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Published in: BioPsychoSocial Medicine 1/2014

Open Access 01-12-2014 | Research

Rational/antiemotional behaviors in interpersonal relationships and the functional prognosis of patients with rheumatoid arthritis: a Japanese multicenter, longitudinal study

Authors: Jun Nagano, Takako Morita, Koji Taneichi, Shohei Nagaoka, Sadanobu Katsube, Tomiaki Asai, Masao Yukioka, Kiyoshi Takasugi, Masakazu Kondo, Yasuro Nishibayashi

Published in: BioPsychoSocial Medicine | Issue 1/2014

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Abstract

Background

The repression of negative emotions is a personality factor that received considerable attention in the 1950-60s as being relevant to the onset and course of rheumatoid arthritis (RA). Despite subsequent, repeated criticisms of the cross-sectional nature of the earlier studies, even to date few prospective studies have been reported on this issue. This multicenter study prospectively examined if “rational and antiemotional” behavior (antiemotionality), characterized by an extreme tendency to suppress emotional behaviors and to rationalize negative experiences in conflicting interpersonal situations, is associated with the functional prognosis of patients with RA.

Methods

532 patients with RA who regularly visited one of eight hospitals/clinics in Japan in 2000 were recruited for study. All completed a self-administered baseline questionnaire about lifestyle and psychosocial factors including antiemotionality. Two years after, 460 (mean age, 56.1 years; 54 men and 406 women) of 471 patients who continued to visit the clinics agreed to take the follow-up questionnaire. The functional status of the patients was evaluated by rheumatologists based on the ACR classification system.

Results

A multiple logistic regression model that included baseline demographic, disease activity/severity-related, therapeutic, and socioeconomic factors as covariates found a tendency toward higher antiemotionality to be related to poorer functional status at follow-up. This relationship was not explained by lifestyle factors.

