Biopsychosocial factors in rheumatoid arthritis : disease severity, functional performance, and the structural analysis of behavior



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Rheumatoid Arthritis (RA) patients were studied to evaluate the extent to which self-reported psychosocial relationships (including intrapersonal), as measured by the Structural Analysis of Social Behavior, accounted for the discrepancy between functioning, as measured by the Health Assessment Questionnaire, and disease severity, as indexed by number of large joints swollen, deformed, or with limited mobility. Against predictions, neither attack by significant other, hateful withdrawal by patient, patient submissiveness toward significant other, or relationship ambivalence were significantly correlated with underfunctioning. As predicted, self-attack or suicidal behavior was related to underfunctioning while self-restraint was negatively rather than positively related to underfunctioning. Overfunctioning was correlated with greater self-care and having a friendly, but dependent and submissive significant other. Psychosocial relationships were related to change for the worse, greater dissatisfaction, and greater need for help. Directions for research and parallels between findings and current treatment literature are discussed.



Rheumatoid arthritis, Patients, Social conditions