Arthritis Patients' Reactions to Unavoidable Social Comparisons

Seventy-two women with rheumatoid arthritis (RA) were randomly assigned to view a depiction of a woman having either very mild or very severe RA and coping either quite weal or quite poorly with the illness. Subjects rated the woman's arthritis severity, her coping with RA, their own arthritis severity, and their own coping with RA. These ratings provided an indirect assessment of how subjects evaluated themselves relative to the stimulus woman. In addition, subjects compared their RA severity and coping directly with the stimulus woman's. In the direct comparisons, subjects who saw the good coper did not acknowledge her coping superiority, despite having done so on the indirect assessment. No effects were obtained for the severity condition. These findings suggest that individuals extract self-enhancing information from social comparisons, even when the comparison target and dimension are constrained and the target's status is superior

The Role of Social Support in Coping with Daily Pain among Patients with Rheumatoid Arthritis

Using a daily process methodology, the current study examined the role of social support in coping and pain severity among patients with rheumatoid arthritis (RA). Seventy-three adults with RA completed a structured record twice daily for one week on pain severity, pain coping, satisfaction with support and disappointment in support. Findings suggested that support influenced pain indirectly, by encouraging the use of specific coping strategies, as well as impacting coping effectiveness. Satisfaction with support was associated with adaptive and maladaptive coping, while disappointment was associated with maladaptive coping. Findings highlight the importance of close others in promoting adaptive coping strategies.

Play Hurt, Live Hurt: Living with and Managing Osteoarthritis from the Perspective of Ex-professional Footballers

Personal accounts of living with osteoarthritis (OA) are rare and qualitative research has focused mainly on the experiences of women. As yet no studies have focused solely on the experience of men living with OA. The primary focus of this study was the experience of living with OA from the perspective of ex-professional footballers in the UK using semi-structured interviews with interpretative phenomenological analysis. Participants identified the cause of their OA to be associated with aspects of their playing career. Living with OA involved pain, surgery, medication and restricted mobility. Feelings of frustration were often associated with disruption to work, social and leisure activities. Participants' experiences and memories of playing professional football were important in helping them manage the threat of the disease. The findings have provided an insight into the experience of ex-professional footballers as they seek to accommodate to a life of pain, disability and functional impairment.

Social comparisons and chronic illness: research synthesis and clinical implications

The chronically ill patient must adjust to new life circumstances and manage ongoing threats to personal health. Patients often make comparisons with each other, which can have effects on their psychological and physical well-being. One question is whether health psychologists can develop interventions to strategically facilitate the use of such comparisons to optimise adjustment. This paper critically reviews evidence on patients' comparisons in studies using selection, narration and reaction methods. Discussion focuses on gaps in the empirical literature and describes some new basic concepts in social comparison, which may advance knowledge about the process in medical patients. Recommendations also are provided about the kinds of studies needed to inform the future design of effective social comparison interventions.

The functional and psychological impact of hand osteoarthritis

OBJECTIVES

Studies suggest that hand osteoarthritis (OA) can result in impairment of hand function and participation restriction. The objective of the current study was to investigate the impact of functional impairments caused by hand OA on everyday life.

METHODS

Semi-structured interviews with primary care (n = 15; mean age 62.4 years; M : F ratio 1 : 4) and secondary care (n = 14; mean age 63.6 years; M : F ratio 1 : 13) patients aged 50 years and over were conducted. Data were analysed using thematic analysis and the constant comparison method.

RESULTS

Individuals reported impact across day-to-day activities. Perceptions of dependence and independence were important. They reported embarrassment due to the appearance of their hands and their inability to carry out 'normal' tasks. Work status had been affected for two of the participants. Negative emotional responses were captured. Participants utilized cognitive, behavioural and avoidance forms of coping.

CONCLUSION

We have captured the impact of functional impairment on everyday life and related psychological effects. With a retirement age increasing, the study raises the potential issue of future employment restriction for those with hand OA. Individuals utilising 'temporal' comparison as a form of coping may be less well adjusted to their hand problem, which could have implications for future management.

When mental health becomes health: age and the shifting meaning of self-evaluations of general health

Do self-evaluations of general health change as individuals age? Although several perspectives point to age-related shifts, few researchers have compared them. For this article, several competing hypotheses were tested using a large, nationally representative, and longitudinal data set. The results suggest two trends. First, the correspondence between functional limitations and self-rated health declines, especially after age 50. Similarly, the correspondence between various chronic conditions and self-rated health declines with age. These findings are consistent with social comparison theory. Yet, the results also suggest that the correspondence between depressive symptoms and self-rated health increases. Indeed, after age 74, the correspondence between self-rated health and some common symptoms of depression becomes stronger than that between self-rated health and several chronic, and often fatal, somatic conditions. This crossover has important implications for the detection and treatment of depressive symptoms in later life.

Effect of valued activity disability, social comparisons, and satisfaction with ability on depressive symptoms in rheumatoid arthritis

This longitudinal study identified a model through which function affects the psychologicalwell-being of individuals with rheumatoid arthritis (RA). Results of hierarchical linear regression analyses (N = 436) demonstrated that greater physical impairment resulted in greater disability in valued activities and engagement in unfavorable social comparisons. All 3 factors--greater physical impairment, greater disability in valued activities, and unfavorable comparison evaluations--predicted low satisfaction with abilities. Low satisfaction with abilities was the most important predictor of higher depressive symptoms and mediated the impact of physical impairment, valued activity disability, and unfavorable comparisons on depressive symptoms. Results highlight the role of personal meaning attached to changes in functional status in predicting the long-term psychological well-being of individuals with chronic illnesses such as RA.

Construing benefits from adversity: adaptational significance and dispositional underpinnings

The discovery of benefits from living with adversity has been implicated in psychological well-being in numerous investigations, is pivotal to several prominent theories of cognitive adaptation to threat, and can be predicted by personality differences. This article summarizes the prevalence and adaptive significance of finding benefits from major medical problems, locates the place of benefit-finding in stress and coping theories, and examines how it may be shaped by specific psychological dispositions such as optimism and hope and by broader personality traits such as Extraversion and Openness to Experience. The distinction between beliefs about benefits from adversity (benefit-finding) and the use of such knowledge as a deliberate strategy of coping with the problem (benefit-reminding) is underscored and illustrated by daily process research on coping with chronic pain.

Coping with rheumatoid arthritis

RA patients may develop a coping style early in the illness and utilize their favourite strategies when confronted with the stressor of illness. Little distinction was found between specific illness stressors, i.e. pain vs. disability, or whether a strategy had been successfully used before. In the face of a new illness, strategies may be tried out over a period of time, as the stressor is one for which everyday coping strategies are no longer appropriate or sufficient. As one health psychologist has written, 'Individuals' coping responses are often spontaneous; that is, people do what comes naturally to them and what has worked in the past. But sometimes these efforts will not be enough. The stressor may be so novel, so chronic, or so elusive that people's own efforts may be unsuccessful in reducing stress' (Taylor, 1985, p 213).