Conclusions

Antiemotionality may be a prognostic factor for the functional status of patients with RA. This finding sheds light on a seemingly forgotten issue in the care of patients with RA.
Appendix
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Literature
1.
go back to reference Scott DL, Wolfe F, Huizinga TW: Rheumatoid arthritis. Lancet. 2010, 376 (9746): 1094-1108. 10.1016/S0140-6736(10)60826-4.CrossRefPubMed Scott DL, Wolfe F, Huizinga TW: Rheumatoid arthritis. Lancet. 2010, 376 (9746): 1094-1108. 10.1016/S0140-6736(10)60826-4.CrossRefPubMed
2.
go back to reference Scharloo M, Kaptein AA, Weinman JA, Hazes JMW, Breedveld FC, Rooijmans HGM: Predicting functional status in patients with rheumatoid arthritis. J Rheumatol. 1999, 26 (8): 1686-1693.PubMed Scharloo M, Kaptein AA, Weinman JA, Hazes JMW, Breedveld FC, Rooijmans HGM: Predicting functional status in patients with rheumatoid arthritis. J Rheumatol. 1999, 26 (8): 1686-1693.PubMed
3.
go back to reference Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW: Stress-vulnerability factors as long-term predictors of disease activity in early rheumatoid arthritis. J Psychosom Res. 2003, 55 (4): 293-302. 10.1016/S0022-3999(02)00632-3.CrossRefPubMed Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW: Stress-vulnerability factors as long-term predictors of disease activity in early rheumatoid arthritis. J Psychosom Res. 2003, 55 (4): 293-302. 10.1016/S0022-3999(02)00632-3.CrossRefPubMed
4.
go back to reference Stojanovich L, Marisavljevich D: Stress as a trigger of autoimmune disease. Autoimmun Rev. 2008, 7 (3): 209-213. 10.1016/j.autrev.2007.11.007.CrossRefPubMed Stojanovich L, Marisavljevich D: Stress as a trigger of autoimmune disease. Autoimmun Rev. 2008, 7 (3): 209-213. 10.1016/j.autrev.2007.11.007.CrossRefPubMed
5.
go back to reference Jessop DS, Richards LJ, Harbuz MS: Effects of stress on inflammatory autoimmune disease: destructive or protective?. Stress. 2004, 7 (4): 261-266. 10.1080/10253890400025497.CrossRefPubMed Jessop DS, Richards LJ, Harbuz MS: Effects of stress on inflammatory autoimmune disease: destructive or protective?. Stress. 2004, 7 (4): 261-266. 10.1080/10253890400025497.CrossRefPubMed
6.
go back to reference Cutolo M, Straub RH: Stress as a risk factor in the pathogenesis of rheumatoid arthritis. Neuroimmunomodulation. 2006, 13 (5–6): 277-282.CrossRefPubMed Cutolo M, Straub RH: Stress as a risk factor in the pathogenesis of rheumatoid arthritis. Neuroimmunomodulation. 2006, 13 (5–6): 277-282.CrossRefPubMed
7.
go back to reference de Brouwer SJ, Kraaimaat FW, Sweep FC, Creemers MC, Radstake TR, van Laarhoven AI, van Riel PL, Evers AW: Experimental stress in inflammatory rheumatic diseases: a review of psychophysiological stress responses. Arthritis Res Ther. 2010, 12 (3): R89-10.1186/ar3016.PubMedCentralCrossRefPubMed de Brouwer SJ, Kraaimaat FW, Sweep FC, Creemers MC, Radstake TR, van Laarhoven AI, van Riel PL, Evers AW: Experimental stress in inflammatory rheumatic diseases: a review of psychophysiological stress responses. Arthritis Res Ther. 2010, 12 (3): R89-10.1186/ar3016.PubMedCentralCrossRefPubMed
8.
go back to reference Alexander F: Psychosomatic Medicine. Its Principles and Applications. 1950, New York: W. W. Norton & Co. Press Alexander F: Psychosomatic Medicine. Its Principles and Applications. 1950, New York: W. W. Norton & Co. Press
9.
go back to reference Rogers M, Brooks E: Psychosocial influences, immune function, and the progression of autoimmune disease. Psychoneuroimmunology. Volume 2. Edited by: Ader R, Felten D, Cohen N. 2001, San Diego, San Francisco, New York, Boston, London, Sydney, Tokyo: Academic press, 399-419. 3 Rogers M, Brooks E: Psychosocial influences, immune function, and the progression of autoimmune disease. Psychoneuroimmunology. Volume 2. Edited by: Ader R, Felten D, Cohen N. 2001, San Diego, San Francisco, New York, Boston, London, Sydney, Tokyo: Academic press, 399-419. 3
10.
go back to reference King SH: Psychosocial factors associated with rheumatoid arthritis; an evaluation of the literature. J Chronic Dis. 1955, 2 (3): 287-302. 10.1016/0021-9681(55)90137-5.CrossRefPubMed King SH: Psychosocial factors associated with rheumatoid arthritis; an evaluation of the literature. J Chronic Dis. 1955, 2 (3): 287-302. 10.1016/0021-9681(55)90137-5.CrossRefPubMed
11.
go back to reference Cobb S: Contained hostility in rheumatoid arthritics. Arthritis Rheum. 1959, 2: 419-426. 10.1002/1529-0131(195910)2:5<419::AID-ART1780020507>3.0.CO;2-3.CrossRef Cobb S: Contained hostility in rheumatoid arthritics. Arthritis Rheum. 1959, 2: 419-426. 10.1002/1529-0131(195910)2:5<419::AID-ART1780020507>3.0.CO;2-3.CrossRef
