STRESS AND ADAPTATION TO RHEUMATOID ARTHRITIS

描述（改编自研究者摘要）：本研究旨在 来确定认知行为疗法的变化 减少疾病活动，改善老年人的心理健康， 类风湿性关节炎（RA）。该研究结合了实地评估、实验室 压力反应测试和精神和身体的临床评估 纵向设计中的受试者的健康。经过预测试，210名RA患者 将随机选择三种治疗方法之一：认知行为 疼痛治疗（CBT-P），抑郁症认知行为治疗（CBT-D）或 仅教育组（EG），作为对照。之间的区别 疼痛和抑郁作为CBT在RA中的焦点， 研究人员对人际压力和疾病活动的研究， 关节炎患者。疾病严重程度、抑郁症状和人际关系 困难预计预测心理和生理压力 参与者的回应。压力反应性测量预计可以预测 随着时间的推移，疾病的进程。那些接受CBT-D的人预计将显示 身体机能、心理健康和疾病的最大改善 活动成功的治疗有望改变应激反应， 随着时间的推移，身体和精神健康会更好。

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.