title: Pain and functioning of rheumatoid arthritis patients based on marital status: is a distressed marriage preferable to no marriage?
abstract: Relationships may influence adjustment to chronic pain conditions such as rheumatoid arthritis (RA). We examined how both marital status and marital adjustment were related to pain, physical disability, and psychological disability in 255 adults with RA. Among married participants (n = 158), better marital adjustment (assessed using the Locke-Wallace Marital Adjustment Scale) was correlated with less pain and physical and psychological disability (all P values < .05). Married participants were divided into distressed (n = 44) and nondistressed (n = 114) subgroups and compared with unmarried participants (n = 97). Controlling for demographics and disease severity, unmarried participants had higher affective pain (P = .009) and higher psychological disability (P = .02) than only the nondistressed married participants, but unmarried participants did not differ from distressed married participants. These findings suggest that being married in itself is not associated with better health in RA but that being in a well-adjusted or nondistressed marriage is linked with less pain and better functioning.
  
  
  CONCLUSIONS
  This study examined relationships of marital status and marital adjustment to pain and physical and psychological disability in RA. Findings underscore the importance of considering not only marital status but also degree of marital adjustment in RA and may inform clinical interventions in this population.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland 21224, USA. jreese13@jhmi.edu
authors.forename: Jennifer Barsky
authors.initials: JB
authors.lastname: Reese
authors.forename: Tamara J
authors.initials: TJ
authors.lastname: Somers
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Angelia
authors.initials: A
authors.lastname: Mosley-Williams
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lumley
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D002908:Chronic Disease; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008393:Marriage / Q000523:psychology* / Q000639:trends; D008875:Middle Aged; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*