Parameters of the Subjective Pattern of Disease in Rheumatoid Patients

Abstract

Introduction. A patient’s subjective pattern of disease (SPD) is considered both as a result of his/her adjustment to disease and as an instrument of personal self-regulation in disease. Modern clinical psychology actively investigates this psychological construct, which expands available knowledge obtained in the process of determining psychological factors of the treatment process. The present study appears to be the first that examines rheumatoid patients using a SPD multilevel model, which focuses on illness perceptions and coping with it. Methods. The study sample consisted of 80 patients with rheumatic diseases aged 18–52 years, 50 % of whom were patients with rheumatoid arthritis (RA) and 50 % of whom were patients with systemic lupus erythematosus (SLE). The study used the following techniques for assessing the structure and content of various levels of the subjective pattern of disease: (a) the Symptoms Check-List-90-Revised (SCL-90-R), (b) the Brief Inventory of Illness Perceptions, and (c) the technique for psychological assessment of coping with stressful and problematic events. Results. In the comparison groups, significant differences were observed on the scales of illness perceptions (‘illness understanding’, ‘course of illness’, ‘control of illness’, ‘control of treatment’), the scales of coping behavior (‘search for social support’, ‘acceptance of responsibility’), and the scales of ‘somatization’, ‘depression’, and ‘anxiety’. The correlations indicate associations among the parameters of various levels of the subjective pattern of disease in patients in both groups. Discussion. The parameters of the subjective pattern of disease in patients with systemic lupus erythematosus indicate their desire to recognize and overcome uncertainty and unpredictability of their disease. However, this does not reduce their emotional involvement in the problem. The subjective pattern of disease in patients with rheumatoid arthritis is characterized by a worse understanding and control of disease, as well as by emotion-focused coping strategies aimed at distancing from anxiety-related experiences associated with their disease.