INTERPERSONAL STRESS AND DISEASE ACTIVITY IN ARTHRITIS

本研究将检验人际压力源影响 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。RA是一种渐进性疾病 系统性疾病，涉及调节紊乱 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疾病进展的关键因素可能是 患者对生活环境的反应：压力事件似乎 对人的生理反应和心理健康有更大的影响 RA患者与OA患者相比。本研究旨在研究 通过对RA患者随时间的重复测量， 评估他们对自然环境的心理和生理反应， 发生人际应激事件。他们的反应将被比较 OA患者和健康对照者的反应，年龄和 婚姻状况80例女性类风湿关节炎（RA）患者，80例女性 骨关节炎（OA）患者和80名健康对照者将接受采访 每周通过电话评估人际压力水平，并监测 初步基线评估后的疾病状态。 与一个 基线访谈，在人际压力增加的时期， 患者组中疾病发作期，临床评估 将进行疾病状态评估并抽取血液样本。血样 将被分析以检测压力激素水平的变化， 基线和应激时间之间的免疫参数，以及 基线和发作时间。

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.