This is a three-armed randomized, controlled intervention trial to determine the effect of relaxation response training (RR) and of relaxation training combined with cognitive/behavioral therapy (RRCBT) on the symptoms, functional ability, role impairment, and medical care utilization of patients with rheumatoid arthritis (RA). We will also examine the role of selected attitudes and beliefs expected to moderate the treatment response and predict outcome. These same attitudes and beliefs are also hypothesized to predict the incidence of medication side-effects and to be associated with the inter- individual variability in RA symptoms seen among patients with RA of comparable severity and extent. Three-hundred and seventy- five RA patients will undergo a baseline assessment of the independent variables (including hypochondriacal health anxiety, bodily amplification, normative beliefs about health, and alexithymia) and covariates (including RA severity, life stress, social support, and psychological distress). They will then be randomly assigned to RR, RRCBT, or an attention control group. The outcome variables (RA symptoms, functional ability, role impairment, and medical care utilization) will be measured immediately after treatment, and 6 and 12 (the primary outcome) months later. The effect of treatment will be determined by comparing each intervention group to the control group, and by within-subject comparisons before and after treatment. Additional group analyses will be conducted to determine the influence of cognitive and attitudinal variables on outcome.
| Barsky, Arthur J; Ahern, David K; Orav, E John et al. (2010) A randomized trial of three psychosocial treatments for the symptoms of rheumatoid arthritis. Semin Arthritis Rheum 40:222-32 |
| Nestoriuc, Yvonne; Orav, E John; Liang, Matthew H et al. (2010) Prediction of nonspecific side effects in rheumatoid arthritis patients by beliefs about medicines. Arthritis Care Res (Hoboken) 62:791-9 |
| Braun, Ilana M; Liang, Matthew H; Orav, E John et al. (2008) A personality characteristic, somatic absorption, and the perception of somatic symptoms in rheumatoid arthritis patients. J Rheumatol 35:782-9 |
