INTERPERSONAL STRESS AND DISEASE ACTIVITY IN ARTHRITIS

这项研究将检验人际压力影响的假设 女性(55-75岁)类风湿性关节炎(RA)的病程 激活内分泌和免疫系统。拉是一个进步的人 全身性疾病，涉及调节的紊乱。 神经内分泌和自身免疫系统。在我们之前的研究中，我们发现 强有力的证据表明，RA疾病进展的一个关键因素可能是 患者对生活环境的反应：应激事件似乎 对人的生理反应和心理健康有更大的影响 类风湿关节炎患者与骨性关节炎患者比较。这项研究旨在检查 这一假设是通过重复测量来跟踪RA患者一段时间的 评估他们对自然环境的心理和生理反应 正在发生的人际应激源事件。他们的反应将被比较 对年龄和年龄匹配的OA患者和健康对照组的反应 婚姻状况。80名女性类风湿关节炎(RA)患者，80名女性 骨关节炎(OA)患者和80名健康对照将接受采访 每周通过电话评估人际压力水平并进行监测 疾病状态，在最初的基线评估之后。与一项 基线面谈，在人际关系压力增加和 在患者群体中出现疾病发作的一段时间，临床评估 将对疾病状态进行评估，并抽取血液样本。血液样本 将被分析以检测压力荷尔蒙水平的变化，以及 在基线和应激时间之间以及在 每组的基线和闪光时间。

This research will test the hypothesis that interpersonal stressors affect the course of rheumatoid arthritis (RA) among women (age 55-75) through activation of the endocrine and immune systems. RA is a progressive systemic disease involving disturbance in the regulation of the neuroendocrine and auto-immune systems. In our prior research, we found strong evidence that a key factor in RA disease progression may be the patient's reactivity to life circumstances: Stressful events appear to have a greater impact on the physiological responses and mental health of RA patients as compared to OA patients. This study is designed to examine this hypothesis by following RA patients over time with repeated measures to assess their psychological and physiological reactions to naturally occurring interpersonal stressor events. Their reactions will be compared to the reactions of OA patients and healthy controls, matched in age and marital status. 80 female rheumatoid arthritis (RA) patients, 80 female osteoarthritis (OA) patients, and 80 healthy controls will be interviewed weekly by telephone to assess interpersonal stress levels and monitor disease state, after an initial baseline assessment. Coincident with a baseline interview, during a period of increased interpersonal stress and a period of disease flare among the patient groups, clinical assessments of disease state will be made and blood samples drawn. The blood samples will be analyzed to detect changes in levels of stress hormones, and immune parameters between baseline and a time of stress, and between baseline and a time of flare, for each group.