title: Adjustment in patients with rheumatoid arthritis and their children.
abstract: OBJECTIVE
  To assess everyday life stress and emotional adjustment in patients with rheumatoid arthritis (RA) and their children.
  
  
  METHODS
  We conducted a 6 month study of 14 patients with RA with children aged 4-16 years (25 children) and 24 control families (53 children). Life event stress and functional capacity were assessed at the beginning and end of the study, and minor stressors (hassles), positive events (uplifts), and salivary cortisol were recorded weekly. Emotional adjustment was measured monthly in adults by self-report, and bimonthly in children using the Child Behavior Checklist (completed by parents). Social support and psychological coping responses were also measured.
  
  
  RESULTS
  Patients with RA experienced fewer positive events than did controls, and they tended to have smaller support networks. Daily hassle levels correlated with severity of disability, and differences in psychological coping were also observed. Children from RA families reported nearly 50% more hassles per week than did controls, and their social networks were significantly smaller. They were rated as having greater problems of social adjustment than controls. Cortisol concentration was greater among children who experienced more life event stress over the study period, but did not differ between groups.
  
  
  CONCLUSIONS
  The patients with RA in this study showed good adaptation, but experienced less pleasure in their daily lives. The children of patients with RA may have heightened vulnerability to stress related problems, with fewer social resources and difficulties in behavioral adjustment.
authors.affiliation: St. George's Hospital Medical School and St. Bartholomew's Hospital Medical College, University of London, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Turner Cobb
authors.forename: A
authors.initials: A
authors.lastname: Steptoe
authors.forename: L
authors.initials: L
authors.lastname: Perry
authors.forename: J
authors.initials: J
authors.lastname: Axford
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001172:Arthritis, Rheumatoid; D002648:Child; D016241:Child of Impaired Parents; D002675:Child, Preschool; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009679:Nuclear Family / Q000523:psychology*; D011584:Psychology; D012944:Social Support