Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced selfawareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress. Many philosophical, spiritual, and psychological traditions emphasize the importance of the quality of consciousness for the maintenance and enhancement of well-being (Wilber, 2000). Despite this, it is easy to overlook the importance of consciousness in human well-being because almost everyone exercises its primary capacities, that is, attention and awareness. Indeed, the relation between qualities of consciousness and well-being has received little empirical attention. One attribute of consciousness that has been much-discussed in relation to well-being is mindfulness. The concept of mindfulness has roots in Buddhist and other contemplative traditions where conscious attention and awareness are actively cultivated. It is most commonly defined as the state of being attentive to and aware of what is taking place in the present. For example, Nyanaponika Thera (1972) called mindfulness “the clear and single-minded awareness of what actually happens to us and in us at the successive moments of perception” (p. 5). Hanh (1976) similarly defined mindfulness as “keeping one’s consciousness alive to the present reality” (p. 11). Recent research has shown that the enhancement of mindfulness through training facilitates a variety of well-being outcomes (e.g., Kabat-Zinn, 1990). To date, however, there has been little work examining this attribute as a naturally occurring characteristic. Recognizing that most everyone has the capacity to attend and to be aware, we nonetheless assume (a) that individuals differ in their propensity or willingness to be aware and to sustain attention to what is occurring in the present and (b) that this mindful capacity varies within persons, because it can be sharpened or dulled by a variety of factors. The intent of the present research is to reliably identify these inter- and intrapersonal variations in mindfulness, establish their relations to other relevant psychological constructs, and demonstrate their importance to a variety of forms of psychological well-being.

/pdf/the-benefits-of-being-present-mindfulness-and-its-role-in-3carfso5c8.pdf

The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being

The present article presents a meta-analytic test of intergroup contact theory. With 713 independent samples from 515 studies, the meta-analysis finds that intergroup contact typically reduces intergroup prejudice. Multiple tests indicate that this finding appears not to result from either participant selection or publication biases, and the more rigorous studies yield larger mean effects. These contact effects typically generalize to the entire outgroup, and they emerge across a broad range of outgroup targets and contact settings. Similar patterns also emerge for samples with racial or ethnic targets and samples with other targets. This result suggests that contact theory, devised originally for racial and ethnic encounters, can be extended to other groups. A global indicator of Allport's optimal contact conditions demonstrates that contact under these conditions typically leads to even greater reduction in prejudice. Closer examination demonstrates that these conditions are best conceptualized as an interrelated bundle rather than as independent factors. Further, the meta-analytic findings indicate that these conditions are not essential for prejudice reduction. Hence, future work should focus on negative factors that prevent intergroup contact from diminishing prejudice as well as the development of a more comprehensive theory of intergroup contact.

A meta-analytic test of intergroup contact theory.

Numerous studies show that happy individuals are successful across multiple life domains, including marriage, friendship, income, work performance, and health. The authors suggest a conceptual model to account for these findings, arguing that the happiness-success link exists not only because success makes people happy, but also because positive affect engenders success. Three classes of evidence--crosssectional, longitudinal, and experimental--are documented to test their model. Relevant studies are described and their effect sizes combined meta-analytically. The results reveal that happiness is associated with and precedes numerous successful outcomes, as well as behaviors paralleling success. Furthermore, the evidence suggests that positive affect--the hallmark of well-being--may be the cause of many of the desirable characteristics, resources, and successes correlated with happiness. Limitations, empirical issues, and important future research questions are discussed.

