Objectives. This research was carried out in two stages: the objectives of the first stage were (1) to identify the existing relationships between the level of anxiety, the frequency of automatic negative thoughts, and unconditional self-acceptance and (2) to capture the existing differences regarding these variables between people diagnosed with rheumatoid arthritis and those with no such medical history. Methods. The sample made up of 50 subjects filled out the following three questionnaires: the Hamilton Anxiety Scale, the Automatic Thoughts Questionnaire, and the Unconditional Self-Acceptance Questionnaire. Results. Psychological anxiety is positively correlated with automatic negative thoughts, while unconditional self-acceptance is negatively correlated with both psychological anxiety and somatic anxiety as well as with automatic negative thoughts. All studied variables were significantly different in rheumatoid arthritis as compared to the control population. Conclusions. The results showed the presence to a greater extent of anxiety and automatic negative thoughts, along with reduced unconditional self-acceptance among people with rheumatoid arthritis. Intervention on these variables through support and counseling can lead to reducing anxiety and depression, to altering the coping styles, and, implicitly, to improving the patients’ quality of life. 1. Introduction Rheumatoid arthritis (RA) is one of the main and most common inflammatory rheumatic diseases that affect the joints, causing chronic pain and disability [1]. Although in arthritis disability has been associated with damaging effect on the joints, gradually, the predictive nature of psychological and social factors has also been acknowledged in increasing disability over time (e.g., attitude towards the disease, coping styles, anxiety, automatic negative thoughts, or depression). This can determine significant influences in carrying out one’s roles, in one’s quality of life and mental health [2]. Fortunately, as the disease progresses, patients can learn how to adapt to it and its consequences, so as to maintain a normal level of distress [3]. The literature explaining rheumatoid arthritis highlights the role played by psychological factors in health-seeking behaviors and in using medical services [4] or in developing counseling and support programs. The self-regulation model suggests the fact that the emotional and cognitive aspects of perceiving the disease guide the response to this illness and determine the efficiency of the coping mechanisms developed by patients. Coping—seen as a
References
[1]
R. Puchner, J. Sautner, D. Loisl, and U. Puchner, “Does a special relationship between personality and rheumatoid arthritis exist? Experiences with an Austrian Psychological Questionnaire,” Clinical Rheumatology, vol. 28, no. 10, pp. 1147–1152, 2009.
[2]
J. E. Broderick, A. A. Stone, J. M. Smyth, and A. T. Kaell, “The feasibility and effectiveness of an expressive writing intervention for rheumatoid arthritis via home-based videotaped instructions,” Annals of Behavioral Medicine, vol. 27, no. 1, pp. 50–59, 2004.
[3]
R. K. Dissanayake and J. V. Bertouch, “Psychosocial interventions as adjunct therapy for patients with rheumatoid arthritis: a systematic review,” International Journal of Rheumatic Diseases, vol. 13, no. 4, pp. 324–334, 2010.
[4]
T. Covic, G. Tyson, D. Spencer, and G. Howe, “Depression in rheumatoid arthritis patients: demographic, clinical, and psychological predictors,” Journal of Psychosomatic Research, vol. 60, no. 5, pp. 469–476, 2006.
[5]
Y. Zyrianova, B. D. Kelly, J. Sheehan, C. McCarthy, and T. G. Dinan, “The psychological impact of arthritis: the effects of illness perception and coping,” Irish Journal of Medical Science, vol. 180, no. 1, pp. 203–210, 2011.
[6]
L. Sharpe, “Arthritis: behavioral treatment,” in Encyclopedia of Health & Behavior, N. B. Anderson, Ed., Sage Publications, Thousand Oaks, Calif, USA, 2004.
[7]
F. J. Keefe, S. J. Smith, A. L. H. Buffington, J. Gibson, J. L. Studts, and D. S. Caldwell, “Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis,” Journal of Consulting and Clinical Psychology, vol. 70, no. 3, pp. 640–655, 2002.
[8]
A. J. Zautra and B. W. Smith, “Depression and reactivity to stress in older women with rheumatoid arthritis and osteoarthritis,” Psychosomatic Medicine, vol. 63, no. 4, pp. 687–696, 2001.
[9]
B. W. Smith and A. J. Zautra, “The role of personality in exposure and reactivity to interpersonal stress in relation to arthritis disease activity and negative affect in women,” Health Psychology, vol. 21, no. 1, pp. 81–88, 2002.
[10]
B. W. Smith and A. J. Zautra, “The role of purpose in life in recovery from knee surgery,” International Journal of Behavioral Medicine, vol. 11, no. 4, pp. 197–202, 2004.
