Emotion regulation and disease adjustment in women and men with rheumatoid arthritis

Strategies to regulate emotions (alexithymia, affect intensity, and emotional expression) were examined by questionnaires in 249 female and 96 male patients with rheumatoid arthritis (RA; age range: 19-87 years) and compared to the scores of 196 female control participants (age range: 19-82 years). Cross-sectional associations of emotion regulation with mental well-being, social and physical functioning, and self-assessed disease activity were examined, as well as predictive associations in a subsample of 65 patients (age range 32-79, 65% female). Women with RA showed more difficulty identifying and describing feelings, a higher prevalence of alexithymia (RA women: 27%, control group: 9%), lower affect intensity, and lower expressivity of positive and negative emotions than female control participants. Regarding gender differences within the RA-sample, women experienced their emotions much more strongly (p <.001) and expressed their positive (p <.001) but not their negative emotions (p = .38) to a larger extent than men. Men showed a marginally higher prevalence of alexithymia (35% versus 27%, p = .06). More cross-sectional associations (r >= 30) between emotion regulation and especially psychological and social well-being were found in women than in men with rheumatoid arthritis. Alexithymia, affect intensity, and expressivity were especially in men predictive of decreased mental and physical functioning. The results suggest that patients with RA are less emotionally aware and expressive than control participants and that emotion regulation is mainly in men with rheumatoid arthritis predictive of changes in disease adjustment