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Cognitive behavioral coping skills training improved health status in patients with RA
While coping skills training improved health status in patients with rheumatoid arthritis, written emotional disclosure showed limited benefits and needs strengthening or better targeting to appropriate patients, according to a recently published study.
Researchers randomly assigned 264 adults with rheumatoid arthritis (RA) to either written emotional disclosure (WED) or control writing followed by coping skills training (CST) or arthritis education control training. At baseline, 1-month, 4-month and 12-month follow-ups, researchers assessed patient-reported pain and functioning, blinded evaluations of disease activity and walking speed and an inflammatory marker.
Although researchers found no interactions between writing and training, both interventions had main effects on outcomes with small effect sizes. Study results showed a decrease in RA pain and psychological symptoms among patients who underwent CST vs. control training through 12 months. However, while WED reduced disease activity and physical disability at 1 month only, it had more pain on one of two measures at 4 months and 12 months vs. control writing, according to study results.
“Our study revealed that patients with RA receive positive benefits in both the short- and long-term using cognitive behavioral techniques such as relaxation, increasing pleasant activities, changing negative thoughts and problem solving,” Mark A. Lumley, PhD, professor of psychology at Wayne State University, stated in a press release. “WED, however, was less effective, and an examination of patients’ expressive writings suggests that many patients either did not have much unresolved stress or more likely did not know how to effectively identify important stressors, label and express their negative emotions and learn from or resolve these conflicts while writing by themselves. We probably need to identify and target those patients with unresolved stress or trauma, and then help them more effectively disclose and work with their unexpressed emotions.”
Disclosure: Funding was provided by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health. See full study for full list of authors’ relevant financial disclosures.