The long-term objective of this project is to gain a fuller understanding of the behavioral aspects of rheumatoid arthritis (RA), a chronic condition which affects over 5 million persons in the U.S. and is a leading cause of disability. The major question to be explored is why and how do some persons with RA manage to cope very effectively with this disease while others appear to become helpless in the face of it? Specifically, this investigation aims to (1) investigate longitudinally the health and illness behaviors of a samples (panel) of persons with RA (2) to determine the extent and developmental course of learned helplessness and active coping in persons with this condition. This investigation will lay the groundwork for future interventions aimed at helping persons with RA cope with their illness. A panel of 360 patients with RA ranging from those newly diagnosed to those who have had the condition from 5-6 years will be studied at six-month intervals over a 3-3 1/2 year period via mialed questionnaires and/or telephone interviews. Among the instruments already developed for this project are measures fo arthritis-specific attitudes, locus of control beliefs, depressive affect, values, health and illness behaviors, and functional capacity. These measures will be administered repeatedly over the course of the study to ascertain changes in behavior and its psychological concomitants. This design was chosen to provide data over the first 10 years of a person's history with RA. Multiple regression analyses are planned to test theoretical models linking arthritis history and experience variables to indicators of learned helplessness or coping which, in turn, will be regressed upon health and illness behaviors and health outcomes. In addition to testing models, these data will provide a wealth of systematically gathered descriptive information to greatly expand our knowledge of RA.