/pdf/the-benefits-of-frequent-positive-affect-does-happiness-lead-4k0h6bmoho.pdf

The Benefits of Frequent Positive Affect: Does Happiness Lead to Success?

the total number of papers may exceed 10,000. Nevertheless, cost consideration forced us to consider mostly published papers and technical reports in English. 4 Formula 4 in Seifert (1991) is in error—a multiplier of n, of cell size, is missing in the numerator. 5 Unfortunately, the technique of meta-analysis cannot be applied, at present time, to such effects because the distribution of dis based on a sampling of people, whereas the statistics of techniques such as ARIMA are based on the distribution of a sampling of observations in the time domain regardless of the size of the people sample involved (i.e., there is no way to compare a sample of 100 points in time with a sample of 100 people). That is, a sample of 100 points in time has the same degrees of freedom if it were based on an observation of 1 person or of 1,000 people. 258 KLUGER AND DENISI From the papers we reviewed, only 131 (5%) met the criteria for inclusion. We were concerned that, given the small percentage of usable papers, our conclusions might not fairly represent the larger body of relevant literature. Therefore, we analyzed all the major reasons to reject a paper from the meta-analysis, even though the decision to exclude a paper came at the first identification of a missing inclusion criterion. This analysis showed the presence of review articles, interventions of natural feedback removal, and papers that merely discuss feedback, which in turn suggests that the included studies represent 1015% of the empirical FI literature. However, this analysis also showed that approximately 37% of the papers we considered manipulated feedback without a control group and that 16% reported confounded treatments, that is, roughly two thirds of the empirical FI literature cannot shed light on the question of FI effects on performance—a fact that requires attention from future FI researchers. Of the usable 131 papers (see references with asterisks), 607 effect sizes were extracted. These effects were based on 12,652 participants and 23,663 observations (reflecting multiple observations per participant). The average sample size per effect was 39 participants. The distribution of the effect sizes is presented in Figure 1. The weighted mean (weighted by sample size) of this distribution is 0.41, suggesting that, on average, FI has a moderate positive effect on performance. However, over 38% of the effects were negative (see Figure 1). The weighted variance of this distribution is 0.97, whereas the estimate of the sampling error variance is only 0.09. A potential problem in meta-analyses is a violation of the assumption of independence. Such a violation occurs either when multiple observations are taken from the same study (Rosenthal, 1984) or when several papers are authored by the same person (Wolf, 1986). In the present investigation, there were 91 effects derived from the laboratory experiments reported by Mikulincer (e.g., 1988a, 1988b). This raises the possibility that the average effect size is biased, because his studies manipulated extreme negative FIs and used similar tasks. In fact, the weighted average d in Mikulincer's studies was —0.39; whereas in the remainder of the

The effects of feedback interventions on performance: A historical review, a meta-analysis, and a preliminary feedback intervention theory.

Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.

Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults.

