Skip to main content
Log in

The Contribution of Attributional Style to Perceived Disability in Rheumatoid Arthritis: A Longitudinal Study

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

The current study investigated the influence of general causal attributions on self-reported physical disability over the course of 1 year in a sample of 42 patients with rheumatoid arthritis (RA). Participants completed measures of attributional style, pain, and disability; physician assistants completed objective measures of disability on two occasions, approximately 1 year apart. Results indicated that internal attributions for disease-unrelated negative events assessed at Time 1 were associated with lower perceived physical disability, whereas stable attributions for negative events were associated with greater perceived physical disability 1 year later. These findings are discussed in terms of behavioral and characterological self-blame models, respectively. Implications of our findings for clinical management of RA are also discussed.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Abramson, L. Y., Metalsky, G., & Alloy, L. (1989). Hopelessness depression:Atheory-based subtype of depression. Psychological Review, 96, 358-372.

    Google Scholar 

  • Abramson, L. Y., Seligman, M. E. P., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87(1), 49-74.

    Google Scholar 

  • Allaire, S. H., Meenan, R. F., & Anderson, J. J. (1991). The impact of rheumatoid arthritis on the household work performance of women. Arthritis and Rheumatism, 34(6), 669-678.

    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., & Hunder, G. (1988). The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis and Rheumatism, 31, 315-324.

    Google Scholar 

  • Brown, J. D., & Siegel, J. M. (1988). Attributions for negative life events and depression: The role of perceived control. Journal of Personality and Social Psychology, 54(2), 316-322.

    Google Scholar 

  • Callahan, L. F., Brooks, R. H.,& Pincus, T. (1988). Further analysis of learned helplessness in rheumatoid arthritis using a Rheumatology Attitudes Index. Journal of Rheumatology, 15, 418-426.

    Google Scholar 

  • Chaney, J. M., Mullins, L. L., Uretsky, D. L., Doppler, M. J., Palmer, W. R., Wees, S. J., Klein, H. S., Doud, D. K., & Reiss, M. J. (1996). Attributional style and depression in rheumatoid arthritis: The moderating role of perceived illness control. Rehabilitation Psychology, 3, 205-223.

    Google Scholar 

  • Chaney, J. M., Uretsky, D. L., Mullins, L. L., Doppler, M. J., Palmer, W. R., Wees, S. J., Klein, H. S., Doud, D. K., & Reiss, M. J. (1996). Differential effects of age and illness duration on pain–depression and disability–depression relationships in rheumatoid arthritis. International Journal of Rehabilitation and Health, 2(2), 101-112.

    Google Scholar 

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

    Google Scholar 

  • DeVellis, B. M., & Blalock, S. J. (1992). Illness attributions and hopelessness depression: The role of hopelessness expectancy. Journal of Abnormal Psychology, 101, 257-264.

    Google Scholar 

  • Dowdy, S. W., Dwyer, K. A., Smith, C. A., & Wallston, K. A. (1996). Gender and psychological well-being of persons with rheumatoid arthritis. Arthritis Care and Research, 9(6), 449-456.

    Google Scholar 

  • Frank, R. G., Chaney, J. M., Clay, D. L., & Kay, D. R. (1991). Depression in rheumatoid arthritis:Are-evaluation. Rehabilitation Psychology, 36, 219-230.

    Google Scholar 

  • Fries, J. F., Spitz, P., Kraines, R. G., & Holman, H. R. (1980). Measurement of patient outcome in arthritis. Arthritis and Rheumatism, 23(2), 137-145.

    Google Scholar 

  • Gerber, L. (1988). Outcome measures in rheumatic disease. In Hicks, J., Nichols, J., & Sweezy, R. (Eds.), Handbook of rehabilitative rheumatology(pp. 9-19). Atlanta, GA: American Rheumatism Association.

    Google Scholar 

  • Hagglund, K. J., Haley, W. E., Reveille, J. D., & Alarcon, G. S. (1989). Predicting individual differences in pain and functional impairment among patients with rheumatoid arthritis. Arthritis and Rheumatism, 32(7), 851-858.

    Google Scholar 

  • Hewlett, S., Young, P.,& Kirwan, J. (1995). Dissatisfaction, disability, and rheumatoid arthritis. Arthritis Care and Research, 8(1), 4-9.

    Google Scholar 

  • Hidding, A., van Santen, M., De Klerk, E., Gielen, X., Beers, M., Geenen, R., Vlaeyen, J., Kester, A., & van der Linden, S. (1994). Comparison between self-report measures and clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia. Journal of Rheumatology, 21, 818-823.

    Google Scholar 

  • Hollingshead, A. (1957). Two factor index of social position.New Haven, CT: Author.

    Google Scholar 

  • Holm, M. B., Rogers, J. C., & Kwoh, C. K. (1998). Predictors of functional disability in patients with rheumatoid arthritis. Arthritis Care and Research, 11(5), 346-355.

    Google Scholar 

  • Hommel, K. A., Chaney, J. M., Mullins, L. L., Palmer, W., Wees, S., & Klein, H. (1998). The relative contributions of attributional style and arthritis helplessness to depression in rheumatoid arthritis: A longitudinal investigation. International Journal of Rehabilitation and Health, 4(1), 59-67.

