ORIGINAL ARTICLES zyxwvu Do People with Rheumatoid Arthritis Develop Illness-Related Schemas? Robert F: DeVellis, Carol Carswell Patterson, Susan J. Blalock, Barbara R. Renner, and Brenda M. DeVellis zyxwvuts Objective. To assess, using both qualitativelinduc- tive and quantitative data, whether people with rheu- matoid arthritis (RA) have schemas related to arthritis. Methods. Themes identified from interview and fo- cus group transcripts were used to develop I) ques- tionnaire items, and zyxwvutsr 2) statements participants were asked to recall during home interviews. Two hundred one people with zyxwvuts RA completed questionnaires and re- call tasks of the type used in cognitive research, fol- lowed zyxwvuts 10 days later by another recall assessment by telephone. Results. Qualitative methods, item-level question- naire data, and category-level recall data yielded con- vergent results supporting 4 final categories: mastery support, loss of independence, and depression. Re- gression analyses indicated that category of earlier rec- ollections predicted subsequent recollections assessed via phone. Conclusions. Results from widely different methods ofier at least partial support for arthritis schemas and suggest that the concepts identified are meaningful to patients as well as to researchers. Supported by NIAMS grant P60-AR30701 awarded to the Uni- versity of North Carolina Thurston Arthritis Research Center. Robert F. DeVellis, PhD, and Susan J. Blalock, PhD, Thurston Arthritis Research Center and Department of Health Behavior and Health Education, Carol Carswell Patterson, MA, Thurston Arthritis Research Center, Barbara R. Renner, PhD, Office of Community Med- ical Education, and Brenda M. DeVellis, PhD, Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill. Address correspondence to Robert E DeVellis, PhD, Thurston Ar- thritis Research Center, CB #7330, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7330. Submitted for publication June 17,1996;accepted in revised form September 18, 1996. 0 1997 by the American College of Rheumatology. Key words. Schemas; Cognitions; Independence: Mastery; Depression; Support. zyx INTRODUCI’ION Human beings are not passive recipients of infor- mation but active processors of the events they expe- rience. Information is selected from the environment, stored in memory, and organized cognitively in ways that affect how people feel, behave, and evaluate them- selves, as well as how they select and process new information zyxw (1,Z). Thoughts and actions, therefore, are influenced by how people come to view certain issues and not merely by objectively factual information. This is certainly no less true for people with arthritis. A number of studies support this assertion.Recent articles, for example, suggest that people with musculoskeletal diseases frequently view prayer as an effective remedy (3) and believe, despite a lack of supporting evidence, that weather contributes to their symptoms zy (4). Studies examining social comparison processes among people with arthritis also have found that information from the social environment is actively processed rather than passively accepted at face value. In one study, for example, women with rheumatoid arthritis (RA) were asked to evaluate how well they coped with arthritis compared to a hypothetical woman who had been de- scribed to them (5). The results suggested that people were able to extract self-enhancing information from this comparison, even when doing so was at odds with factual information. What determines how people process information? An extensive body of literature in the cognitive sci- ences has described and documented the existence of “schemas.” According to Malle and Horowitz (6), zy 78