Meta-analytic procedures for social research

The optimal first-line treatment of patients with early rheumatoid arthritis (eRA) is not established.To compare clinical and radiographic outcomes of active conventional therapy (ACT) with each of three biological therapies with different modes of action.In this investigator-initiated, randomized, open-label, blinded-assessor study (NCT01491815), patients with treatment-naïve eRA with DAS28>3.2 and RF+/ACPA+/CRP>10mg/L, were randomized 1:1:1:1 to methotrexate combined with: 1) oral prednisolone (tapered quickly; discontinued at w36); or: sulphasalazine, hydroxychloroquine and mandatory intra-articular (IA) glucocorticoid injections in swollen joints (ACT); 2) certolizumab-pegol (CZP); 3) abatacept (ABA) or 4) tocilizumab (TCZ). IA glucocorticoid was allowed in all arms except w20-24 and w44-48. Co-primary outcomes at w48 were CDAI remission (CDAI≤2.8) and change in total van der Heijde-modified Sharp Score from baseline (ΔvdHSSw0-w48). A combination of Bonferroni and Dunnet’s procedure adjusted for multiple testing. The primary endpoints were estimated using logistic regression and analysis of covariance, adjusted for sex, anti-CCP status and country.812 patients were randomized. Adjusted CDAI remission rates at w48 were: 59.3% (ABA), 52.3% (CZP), 51.9% (TCZ) and 39.2% (ACT). Compared to ACT, CDAI remission rates were superior for ABA (adjusted difference +20.1%; adjusted p<0.001) and CZP (+13.1%; p=0.021), but not TCZ (+12.7%; p=0.030) (Table 1). Key secondary clinical outcomes were consistently better in biological groups compared to ACT. Adjusted mean ΔvdHSSw0-w48 was low (Table 1), with no significant differences between drugs.Table 1.Baseline characteristicsACT (n=200)CZP+MTX (n=203)ABA+MTX (n=204)TCZ+MTX (n=188) §Age (y)55 (15)55 (15)55 (14)52 (15)Women, %139 (70%)139 (69%)140 (69%)129 (69%)Time from diagnosis to baseline, days13 (21)12 (17)16 (34)16 (33)Anti-CCP/RF positive, %82% / 76%82% / 73%83% / 78%82% / 72%CDAI28.7 (12.1)27.9 (12.4)28.6 (11.3)26.6 (11.7)Total vdHSS (0-448) [median; IQR)6.3 (8.2) [4; 1 - 8.5]5.9 (7.6) [3; 1 - 8]5.8 (9.8) [3; 1 - 6]4.2 (6.7) [2; 0.5 - 5]Estimated adjusted outcome (ITT)1, PrimaryCDAI remission, w4839.2% (32.5 - 45.9)52.3% (45.5 - 59.1)59.3% (52.6 - 66)51.9% (44.9 - 59.0)Δ1.9% (44.9 -0.45 (0.31 to 0.59)0.47 (0.33 to 0.61)0.62 (0.48 to 0.76)0.5 (0.36 to 0.64)Estimated adjusted treatment difference (ITT)2, PrimaryCDAI remission, w48Ref13.1% (3.5 to 22.6)*20.1% (10.6 to 29.5)*12.7% (3 to 22.5)Δ2.7% (3 to 2Ref0.02 (-0.17 to 0.22)0.17 (-0.02 to 0.37)0.05 (-0.15 to 0.25)Key secondaryACR/EULAR Boolean remission, w48Ref14.7% (5.4 to 23.9)19.4% (10.1 to 28.7)13% (3.5 to 22.4)DAS28 remission,w48Ref12.9% (3.5 to 22.2)17.4% (8.2 to 26.6)14.4% (5 to 23.9)EULAR good response, w48Ref8.2% (-0.6 to 17.1)11.3% (2.7 to 20)2.9% (-6.3 to 12.2)vdHSS progression ≤0.5, w0-w48Ref-3.3% (-11.1 to 4.6)3.5% (-4.7 to 11.8)-2.2% (-10.3 to 5.9)Values are mean (SD), if not otherwise indicated. §Finnish patients randomised to TCZ+MTX, but not receiving it due to unavailability, are not included. 