Date of Award


Publication Type

Doctoral Thesis

Degree Name




First Advisor

Jackson, Dennis L.


Psychology, Psychological adjustment, Resilience, Rheumatic disease, Subjective wellbeing




The purpose of this study was to explore different trajectories of subjective well-being (SWB) in a sample of people with rheumatic conditions using growth mixture modeling (GMM), and to identify demographic, disease-related, and psychosocial risk and protective factors associated with these response patterns. Four hundred and thirty two adults with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis (AS), or gout were recruited online, and data were collected over the internet at six monthly intervals. Satisfaction with life (SWL; Diener, Emmons, Larson &Griffin, 1985) and positive and negative affect (PANAS; Watson, Clark, &Tellegen, 1988) were measured at each time point. Other measures included demographic information, disability, pain, disease activity, control beliefs, optimism, perceived social support, and other major life events. The majority of the sample were Caucasian (70.8%), married (60.7%), women (70%).The average age of respondents was 44.3 years and the mean time since diagnosis was 8.9 years. Four trajectory groups were uncovered representing resilient, low SWB, rapid recovery, and gradual recovery response patterns. Compared to the resilient group, the low SWB group experienced greater negative emotions and less positive emotions, and reported lower income, greater disability and disease activity, and less optimism and perceived control. The rapid recovery group were less optimistic, and reported greater disability, disease activity, and less perceived control initially. The gradual recovery group was less optimistic, had greater pain at Time 1(T1), and less perceived control at Time 2 (T2). Low SWB and resilience were the most prevalent trajectory groups, whereas the two recovery groups were less represented. Experiencing greater positive emotions was associated with recovery in life satisfaction, whereas negative emotions hindered life satisfaction growth. The combination of maintaining higher positive emotions and experiencing fewer negative emotions over time was critical for sustainable higher satisfaction with life. Disease fluctuations and optimism played important roles in achieving and maintaining well-being. Future research directions are discussed.