The effects of written emotional disclosure and coping skills training in rheumatoid arthritis: A randomized clinical trial.

• DOI: 10.1037/a0036958
• Publication Date: 2014-05-27T16:57:26Z
• Authors: Mark A. Lumley; Francis J. Keefe; Angelia Mosley-Wi...; John R. Rice; Daphne McKee; Sandra J. Waters; R. Ty Partridge; Jennifer N. Carty; Ainoa M. Coltri; Anita Kalaj; Jay L. Cohen; Lynn C. Neely; Jennifer K. Pahssen; Mark A. Connelly; Yelena B. Bouaziz; Paul A. Riordan
• Keywords: Repeated measures design

Two psychological interventions for rheumatoid arthritis (RA) are cognitive-behavioral coping skills training (CST) and written emotional disclosure (WED). These approaches have developed independently, their combination may be more effective than either one alone. Furthermore, most studies of each intervention methodological limitations, needs further testing.We randomized 264 adults with RA in a 2 × factorial design to 1 writing conditions (WED vs. control writing) followed by (CST education training). Patient-reported pain functioning, blinded evaluations disease activity walking speed, an inflammatory marker (C-reactive protein) were assessed at baseline 1-, 4-, 12-month follow-ups.Completion was high (>90% patients), attrition low (10.2% follow-up). Hierarchical linear modeling treatment effects over the follow-up period, analyses covariance assessment point, revealed no interactions between training; however, both had main on outcomes, small effect sizes. Compared training, CST decreased symptoms through 12 months. The WED mixed: writing, reduced physical disability month only, but measures 4 months.The does not improve perhaps because has unique different time points. improves health status is recommended patients, whereas limited benefits strengthening or better targeting appropriate patients.