Cognitive Intrusion of Pain, Autobiographical Memory Characteristics, and Aggression Across Rheumatic Diseases: A...

Cognitive intrusion of pain, autobiographical memory, and aggression have not been simultaneously compared in rheumatic diseases. We compared these constructs across rheumatoid arthritis (RA), psoriatic arthritis (PsA), osteoarthritis (OA), and fibromyalgia (FM) and identified disease-specific predictors.

Two hundred twenty-five patients (62 RA, 52 PsA, 56 OA, 55 FM) were assessed (May to October 2025) with the Experience of Cognitive Intrusion of Pain Scale (ECIPS), Autobiographical Memory Questionnaire (AMQ), Buss-Perry Aggression Scale (BPAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Visual Analog Scale (VAS). Disease burden was measured with the Disease Activity Score 28-C-reactive protein (DAS28-CRP), Disease Activity Index for Psoriatic Arthritis (DAPSA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Fibromyalgia Impact Questionnaire (FIQ). Analysis of variance and covariance (ANOVA, ANCOVA; age, sex, depression, anxiety) and multiple regression were applied with Benjamini-Hochberg false discovery rate (FDR) correction.

After adjustment, ECIPS did not differ across groups (F3,217=0.63, p=0.595, partial η²=0.009). Hostility differences attenuated after mood adjustment (p=0.784). Scene imagery differed among groups (p=0.023). Physical aggression (β=0.270, p=0.005) and memory rehearsal (β=0.653, p<0.001) were associated with cognitive intrusion. DAS28-CRP predicted ECIPS in RA (β=0.357, p=0.006) and FIQ in FM (β=0.401, p=0.003). No medication subgroup differences emerged.

Cognitive pain intrusion did not differ across rheumatic diseases after mood adjustment (partial η²=0.009). Because the ECIPS lacks rheumatology validation, this may reflect limited measurement sensitivity, residual confounding, or insufficient power rather than true equivalence. Disease activity was independently associated with cognitive intrusion in RA and FM. Rheumatology-specific psychometric validation is warranted.