12.
go back to reference Moos RH: Personality factors associated with rheumatoid arthritis: a review. J Chronic Dis. 1964, 17: 41-55. 10.1016/0021-9681(64)90038-4.CrossRefPubMed Moos RH: Personality factors associated with rheumatoid arthritis: a review. J Chronic Dis. 1964, 17: 41-55. 10.1016/0021-9681(64)90038-4.CrossRefPubMed
15.
go back to reference Robinson H, Kirk RF, Frye RF, Robertson JT: A psychological study of patients with rheumatoid arthritis and other painful diseases. J Psychosom Res. 1972, 16 (1): 53-56. 10.1016/0022-3999(72)90024-4.CrossRefPubMed Robinson H, Kirk RF, Frye RF, Robertson JT: A psychological study of patients with rheumatoid arthritis and other painful diseases. J Psychosom Res. 1972, 16 (1): 53-56. 10.1016/0022-3999(72)90024-4.CrossRefPubMed
16.
go back to reference Crown S, Crown JM, Fleming A: Aspects of the psychology and epidemiology of rheumatoid disease. Psychol Med. 1975, 5 (3): 291-299. 10.1017/S0033291700056671.CrossRefPubMed Crown S, Crown JM, Fleming A: Aspects of the psychology and epidemiology of rheumatoid disease. Psychol Med. 1975, 5 (3): 291-299. 10.1017/S0033291700056671.CrossRefPubMed
17.
go back to reference Pincus T, Callahan LF, Bradley LA, Vaughn WK, Wolfe F: Elevated MMPI scores for hypochondriasis, depression, and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status. Arthritis Rheum. 1986, 29 (12): 1456-1466. 10.1002/art.1780291206.CrossRefPubMed Pincus T, Callahan LF, Bradley LA, Vaughn WK, Wolfe F: Elevated MMPI scores for hypochondriasis, depression, and hysteria in patients with rheumatoid arthritis reflect disease rather than psychological status. Arthritis Rheum. 1986, 29 (12): 1456-1466. 10.1002/art.1780291206.CrossRefPubMed
18.
go back to reference Grossarth-Maticek R: Synergetic effects of cigarette smoking, systolic blood pressure, and psychosocial risk factors for lung cancer, cardiac infarct and apoplexy cerebri. Psychother Psychosom. 1980, 34 (4): 267-272. 10.1159/000287468.CrossRefPubMed Grossarth-Maticek R: Synergetic effects of cigarette smoking, systolic blood pressure, and psychosocial risk factors for lung cancer, cardiac infarct and apoplexy cerebri. Psychother Psychosom. 1980, 34 (4): 267-272. 10.1159/000287468.CrossRefPubMed
19.
go back to reference Grossarth-Maticek R, Kanazir DT, Schmidt P, Vetter H: Psychosocial and organic variables as predictors of lung cancer, cardiac infarct and apoplexy: some differential predictors. Pers Individ Dif. 1985, 6: 313-321. 10.1016/0191-8869(85)90055-8.CrossRef Grossarth-Maticek R, Kanazir DT, Schmidt P, Vetter H: Psychosocial and organic variables as predictors of lung cancer, cardiac infarct and apoplexy: some differential predictors. Pers Individ Dif. 1985, 6: 313-321. 10.1016/0191-8869(85)90055-8.CrossRef
20.
go back to reference Grossarth-Maticek R, Eysenck HJ: Personality, stress and disease: description and validation of a new inventory. Psychol Rep. 1990, 66 (2): 355-373. 10.2466/pr0.1990.66.2.355.CrossRefPubMed Grossarth-Maticek R, Eysenck HJ: Personality, stress and disease: description and validation of a new inventory. Psychol Rep. 1990, 66 (2): 355-373. 10.2466/pr0.1990.66.2.355.CrossRefPubMed
21.
go back to reference Grossarth-Maticek R, Eysenck HJ: Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: part I-description of treatment. Behav Res Ther. 1991, 29 (1): 1-16. 10.1016/S0005-7967(09)80002-8.CrossRefPubMed Grossarth-Maticek R, Eysenck HJ: Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: part I-description of treatment. Behav Res Ther. 1991, 29 (1): 1-16. 10.1016/S0005-7967(09)80002-8.CrossRefPubMed
22.
go back to reference Eysenck HJ, Grossarth-Maticek R: Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: part II-effects of treatment. Behav Res Ther. 1991, 29 (1): 17-31. 10.1016/S0005-7967(09)80003-X.CrossRefPubMed Eysenck HJ, Grossarth-Maticek R: Creative novation behaviour therapy as a prophylactic treatment for cancer and coronary heart disease: part II-effects of treatment. Behav Res Ther. 1991, 29 (1): 17-31. 10.1016/S0005-7967(09)80003-X.CrossRefPubMed
23.
go back to reference Grossarth-Maticek R: Autonomietraining: Gesundheit und Problemlösung durch Anregung der Selbstregulation. 2000, New York, Berlin: de GruyterCrossRef Grossarth-Maticek R: Autonomietraining: Gesundheit und Problemlösung durch Anregung der Selbstregulation. 2000, New York, Berlin: de GruyterCrossRef
24.
