References 185Another promising treatment, mindfulness meditation, trains
attention deployment and promotes nonjudgmental acceptance
of all life conditions, whether positive or negative (Kabat-Zinn,
1990). Preliminary studies on the effects of mindfulness
meditation in FM populations (Kaplan, Goldenberg, & Galvin-
Nadeau, 1993; Singh, Berman, Hadhazy, & Creamer, 1998)
have shown it to be effective in decreasing pain and fatigue as
well as improving quality of sleep. The use of mindfulness
meditation with people suffering from arthritis and musculo-
skeletal conditions is likely to increase as more professionals
become aware of its ef“cacy in enhancing holistic well-being.
Due to the fact that the effects of arthritis and musculo-
skeletal conditions are not limited to the individual af”icted
with the disease, the social aspect of each condition may be a
particularly important component to target, with signi“cant
implications for quality of life. We have reviewed evidence
that interpersonal stress is particularly damaging to the health
of individuals with RA. Therefore, interventions that seek to
improve the quality of relationships between people with RA
and their family members and/or spouses by eliciting family
participation may yield more powerful effects. Relatedly, tar-
geting improvements in the social environment of individuals
with OA may assist individuals in adopting lifestyle changes
(e.g., exercise, weight management) important in the preven-
tion and treatment of OA. In addition, we have illustrated
how individuals with FM often feel misunderstood by their
health care providers and react to stress by withdrawing from
social relationships. Thus, interventions that encourage
spouses and family members of individuals with FM to con-
tinue to engage them in their social activities may improve
the outcome of these patients. Furthermore, •doctor-
shoppingŽ among patients with FM may be reduced by teach-
ing health care professionals to be aware of stigmatization
factors and highlighting the importance of effective commu-
nication with their patients.
This discussion emphasized that RA, OA, and FM are dis-
tinct conditions, despite the fact that they share many com-
mon symptoms and forms of treatment. More comprehensive
models and ef“cacious treatments for these chronic condi-
tions will result from careful consideration of their unique
biological, psychological, and social factors.
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