RELATIONSHIP OF COGNITIVE CONSTRUCTS TO ADJUSTMENT IN RHEUMATOID-ARTHRITIS PATIENTS

The present study investigated the interrelationship of several common ly used arthritis-related cognitive measures and their relationship to physical disability, pain, depression, and anxiety in rheumatoid arth ritis (RA) patients. Subjects were 103 RA patients recruited from an o utpatient rheumatology clinic. Each subject completed the Cognitive Er rors Questionnaire (CEQ), the Arthritis Self-Efficacy Scale, the Copin g Strategies Questionnaire (CSQ), the Pain Beliefs and Perceptions Inv entory (PBAPI), and the Arthritis Impact Measurement Scale (AIMS). Cor relational analysis indicated that the cognitive measures were highly interrelated. Factor analysis of the summary scores from these cogniti ve measures suggested two separate factors, labeled a distorted cognit ion factor and an efficacy expectations factor. Regression analyses re vealed that after controlling for age, gender, and physician disease s everity rating, each factor separately was significantly related to al l measures of adjustment However, in a regression model including both factors, the efficacy expectations factor was more strongly related t o all adjustment measures. Patients scoring higher on the efficacy exp ectations factor had lower levels of physical disability, pain, depres sion, and anxiety. Taken together, these findings suggest that expecta ncies about arthritis-related symptoms and pain are more strongly rela ted to adjustment than are general and arthritis-related cognitive err ors. Comparison and integration of cognitive constructs and how these relate to function is discussed as an important next step in the psych ology and RA literature.