go back to reference Nagano J, Ichinose Y, Asoh H, Ikeda J, Ohshima A, Sudo N, Kubo C: A prospective Japanese study of the association between personality and the progression of lung cancer. Intern Med. 2006, 45 (2): 57-63. 10.2169/internalmedicine.45.1453.CrossRefPubMed Nagano J, Ichinose Y, Asoh H, Ikeda J, Ohshima A, Sudo N, Kubo C: A prospective Japanese study of the association between personality and the progression of lung cancer. Intern Med. 2006, 45 (2): 57-63. 10.2169/internalmedicine.45.1453.CrossRefPubMed
25.
go back to reference Nishibayashi Y: Assessment and improvement of the system for interdisciplinary medical service for RA. Report for Research on Immunological and Allergic disease, Health Sciences Research Grant 2001. Volume 1, edn. Edited by: Kudo H. 2002, Tokyo: Bureau of the Research on Immunological and Allergic disease, Japan Ministry of Health and Welfare, 1-9. Nishibayashi Y: Assessment and improvement of the system for interdisciplinary medical service for RA. Report for Research on Immunological and Allergic disease, Health Sciences Research Grant 2001. Volume 1, edn. Edited by: Kudo H. 2002, Tokyo: Bureau of the Research on Immunological and Allergic disease, Japan Ministry of Health and Welfare, 1-9.
26.
go back to reference Hochberg MC, Chang RW, Dwosh I, Lindsey S, Pincus T, Wolfe F: The American College of Rheumatology 1991 revised criteria for the classification of global functional status in rheumatoid arthritis. Arthritis Rheum. 1992, 35 (5): 498-502. 10.1002/art.1780350502.CrossRefPubMed Hochberg MC, Chang RW, Dwosh I, Lindsey S, Pincus T, Wolfe F: The American College of Rheumatology 1991 revised criteria for the classification of global functional status in rheumatoid arthritis. Arthritis Rheum. 1992, 35 (5): 498-502. 10.1002/art.1780350502.CrossRefPubMed
27.
go back to reference Koike R, Takeuchi T, Eguchi K, Miyasaka N: Update on the Japanese guidelines for the use of infliximab and etanercept in rheumatoid arthritis. Mod Rheumatol. 2007, 17 (6): 451-458. 10.3109/s10165-007-0626-3.CrossRefPubMed Koike R, Takeuchi T, Eguchi K, Miyasaka N: Update on the Japanese guidelines for the use of infliximab and etanercept in rheumatoid arthritis. Mod Rheumatol. 2007, 17 (6): 451-458. 10.3109/s10165-007-0626-3.CrossRefPubMed
28.
go back to reference Steinbrocker O, Traeger CH, Batterman RC: Therapeutic criteria in rheumatoid arthritis. J Am Med Assoc. 1949, 140 (8): 659-662. 10.1001/jama.1949.02900430001001.CrossRefPubMed Steinbrocker O, Traeger CH, Batterman RC: Therapeutic criteria in rheumatoid arthritis. J Am Med Assoc. 1949, 140 (8): 659-662. 10.1001/jama.1949.02900430001001.CrossRefPubMed
29.
go back to reference Nagano J, Sudo N: Development of a self-administered questionnaire to assess disease-prone personalities: Item construction and content validity (in Japanese). Kenko Kagaku. 2001, 23: 41-52. English translation: http://hdl.handle.net/2324/724 Nagano J, Sudo N: Development of a self-administered questionnaire to assess disease-prone personalities: Item construction and content validity (in Japanese). Kenko Kagaku. 2001, 23: 41-52. English translation: http://​hdl.​handle.​net/​2324/​724
30.
go back to reference Nagano J, Sudo N, Kaihara C, Shimura M, Kubo C: Validity and reliability of the Stress Inventory: self-administered questionnaire to assess disease-prone personalities (in Japanese). Kenko Shien. 2001, 3 (2): 107-119. English translation: http://hdl.handle.net/2324/15513 Nagano J, Sudo N, Kaihara C, Shimura M, Kubo C: Validity and reliability of the Stress Inventory: self-administered questionnaire to assess disease-prone personalities (in Japanese). Kenko Shien. 2001, 3 (2): 107-119. English translation: http://​hdl.​handle.​net/​2324/​15513
31.
go back to reference Nagano J, Nagase S, Sudo N, Kubo C: Psychosocial stress, personality, and the severity of chronic hepatitis C. Psychosomatics. 2004, 45 (2): 100-106. 10.1176/appi.psy.45.2.100.CrossRefPubMed Nagano J, Nagase S, Sudo N, Kubo C: Psychosocial stress, personality, and the severity of chronic hepatitis C. Psychosomatics. 2004, 45 (2): 100-106. 10.1176/appi.psy.45.2.100.CrossRefPubMed
32.
go back to reference Nagano J, Kono S, Toyomura K, Mizoue T, Yin G, Mibu R, Tanaka M, Kakeji Y, Maehara Y, Okamura T, Ikejiri K, Futami K, Yasunami Y, Maekawa T, Takenaka K, Ichimiya H, Imaizumi N: Personality and colorectal cancer: the Fukuoka colorectal cancer study. Jpn J Clin Oncol. 2008, 38 (8): 553-561. 10.1093/jjco/hyn067.CrossRefPubMed Nagano J, Kono S, Toyomura K, Mizoue T, Yin G, Mibu R, Tanaka M, Kakeji Y, Maehara Y, Okamura T, Ikejiri K, Futami K, Yasunami Y, Maekawa T, Takenaka K, Ichimiya H, Imaizumi N: Personality and colorectal cancer: the Fukuoka colorectal cancer study. Jpn J Clin Oncol. 2008, 38 (8): 553-561. 10.1093/jjco/hyn067.CrossRefPubMed
