Krankheitsbewältigung und Situationseinschätzung bei Patienten mit rheumatoider Arthritis und Fibromyalgie-Syndrom/ Coping and appraisal in rheumatoid arthritis and fibromyalgia patients

OBJECTIVES AND METHODS In a cognitive framework appraisal and coping are seen as major factors in the adaptation of chronic pain patients. This study evaluates the differences between rheumatoid arthritis (N = 70) and fibromyalgia (N = 74) outpatients in regard to coping and appraisal, and the relationship between appraisal, coping and adaptation in general. RESULTS In rheumatoid arthritis patients acceptance of illness and cognitive-reappraising coping prevails. In fibromyalgia patients, however, passive, emotion-focused coping and the judgement of illness as a "threat" or "punishment" (Lipowsky) was pronounced. A connection between individual appraisal of the illness and means of coping was observed. There was also a strong relationship between coping and adaptation, with one third of the variance of the mood variables explained by appraisal and coping. The presence of a psychic disorders played only a minor role. CONCLUSIONS A detailed understanding of the relationship between appraisal, coping, and adaptation may contribute to improved treatment concepts in pain patients. One aim of psychotherapy in chronic pain patients should be to reduce passive, emotion-focused coping and to change maladaptative concepts of illness.