title: Psychological predictors of pain severity, pain interference, depression, and anxiety in rheumatoid arthritis patients with chronic pain.
abstract: OBJECTIVE
  Rheumatoid arthritis is a chronic and progressive autoimmune disorder with symptoms sometimes including chronic pain and depression. The current study aimed to explore some of the psychological variables which predict both pain-related outcomes (pain severity and pain interference) and psychological outcomes (depression and anxiety) amongst patients with rheumatoid arthritis experiencing chronic pain. In particular, this study aimed to establish whether either self-concealment, or the satisfaction of basic psychological needs (autonomy, relatedness, and competence), could explain a significant portion of the variance in pain outcomes and psychological outcomes amongst this patient group.
  
  
  METHODS
  Online questionnaires were completed by 317 rheumatoid arthritis patients with chronic pain, providing data across a number of predictor and outcome variables.
  
  
  RESULTS
  Hierarchical multiple linear regressions indicated that the predictive models for each of the four outcome variables were significant, and had good levels of fit with the data. In terms of individual predictor variables, higher relatedness significantly predicted lower depression, and higher autonomy significantly predicted lower anxiety.
  
  
  CONCLUSIONS
  The model generated by this study may identify factors to be targeted by future interventions with the goal of reducing depression and anxiety amongst patients with rheumatoid arthritis experiencing chronic pain. The findings of this study have shown that the autonomy and the relatedness of patients with rheumatoid arthritis play important roles in promoting psychological well-being. Targeted interventions could help to enhance the lives of patients despite the presence of chronic pain.
  What is already known about the subject? Amongst a sample of chronic pain patients who primarily had a diagnosis of fibromyalgia, it was found that higher levels of self-concealment were associated with higher self-reported pain levels and reduced well-being (as measured by anxiety/depression), and these associations were mediated by patients' needs for autonomy not being met (Uysal & Lu, Health Psychology, 2011, 30, 606). What does this study add? For the first time amongst a rheumatoid arthritis population experiencing chronic pain, we found that higher levels of relatedness significantly predicted lower depression. For the first time amongst the same population, we found that higher levels of autonomy significantly predicted lower anxiety.
authors.affiliation: Health Service Executive West, Psychology Department, Primary Care, St Mary's Headquarters, Castlebar, County Mayo, Ireland.
authors.forename: Seamus
authors.initials: S
authors.lastname: Ryan
authors.affiliation: School of Psychology, Arts Millennium Building Extension, National University of Ireland Galway, Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: McGuire
mesh_terms: D000223:Adaptation, Psychological; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology*; D059350:Chronic Pain / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: anxiety; autonomy; basic psychological needs; chronic pain; competence; depression; relatedeness; rheumatoid arthritis; self-determination theory