Positive affect as a factor of resilience in the pain-negative affect relationship in patients with rheumatoid arthritis.

OBJECTIVE The purpose of this study is to examine positive affect (PA) as a factor of resilience in the relationships between pain and negative affect (NA) in a sample of patients with rheumatoid arthritis. METHODS Forty-three patients (30 women; mean age, 57 years) were interviewed weekly by telephone for 8 weeks. Multilevel modeling was applied to study the within-week relationships among the variables. RESULTS There was a Pain x PA interaction effect on NA (beta=-0.05, P<.01) indicating a weaker relationship between pain and NA in weeks with more PA. Pain (beta=0.37, P<.002), interpersonal stress (beta=2.42, P<.001), depression (beta=0.26, P<.01), average perceived stress (beta=10.80, P<.001), and also weekly PA (beta=-0.1, P<.01) had a main effect upon NA. CONCLUSION Positive affect is most influential in reducing NA during weeks of higher pain and may be a factor of resilience, helping patients experiencing pain fluctuations as less distressful than at lower levels of PA.

[1]  B. Fredrickson,et al.  Resilient individuals use positive emotions to bounce back from negative emotional experiences. , 2004, Journal of personality and social psychology.

[2]  Lisa M. Johnson,et al.  Positive affect as a source of resilience for women in chronic pain. , 2005, Journal of consulting and clinical psychology.

[3]  Jack Block,et al.  IQ and ego-resiliency: conceptual and empirical connections and separateness. , 1996 .

[4]  D. Blumer.  The pain-prone disorder: , 1981 .

[5]  J. Moskowitz,et al.  Positive affect and the other side of coping. , 2000, The American psychologist.

[6]  B. Fredrickson.  The broaden-and-build theory of positive emotions. , 2004, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[7]  P. Vaglum,et al.  The relationship between psychological distress and traditional clinical variables: a 2 year prospective study of 216 patients with early rheumatoid arthritis. , 1997, British journal of rheumatology.

[8]  M E Robinson,et al.  Negative affect and the experience of chronic pain. , 1992, Journal of psychosomatic research.

[9]  P. Katz,et al.  The stresses of rheumatoid arthritis: appraisals of perceived impact and coping efficacy. , 1998, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[10]  Bruce W. Smith,et al.  Chronic pain, stress, and the dynamics of affective differentiation. , 2004, Journal of personality.

[11]  B. Fredrickson,et al.  Psychological resilience and positive emotional granularity: examining the benefits of positive emotions on coping and health. , 2004, Journal of personality.

[12]  John W. Reich,et al.  Dimensions of Affect Relationships: Models and Their Integrative Implications , 2003 .

[13]  Shelly L. Gable,et al.  Journal of Personality and Social Psychology Behavioral Activation and Inhibition in Everyday Life , 2022 .

[14]  G. Affleck,et al.  The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients , 1999, Pain.

[15]  C. Jacelon.  The trait and process of resilience. , 1997, Journal of advanced nursing.

[16]  J. Farrar,et al.  Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale , 2001, PAIN.

[17]  D. Turk,et al.  Evaluating the Role of Physical, Operant, Cognitive, and Affective Factors in the Pain Behaviors of Chronic Pain Patients , 1997, Behavior modification.

[18]  A. Singer,et al.  Ability of patients to accurately recall the severity of acute painful events. , 2001, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[19]  F. Keefe,et al.  Psychosocial assessment of pain in patients having rheumatic diseases. , 1999, Rheumatic diseases clinics of North America.

[20]  H. Merskey,et al.  Prospective study on the relationship between depressive symptoms and chronic musculoskeletal pain , 1994, Pain.

[21]  T. Kvien,et al.  Preferences for improved health examined in 1,024 patients with rheumatoid arthritis: pain has highest priority. , 2002, Arthritis and rheumatism.

[22]  Jeffrey J Gedney,et al.  Predictors of short-term and long-term memory of sensory and affective dimensions of pain. , 2003, The journal of pain : official journal of the American Pain Society.

[23]  D. Kahneman,et al.  Patients' memories of painful medical treatments: real-time and retrospective evaluations of two minimally invasive procedures , 1996, Pain.

