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Findings revealed three distinct vulnerability trajectories (45% persistently low, 30% fluctuating improvement, 25% persistently high) and four adaptation stages, with critical intervention periods occurring 3-6 months post-diagnosis and during disease flares. Multiple factors significantly influence psychological outcomes, including gender (females showing 1.8-fold increased risk), age (younger patients experiencing 42% higher vulnerability), pain intensity, inflammatory markers, and neuroendocrine dysregulation (48% showing cortisol rhythm disruption). Early psychological intervention (within 3 months of diagnosis) demonstrated robust benefits, reducing depression incidence by 42% with effects persisting 24-36 months, while different modalities showed complementary advantages: Cognitive behavioral therapy for depression (Cohen\u2019s d = 0.68), mindfulness for pain acceptance (38% improvement), and peer support for meaning reconstruction (25.6% increase). These findings underscore the importance of integrating routine psychological assessment into standard RA care, developing stage-appropriate interventions, and advancing research toward personalized biopsychosocial approaches that address the dynamic psychological dimensions of the disease.<\/jats:p>","DOI":"10.5498\/wjp.v16.i1.111812","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T01:30:15Z","timestamp":1767144615000},"source":"Crossref","is-referenced-by-count":2,"title":["Dynamic psychological vulnerability and adaptation in rheumatoid arthritis: Trajectories, predictors, and 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