PERSONALITY AND STRESS - AN EXPLORATORY COMPARISON OF RHEUMATOID-ARTHRITIS AND OSTEOARTHRITIS

Objective: To characterize and investigate the relationship between st ress and personality in people with rheumatoid arthritis (RA) compared to those with osteoarthritis (OA). Design: Survey of personality char acteristics determined by using Cattell's 16 Personality Factor (16PF) questionnaire and stressful life events at disease onset determined b y using the Social Readjustment Rating Scale of Holmes and Rahe. Setti ng: Inpatients of an arthritis hospital and outpatients of a clinic, b oth of which specialize in rheumatic diseases and musculoskeletal prob lems. Participants: Diagnosed as ''definite'' or ''classical'' RA (N=1 28) according to the ARA Diagnostic Criteria for Rheumatoid Arthritis (1958 Revision) or as OA (N=79) according to radiological and clinical evidence; randomly selected, resulting in a close match for gender, a ge at disease onset, duration of disease, functional classification, a nd pattern of disease progress. All individuals approached participate d. Interventions: None. Main Outcome Measures: Twenty personality char acteristics, as well as amount of stressful life events at disease ons et (Life Change Units). Results: The RA subjects had significantly (p <.001) more stress at disease onset compared to the OA subjects. A sub group of high-stress-at-onset RA subjects experienced a higher degree of disease severity (p <.01) than did the RA subjects with no stress a t onset. Although the mean personality scores for those with RA were n ot significantly different from those with OA, the RA personality freq uency distributions were different. Some of these differences could be explained by the stress-at-onset subgroup personality characteristics . Conclusions: As a group, subjects with RA exhibited more stress at d isease onset than those with OA. Although mean personality scores were not different between RA and OA subjects, they did exhibit different frequency distributions. There appeared to be a high-stress-at-onset s ubgroup of RA patients who had a worse disease prognosis and who corre sponded to a personality frequency subgroup. The interaction between t hese variables is more complex than implied by the ''RA personality'' concept. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.