33.
go back to reference Nagano J, Kakuta C, Motomura C, Odajima H, Sudo N, Nishima S, Kubo C: The parenting attitudes and the stress of mothers predict the asthmatic severity of their children: a prospective study. BioPsychoSocial Medicine. 2010, 4: 12-10.1186/1751-0759-4-12.PubMedCentralCrossRefPubMed Nagano J, Kakuta C, Motomura C, Odajima H, Sudo N, Nishima S, Kubo C: The parenting attitudes and the stress of mothers predict the asthmatic severity of their children: a prospective study. BioPsychoSocial Medicine. 2010, 4: 12-10.1186/1751-0759-4-12.PubMedCentralCrossRefPubMed
34.
go back to reference Spielberger CD: Manual for the State-Trait Anger Expression Inventory. 1988, Psychological Assessment Resources: Odessa Spielberger CD: Manual for the State-Trait Anger Expression Inventory. 1988, Psychological Assessment Resources: Odessa
35.
go back to reference McCollum L, Pincus T: A biopsychosocial model to complement a biomedical model: patient questionnaire data and socioeconomic status usually are more significant than laboratory tests and imaging studies in prognosis of rheumatoid arthritis. Rheum Dis Clin N Am. 2009, 35 (4): 699-712. 10.1016/j.rdc.2009.10.003.CrossRef McCollum L, Pincus T: A biopsychosocial model to complement a biomedical model: patient questionnaire data and socioeconomic status usually are more significant than laboratory tests and imaging studies in prognosis of rheumatoid arthritis. Rheum Dis Clin N Am. 2009, 35 (4): 699-712. 10.1016/j.rdc.2009.10.003.CrossRef
36.
go back to reference Kremer J: Nutrition and rheumatic diseases. Kelley’s textbook of rheumatology. Volume 1. Edited by: Ruddy S, Harris EJ, Sledge C. 2001, Philadelphia: Saunders, 713-727. 6 Kremer J: Nutrition and rheumatic diseases. Kelley’s textbook of rheumatology. Volume 1. Edited by: Ruddy S, Harris EJ, Sledge C. 2001, Philadelphia: Saunders, 713-727. 6
37.
go back to reference Ishii H, Nagashima M, Tanno M, Nakajima A, Yoshino S: Does being easily moved to tears as a response to psychological stress reflect response to treatment and the general prognosis in patients with rheumatoid arthritis?. Clin Exp Rheumatol. 2003, 21 (5): 611-616.PubMed Ishii H, Nagashima M, Tanno M, Nakajima A, Yoshino S: Does being easily moved to tears as a response to psychological stress reflect response to treatment and the general prognosis in patients with rheumatoid arthritis?. Clin Exp Rheumatol. 2003, 21 (5): 611-616.PubMed
38.
go back to reference Pincus T, Sokka T: Complexities in the quantitative assessment of patients with rheumatic diseases in clinical trials and clinical care. Clin Exp Rheumatol. 2005, 23 (5 Suppl 39): S1-S9.PubMed Pincus T, Sokka T: Complexities in the quantitative assessment of patients with rheumatic diseases in clinical trials and clinical care. Clin Exp Rheumatol. 2005, 23 (5 Suppl 39): S1-S9.PubMed
39.
go back to reference Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Menard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D: 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010, 62 (9): 2569-2581. 10.1002/art.27584.CrossRefPubMed Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Menard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D: 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010, 62 (9): 2569-2581. 10.1002/art.27584.CrossRefPubMed
40.
go back to reference Prevoo ML, van ’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL: Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995, 38 (1): 44-48. 10.1002/art.1780380107.CrossRefPubMed Prevoo ML, van ’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL: Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995, 38 (1): 44-48. 10.1002/art.1780380107.CrossRefPubMed
Metadata
Title
Rational/antiemotional behaviors in interpersonal relationships and the functional prognosis of patients with rheumatoid arthritis: a Japanese multicenter, longitudinal study
Authors
Jun Nagano
Takako Morita
Koji Taneichi
Shohei Nagaoka
Sadanobu Katsube
Tomiaki Asai
Masao Yukioka
Kiyoshi Takasugi
Masakazu Kondo
Yasuro Nishibayashi
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BioPsychoSocial Medicine / Issue 1/2014
Electronic ISSN: 1751-0759
DOI
https://doi.org/10.1186/1751-0759-8-8

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