A biopsychosocial model of disability in rheumatoid arthritis

Arthritis Care Res. 1996 Oct;9(5):368-75. doi: 10.1002/1529-0131(199610)9:5<368::aid-anr1790090505>3.0.co;2-5.


Objective: To test and cross-validate a model using disease activity, pain, and helplessness to predict future psychological and physical disability in persons with rheumatoid arthritis (RA) across time.

Methods: Measures of disease activity, pain, helplessness, psychological function, and physical function were collected from 63 males with RA at baseline, 3 months, and 6 months. Path analytic methods were used to examine longitudinal relationships among these variables.

Results: Path analysis revealed that pain and helplessness were significant mediators of the relationship between disease activity and future disability in RA; the predictive model withstood two cross-validations.

Conclusion: The findings suggest that pain and helplessness are key biopsychosocial variables that affect the development of disability in RA.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / physiopathology
  • Arthritis, Rheumatoid* / psychology
  • Disabled Persons*
  • Factor Analysis, Statistical
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Models, Statistical*
  • Predictive Value of Tests
  • Time Factors