The measurement of helplessness in rheumatoid arthritis. The development of the arthritis helplessness index.
ABSTRACT 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.
- SourceAvailable from: John W. Reich[Show abstract] [Hide abstract]
ABSTRACT: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain condition poorly understood in terms of etiology and treatment by both physicians and patients. This condition of "uncertainty of illness" was examined as a variable involved in the adjustment of FMS patients, relating it to their depression, anxiety, affect, and coping styles. Fifty-one community-residing FMS patients provided self-report information on subsets of adjustment variables. Both cross-sectional and more dynamic longitudinal analyses showed that illness uncertainty was significantly associated with anxiety, negative affect, and avoidant and passive coping. Its positive relationship with depression was eliminated when a control variable, pain helplessness, was included as a covariate. Longitudinally, illness uncertainty interacted with interpersonally stressful daily events in predicting reports of reduced positive affect, suggesting that illness uncertainty acts as a risk factor for affective disturbances during stressful times. Implications of these results for therapeutic interventions are discussed.Journal of Behavioral Medicine 09/2006; 29(4):307-16. DOI:10.1007/s10865-006-9054-7 · 3.10 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To examine a learned helplessness conceptualization of psychological sequela in children and adolescents with juvenile rheumatic diseases (JRD) via an experimental procedure utilizing behavior-outcome contingent and noncontingent feedback. Thirty-eight children and adolescents with JRD completed measures of transient affect, self-efficacy for functional ability, and causal attributions prior to and immediately following a computerized learned helplessness induction procedure. Children across contingent and noncontingent feedback conditions experienced decreased positive affect with a slightly more pronounced decline in the noncontingent condition. Noncontingent feedback resulted in poorer internalization of success for problem solving, while contingent feedback resulted in greater internalization of success for problem solving. Additionally, posttreatment control self-efficacy was significantly greater for children in the contingent condition that initially endorsed higher levels of internal task attributions. Children with JRD who experience behavior-outcome contingency in their environment may develop increased perceptions of control over functional ability. Furthermore, environmental noncontingency may result in poorer internalization of success, whereas contingent reinforcement may enhance cognitive appraisal mechanisms (i.e., causal attributions) associated with favorable disease outcome. Despite a modest decline in positive affect for children in the noncontingent condition, mood dysfunction is not entirely explicable within the context of noncontingent reinforcement.Journal of Psychosomatic Research 02/2006; 60(1):73-81. DOI:10.1016/j.jpsychores.2005.07.001 · 2.84 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To examine the contribution of perceived importance of activities of daily living (ADL) to arthritis-specific helplessness in a sample of rheumatoid arthritis (RA) patients over a 1-year period. Forty-two individuals from an outpatient rheumatology clinic completed measures of ADL importance, helplessness, depression, pain, and disability; the physician's assistant provided objective ratings of disability. Time 1 importance of ADL predicted a significant amount of variance in Time 2 arthritis helplessness after statistically controlling disease and psychological covariates. Moreover, increased perceived ADL importance predicted decreased arthritis helplessness over the 1-year period. Results indicate that RA patients' experience of arthritis-specific helplessness may be minimized over time when performing ADL is perceived as important. Furthermore, these findings provide preliminary evidence for one possible antecedent to increased perceptions of arthritis helplessness in individuals with RA.Journal of Psychosomatic Research 09/2004; 57(2):159-64. DOI:10.1016/S0022-3999(03)00600-7 · 2.84 Impact Factor