[24]  L. Bradley,et al.  Psychological and behavioral approaches to pain management for patients with rheumatic disease. , 1999, Rheumatic diseases clinics of North America.

[25]  Christian E. Waugh,et al.  What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. , 2003, Journal of personality and social psychology.

[26]  S. Dworkin,et al.  First onset of common pain symptoms: a prospective study of depression as a risk factor , 1993, Pain.

[27]  J. Turner,et al.  Chronic pain and depression: does the evidence support a relationship? , 1985, Psychological bulletin.

[28]  D. Blumer,et al.  Chronic Pain as a Variant of Depressive Disease The Pain‐Prone Disorder , 1982, The Journal of nervous and mental disease.

[29]  Judith D. Singer,et al.  Using SAS PROC MIXED to Fit Multilevel Models, Hierarchical Models, and Individual Growth Models , 1998 .

[30]  A. Gratwohl,et al.  Bone marrow transplantation in the treatment of autoimmune diseases. , 1997, British journal of rheumatology.

[31]  Shelley E. Taylor,et al.  Psychological resources, positive illusions, and health. , 2000, The American psychologist.

[32]  G. Birchler,et al.  Interpersonal stress and pain behaviors in patients with chronic pain. , 1994, Journal of consulting and clinical psychology.

[33]  D. Watson,et al.  Development and validation of brief measures of positive and negative affect: the PANAS scales. , 1988, Journal of personality and social psychology.

[34]  E. Diener,et al.  Norms for experiencing emotions in different cultures: inter- and intranational differences. , 2001, Journal of personality and social psychology.

[35]  T. Milburn,et al.  Sensory and affective predictors of overall pain and emotions associated with affective pain. , 1994, The Clinical journal of pain.

[36]  Gregory Camilli,et al.  Application of a Method of Estimating DIF for Polytomous Test Items , 1999 .

[37]  B. Fredrickson.  The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions. , 2001, The American psychologist.

[38]  C. Guarnaccia,et al.  Measuring small life events , 1986, American journal of community psychology.

[39]  D. Berry,et al.  Positive affect, negative affect, and social interaction , 1996 .

[40]  Richard S. Lazarus,et al.  Stress and Emotion: A New Synthesis , 1999 .

[41]  A. Beck,et al.  Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation , 1988 .

[42]  D. Turk,et al.  The scope and significance of anger in the experience of chronic pain , 1995, Pain.

[43]  R. Kerns,et al.  Self-appraised problem solving and pain-relevant social support as predictors of the experience of chronic pain , 2002, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[44]  G. L. Engel,et al.  Psychogenic pain and pain-prone patient. , 1959, The American journal of medicine.

[45]  S. Manne,et al.  Spouse criticism and support: their association with coping and psychological adjustment among women with rheumatoid arthritis. , 1989, Journal of personality and social psychology.

[46]  E. Klohnen,et al.  Conceptual analysis and measurement of the construct of ego-resiliency. , 1996, Journal of personality and social psychology.

[47]  G. Affleck,et al.  Examinations of chronic pain and affect relationships: applications of a dynamic model of affect. , 2001, Journal of consulting and clinical psychology.

[48]  P. Leino,et al.  Depressive and distress symptoms as predictors of low back pain, neck-shoulder pain, and other musculoskeletal morbidity: a 10-year follow-up of metal industry employees , 1993, Pain.

[49]  A. Stone,et al.  Does the peak-end phenomenon observed in laboratory pain studies apply to real-world pain in rheumatoid arthritics? , 2000, The journal of pain : official journal of the American Pain Society.

[50]  S. Janssen,et al.  Negative affect and sensitization to pain. , 2002, Scandinavian journal of psychology.

[51]  G. Affleck,et al.  Neuroticism and the pain-mood relation in rheumatoid arthritis: insights from a prospective daily study. , 1992, Journal of consulting and clinical psychology.

[52]  B R Mascarenhas,et al.  Gold metabolism in patients with rheumatoid arthritis treated with gold compounds--reinvestigated. , 1972, Arthritis and rheumatism.