title: Adaptation to early knee osteoarthritis: the role of risk, resilience, and disease severity on pain and physical functioning.
abstract: BACKGROUND
  Radiographic joint changes are used to diagnose osteoarthritis; however, they alone do not adequately predict who experiences symptoms.
  
  
  OBJECTIVE
  To examine psychological risk and resilience factors in combination with an objective indicator of disease severity (knee X-rays) to determine what factors best account for pain and physical functioning in an early knee osteoarthritis (KOA) population.
  
  
  METHODS
  Structural equation modeling was used to analyze data from 275 men and women with early KOA.
  
  
  RESULTS
  Structural equation modeling yielded a fair to good fit of the data, suggesting that both risk and resilience were important in predicting pain and physical functioning over and above disease severity in the expected directions. Resilience's effect on pain was mediated through self-efficacy, suggesting that higher self-efficacy was linked to lower pain and better physical functioning.
  
  
  CONCLUSIONS
  Results provide an integrative model of adjustment to early KOA and may be important to the prevention of disability in this population.
authors: University of California, San Diego, San Diego, CA, 92093-0738, USA. lmjwright@ucsd.edu
authors: Lisa Johnson
authors: LJ
authors: Wright
authors: Alex J
authors: AJ
authors: Zautra
authors: Scott
authors: S
authors: Going
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D020370:Osteoarthritis, Knee / Q000150:complications / Q000473:pathology / Q000523:psychology*; D017288:Pain Threshold / Q000523:psychology*; D011859:Radiography; D018570:Risk Assessment; D020377:Self Efficacy; D012647:Self-Assessment; D012720:Severity of Illness Index