[11]
B. W. Smith and A. J. Zautra, “The effects of anxiety and depression on weekly pain in women with arthritis,” Pain, vol. 138, no. 2, pp. 354–361, 2008.
[12]
J. F. Brosschot, W. Gerin, and J. F. Thayer, “The perseverative cognition hypothesis: a review of worry, prolonged stress-related physiological activation, and health,” Journal of Psychosomatic Research, vol. 60, no. 2, pp. 113–124, 2006.
[13]
J. S. Beck, Cognitive Therapy: Basics and Beyond, Guilford, New York, NY, USA, 1995.
[14]
J. W. Kanter, R. J. Kohlenberg, and E. F. Loftus, “Experimental and psychotherapeutic demand characteristics and the cognitive therapy rationale: an analogue study,” Cognitive Therapy and Research, vol. 28, no. 2, pp. 229–239, 2004.
[15]
C. A. Arpin-Cribbie and R. A. Cribbie, “Psychological correlates of fatigue: examining depression, perfectionism, and automatic negative thoughts,” Personality and Individual Differences, vol. 43, no. 6, pp. 1310–1320, 2007.
[16]
D. Clarke and T. Goosen, “The mediating effects of coping strategies in the relationship between automatic negative thoughts and depression in a clinical sample of diabetes patients,” Personality and Individual Differences, vol. 46, no. 4, pp. 460–464, 2009.
[17]
G. L. Flett, A. Besser, R. A. Davis, and P. L. Hewitt, “Dimensions of perfectionism, unconditional self-acceptance, and depression,” Journal of Rational, vol. 21, no. 2, pp. 119–138, 2003.
[18]
L.-G. Lundh, “Perfectionism and acceptance,” Journal of Rational: Emotive and Cognitive-Behavior Therapy, vol. 22, no. 4, pp. 255–269, 2004.
[19]
J. M. Chamberlain and D. A. F. Haaga, “Unconditional self-acceptance and psychological health,” Journal of Rational-Emotive and Cognitive-Behavior Therapy, vol. 19, no. 3, pp. 163–176, 2001.
[20]
D. David, Ed., Sistem de Evaluare Clinic？, Editura RTS, Cluj-Napoca, Romania, 2007.
[21]
M. Hamilton, “Scala de anxietate Hamilton, (adaptat de Macavei, B),” in Sistem de Evaluare Clinic？, D. David, Ed., Editura RTS, Cluj-Napoca, Romania, 2007.
[22]
S. D. Hollon and P. C. Kendall, “Chestionarul gandurilor automate” (adaptat de Moldovan, R.),” in Sistemul de Evaluare Clinic？, D. David, Ed., Editura RTS, Cluj-Napoca, Romania, 2006.
[23]
J. M. Chamberlain and D. A. F. Haaga, “Chestionarul de acceptare necondi？ionat？ a propriei persoane” (adaptat de Macavei B),” in Sistem de Evaluare Clinic？, D. David, Ed., Editura RTS, Cluj-Napoca, Romania, 2007.
[24]
M. Popa, Statistic？ Pentru Psihologie. Teorie？iaplica？ii SPSS, Editura Polirom, Ia？i, Romania, 2008.
[25]
A. T. Beck, “Cognitive models of depression,” Journal of Cognitive Psychotherapy: An International Quarterly, vol. 1, pp. 5–57, 1987.
[26]
E. L. Garland, B. Fredrickson, A. M. Kring, D. P. Johnson, P. S. Meyer, and D. L. Penn, “Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology,” Clinical Psychology Review, vol. 30, no. 7, pp. 849–864, 2010.
[27]
J. M. Chamberlain and D. A. F. Haaga, “Unconditional self-acceptance and responses to negative feedback,” Journal of Rational-Emotive and Cognitive-Behavior Therapy, vol. 19, no. 3, pp. 177–189, 2001.
[28]
A. Ellis, Reason and Emotion in Psychotherapy, Birch Lane, Secaucus, NJ, USA, 1994.
[29]
D. David, Ed., Tratat de Psihoterapii Cognitive ？i Comportamentale, Editura Polirom, Ia？i, Romania, 2006.
[30]
G. Kingsley, I. C. Scott, and D. L. Scott, “Quality of life and the outcome of established rheumatoid arthritis,” Best Practice and Research Clinical Rheumatology, vol. 25, no. 4, pp. 585–606, 2011.
[31]
M. G. Albano, J.-S. Giraudet-Le Quintrec, C. Crozet, and J.-F. d'Ivernois, “Characteristics and development of therapeutic patient education in rheumatoid arthritis: analysis of the 2003–2008 literature,” Joint Bone Spine, vol. 77, no. 5, pp. 405–410, 2010.
