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Illness representations were assessed in 63 adults with rheumatoid arthritis (RA) and 66 with multiple sclerosis (MS). The relationship of illness representations to concurrent and later mood was explored. MS patients' beliefs in symptom variability were associated with higher depressed mood 4 months later, over and above initial levels of depression. RA patients who saw RA as curable or who saw themselves as responsible for the illness reported significant increases in depression over time. Belief in the serious consequences of RA interacted with later illness severity to predict change in depression. When belief in the serious consequences of RA was high, less severe illness status was associated with less depression and more severe illness status was associated with more depression. When RA was initially viewed as only moderately serious, less severe illness was associated with somewhat higher levels of depression.

The relationship between the cognitive and physical aspects of multiple sclerosis (MS) and health-related quality of life (HRQL) was examined with particular focus on illness intrusiveness as a mediator of this relationship. Disease severity, cognitive functioning HRQL, depression, and illness intrusiveness were assessed in 90 patients with MS. Disease severity (Expanded Disability Status Scale [EDSS]) predicted physical aspects of HRQL (SF-36 Physical Component Summary [PCS], fatigue, and bladder control). Information-processing speed (Paced Auditory Serial Addition Test [PASAT]) predicted mental and emotional aspects of HRQL (SF-36 Mental Component Summary [MCS]). However, both the EDSS and the PASAT predicted depression. Illness intrusiveness was significantly correlated with all indicators of HRQL Illness intrusiveness also mediated the manner in which disease severity predicted: physical health, fatigue, and depression. Results underscore the need to assess MS and its impact more broadly rather than relying on traditional mobility-centered assessments. While in most cases physical indices of disease predict physical quality of life and cognitive assessments predict mental and emotional quality of life, the individuals perception of MS is also a major factor contributing to quality of life. MS dearly affects multiple aspects of life and activity, as illustrated by the broad and powerful network of relationships between illness intrusiveness and all aspects of HRQL Perceptions of illness intrusiveness appear to be a central and essential measure of the impact of MS on HRQL.

This article examines the influence of self‐efficacy beliefs on problem‐solving coping, functional disability, and psychological well‐being for 101 recently diagnosed adult patients with rheumatoid arthritis (RA). Data were drawn from a longitudinal study of psychosocial adaptation to the onset of RA. Self‐efficacy beliefs were associated with less functional disability assessed concurrently and 1 year later. Self‐efficacy beliefs were also associated with greater use of problem‐solving coping 1 year later. There was an interaction between pain and self‐efficacy beliefs in the prediction of depression 1 year later: at low pain, self‐efficacy beliefs were unrelated to depression, but at higher levels of pain, greater self‐efficacy was related to greater depression. Finally, problem‐solving coping mediated the relationship between disability and initial self‐efficacy beliefs. The distinct patterns that emerge for pain, self‐efficacy beliefs, and coping, with respect to functional status as compared to psychological status, are discussed.