Psychosocial Factors in Arthritis

  • Alex Zautra
  • Denise Kruszewski


Psychosocial factors play an important role in the etiology and course of rheumatic diseases. In this chapter, we introduce concepts that may aid the reader in understanding the relationship. Psychosocial challenges and physiological mechanisms involved in rheumatic disease manifestations may be best understood within the conceptual framework of stress and the individual response to stress. It has become increasingly evident that psychosocial factors are essential to understanding who is most affected by illness and other stressors, as well as when they are most vulnerable. We end the chapter with a discussion of resilience, as it important to acknowledge the capacities of individuals to cope successfully with their illness.


Rheumatoid Arthritis Patient Rheumatic Disease Social Connectedness Pain Catastrophizing Fibromyalgia Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Potter PT, Zautra AJ. Stressful life events’ effects on rheumatoid arthritis disease activity. J Consult Clin Psychol 1997;65:319–323.CrossRefPubMedGoogle Scholar
  2. 2.
    Zautra AJ, Burleson MH, Matt KS, Roth S, Burrows L. Interpersonal stress, depression, and disease activity in rheumatoid arthritis and osteoarthritis patients. Health Psychol 1994;13:139–148.CrossRefPubMedGoogle Scholar
  3. 3.
    McBeth J, MacFarlane GJ, Benjamin S, Morris S, Silman AJ. The association between tenderpoints, psychological distress, and adverse childhood experiences: a community-based study. Arthritis Rheum 1999;42:1397–1404.CrossRefPubMedGoogle Scholar
  4. 4.
    Sherman JJ, Turk DC, Okifuji A. Prevalence and impact of posttraumatic stress disorder-like symptoms in patients with fibromyalgia syndrome. Clin J Pain 2000;16:127–134.CrossRefPubMedGoogle Scholar
  5. 5.
    Cicchetti D, Rogosch FA. Diverse patterns of neuroendocrine activity in maltreated children. Dev Psychopathol 2001;13:677–694.CrossRefPubMedGoogle Scholar
  6. 6.
    Heim C, Ehlert U, Hanker JP, Hellhammer DH. Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvis pain. Psychosom Med 1998;60:309–318.PubMedGoogle Scholar
  7. 7.
    Hudson JI, Mangweth B, Pope HG, et al. (2003). Family study of affective spectrum disorder. Arch Gen Psychiatry 2003;60:170–177.CrossRefPubMedGoogle Scholar
  8. 8.
    Rainville P, Duncan GH, Price DD, Carrier B, Bushnell MC. Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science 1977;277:968–971.CrossRefGoogle Scholar
  9. 9.
    Zautra AJ, Smith B. Depression and reactivity to stress in older women with rheumatoid arthritis and osteoarthritis. Psychosom Med 2001;63:687–696.PubMedGoogle Scholar
  10. 10.
    Zautra AJ, Yocum DC, Villanueva I, et al. (2003). Immune activation and depression in women with rheumatoid arthritis. J Rheumatol 2003;31:457–463.Google Scholar
  11. 11.
    Conner T, Tennen H, Zautra AJ, Affleck G, Armeli S, Fifield J. Coping with chronic arthritis pain in daily life: within-person analyses reveal hidden vulnerability for the formerly depressed. Pain 2006;128:128–135.Google Scholar
  12. 12.
    Affleck G, Tennen H, Urrows S, Higgins P. Neuroticism and the pain-mood relation in rheumatoid arthritis: insights from a prospective daily study. J Consult Clin Psychol 1992;60:119–126.CrossRefPubMedGoogle Scholar
  13. 13.
    Janssen SA. Negative affect and sensitization to pain. Scand J Psychol 2002;43:131–137.CrossRefPubMedGoogle Scholar
  14. 14.
    Zautra AJ, Johnson LM, Davis MC. Positive affect as a source of resilience for women in chronic pain. J Counsel Clin Psychol 2005;73:212–220.CrossRefGoogle Scholar
  15. 15.
    Keefe FJ, Smith SJ, Buffington ALH, Gibson J, Studts JL, Caldwell DS. Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis. J Consult Clin Psychol 2002;70:640–655.CrossRefPubMedGoogle Scholar
  16. 16.
    Keefe FJ, Affleck G, Lefebvre JC, Starr K, Caldwell DS, Tennen H. Coping strategies and coping efficacy in rheumatoid arthritis: a daily process analysis. Pain 1997;69:43–48.CrossRefGoogle Scholar
  17. 17.
    Lorig KR, Mazonson PD, Holman HR. Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum 1993;36:439–446.CrossRefPubMedGoogle Scholar
  18. 18.
    Buckelew SP, Parker JC, Keefe FJ, et al. Self-efficacy and pain behavior among subjects with fibromyalgia. Pain 1994;59:377–384.CrossRefPubMedGoogle Scholar
  19. 19.
    Keefe FJ, Lumley M, Anderson T, Lynch T, Carson KL. Pain and emotion: new research directions. J Clin Psychol 2001;57:587–607.CrossRefPubMedGoogle Scholar
  20. 20.
    Gracely RH, Geisser ME, Giesecke MAB, Petzke F, Williams DA, Clauw DJ. Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain 2004;127:835–843.CrossRefPubMedGoogle Scholar
  21. 21.
    Dick B, Eccleston C, Crombez G. Attentional functioning in fibromyalgia, rheumatoid arthritis, and musculoskeletal pain patients. Arthritis Rheum 2002;47:634–644.CrossRefGoogle Scholar
  22. 22.
    Perry BD, Pollard RA, Blakley TL, Baker WL, Vigilante D. Childhood trauma, the neurobiology of adaptation and use-dependent development of the brain: how states become traits. Infant Mental Health 1995;16:271–291.CrossRefGoogle Scholar
  23. 23.
    Eccleston C, Crombez G. Pain demands attention: a cognitive-affective model of the interruptive function of pain. Psychol Bull 1999;125:356–366.CrossRefPubMedGoogle Scholar
  24. 24.
    MacDonald G, Leary MR. Why does social exclusion hurt? The relationship between social and physical pain. Psychol Bull 2005;131:202–223.CrossRefPubMedGoogle Scholar
  25. 25.
    Eisenberger NI, Lieberman MD, Williams KD. Does rejection hurt? An fMRI study on social exclusion. Science 2003;302:290–292.CrossRefPubMedGoogle Scholar
  26. 26.
    Liotti G. Disorganized/disoriented attachment in the etiology of dissociative disorders. Dissociation, 1992;4:196–204.Google Scholar
  27. 27.
    Roche DN, Runtz MG, Hunter MA. Adult attachment: A mediator between childhood sexual abuse and later psychological adjustment. J Interpersonal Violence 1999;14:184–207.CrossRefGoogle Scholar
  28. 28.
    Montoya P, Larbig W, Braun C, Preissl H, Birbaumer N. Influence of social support and emotional context on pain processing and magnetic brain responses in fibromyalgia. Arthritis Rheum 2004;50:4035–4044.CrossRefPubMedGoogle Scholar
  29. 29.
    Davis MC, Zautra AJ, Reich JW. Vulnerability to stress among women in chronic pain from fibromyalgia and osteoarthritis. Ann Behav Med 2001;23:215–226.CrossRefPubMedGoogle Scholar
  30. 30.
    Masten AS. Ordinary magic: resilience processes in development. Am Psychol 2001;56:227–238.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Alex Zautra
    • 1
  • Denise Kruszewski
    • 1
  1. 1.Department of PsychologyArizona State UniversityTempeUSA

Personalised recommendations