RELATIONSHIP OF COGNITIVE CONSTRUCTS TO ADJUSTMENT IN RHEUMATOID-ARTHRITIS PATIENTS

The present study investigated the interrelationship of several commonly used arthritis-related cognitive measures and their relationship to physical disability, pain, depression, and anxiety in rheumatoid arthritis (RA) patients. Subjects were 103 RA patients recruited from an outpatient rheumatology clinic. Each subject completed the Cognitive Errors Questionnaire (CEQ), the Arthritis Self-Efficacy Scale, the Coping Strategies Questionnaire (CSQ), the Pain Beliefs and Perceptions Inventory (PBAPI), and the Arthritis Impact Measurement Scale (AIMS). Correlational analysis indicated that the cognitive measures were highly interrelated. Factor analysis of the summary scores from these cognitive measures suggested two separate factors, labeled a distorted cognition factor and an efficacy expectations factor. Regression analyses revealed that after controlling for age, gender, and physician disease severity rating, each factor separately was significantly related to all measures of adjustment However, in a regression model including both factors, the efficacy expectations factor was more strongly related to all adjustment measures. Patients scoring higher on the efficacy expectations factor had lower levels of physical disability, pain, depression, and anxiety. Taken together, these findings suggest that expectancies about arthritis-related symptoms and pain are more strongly related to adjustment than are general and arthritis-related cognitive errors. Comparison and integration of cognitive constructs and how these relate to function is discussed as an important next step in the psychology and RA literature.