    Google Scholar 

  • Liang, M. H., Cullen, K., & Larson, M. (1982). In search of a more perfect mousetrap (health status or quality of life instrument). Journal of Rheumatology, 9, 775-779.

    Google Scholar 

  • Lorish, C. D., Abraham, N., Austin, J., Bradley, L. A., & Alarcon, G. S. (1991). Disease and psychosocial factors related to physical functioning in rheumatoid arthritis. Journal of Rheumatology, 18(8), 1150-1157.

    Google Scholar 

  • McCracken, J. M. (1991). Cognitive-behavioral treatment of rheumatoid arthritis:Apreliminary review of efficacy and methodology. Annals of Behavioral Medicine 13(2), 57-65.

    Google Scholar 

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

    Google Scholar 

  • O'Leary, A., Shoor, S., Lorig, K., & Holman, H. R. (1988). A cognitive-behavioral treatment for rheumatoid arthritis. Health Psychology, 7(6), 527-544.

    Google Scholar 

  • Peterson, C. (1988). Explanatory style as a risk factor for illness. Cognitive Therapy and Research, 12(2), 119-132.

    Google Scholar 

  • Peterson, C., Maier, S. F., & Seligman, M. E. P. (1993). Learned Helplessness: A Theory for the Age of Personal Control.New York, NY: Oxford University Press.

    Google Scholar 

  • Peterson, C., & Seligman, M. E. P. (1984). Causal explanations as risk factors for depression: Theory and evidence. Psychological Review, 91, 347-374.

    Google Scholar 

  • Peterson, C., Semmel, A., von Baeyer, C., Abramson, L., Metalsky, G., & Seligman, M. (1982). The Attributional Style Questionnaire. Cognitive Therapy and Research, 6, 287-300.

    Google Scholar 

  • Pincus, T., Summey, J., Soraci, S., Wallston, K., & Hummon, N. (1983). Assessment of patient satisfaction in activities of daily living using amodified Stanford Health Assessment Questionnaire. Arthritis and Rheumatism, 26, 1346-1353.

    Google Scholar 

  • Schiaffino, K. M., & Revenson, T. A. (1992). The role of perceived self-efficacy, perceived control, and causal attributions in adaptation to rheumatoid arthritis: Distinguishing mediator from moderator effects. Personality and Social Psychology Bulletin, 18(6), 709-718.

    Google Scholar 

  • Schiaffino, K., & Revenson, T. (1995). Why me? The persistence of negative appraisals over the course of illness. Journal of Applied Social Psychology, 25, 601-619.

    Google Scholar 

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

    Google Scholar 

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

    Google Scholar 

  • Smith, T. W., Peck, J. R., Milano, R. A., & Ward, J. R. (1988). Cognitive distortion in rheumatoid arthritis: Relation to depression and disability. Journal of Consulting and Clinical Psychology, 56(3), 412-416.

    Google Scholar 

  • Smith, T., Peck, J., & Ward, J. (1990). Helplessness and depression in rheumatoid arthritis. Health Psychology, 9, 377-389.

    Google Scholar 

  • Spiegel, J. S., Leake, B., Spiegel, T. M., Paulus, H. E., Kane, R. L., Ward, N. B.,& Ware, J. E. (1988). What are we measuring? An examination of self-reported functional status measures. Arthritis and Rheumatism, 31(6), 721-728.

    Google Scholar 

  • Stein, M., Wallston, K., & Nicassio, P. (1988). Factor structure of the Arthritis Helplessness Index. Journal of Rheumatology, 15, 427-432.

    Google Scholar 

  • Stein, M. J., Wallston, K. A., Nicassio, P. M., & Castner, N. M. (1988). Correlates of a clinical classification schema for the arthritis helplessness subscale. Arthritis and Rheumatism, 31(7), 876-881.

    Google Scholar 

  • Tennen, H., Affleck, G.,& Gershman, K. (1986). Self-blame among parents of infants with perinatal complications: The role of self-protective motives. Journal of Personality and Social Psychology, 50(4), 690-696.

    Google Scholar 

  • Ward, M. M., & Leigh, J. P. (1993). The relative importance of pain and functional disability to patients with rheumatoid arthritis. Journal of Rheumatology, 20(9), 1494-1499.

    Google Scholar 

  • Wilder, R. (1993). Rheumatoid arthritis. In H. R. Schumacher, Jr., J. H. Klippel, & W. J. Koopman (Eds.), Primer on the rheumatic diseases(10th ed., pp. 86-89). Atlanta, GA: Arthritis Foundation.

    Google Scholar 

  • Wright, G. E., Parker, J. C., Smarr, K. L., Schoenfeld-Smith, K., Buckelew, S. P., Slaughter, J. R., Johnson, J. C., & Hewett, J. E. (1996). Risk factors for depression in rheumatoid arthritis. Arthritis Care and Research, 9(4), 264-272.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hommel, K.A., Chaney, J.M., Mullins, L.L. et al. The Contribution of Attributional Style to Perceived Disability in Rheumatoid Arthritis: A Longitudinal Study. Journal of Clinical Psychology in Medical Settings 7, 113–120 (2000). https://doi.org/10.1023/A:1009543631311

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1009543631311

Navigation