Life change, irrational attitudes and disease impacts in patients with ankylosing spondylitis

The present study is concerned with (1) the question whether patients with ankylosing spondylitis (AS) are different from patients with rheumatoid arthritis (RA) reported previously, with respect to the personality trait of irrational attitudes and to disease impacts, and (2) how the socio-psychological variables of life stress and irrational attitudes relate to disease impacts. Subjects were 197 patients with definite AS from a rheumatic treatment center. AS-patients scored lower in irrationality, pain-intensity, sensory pain, pain avoidance and disability than RA-patients but were not different in affective pain and in general health condition. Relations between negative events and avoidance behavior were stronger in AS-patients. The associations between irrationality versus pain intensity, affective pain and disability were lower (but significant) in AS-patients compared to RA. Of equal strength were correlations between irrationality and avoidance as well as general symptoms. Hierarchical regression analyses with disease activity as control variables revealed 2.2% to 7.1% common variance between life stress and disease impacts (affective pain, avoidance behavior, general symptoms). Irrational attitudes explained 8.9% to 18.3% of disease impact variation. The results suggest influences of social and personality variables on suffering of AS-patients and expect these patients to be good treatment candidates-though they seem stable and non-neurotic in their personality.