Relative contributions of spousal support and illness appraisals to depressed mood in arthritis patients

To examine the ability of cognitive appraisals of illness and spousal support to modify depressed mood in arthritis patients. Psychosocial data were collected from 64 married patients with rheumatoid arthritis (RA) within 2 years of diagnosis and at an 18-month followup. The interaction of challenge appraisals with positive support received from the spouse was related to changes in depression over time. There was an increase in depression as challenge appraisals increased when accompanied by greater receipt of positive support, whereas individuals who did not experience a sense of challenge in response to the diagnosis of RA had the lowest levels of residualized depression when they also received higher positive support from their spouses at the beginning of the study. The results are considered in terms of the cognitive-behavioral mediation model suggested by Kerns and associates concerning the relationship of chronic pain to depression and have implications for interventions aimed at arthritis patients and their spouses.