Disease characteristics, pain, optimism, coping strategies, and psychological well-being of rheumatoid arthritis patients

This study was concerned with variables likely to influence psychological well-being in chronic rheumatoid arthritis (RA) patients, a group at risk psychologically as a consequence of their disease condition. The study examined the relationships of personality characteristics (optimism) and coping strategies (wishful thinking and problem solving) in predicting psychological well-being (operationalized as psychological distress), after removing the effects of age, stressor type, and disease characteristics (physical disability and pain). Subjects were 107 adult RA patients drawn at random from the referral files of The Arthritis Society. Data were collected by means of a questionnaire mailed to potential respondents. Coping strategies were assessed, with reference to a respondent identified stressor, using two scales (wishful thinking and problem solving) from Vitaliano's revised Ways of Coping Checklist. Both raw and relative scores were used in analyses. Optimism was assessed using the Life Orientation Test, physical disability and pain were measured using two scales (physical health status and pain) of the Arthritis Impact Measurement Scale, and distress was measured using a modified Brief Symptom Inventory. Preliminary analysis was done to compare subjects reporting arthritis or arthritis-related stressors with those reporting other stressors on all independent and dependent measures. There were no between group differences. Hierarchical multiple regression analysis was used to examine relations among variables with variables entered in five steps: (1) age, stressor type, and physical disability; (2) pain; (3) optimism; (4) wishful thinking and problem solving; and (5) relative coping. The regression equation reached significance, F(8,98) = 12.35, p ≤.01, and accounted for 50% of the variance in distress. Optimism and, to a lesser extent, wishful thinking accounted for the largest proportions of variance, the relationships being negative and positive, respectively. Age accounted for a small but significant proportion of the variance. The findings clarify the relations between wishful thinking, problem solving, optimism, and psychological distress in adult RA patients.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat