title: Neuroendocrine-immune relationships between emotion regulation and health in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Emotion regulation is hypothesized to be related to health through neuroendocrine-immune changes. This study examined the role of the neuroendocrine variables 24-h urinary cortisol and noradrenaline, and the immune variable serum interleukin 6 as mediators between emotion regulation styles and health (perceived health and disease activity: erythrocyte sedimentation rate (ESR) and Thompson joint score).
  
  
  METHODS
  Sixty patients with rheumatoid arthritis (mean age 59.0+/-11.2 yr; 38 female) participated.
  
  
  RESULTS
  Emotion regulation was not associated with immune functioning or disease activity, but it was somewhat related to neuroendocrine functioning: one of the emotion regulation styles, ambiguity, was related to noradrenaline in women (r = 0.39) but not in men. The indicators of neuroendocrine functioning (cortisol and noradrenaline) were correlated (r = 0.40), as were indicators of immune functioning (interleukin 6) and inflammatory activity (ESR; r = 0.53), but analyses did not indicate a role of these physiological variables in mediating between emotion regulation and health: neuroendocrine variables were not related to interleukin 6 or ESR, and none of the physiological parameters was correlated with joint score or perceived health.
  
  
  CONCLUSIONS
  To examine whether the proposed mediational processes apply to individual patients, a longitudinal within-subjects design is needed. In our cross-sectional study, emotion regulation was somewhat related to neuroendocrine functioning, but our study did not uncover a potential mediational role of cortisol, noradrenaline or interleukin 6 in the relationship between emotion regulation and health in rheumatoid arthritis.
authors.affiliation: Department of Health Psychology, Utrecht University, PO Box 80140, 3508 TC Utrecht, The Netherlands. H.vanMiddendorp@fss.uu.nl
authors.forename: H
authors.initials: H
authors.lastname: van Middendorp
authors.forename: R
authors.initials: R
authors.lastname: Geenen
authors.forename: M J
authors.initials: MJ
authors.lastname: Sorbi
authors.forename: L J P
authors.initials: LJ
authors.lastname: van Doornen
authors.forename: J W J
authors.initials: JW
authors.lastname: Bijlsma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000503:physiopathology / Q000523:psychology*; D001799:Blood Sedimentation; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009490:Neurosecretory Systems / Q000503:physiopathology*; D009638:Norepinephrine / Q000652:urine; D012720:Severity of Illness Index
chemical_list: D015850:Interleukin-6; D006854:Hydrocortisone; D009638:Norepinephrine