Stressful life events' effects on rheumatoid arthritis disease activity.

Abstract

A 53-year-old female rheumatoid arthritis (RA) patient endured 2 unexpected family deaths during a 12-week study investigating the prospective relationships between stressful small life events, negative affect, and disease activity. Her disease went into temporary remission the same week as the deaths. She was identified as a case study participant, and weekly data collection was extended to 1 year. Clinical exams verified a large decrease in disease status immediately after the major losses. In addition to major events, negative affect and small events were found to serve as independent arthritis symptom predictors within this patient. Major events were associated with decreased symptoms. Negative affect and small events related to symptom increases. Subsequent between-subjects analyses conducted on 25 participants from the parent project probed for generalizability. The substantive findings from the case study were supported: Major life events and small life events functioned as opposing predictors of RA disease states.

Psychological Factors Associated with Response to Treatment in Rheumatoid Arthritis

“…Data indicate that enduring minor and interpersonal stressors can be related to concurrent or subsequent increases in disease activity [14][15][16]. The study by Zautra is especially interesting, the disease activity increases in association with stress, and concurrent depression was mirrored by higher levels of circulating interleukin (IL) 6.…”

A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study

“…Skeletal muscle relaxation can reduce joint pain. Stress has been linked to exacerbations in RA activity, and catastrophizing, in particular, affects many pain-related outcomes in RA and other rheumatic diseases 33,34,35,36 . A central goal of the IFS approach is to enhance self-compassion; by doing so, psychological reactions to pain, hopelessness, and anxiety may improve, as may the degree of inner conflict, perceived stress, and its effect on physical symptoms.…”

Personality, Brain Asymmetry, and Neuroendocrine Reactivity in Two Immune-Mediated Disorders: A Preliminary Report

“…However, marked abnormalities in several psychiatric and psychosomatic disorders along with marked activation in acute and chronic psychogenic stress (Chrousos & Gold, 1992;Levine, 1993) and some evidence for a sidedness effect on endocrine reactivity (Kalin et al, 1998;Kalin et al, 2000;Kim et al, 1999;Wittling, 1990;Wittling & Pfluger, 1990) suggest the possible relevance of central neuropsychologic factors. This could help explain reported associations between stress and handedness with some immune-mediated disorders (Kang et al, 1991;Neveu, 1997;Potter & Zautra, 1997).…”

“…Such evidence suggests that cognitive and emotive modulation of HPA activity is relevant in human health and disease (Carlson, 1994;Evans, 1998). Behavioral factors are being increasingly recognized as important in order to understand who gets sick and who recovers, one possible link being HPA activity (Adler & Matthews, 1994;Neveu, 1997;Potter & Zautra, 1997). In this regard, personality may be a global, integrative characteristic, suitable to explore relevant relations between behavior, neuroendocrine reactivity, and the immune system.…”