The Measurement of Helplessness in Rheumatoid Arthritis: The Development of the Arthritis Helplesness Index

The Journal of Rheumatology (Impact Factor: 3.19). 07/1985; 12(3):462-7.
Source: PubMed


We describe the development of the Arthritis Helplessness Index (AHI), a self-report instrument designed to measure patients' perceptions of loss of control with arthritis. The participants in this research were 219 patients with rheumatoid arthritis (RA) who completed a quantity of mailed materials, including the AHI, functional measures and other psychological scales. Significant evidence of reliability and validity of the AHI was found. Greater helplessness correlated with greater age, lesser education, lower self-esteem, lower internal health locus of control, higher anxiety, and depression, and impairment in performing activities of daily living using a health assessment questionnaire. Over one year, changes in helplessness correlated with changes in difficulty in performing activities of daily living. The AHI appears to be a useful measure for further studies in RA and a valuable clinical tool in monitoring the psychological status of patients with RA.

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    • "In such cases, the individual has learned to behave helplessly irrespective of whether the opportunity is restored to help themselves, by avoiding unpleasant or harmful circumstances to which they have been subjected. Over time, attributional characteristics, in particular the existence of a pessimistic explanatory style affects the likelihood of acquiring helplessness, as it negatively colors an individual's interpretation of an event, and leads to the anticipation that their actions will be ineffective in producing desired outcomes (Nicassio et al., 1985; Saxena & Shah, 2008; Schiaffino & Revenson, 1995). Consequently, the person may no longer participate or attempt to participate in a particular activity. "
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    Tourism Management 06/2012; 33(3). DOI:10.1016/j.tourman.2011.06.011 · 2.57 Impact Factor
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    • "2.2.3 Psychological functioning Illness beliefs: The Helplessness and Internality Subscales of the Arthritis Helplessness Index [23] "
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    ABSTRACT: The objective of this article is to assess the contribution of disease activity, pain, and psychological factors to self-reported sleep disturbance in patients with rheumatoid arthritis (RA), and to evaluate whether depression mediates the effects of pain on sleep disturbance. The sample included 106 patients with confirmed RA who participated in an assessment of their disease activity, pain, psychological functioning, and sleep disturbance during a baseline evaluation prior to participating in a prospective study to help them manage their RA. Self-measures included the Rapid Assessment of Disease Activity in Rheumatology, the SF-36 Pain Scale, the Helplessness and Internality Subscales of the Arthritis Helplessness Index, the Active and Passive Pain Coping Scales of the Pain Management Inventory, the Center for Epidemiological Studies Depression Scale, and the Pittsburgh Sleep Quality Index. Hierarchical multiple regression analysis confirmed that higher income, pain, internality, and depression contributed independently to higher sleep disturbance. A mediational analysis demonstrated that depression acted as a significant mechanism through which pain contributed to sleep disturbance. Cross-sectional findings indicate that pain and depression play significant roles in self-reported sleep disturbance among patients with RA. The data suggest the importance of interventions that target pain and depression to improve sleep in this medical condition.
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    • "BRCS scores can range from 0 to 20, with higher scores indicating higher resilience [28]. The Arthritis Helplessness Index (AHI) is a 15-item self-report questionnaire designed to measure patient's perceptions of loss of control in association with their chronic arthritis [29]. We used the two subscales, internality (seven items) and helplessness (five items), which reflect separate constructs and have been found to have greater reliability and validity than the total AHI score [30]. "
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    ABSTRACT: Functional status is an integral component of health-related quality of life in patients with ankylosing spondylitis (AS). The purpose of this study was to investigate the role of psychological variables in self-reported functional limitation in patients with AS, while controlling for demographic and medical variables. 294 AS patients meeting modified New York Criteria completed psychological measures evaluating depression, resilience, active and passive coping, internality and helplessness at the baseline visit. Demographic, clinical, and radiologic data were also collected. Univariate and multivariate analyses were completed to determine the strength of correlation of psychological variables with functional limitation, as measured by the Bath AS Functional Index (BASFI). In the multivariate regression analysis, the psychological variables contributed significantly to the variance in BASFI scores, adding an additional 24% to the overall R-square beyond that accounted by demographic and medical variables (R-square 32%), resulting in a final R-square of 56%. Specifically, arthritis helplessness, depression and passive coping beside age, ESR and the Bath AS Radiograph Index accounted for a significant portion of the variance in BASFI scores in the final model. Arthritis helplessness, depression, and passive coping accounted for significant variability in self-reported functional limitation beyond demographic and clinical variables in patients with AS. Psychological health should be examined and accounted for when assessing functional status in the AS patients.
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