The effects of cognitive distortion and depression on disability in rheumatoid arthritis

Abstract

The question explored in this study was: What is the effect of cognitive distortion and depression on disability in arthritis patients when stage of disease is controlled? Patients (N = 165) completed the Sickness Impact Profile, two Cognitive Error Questionnaires, and the Symptom Questionnaire, and were staged for severity of disease. Findings indicated a significant effect of distortion on disability in rheumatoid arthritis patients; however, this effect varied by stage. Distortion and depression best explained total disability in Stage II (R2 = .60 using general distortion; R2 = .58 using arthritis distortion). Future nursing interventions designed to decrease or prevent distortion might reduce disability as well as depression.

A Cognitive-Behavioral Self-Help Educational Program for Patients with COPD

“…It is also possible that the specific instruction around identifying and re structuring negative cognitions was responsible for the decrease in the level of psychosocial disability. This is consistent with the model proposed by Clough [12] that indicates that distortion has a direct effect on disability.…”

“…Subscores include catastrophizing, overgeneraliza tion, personalization, and selective abstraction [29]. The reliability and validity of the CEQ have been demonstrated for various chronic illness populations [12,29]. The COPD-CEQ was evaluated for face validity by an expert in chronic illness and was piloted with four COPD patients prior to this study.…”

“…Elevated levels of depression and anxiety have been reported and correlated with severity of dyspnea [2,[5][6][7], Cherniack and Altose [8] suggest that dyspnea 'has a cer tain affective dimension of unpleasantness that is shaped by cognitive and contextual factors ' [p. 207], According to Beck [9], individuals who experience pro longed, insidious stressors are at risk for making cognitive errors which are called cognitive distortions and are described as 'extreme, one-sided, absolutists and global judgments ' [p. 340], In this context, cognitive distortion appears related to the level of disability and depression in individuals with low back pain [10] and rheumatoid arthritis [11][12][13], Although cognitive distortion has not been measured in individuals with COPD, perceptions, attitudes and beliefs are known to influence level of dis ability [14,15], Research has shown that level of disability is often disproportionate to actual pulmonary function in individuals with COPD. Therefore, it would be important to determine whether a general pattern of cognitive dis tortion or specific illness-related cognitive distortions could be identified in these individuals and whether an intervention designed to correct such distortions would improve level of function.…”

Experiencing Health in the Context of Rheumatoid Arthritis

“…The other participants chose not to dwell on that aspect of their lives, but instead related the activities that moved them forward beyond painful moments. In quantitative studies researchers have identified an exaggerated appraisal of the environment and cognitive distortions and depression among those with RA (Clough, 1991). While the men and women in this study used the terms sadness and occasionally depressed, unpleasant feelings were not a frequent topic nor were the thoughts and actions reported indicative of depression.…”

Validity and reliability of a revised Japanese version of the Arthritis Impact Measurement Scales version 2 (AIMS2)

“…Perception of support needs and of their fulfilment is closely associated with subjects' coping behaviors, and therefore can vary greatly among individuals. [26][27][28] The roles of family care and social support in the management of RA patients remain to be studied. 29 In this study, the validity of the questionnaire was assessed by internal standards, based on the premise that if several questions measure the same or related things, then they should be highly correlated with one another.…”