title: Cultural syndromes and age moderate the emotional impact of illness intrusiveness in rheumatoid arthritis.
abstract: OBJECTIVE
  The authors investigated cultural syndromes (multidimensional vectors comprising culturally based attitudes, values, and beliefs) and age as moderators of the emotional impact of illness intrusiveness--illness-induced lifestyle disruptions--in rheumatoid arthritis (RA) and examined illness intrusiveness effects in total and separately for three life domains (relationships and personal development, intimacy, and instrumental).
  
  
  METHODS
  People with RA (n = 105) completed the Illness Intrusiveness Ratings, Individualism-Collectivism, and Center for Epidemiologic Studies--Depression scales in a one-on-one interview.
  
  
  RESULTS
  Controlling for disease and background characteristics, the association between illness intrusiveness (total score and the Relationships and Personal Development subscale) and distress was inverse when young adults with RA endorsed high horizontal individualism. Illness intrusiveness into intimacy was associated with increased distress, and this intensified when respondents endorsed high vertical individualism, horizontal collectivism, vertical collectivism, or low horizontal individualism. The negative emotional impact of illness intrusiveness into intimacy diminished with increasing age.
  
  
  CONCLUSIONS
  Given an aging and increasingly pluralistic society, diversity can no longer be ignored in addressing the psychosocial impact of chronic, disabling disease.
authors.affiliation: Ontario Cancer Institute, Psychosocial Oncology and Palliative Care Program, Princess Margaret Hospital, and Department of Psychiatry, University of Toronto, Ontario, Canada. gdevins@uhnres.utoronto.ca
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Devins
authors.forename: Anita
authors.initials: A
authors.lastname: Gupta
authors.forename: Jill
authors.initials: J
authors.lastname: Cameron
authors.forename: Kirsten
authors.initials: K
authors.lastname: Woodend
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mah
authors.forename: Dafna
authors.initials: D
authors.lastname: Gladman
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000523:psychology* / Q000534:rehabilitation; D003299:Cooperative Behavior; D017281:Cost of Illness; D003431:Cross-Cultural Comparison; D003469:Culture; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007206:Individuality; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology / Q000534:rehabilitation; D020377:Self Efficacy; D012803:Sick Role; D012933:Social Identification; D012945:Social Values; D011795:Surveys and Questionnaires; D055815:Young Adult