1Values are estimated adjusted marginal means and estimated marginal differences against ACT with 95% CI. ITT: intention to treat population. *Superiority compared with ACT was demonstrated.No new safety signals were reported. Total numbers of serious adverse events (% patients with ≥1 event) were for ABA 21 (8.3%), CZP 28 (12.4%), TCZ 20 (9.2%) and ACT 23 (10.7%).Compared with active conventional therapy (csDMARD + glucocorticoids), superiority regarding CDAI remission rates was demonstrated for abatacept and certolizumab-pegol, and not for tocilizumab. Radiographic progression was low and similar between treatments.Figure 1.We thank the patients, investigators, nurses, joint assessors and study teams who were involved in the NORD-STAR trial; Eleonore Nilsson, chief study nurse, Lise Hejl Hyldstrup, coordinating study nurse, Niels Steen Krogh, data manager, Monica Rydén Aulin study coordinator and Eva Larsson, patient research partner. We also thank members of the NORD-STAR study group: Anders Bengtsson, Anders Gülfe, Annelies Blanken, Annette Schlemmer, Åsa Reckner Olsson, Aulikki Kononoff, Carl Turesson, Christina Dackhammar, Cidem Gentline, Elisabet Lindqvist, Ellen-Margrethe Hauge, Emma Grenholm, Erik af Klint, Erik Rødevand, Eva Baecklund, Fredrik Markros, Hamed Rezaei, Hanne Merete Lindegaard, Heikki Relas, Heikki Valleala, Ilia Qirjazo, Inger Marie Jensen Hansen, Jarno Rutanen, Jens Kristian Pedersen, Jens Rathmann, Johan Wallman, Johanna Carlestam, Jon Einarsson, Jörgen Lysholm, Kajsa Öberg, Katarina Almehed, Kathrine Lederballe Grøn, Kati Mykkänen, Lena Karlberg, Malin Hemberg, Maria K. Stilling-Vinther, Marjatta Leirisalo-Repo, Mohaned Hameed, Nancy Vivar, Oili Kaipiainen-Seppänen, Peter Olsson, Petrus Linge, Pia Lindell, Pia Neuer Jensen, René Østgård, Riitta Tuompo, Sabine Dieperink, Sara Nysom Christiansen, Sofia Exarchou, Thiab Saleh, Tomas Husmark, Tor Olofsson, Torkell Ellingsen, Trude Bruun, Vappu Rantalaiho and Ylva Borgas.Mikkel Østergaard Speakers bureau: AbbVie, BMS, Boehringer-Ingelheim, Eli Lilly, Janssen, Merck, Pfizer, Roche, UCB, Celgene, Sanofi, Regeneron, Novartis, Orion, Hospira, Consultant of: AbbVie, BMS, Boehringer-Ingelheim, Eli Lilly, Janssen, Merck, Pfizer, Roche, UCB, Celgene, Sanofi, Regeneron, Novartis, Orion, Hospira, Grant/research support from: AbbVie, BMS, Merck, UCB, Celgene, Novartis, Ronald van Vollenhoven Speakers bureau: AbbVie, AstraZeneca, Biogen, Celgene, Galapagos, Gilead, Janssen, Pfizer, Servier, UCB, Consultant of: AbbVie, AstraZeneca, Biogen, Celgene, Galapagos, Gilead, Janssen, Pfizer, Servier, UCB, Grant/research support from: BMS, GSK, Eli Lilly, UCB, Pfizer, Roche, Anna Rudin Grant/research support from: AstraZeneca, Merete L. Hetland Speakers