorbidities. Mixed methods analyses illustrated the range of body mindsets in people with CKD, with some describing their body as "A ticking time bomb" and others stating "My body is a fighter just like me. My body is amazing."

Conclusion: Mindsets about the body are significantly associated with psychological distress in people with CKD. These cross-sectional data provide a foundation for future longitudinal and interventional studies on the relationship between mindsets and distress outcomes in people living with CKD.