Family adaptability, cohesion and conflict in families with rheumatoid arthritis, chronic pain and depression

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Virginia Polytechnic Institute and State University


Seventy-four women with either rheumatoid arthritis (RA). chronic pain syndrome or depression and 59 of their spouse reported on their family cohesion, adaptability, and conflict. From a review of the literature. these three-dimension of family functioning were identified as important in “psychosomatic" families in which an adult member is physiologically vulnerable (Flor & Turk, 1985).

Data analysis consisted of cross tabular procedure and MANOVAs. Differences between the groups in terms of health status were explored using a MANOVA with group membership as the independent variable and the Arthritis Impact Measurement Scale (AIMS) as dependent variables. Overall the depression and chronic pain groups; were more similar than the PA group with the exception of the levels of Physical Activity and Pain. For these two dimensions, the RA and chronic pain group were similar while the depression group score indicated better health state.

Crosstabular procedures were performed on the FACES III score on cohesion and adaptability both separately and then combined on the Circumplex Model. Higher than expected percentage of disengaged scores were reported by the women in the RA and chronic pain groups and this trend was more pronounced in the spouses' scores of all three groups. The women in all three groups reported fairly normal levels of adaptability as did the spouses of the depression group members, but the spouses of those women with RA and chronic pain reported higher than expected levels of rigidity. Results of MANOVAs to examine differences between the three groups in terms of the family characteristics were significant. The women in the depression group and their spouses reported higher levels of conflict than the members of the RA group.