Skip to main content
SpringerLink
Log in

Differential effects of age and illness duration on pain-depression and disability-depression relationships in rheumatoid arthritis

  • Published:
International Journal of Rehabilitation and Health

Abstract

We examined the differential effects of age and illness duration on pain—depression and disability—depression relationships in a sample of patients diagnosed with rheumatoid arthritis (RA). Consistent with existing literature, main effect results indicated that shorter illness duration and greater perceived pain and functional disability all related to increased levels of depression. More importantly, multiple regression analyses revealed that illness duration moderated the observed disability—depression relationship. Specifically, perceived functional disability exerted a greater negative impact on levels of depression in patients with relatively shorter illness durations compared to patients with longer illness durations. Neither age nor illness duration moderated the association between pain and depression. In general, our findings suggest that age and illness duration differentially influence pain—depression and disability—depression relationships in RA. We conclude the paper with a discussion of treatment implications of our findings for persons with RA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Affleck, G., Tennen, H., Pfeifer, C., and Fifield, J. (1987). Appraisals of control and predictability in adapting to a chronic disease.J. Pers. Soc. Psychol. 53: 273–279.

    Google Scholar 

  • Affleck, G., Tennen, H., Urrows, S., and Higgins, P. (1991). Individual differencs in the day-to-day experience of chronic pain: A prospective daily study of rheumatoid arthritis patients.Health Psychol. 10: 419–426.

    Google Scholar 

  • American Psychiatric Association. (1994).Diagnostic and Statistical Manual of Mental Disorders, 4th ed., APA, Washington, DC.

    Google Scholar 

  • Arnett, F., Edworthy, S., Bloch, D., McShane, D., Fries, J., Cooper, N., Healy, L., Kaplan, S., Liang, M., Luthra, H., Medsger, T., Jr., Mitchell, D., Neustadt, D., Pinals, R., Schaller, J., Sharp, J., Wilder, R., and Hunder, G. (1988). The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.Arth. Rheum. 31: 315–324.

    Google Scholar 

  • Baron, R., and Kenny, D. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.J. Pers. Soc. Psychol. 51: 1173–1182.

    Google Scholar 

  • Bennett, J. (1988). Clinical features. In Schumacher, H., Klippel, J., and Robinson, D. (eds.),Primer on the Rheumatic Diseases 9th ed., Arthritis Foundation, Atlanta, pp. 36–44.

    Google Scholar 

  • Bijlsma, J., Huiskes, C., Kraaimaat, F., Vanderveen, M., and Huber-Bruning, O. (1991). Relation between patients' own health assessment and clinical and laboratory findings in rheumatoid arthritis.J. Rheum. 18: 650–653.

    Google Scholar 

  • Bombardier, C., Tugwell, P., Anderson, G., and Buchanan, W. (1982). Choice of clinical measures for drug trials: Results of a workshop.Arth. Rheum. 25S: 24 (abstract).

    Google Scholar 

  • Brown, G. (1990). A causal analysis of chronic pain and depression.J. Abnorm. Psychol. 99: 127–137.

    Google Scholar 

  • Brown, G., and Nicassio, P. (1987). Development of a questionnaire for the assessment of active and passive coping strategies in chronic pain patients.Pain 31: 53–64.

    Google Scholar 

  • Chaney, J., Mullins, L., Uretsky, D., Doppler, M., Palmer, W., Wees, S., Klein, H., Doud, D., and Reiss, M. (1996). Attributional style and depression in rheumatoid arthritis: The moderating role of perceived illness control.Rehab. Psychol. (in press).

  • Cohen, J., and Cohen, P. (1983).Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, 2nd ed., Erlbaum, Hillsdale, NJ.

    Google Scholar 

  • Council, J., Ahern, D., Follick, M., and Kline, C. (1988). Expectancies and functional impairment in chronic low back pain.Pain 33: 323–331.

    Google Scholar 

  • Cronbach, L. (1951). Coefficient alpha and the internal structure of tests.Psychometrika 16: 297–334.

    Google Scholar 

  • Devins, G., Edworthy, S., Guthrie, N., and Martin, L. (1992). Illness intrusiveness in rheumatoid arthritis: Differential impact on depressive symptoms over the adult lifespan.J. Rheum. 19: 709–715.

    Google Scholar 

  • Deyo, R., Unui, T., Leininger, J., and Overman, S. (1982). Physical and psychosocial function in rheumatoid arthritis.Arch. Int. Med. 142: 879–882.

    Google Scholar 

  • Felton, B., and Revenson, T. (1987). Age differences in coping with chronic illness.Psychol. Aging 2: 164–170.

    Google Scholar 

  • Frank, R., Beck, N., Parker, J., Kashani, J., Elliott, T., Haut, A., Smith, E., Atwood, C., Brownlee-Duffeck, M., and Kay, D. (1988). Depression in rheumatoid arthritis.J. Rheum. 15: 920–925.

