The intrafamilial transmission of rheumatoid arthritis. IV. Recalled parent-child relations by rheumatoid arthritics and controls.

THE PURPOSE of this report is to describe how persons having rheumatoid arthritis differ from unaffected controls in their recall of early parent+hild relations. The hypotheses examined in this study were mainly derived from research presented in several major reviews [l-3], as well as from case reports [4-61. Cross-reference to research articles shows that findings specifically describing parent-child relations among rheumatoid arthritics seem restricted to a few, often cited studies. See Table 1 for a summary. These reports vary in many ways, such as the precision of the methods used or the age and sex composition of the study sample. Earlier reports tend to be based on clinical interviews of selected patients, mostly women, with no control groups [7-91. More recent studies aim toward more explicitness in theory and precision in design [14-161. All studies agree, however, in assuming the importance of studying the general hypothesis that the presence of rheumatoid arthritis in adults may be related to early punitive parent treatment inducing chronic resentment and inhibited anger, which later may act to promote, precipitate, or exacerbate the disease. This idea, of course, can be best tested with longitudinal designs; however, the majority of studies, including the present one, rely on testing for differences in recalled parent treatment as reported by adults with and without the disease. It might be noted in passing that this general hypothesis does not call for observations of relations between arthritic children and their mothers [ll], where the childhood disease as well as the relationship of the mother with the sick child are probably different phenomena. Our review of the literature in this area further indicates that most inquiries are focused on females and on their mothers [6, 14-161 and are often associated with reports of personality differences. These personality differences suggest that rheumatoid arthritics are inhibited in their expression of feelings, have difficulty with interpersonal relations, and are angry, but express aggression ineptly and rarely [I, 15-191. While most of such literature is expressed in psychoanalytic terms, the viewpoint of this study is explicitly a social-psychological one. Our central hypothesis is that adults with rheumatoid arthritis will with excessive frequency recall (1) their parents’ authority as being ‘arbitrary’, and (2) their childhood response to such parent treatment as being ‘resentment’.