The intrafamilial transmission of rheumatoid arthritis. 8. Summary of findings.

A SAMPLING of 49 family clusters consisting of a key person with arthritis, his (her) spouse, a sibling and the sibling’s spouse, 2 cousins, and an unrelated individual were interviewed three times with regard to their arthritis and a variety of social and psychological factors. The sample was drawn in part from a national random sample and in part from an arthritis clinic. A detailed interview measure was developed in order to classify respondents with regard to rheumatoid arthritis. It is estimated that this Rheumatoid Arthritis (RA) Measure has a sensitivity of 86 per cent and a specificity of 98 per cent. Altogether 324 respondents, 169 men and 155 women, are involved in this study. Of these, 66 are classified as having RA: 49 women and 17 men. Of the 49 key persons, 43 were eventually classified as having RA; the additional 23 RA’s were other members of the family clusters. The results of this study do not support the conclusion that heredity is an important feature of the etiology of rheumatoid arthritis. However, a number of social-pshycological factors were revealed as contributing to the disease. These results are summarized for women and men separately, inasmuch as important sex differences exist. Women with RA are more likely to come from homes which were high on parental status stress, i.e., high discrepancies between the several social status indicators of mother and father, than are women without RA. Moreover, the RA women recall their mother’s authority and disciplining as much more arbitrary (unreasonable, severe, irritable, and controlling); their reaction to such arbitrary authority was high covert hostility but very low overt resistance and aggressiveness. In spite of this negative picture of the mothers, the RA women chose them as often for role (identification) models, as did the women without RA. The descriptions of the father’s behavior and reactions to him showed no differences between RA’s and non-RA’s.