    Google Scholar 

  • Frank, R., Chaney, J., Clay, D., and Kay, D. (1991). Depression in rheumatoid arthritis: A re-evaluation.Rehab. Psychol. 36: 219–230.

    Google Scholar 

  • Frank, R., Chaney, J., Clay, D., Shutty, M., Beck, N., Kay, D., Elliott, T., and Grambling, S. (1992). Dysphoria: A major symptom factor in persons with disability or chronic illness.Psychiat. Res. 43: 231–241.

    Google Scholar 

  • Fries, J., Spitz, P., Kraines, R., and Holman, H. (1980). Measurement of patient outcome in arthritis.Arth. Rheum. 23: 137–145.

    Google Scholar 

  • Gerber, L. (1988). Outcome measures in rheumatic disease. In Hicks, J., Nichols, J., and Swezey, R. (eds.),Handbook of Rehabilitative Rheumatology. American Rheumatism Association, Atlanta, pp. 9–19.

    Google Scholar 

  • Gibson, T., and Clark, B. (1985). Use of simple analgesics in rheumatoid arthritis.Ann. Rheumatol. Dis. 44: 27–29.

    Google Scholar 

  • Hawley, D., and Wolfe, F. (1988). Anxiety and depression in patients with rheumatoid arthritis: A prospective study of 400 patients.J. Rheum. 15: 932–941.

    Google Scholar 

  • Hidding, A., van Santen, M., De Klerk, E., Gielen, X., Boers, M., Geenen, R., Vlaeyen, J., Kester, A., and van der Linden, S. (1994). Comparison between self-report measures and clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis and fibromyalgia.J. Rheum. 1: 818–823.

    Google Scholar 

  • Hochberg, M. (1988). Epidemiology of the rheumatic diseases. In Schumacher, H., Klippel, J., and Robinson, D. (eds.),Primer on the Rheumatic Diseases, 9th ed., Arthritis Foundation, Atlanta, pp. 48–50.

    Google Scholar 

  • Hollingshead, A. (1957).Two Factor Index of Social Position, Author, New Haven, CT.

    Google Scholar 

  • Kazis, L., Meenan, R., and Anderson, J. (1983). Pain in the rheumatic diseases.Arth. Rheum. 26: 1017–1022.

    Google Scholar 

  • Keefe, F., Brown, G., Wallston, K., and Caldwell, D. (1989). Coping with rheumatoid arthritis pain: Catastrophizing as a maladaptive strategy.Pain 37: 51–56.

    Google Scholar 

  • Kerns, R., and Haythornthwaite, J. (1988). Depression among chronic pain patients: Cognitive-behavioral analysis and effect on rehabilitation outcome.J. Consult. Clin. Psychol. 56: 870–876.

    Google Scholar 

  • Kirsch, I. (1985). Response expectancy as a determinant of experience and behavior.Am. Psychol. 40: 1189–1202.

    Google Scholar 

  • Lorig, K., Chastain, R., Ung, E., Shoor, S., and Holman, H. (1989). Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis.Arth. Rheum. 32: 37–44.

    Google Scholar 

  • McFarlane, A., and Brooks, P. (1988). Determinants of disability of rheumatoid arthritis.Br. J. Rheum. 27: 7–14.

    Google Scholar 

  • McKenna, F., and Wright, V. (1985). Pain and rheumatoid arthritis.Ann. Rheumatol. Dis. 44: 805.

    Google Scholar 

  • Meenan, R., Gertman, P., and Mason, J. (1980). Measuring health status in arthritis: The Arthritis Impact Measurement Scales.Arth. Rheum. 23: 146–152.

    Google Scholar 

  • Minor, M. (1991). Physical activity and management of arthritis.Ann. Behav. Med. 13: 117–124.

    Google Scholar 

  • Murphy, S., Creed, F., and Jayson, I. (1988). Psychiatric disorder and illness behavior in rheumatoid arthritis.Br. J. Rheum. 27: 357–363.

    Google Scholar 

  • Newman, S., Fitzpatrick, R., Lamb, R., and Shipley, M. (1989). The origins of depressed mood in rheumatoid arthritis.J. Rheum. 16: 740–744.

    Google Scholar 

  • Nicassio, P., and Wallston, K. (1992). Longitudinal relationships among pain, sleep problems, and depression in rheumatoid arthritis.J. Abnorm. Psychol. 101: 514–520.

    Google Scholar 

  • Nicassio, P., Wallston, K., Callahan, L., Herbert, M., and Pincus, T. (1985). The measurement of helplessness in rheumatoid arthritis: The development of the Arthritis Helplessness Index.J. Rheum. 12: 462–467.

    Google Scholar 

  • Parker, J., Frank, R., Beck, N., Smarr, K., Buescher, K., Phillips, L., Smith, E., Anderson, S., and Walker, S. (1988). Pain management in rheumatoid arthritis patients: A cognitive-behavioral approach.Arth. Rheum. 31: 593–601.

