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Negative and positive illness representations of rheumatoid arthritis: a latent profile analysis

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Abstract

This study extends previous work to consider whether individuals with rheumatoid arthritis (RA) can be categorised into groups with similar illness representations. Data from 227 RA patients attending outpatient clinics were collected prospectively at two time points, 6 months apart. The optimal number of illness representation groups at the baseline assessment was identified using latent profile analysis. Two groups of individuals sharing similar illness perception profiles were identified. The smaller group (43 %), characterised by a negative representation of their illness, attributed more symptoms to their condition and reported stronger perceptions of the consequences, chronicity and cyclicality of their condition, and lower control compared to the positive representation group (57 %). Cross-sectionally, membership of the negative representation group was associated with higher levels of pain and functional disability and, longitudinally, with increases in levels of pain, functional disability and distress. These data highlight the central role of illness perceptions in RA and suggest that individuals with RA can be categorised into groups with similar illness representations.

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Notes

  1. Bentler (2007) has provided guidelines regarding the interpretation if fit statistics in confirmatory factor analysis. A value of the root mean square error of approximation (RMSEA) ≤0.08 indicates acceptable fit, whereas, for the Comparative Fit Index (CFI) and the Tucker Lewis Index (TLI) values ≥0.95 indicate acceptable fit.

  2. Fit of the expected three-factor structure of the DAPOS was outside acceptable limits (χ 2Sattora-Bentler (9) = 178.2; RMSEA = 0.290; CFI = 0.907; TLI = 0.907).

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Acknowledgments

The study was supported by an ESRC-MRC interdisciplinary studentship awarded to S. Norton and an ESRC CASE studentship awarded to L.D. Hughes. A Sacker was supported by the ESRC International Centre for Lifecourse Studies in Society and Health (RES-596-28-0001). We thank the patients and staff at each centre for their participation.

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Authors and Affiliations

  1. Health Psychology Section, Psychology Department, Institute of Psychiatry, King’s College London, 5th Floor Bermondsey Wing, Guy’s Hospital Campus, London Bridge, London, SE1 9RT, UK

    Sam Norton, Lyndsay D. Hughes & Joseph Chilcot

  2. Institute for Social and Economic Research, University of Essex, Colchester, UK

    Amanda Sacker

  3. Centre for Lifespan and Chronic Illness Research, University of Hertfordshire, Hatfield, UK

    Sandra van Os & John Done

  4. Department of Rheumatology, City Hospital, St Albans, UK

    Adam Young

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  1. Sam Norton
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Norton, S., Hughes, L.D., Chilcot, J. et al. Negative and positive illness representations of rheumatoid arthritis: a latent profile analysis. J Behav Med 37, 524–532 (2014). https://doi.org/10.1007/s10865-013-9506-9

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