Negative affect and pain in arthritis.

The experience of pain in arthritis conditions has important affective dimensions. This article reviews evidence for a relatively strong association between negative affect (i.e., depression, anxiety, and anger) and arthritis-related pain. Possible physiologic and psychologic mechanisms of the relationship between negative affect and pain are examined, and issues relevant to future research, particularly the need for biopsychosocial theoretical models are discussed. Finally, the article highlights the importance of biopsychosocial treatment approaches in managing arthritis-related pain and negative affect.

Predictors of subjective fatigue among individuals with rheumatoid arthritis.

OBJECTIVE: To examine a range of variables potentially associated with rheumatoid arthritis (RA)-related fatigue and to determine which variables best predict subjective fatigue. METHODS: Measures of fatigue, disease activity, pain, and various psychosocial factors were gathered from 73 individuals with RA. Correlations between fatigue and other variables were examined, and the "best" predictors of fatigue were determined with multiple regression analyses. RESULTS: Many of the variables that were significantly correlated with fatigue had a psychosocial character. Moreover, the "best" predictors of increased fatigue were higher levels of pain, more depressive symptoms, and female sex. Longer symptom duration, less perceived adequacy of social support, and less disease activity were significant predictors of fatigue, over and above the "best" model. CONCLUSION: RA-related fatigue appears to be strongly associated with psychosocial variables, apart from disease activity per se. Correspondingly, treatment of fatigue may be enhanced by interventions that address relevant cognitive and behavioral dimensions.