[Affectivity, irrational attitudes, and pain in patients with rheumatoid arthritis.]

The relationship of patients' pain with emotions and irrational attitudes were reported. The subjects were 128 patients with rheumatoid arthritis (RA). The assessment instruments were the Situation-Reaction Questionnaire (SRQ) and the Irrational Attitudes Questionnaire (IAQ). Pain experience was measured by a pain-attribute scale and a visual analog scale, and reported pain behavior by two scales for assessing avoidance and activity in pain situations. The medical control variables were morning stiffness and two indexes of process activity and joint inflammation. Hierarchical regression analyses showed (after the inclusion of medical variables) that affect scales (depression, anxiety, aggression) contribute significantly to the explanation of the variation of pain experience (adjective scale: 3%) and reported pain behavior (avoidance: 11%, activity: 6%). When disease activity and emotions were held constant, the IAQ explained a further 11-14% of pain experience and pain behavior. On the other hand, when medical variables and irrational attitudes were controlled, emotions showed no common variation to pain. According to our results, cognitive concepts seem to be more powerful for explaining pain experience and pain behavior than affective constructions. Implications for the study and the practice of psychological pain treatment are discussed.