bureau: Merck, Biogen, Pfizer, Eli Lilly, Orion Pharma, CellTrion, Samsun Bioepsi, Janssen Biologics BV, MSD, Consultant of: Merck, Biogen, Pfizer, Eli Lilly, Orion Pharma, CellTrion, Samsun Bioepsi, Janssen Biologics BV, MSD, Grant/research support from: BMS, AbbVie, Roche, Novartis, Merck, Biogen, Pfizer, Marte Heiberg Speakers bureau: Eli Lilly, Consultant of: Eli Lilly, Dan Nordström Grant/research support from: UCB, BMS, AbbVie, Celgene, MSD, Novartis, Pfizer, Michael Nurmohamed Speakers bureau: Celltrion, Eli Lilly, Consultant of: Celltrion, Eli Lilly, Grant/research support from: BMS, AbbVie, MSD, Pfizer, Amgen, Björn Gudbjornsson Speakers bureau: Novartis, Consultant of: Novartis, Lykke Midtbøll Ørnbjerg Grant/research support from: Novartis, Pernille Bøyesen: None declared, Inge Olsen: None declared, Kristina Lend: None declared, Kim Hørslev-Petersen: None declared, Till Uhlig Speakers bureau: Grünenthal, Eli Lilly, Novartis, Pfizer, Consultant of: Grünenthal, Eli Lilly, Novartis, Pfizer, Grant/research support from: NORDFORSK, Tuulikki Sokka-Isler Speakers bureau: AbbVie, BMS, Celgene, Medac, Merck, Novartis Orion Pharma, Pfizer, Roche, Sandoz, UCB, Boehringer Ingelheim, Consultant of: AbbVie, BMS, Celgene, Medac, Merck, Novartis Orion Pharma, Pfizer, Roche, Sandoz, UCB, Boehringer Ingelheim, Gerdur Gröndal: None declared, Simon Krabbe Grant/research support from: AbbVie, MSD, Novartis, Joakim Lindqvist: None declared, Inger Gjertsson: None declared, Daniel Glinatsi Speakers bureau: AbbVie, Eli Lilly, Consultant of: AbbVie, Eli Lilly, Meliha C Kapetanovic: None declared, Anna-Birgitte Aga Speakers bureau: AbbVie, Eli Lilly, Novartis, Pfizer, Consultant of: AbbVie, Eli Lilly, Novartis, Pfizer, Francesca Faustini: None declared, Pinja Parmanne Speakers bureau: Novartis, Consultant of: Novartis, Tove Lorenzen Speakers bureau: UCB, Consultant of: UCB, Giovanni Cagnotto: None declared, Johan Back: None declared, Oliver Hendricks Speakers bureau: AbbVie, Novartis, Consultant of: AbbVie, Novartis, Daisy Vedder: None declared, Tuomas Rannio: None declared, Emma Grenholm: None declared, Hanne Merete Lindegaard: None declared, Maud-Kristine A Ljosa: None declared, Eli Brodin: None declared, Annika Soderbergh: None declared, Milad Rizk: None declared, Elsa Hermansson: None declared, Line Uhrenholt Speakers bureau: AbbVie, Eli Lilly, Novartis, Consultant of: AbbVie, Eli Lilly, Novartis, Per Larsson: None declared, Søren Andreas Just: None declared, Gunnstein Bakland Speakers bureau: BMS, Consultant of: BMS, David Stevens Grant/research support from: KLINBEFORSK, Trine Bay Laurberg Speakers bureau: UCB, Consultant of: UCB, Espen A Haavardsholm Speakers bureau: Pfizer, AbbVie, Celgene, Novartis, Janssen, Gilead, Eli Lilly, UCB, Consultant of: Pfizer, AbbVie, Celgene, Novartis, Janssen, Gilead, Eli Lilly, UCB, Grant/research support from: NORDFORSK, Jon Lampa: None declared.