    Google Scholar 

  • Parker, J., Smarr, K., Walker, S., Hagglund, K., Anderson, S., Hewett, J., Bridges, A., and Caldwell, C. (1991). Biopsychosocial parameters of disease activity in rheumatoid arthritis.Arth. Care Res. 4: 73–80.

    Google Scholar 

  • Peck, J., Smith, T., Ward, J., and Milano, R. (1989). Disability and depression in rheumatoid arthritis: A multi-trait, multi-method investigation.Arth. Rheum. 32: 1100–1106.

    Google Scholar 

  • Pincus, T., Summey, J., Soraci, S., Wallston, K., and Hummon, N. (1983). Assessment of patient satisfaction in activities of daily living using a modified Stanford Health Assessment Questionnaire.Arth. Rheum. 26: 1346–1353.

    Google Scholar 

  • Potts, M., Weinberger, M., and Brandt, K. (1984). Views of patients and providers regarding the importance of various aspects of an arthritis treatment program.J. Rheumatol. 11: 71–75.

    Google Scholar 

  • Rolland, J. (1987). Chronic illness and the life cycle: A conceptual framework.Fam. Proc. 26: 203–221.

    Google Scholar 

  • Rolland, J. (1988). A conceptual model of chronic and life-threatening illness and its impact on families. In Chilman, C., Nunnally, E., and Cox, F. (eds.).Chronic Illness and Disability, Sage, Beverly Hills, pp. 17–68.

    Google Scholar 

  • Schiaffino, K., and Revenson, T. (1992). The role of perceived self-efficacy, perceived control, and causal attributions in adaptation to rheumatoid arthritis: Distinguishing mediator from moderator effects.Pers. Soc. Psychol. Bull. 18: 709–718.

    Google Scholar 

  • Smith, C., Wallston, K., and Dwyer, K. (1995). On babies and bathwater: Disease impact and negative affectivity in the self-report of persons with rheumatoid arthritis.Health Psychol. 14: 64–73.

    Google Scholar 

  • Smith, T., Peck, J., Milano, R., and Ward, J. (1988). Cognitive distortion in rheumatoid arthritis: Relation to depression and disability.J. Consult. Clin. Psychol. 56: 412–416.

    Google Scholar 

  • Smith, T., Peck, J., and Ward, J. (1990). Helplessness and depression in rheumatoid arthritis.Health Psychol. 9: 377–389.

    Google Scholar 

  • Smith, T., Christensen, A., Peck, J., and Ward, J. (1994). Cognitive distortion, helplessness, and depressed mood in rheumatoid arthritis: A four-year longitudinal analysis.Health Psychol. 13: 213–217.

    Google Scholar 

  • Stein, M., Wallston, K., Nicassio, P., and Castner, N. (1988). Correlates of a clinical classification schema for the Arthritis Helplessness subscale.Arth. Rheum. 31: 876–881.

    Google Scholar 

  • Young, L. (1992). Psychological factors in rheumatoid arthritis.J. Consult. Clin. Psychol. 60: 619–627.

    Google Scholar 

  • Young, L. (1993). Rheumatoid arthritis. In Gatchel, R., and Blanchard, E. (eds.),Psychophysiological Disorders, American Psychological Association, Washington, DC, pp. 269–298.

    Google Scholar 

  • Zimmerman, M., and Coryell, W. (1987). The Inventory to Diagnose Depression: A self-report scale to diagnose major depressive disorder.J. Consult. Clin. Psychol. 55: 55–59.

    Google Scholar 

  • Zimmerman, M., and Coryell, W. (1988). The validity of a self-report questionnaire for diagnosing major depressive disorder.Arch. Gen. Psychiat. 45: 738–740.

    Google Scholar 

  • Zimmerman, M., and Coryell, W. (1994). Screening for major depressive disorder in the community: A comparison of measures.Psychol. Assess. 6: 71–74.

    Google Scholar 

  • Zimmerman, M., Coryell, W., Wilson, S., and Corenthal, C. (1986). Evaluation of symptoms of major depressive disorder: Self-report vs. clinician ratings.J. Nerv. Ment. Dis. 174: 150–153.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Oklahoma State University, 215 North Murray Hall, 74078, Stillwater, Oklahoma

    John M. Chaney, Debra L. Uretsky, Larry L. Mullins & Matthew J. Doppler

  2. Internal Medicine Associates, P.C., 68131, Omaha, Nebraska

    William R. Palmer, Steven J. Wees, Harry S. Klein, Deborah K. Doud & Mary L. Reiss

Authors
  1. John M. Chaney
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Debra L. Uretsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Larry L. Mullins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Matthew J. Doppler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. William R. Palmer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Steven J. Wees
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Harry S. Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Deborah K. Doud
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mary L. Reiss
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chaney, J.M., Uretsky, D.L., Mullins, L.L. et al. Differential effects of age and illness duration on pain-depression and disability-depression relationships in rheumatoid arthritis. Int J Rehab Health 2, 101–112 (1996). https://doi.org/10.1007/BF02213445

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02213445

Key Words

Search

Navigation