STRESS AND ADAPTATION TO RHEUMATOID ARTHRITIS

描述(改编自研究人员摘要)：本研究旨在 以确定认知行为疗法的变异程度 减少疾病活动，改善老年人的心理健康 类风湿关节炎(RA)。这项研究结合了现场评估、实验室 应激反应测试与心身健康状况的临床评价 纵向设计中受试者的健康状况。经过预测试，210名RA患者 将在三种治疗方法中随机选择一种：认知行为 疼痛疗法(CBT-P)、认知行为疗法(CBT-D)或 仅限教育组(EG)，作为对照。两者之间的区别 疼痛和抑郁作为RA CBT的焦点得到了先前资金的支持 调查人员对人际关系压力和疾病活动的研究 患有关节炎的人。疾病严重程度、抑郁症状和人际关系 困难预计会预测心理和生理压力 参与者的反应。压力反应性指标预计将预测 随时间推移的病程。那些接受CBT-D的人预计将展示 身体机能、心理健康和疾病方面的最大改善 活动。成功的治疗有望改变压力反应，导致 随着时间的推移，更好的身心健康。

Description (adapted from investigator's abstract): This research is designed to determine the extent to which variations in cognitive behavior therapy reduce disease activity and improve the mental health of older adults with rheumatoid arthritis (RA). The study combines field assessments, laboratory tests of stress reactivity and clinical evaluations of the mental and physical health of subjects in a longitudinal design. After pre-testing, 210 RA patients will be randomly selected in one of three treatments: Cognitive-Behavior Therapy for Pain (CBT-P), Cognitive-Behavior Therapy for Depression (CBT-D) or Education Group only (EG), which serves as a control. The distinction between pain and depression as foci of CBT in RA is supported by previously funded research by the investigator on interpersonal stress and disease activity in persons with arthritis. Illness severity, depressive symptoms and interpersonal difficulties are expected to predict psychological and physiologic stress responses in participants. Stress reactivity measures are expected to predict the course of illness over time. Those receiving CBT-D are expected to show the greatest improvement in physical functioning, mental health and disease activity. Successful treatment is expected to alter stress responses, leading to better physical and mental health over time.