Purpose. The Arthritis Helplessness Index (AHI) and its variants were designed to assess patients' perceptions of helplessness in coping with arthritis as delineated by learned helplessness theory. Helplessness is considered a psychological state in which individuals expect their efforts will be ineffective and become more passive and more likely to be depressed. Learned helplessness theory postulates that this helplessness results from experiencing unpredictable and uncontrollable aversive events. Helplessness has also been postulated to mediate relationships between disease or treatment and health outcomes.
The Rheumatology Attitudes Index (RAI) is conceptually identical to the AHI. Item wording and response format were modified slightly to reduce respondent confusion when the instrument was used with individuals with other rheumatic conditions such as fibromyalgia or bursitis.
Four variants of arthritis helplessness measures are available: the original 15-item Arthritis Helplessness Index (1), a 5-item AHI Helplessness Subscale (2), the 15-item Rheumatology Attitudes Index (RAI) (3), and a 5item RAI helplessness subscale (4).
Content. The AHI/RAI consists of 2 types of items: items measuring patients' perceptions of their abilities ("I can reduce my pain by staying calm and relaxed"), and their inabilities ("No matter what I do or how hard I try, I just can't get relief from my pain"), to control their arthritis.
Further investigation revealed 2 distinct factors on both the AHI and RAI, internality ("Managing my arthritis is largely my responsibility," 7 items) and helplessness ("Arthritis is controlling my life," 5 items).