Pain Management in Rheumatoid Arthritis: A Cognitive-Behavioural Intervention

Abstract

Psychological adjustment is thought to play an important role in determining pain experience, disease status, and immune function in rheumatoid arthritis (RA). Fourteen female RA out-patients were tested longitudinally in a matched-random assigned two-groups design with cognitive-behavioural intervention designed to improve pain and stress management skills. Pre-intervention correlational analyses tested the extent to which mood disturbance, self-perceptions of coping efficacy, health locus of control, and stressful life experience were related to pain, disease activity, functional status and lymphocyte proliferation rate variables. Intra- and inter-group analyses were conducted to determine treatment effects, and case studies were conducted. RA was characterized more by poor psychological health status than physical disability, with pain more a function of psychological adjustment than actual disease status. No significant treatment effects were observed. Case studies indicated the complex nature of the individual disease experience. The value of cognitive-behavioural intervention in RA, and implications for future-related research are discussed in terms of such findings.