Psychosocial predictors of functional change in recently diagnosed rheumatoid arthritis patients

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Abstract

In order to examine the influence of active and passive pain-coping strategies and social support characteristics on the change in functional status in the first stage of the disease in rheumatoid arthritis patients, self-report data and clinical and laboratory measures were collected from 91 patients (70% female, mean age 57 yr) shortly after diagnosis and 1 yr later. Multiple regression analyses indicated that, after taking the influence of demographic variables, disease activity and pain into account, a decrease in functional status (mobility, self-care, grip strength) after 1 yr could be predicted by an initially more frequent use of the passive pain-coping strategies of worrying and resting. A decrease in mobility could be additionally predicted by an initially smaller social network. Results indicate the impact of passive pain-coping strategies and social network characteristics for the prognosis of functional outcome in the first stage of the disease and suggest the early manifestation of avoidance mechanisms, including behavioral, cognitive-emotional and social components, in face of a chronic stressor.

References (65)

  • F.J. Keefe et al.

    Pain coping skills training in the management of osteoarthritic knee pain: A comparative study

    Behavior Therapy

    (1990)
  • F.J. Keefe et al.

    Pain coping skills training in the management of osteoarthritic knee pain—II: Follow-up results

    Behavior Therapy

    (1990)
  • L.M. McCracken et al.

    Prediction of pain in patients with chronic low back pain: Effects of inaccurate prediction and pain-related anxiety

    Behavior Research and Therapy

    (1993)
  • B. Mullen et al.

    The effectiveness of attention and rejection as coping styles: a meta-analysis of temporal differences

    Journal of Psychosomatic Research

    (1982)
  • H.C. Philips

    Avoidance behavior and its role in sustaining chronic pain

    Behavior Research and Therapy

    (1987)
  • H.C. Philips et al.

    The effects of persistent pain: The chronic headache sufferer

    Pain

    (1985)
  • A.K. Rosenstiel et al.

    The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment

    Pain

    (1983)
  • E. Taal et al.

    Group education for rheumatoid arthritis patients

    Seminars in Arthritis and Rheumatism

    (1997)
  • L.M. Verbrugge et al.

    Risk factors for disability among U.S. adults with arthritis

    Journal of Clinical Epidemiology

    (1991)
  • J.W.S. Vlaeyen et al.

    Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance

    Pain

    (1995)
  • P.W. Wall

    On the relation of injury to pain

    Pain

    (1979)
  • M. Weinberger et al.

    Improving functional status in arthritis: The effect of social support

    Social Science and Medicine

    (1986)
  • M. Weinberger et al.

    Social support, stress and functional status in patients with osteoarthritis

    Social Science and Medicine

    (1990)
  • F.C. Arnett et al.

    The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis

    Arthritis Rheumatism

    (1988)
  • J.C. Beckham et al.

    Relationship of cognitive constructs to adjustment in rheumatoid arthritis patients

    Cognitive Therapy and Research

    (1994)
  • G.K. Brown et al.

    Social support and depression in rheumatoid arthritis: A one-year prospective study

    Journal of Applied Social Psychology

    (1989)
  • S. Cohen et al.

    Stress, social support and the buffering hypothesis

    Psychological Bulletin

    (1985)
  • M. Corbett et al.

    Factors predicting death, survival and functional outcome in a prospective study of early rheumatoid disease over fifteen years

    British Journal of Rheumatology

    (1993)
  • G. Crombez et al.

    Vermijden en volharden van bewegingen bij patienten met chronische lage-rugpijn [Avoidance and endurance in patients with chronic low-back problems]

    Gedragstherapie

    (1995)
  • J. Dekker et al.

    Pain and disability in osteoarthritis: A review of biobehavioral mechanisms

    Journal of Behavioral Medicine

    (1992)
  • K.B. Eberhardt et al.

    Functional impairment and disability in early rheumatoid arthritis—development over 5 years

    Journal of Rheumatology

    (1995)
  • K.B. Eberhardt et al.

    Early rheumatoid arthritis—some social, economical, and psychological aspects

    Scandinavian Journal of Rheumatology

    (1993)
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