Illness-specific and general perceptions of social relationships in adjustment to rheumatoid arthritis: The role of interpersonal expectations

Background: Adjustment to rheumatoid arthritis (RA) may be made more difficult when patients are unable to meet the expectations of family and friends about how well they are coping. Purpose: This study, investigated the influence of illness-specific interpersonal expectations and general indices of social interactions on depressive symptoms among 39 women with RA (M age = 46.9 years; M disease duration = 11.2 years). Methods: Female patients with RA and their spouses were recruited from an outpatient rheumatology clinic at an urban university hospital. Participants completed questionnaires at home and returned them to the research staff in prepaid, stamped envelopes. Results: Results showed a significant correlation between spousal expectations and patients' perceived inability to meet them. Further hierarchical regression analyses indicated that even when controlling for disease severity and traditional measures of social interactions (e.g., social support, perceived criticism, and general quality of the dyadic relationship), patient's perceived inability to meet spousal expectations contributed unique variance in depressive symptoms. Conclusions: These results suggest that adjustment to RA is not due entirely to the general features of social relationships, but additionally reflect specific aspects of the chronic illness milieu where spousal expectations and the patient's perceived inability to meet them are also related to adjustment.