Perceiving control, construing benefits, and daily processes in rheumatoid arthritis.

Abstract

To examine the influence of perceived pain control and pain benefit appraisals on adjustment to rheumatoid arthritis (RA), we followed fifty-four RA patients for seventy-five days. After completing measures of dispositional optimism and appraisals of control over, and benefits from, their chronic pain, participants reported each day their pain intensity, mood, and activity limitations due to pain. Controlling for disease activity and dispositional optimism, those who believed they had more control over their pain at the outset of the study experienced less daily pain. Daily pain also moderated the relation between control beliefs and adjustment as well as the relation between benefit appraisals and adjustment: With increased levels of pain, greater control was associated with less positive mood. But those who perceived more benefits and then experienced severe pain reported fewer days on which their activities were limited by their pain. These findings are discussed as they relate to current conceptions of control. ResumePendant 75 jours, nous avons suivi 54 patients souffrant de polyarthrite rhumatoide afin d'etudier rinfluencc, sur 1'adaptation a l'arthrite, de la perception qu'ont les patients du controle de la douleur et de leur evaluation des bienfaits qu'ils tirent de la maladie. Les patients ont tout d'abord evalue leur tendance a l'optimisme, Ie controle qu'ils exercaient sur la douleur chronique ainsi que les bienfaits qu'ils tiraient de la maladie. Us ont ensuite consign^, chaque jour, l'intensit£ de leur douleur, leur hurneur et les limites impos£es par la douleur a leurs activity?. En exercant un contrdle sur les manifestations de la maladie et sur la tendance a l'optimisme, les patients qui, au commencement dc I'etude, croyaient davantagc exercer un controle sur leur douleur, ont moins ressenti de douleur quotidiennement. En outre, la douleur eprouvee chaque jour a amoindri la relation entre la perception du contrdle et 1'adaptation des patients, ainsi que la relation entre l'estimation des bienfaits et 1'adaptation. En effet, lorsque l'intensite dc la douleur £tait forte, un contrCle accru correspondait a une humeur moins positive. Par contre, chez les patients qui percevaicnt plus de bienfaits et qui ont par la suite ressenti une douleur tres intense, le nombre de jours ou la douleur restreignait ies activites etait

The Construct Validity of the Illness Cognition Questionnaire: The Robustness of the Three-factor Structure Across Patients with Chronic Pain and Chronic Fatigue

“…Some of these instruments are symptom-specific (19,24,25) and, hence, do not allow comparisons between groups with different symptoms. An example of a disease-specific instrument is the Perceived Control and Benefits Questionnaire (25), designed to measure personal control and the perception of benefits in patients with chronic pain. Other measures assess the constructs in a trait-like fashion unrelated to specific situations such as chronic illnesses (26,27,28).…”

Chronic strain, daily work stress and pain among workers with rheumatoid arthritis: Does job stress make a bad day worse?

“…For instance, having challenging, stimulating work and having control over one's pace, schedule, and activities may give one a feeling of control over the events that occur, as Karasek and Theorell (1990) suggest, or it may offer real options for action that help to neutralize the effect of a negative event. Workers in structural locations that offer such control may also be individuals who happen to possess a personal sense of control irrespective of their social location (see Tennen et al, 1992 for a review of this literature). The effortreward imbalance model of chronic work stress may provide insights into some of these issues, as it includes both a structural and a personal dimension (Siegrist, 2002).…”

Dynamic pain–emotion relations in chronic pain: a theoretical review of moderation studies

“…In a related study, Tennen et al (1992) distinguished between perceived control (primary control) and perceived benefits (secondary, cognitive control) and found that at high levels of pain the former is related to low mood and the latter with low activity limitations, further supporting the two-process model.…”