/pdf/op0058-certolizumab-pegol-abatacept-tocilizumab-or-active-2wubsytc.pdf

Op0058 certolizumab-pegol, abatacept, tocilizumab or active conventional therapy in early rheumatoid arthritis: clinical and radiographic 48-weeks results of the investigator-initiated randomized nord-star trial

The treatment landscape in psoriatic arthritis (PsA) is changing, including newer biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) with different modes of action becoming available. However, the most effective treatment strategy in routine care remains to be established.To explore the uptake and treatment patterns of newer b/tsDMARDs, namely JAK-inhibitors (JAKi; baricitinib, tofacitinib, upadacitinib), IL-17-inhibitors (ixekizumab, secukinumab), abatacept, apremilast, and ustekinumab in PsA patients from the Nordic countries. Furthermore, to describe patient characteristics and extra-musculoskeletal manifestations at treatment start (=baseline).Observational cohort study, using prospectively collected routine care data from 4 Nordic rheumatology registries. Treatments (newer b/tsDMARDs with tumor-necrosis-factor inhibitors (TNFi) as the reference) initiated from January 2009 until December 2020 and corresponding baseline patient characteristics were identified. Linkage to national patient registries was used to identify previous extra-musculoskeletal manifestations (0-5 years). Country-level data were pooled for analyses. Uptake of each drug was explored as the cumulative number of treatment starts (a) overall, irrespective of previous b/tsDMARD experience, and (b) in b/tsDMARD-naïve patients. Each patient could contribute >1 treatment course.Overall, 13,364 unique patients contributing 24,325 treatment courses with either a newer b/tsDMARD (4,855, 20%) or a TNFi (19,470, 80%, whereof 10,897 were started year 2015-20) were identified. For the sub-group of 11,892 first b/tsDMARD treatment courses, 1,009 (8%) were a newer b/tsDMARD (10,883 were a TNFi, whereof 5,956 were started year 2015-20).Secukinumab dominated the newer b/tsDMARD uptake (1,848 new-starts, Figure 1). Ustekinumab-uptake increased over time both overall and in b/tsDMARD-naïve patients. In b/tsDMARD-naïve patients, apremilast had the fastest uptake (490 new-starts) (Figure 1). Use of JAKi was limited, especially in b/tsDMARD-naïve patients.Figure 1.Patients starting a newer b/tsDMARD tended to have longer disease duration and slightly higher disease activity at baseline (DAS28, patient-reported outcomes) than TNFi initiators (Table 1). Previous extra-musculoskeletal manifestations (uveitis, IBD) were rare, and with similar distributions across treatments (Table 1).Table 1.Baseline characteristics upon treatment startAbata-ceptApre-milastBari-citinibIxe-kizumabSecuki-numabTofa-citinibUpada-citinibUste-kinumabAny TNFiCumulative uptake, n3629351063421848494669119470Male gender, %334227384033333744Age54 (12)53 (12)55 (13)52 (13)51 (13)54 (13)52 (10)50 (12)49 (13)b/tsDMARD treatment number, %1952911149020562191512262518171925≥3723378746173836219Disease duration, yrs9 (8)8 (8)10 (8)10 (8)9 (9)11 (10)8 (8)8 (9)7 (8)Pain, VAS (0-100)63 (21)61 (23)64 (23)64 (25)63 (24)66 (23)75 (17)64 (23)59 (24)DAS284.73 (1.34)4.04 (1.35)3.95 (1.36)4.24 (1.19)4.13 (1.36)4.49 (1.33)4.74 (0.88)4.19 (1.32)4.07 (1.29)Uveitis, %*323123022IBD, %*113111-31Numbers are mean (SD) unless otherwise statedIBD: inflammatory bowel disease, bDMARD: biologic DMARD, ts: targeted synthetic*0-5 years previously, available all study period for Iceland, Sweden, Finland until 31Dec2018, not available for DenmarkIn this cross-country collaboration we were able to explore uptake of newer b/tsDMARDs. TNFi still dominates compared to newer b/tsDMARDs in routine care treatment of PsA. Newer b/tsDMARDs are mainly used in patients with several previous treatment failures, i.e. with longer disease duration and higher disease activity, indicating difficult to treat disease. Further studies are planned to explore real-world treatment patterns and outcomes.BG and DdiG contributed equally.Partly funded by NordForsk and Foreum grants. On behalf of the Danish DANBIO, Swedish SRQ, Norwegian NOR-DMARD, Finnish ROB-FIN and Icelandic ICEBIO registriesBente Glintborg Grant/research support from: Pfizer, AbbVie, BMS, Daniela Di Giuseppe: None declared, Johan K Wallman Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Novartis, Grant/research support from: AbbVie, Amgen, Eli Lilly, Novartis, Pfizer, Dan Nordström: None declared, Björn Gudbjornsson Speakers bureau: Novartis and Amgen, Merete Lund Hetland Grant/research support from: AbbVie, Biogen, BMS, Celltrion, Eli Lilly Denmark A/S, Janssen Biologics B.V, Lundbeck Fonden, MSD, Pfizer, Roche, Samsung Biopis, Sandoz, Novartis., Johan Askling Grant/research support from: Abbvie, Astra-Zeneca, BMS, Eli Lilly, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB., Gerdur Gröndal: None declared, Tuulikki Sokka-Isler Grant/research support from: Abbvie, Amgen, BMS, Celgene, Eli Lilly, GSK, Medac, MSD, Novartis, Orion Pharma, Pfizer, Roche, Sandoz, UCB, Sella Aarrestad Provan: None declared, Ulf Lindström: None declared

/pdf/pos0932-uptake-of-newer-biologic-and-targeted-synthetic-2zz3xtv0.pdf

Gwenn W. Gröndal

Papers

Meta-analytic procedures for social research

Op0058 certolizumab-pegol, abatacept, tocilizumab or active conventional therapy in early rheumatoid arthritis: clinical and radiographic 48-weeks results of the investigator-initiated randomized nord-star trial

POS0932 UPTAKE OF NEWER BIOLOGIC AND TARGETED SYNTHETIC DMARDs IN PSORIATIC ARTHRITIS, RESULTS FROM FOUR NORDIC BIOLOGIC REGISTRIES