Dr. Mark Lumley publishes major paper on psychological interventions for rheumatoid arthritis

Department of Psychology professor Mark A. Lumley was the lead author of a major paper on psychological interventions for rheumatoid arthritis. Titled "The Effects of Written Emotional Disclosure and Coping Skills Training in Rheumatoid Arthritis: A Randomized Clinical Trial", the article appears in the Journal of Consulting and Clinical Psychology (Volume 82, Number 4, pp. 644-658).

ABSTRACT:

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

A pdf of the article can be purchased at http://psycnet.apa.org/journals/ccp/82/4/644/