title: Psychophysiological responses to stress after stress management training in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Stress management interventions may prove useful in preventing the detrimental effects of stress on health. This study assessed the effects of a stress management intervention on the psychophysiological response to stress in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Seventy-four patients with RA, who were randomly assigned to either a control group or a group that received short-term stress management training, performed a standardized psychosocial stress task (Trier Social Stress Test; TSST) 1 week after the stress management training and at a 9-week follow-up. Psychological and physical functioning, and the acute psychophysiological response to the stress test were assessed.
  
  
  RESULTS
  Patients in the intervention group showed significantly lower psychological distress levels of anxiety after the training than did the controls. While there were no between-group differences in stress-induced tension levels, and autonomic (α-amylase) or endocrine (cortisol) responses to the stress test 1 week after the intervention, levels of stress-induced tension and cortisol were significantly lower in the intervention group at the 9-week follow-up. Overall, the response to the intervention was particularly evident in a subgroup of patients with a psychological risk profile.
  
  
  CONCLUSIONS
  A relatively short stress management intervention can improve psychological functioning and influences the psychophysiological response to stress in patients with RA, particularly those psychologically at risk. These findings might help understand how stress can affect health and the role of individual differences in stress responsiveness.
  
  
  BACKGROUND
  TrialRegister.nl NTR1193.
authors.affiliation: Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. S.deBrouwer@mps.umcn.nl
authors.forename: Sabine J M
authors.initials: SJ
authors.lastname: de Brouwer
authors.forename: Floris W
authors.initials: FW
authors.lastname: Kraaimaat
authors.forename: Fred C G J
authors.initials: FC
authors.lastname: Sweep
authors.forename: Rogier T
authors.initials: RT
authors.lastname: Donders
authors.forename: Agnes
authors.initials: A
authors.lastname: Eijsbouts
authors.forename: Saskia
authors.initials: S
authors.lastname: van Koulil
authors.forename: Piet L C M
authors.initials: PL
authors.lastname: van Riel
authors.forename: Andrea W M
authors.initials: AW
authors.lastname: Evers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000096:biosynthesis; D008297:Male; D015233:Models, Statistical; D010290:Parents; D011603:Psychophysiology / Q000379:methods; D012306:Risk; D013315:Stress, Psychological / Q000628:therapy; D013997:Time Factors; D000516:alpha-Amylases / Q000096:biosynthesis
chemical_list: D000516:alpha-Amylases; D006854:Hydrocortisone