title: Cognitive, behavioral and physiological reactivity to pain as a predictor of long-term pain in rheumatoid arthritis patients.
abstract: A heightened reactivity to pain is assumed to play a significant role in the maintenance and exacerbation of pain in patients with chronic pain. In a prospective study involving 95 rheumatoid arthritis (RA) patients, the relative contribution of self-reported cognitive, behavioral and physiological components of pain reactivity were examined for a change in pain within 1 year. Regression analyses indicated that self-reported physiological reactivity predicted an increase in clinical and self-reported pain after 1 year, but not cognitive and behavioral reactivity. Neither disease activity nor neuroticism mediated or moderated the relationship of pain reactivity to long-term pain. However, structural equation modeling revealed that neuroticism directly affected physiological reactivity to pain, which in turn was the only significant predictor for subsequent pain. The results of this study underline the crucial role of physiological pain reactivity for exacerbation of pain in RA patients and are indicative for a symptom-specific pattern of physiological pain reactivity that is sustained by psychological predisposition and respondent learning processes.
authors: Department of Medical Psychology, University of Nijmegen, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands Department of Rheumatology, University Medical Center St. Radboud, Nijmegen, The Netherlands Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors: Andrea W M
authors: AWM
authors: Evers
authors: Floris W
authors: FW
authors: Kraaimaat
authors: Piet L C M
authors: PLCM
authors: van Riel
authors: Johannes W J
authors: JWJ
authors: Bijlsma
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology*; D002908:Chronic Disease; D003071:Cognition / Q000502:physiology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000175:diagnosis / Q000523:psychology; D010146:Pain / Q000175:diagnosis* / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011603:Psychophysiology; D012919:Social Behavior; D011795:Surveys and Questionnaires