title: Dealing with emotions when the ability to cry is hampered: emotion processing and regulation in patients with primary Sjögren's syndrome.
abstract: OBJECTIVE
  The hampered ability to cry in patients with Sjögren's syndrome may affect their ways of dealing with emotions. The aim of this study was to examine differences in emotion processing and regulation between people with and without Sjögren's syndrome and correlations of emotion processing and regulation with mental well-being.
  
  
  METHODS
  In 300 patients with primary Sjögren's syndrome and 100 demographically matched control participants (mean age 56.8 years, 93% female), emotion processing (affect intensity and alexithymia, i.e. difficulty identifying and describing feelings), emotion regulation (cognitive reappraisal, suppression and expression of emotions), and mental well-being were assessed.
  
  
  RESULTS
  Criteria for clinical alexithymia applied to 22% of the patients and 12% of the control participants; patients had significantly more difficulty identifying feelings than control participants. No other significant differences in emotion processing and emotion regulation were found. In patients, the emotion processing styles affect intensity and alexithymia (0.32<r<0.51) and the emotion regulation strategy suppression of emotions (r=0.13) significantly correlated with worse mental well-being, which is about similar to control participants.
  
  
  CONCLUSIONS
  Processing and regulating emotions in patients with Sjögren's syndrome does not deviate from normal with one exception: a relatively large number of patients is alexithymic. As in the general population, in patients with Sjögren's syndrome the more intense and deficient processing and regulation of emotions is associated with worse mental well-being. This study indicates that, except for selected patients, processing and regulation of emotions is not a key therapeutic issue for the majority of patients with Sjögren's syndrome.
authors.affiliation: Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. n.vanleeuwen@uu.nl
authors.forename: Ninke
authors.initials: N
authors.lastname: van Leeuwen
authors.forename: Ercolie R
authors.initials: ER
authors.lastname: Bossema
authors.forename: Henriët
authors.initials: H
authors.lastname: van Middendorp
authors.forename: Aike A
authors.initials: AA
authors.lastname: Kruize
authors.forename: Hendrika
authors.initials: H
authors.lastname: Bootsma
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000503:physiopathology* / Q000523:psychology*; D000368:Aged; D003448:Crying / Q000502:physiology / Q000523:psychology*; D019260:Expressed Emotion / Q000502:physiology*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000503:physiopathology; D008297:Male; D008603:Mental Health; D008606:Mental Processes / Q000502:physiology; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012859:Sjogren's Syndrome / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires