title: Styles of emotion regulation and their associations with perceived health in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Patients with rheumatoid arthritis face the challenge of adjusting to adverse health consequences and accompanying emotions. Styles of emotion regulation may affect health.
  
  
  OBJECTIVE
  The objective is to examine associations between styles of emotion regulation and perceived health, consisting of psychological well-being, social functioning, physical functioning, and disease activity.
  
  
  METHODS
  Principal component analysis was used to summarize styles of emotion regulation of 335 patients with rheumatoid arthritis. Relationships between emotion regulation and perceived health were examined with structural equation modeling.
  
  
  RESULTS
  Four styles of emotion regulation were identified: ambiguity, control, orientation, and expression. Ambiguity and control were mutually correlated, as were orientation and expression. Styles of emotion regulation were not uniquely related to perceived physical functioning and disease activity. Emotional ambiguity and orientation were related to poorer, whereas expression and control were related to more favorable psychological well-being and social functioning.
  
  
  CONCLUSIONS
  Our cross-sectional study suggests that emotion regulation is not of direct importance for perceived somatic health of patients with rheumatoid arthritis, but it may be of importance for psychological well-being and social functioning, and perhaps through this route for somatic health. The more conscious and controlled aspects of control and expression are positively related to psychosocial health, and the more unconscious automatic aspects of ambiguity and orientation are negatively related. Changing emotion regulation will potentially affect psychosocial health. It would be worthwhile to verify this possibility in prospective research.
authors.affiliation: Department of Health Psychology, Utrecht University, The Netherlands. H.vanMiddendorp@fss.uu.nl
authors.forename: Henriët
authors.initials: H
authors.lastname: van Middendorp
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
authors.forename: Marjolijn J
authors.initials: MJ
authors.lastname: Sorbi
authors.forename: Joop J
authors.initials: JJ
authors.lastname: Hox
authors.forename: Ad J J M
authors.initials: AJ
authors.lastname: Vingerhoets
authors.forename: Lorenz J P
authors.initials: LJ
authors.lastname: van Doornen
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged