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Rheumatology Advance Access published online on April 6, 2005
Rheumatology, doi:10.1093/rheumatology/keh626
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received December 20, 2004
Accepted February 25, 2005

Concise Report

Neuroendocrine-immune relationships between emotion regulation and health in patients with rheumatoid arthritis

H. van Middendorp 1*, R. Geenen 1, M. J. Sorbi 1, L. J. P. van Doornen 1, and J. W. J. Bijlsma 2

1 Department of Health Psychology, Utrecht University, The Netherlands
2 Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands

* To whom correspondence should be addressed.
H. van Middendorp, E-mail: H.vanMiddendorp{at}fss.uu.nl


  Abstract

Objectives. Emotion regulation is hypothesized to be related to health through neuroendocrine-immune changes. This study examined the role of the neuroendocrine variables 24-h urinary cortisol and noradrenaline, and the immune variable serum interleukin 6 as mediators between emotion regulation styles and health (perceived health and disease activity: erythrocyte sedimentation rate (ESR) and Thompson joint score).

Methods. Sixty patients with rheumatoid arthritis (mean age 59.0±11.2 yr; 38 female) participated.

Results. Emotion regulation was not associated with immune functioning or disease activity, but it was somewhat related to neuroendocrine functioning: one of the emotion regulation styles, ambiguity, was related to noradrenaline in women (r = 0.39) but not in men. The indicators of neuroendocrine functioning (cortisol and noradrenaline) were correlated (r = 0.40), as were indicators of immune functioning (interleukin 6) and inflammatory activity (ESR; r = 0.53), but analyses did not indicate a role of these physiological variables in mediating between emotion regulation and health: neuroendocrine variables were not related to interleukin 6 or ESR, and none of the physiological parameters was correlated with joint score or perceived health.

Conclusions. To examine whether the proposed mediational processes apply to individual patients, a longitudinal within-subjects design is needed. In our cross-sectional study, emotion regulation was somewhat related to neuroendocrine functioning, but our study did not uncover a potential mediational role of cortisol, noradrenaline or interleukin 6 in the relationship between emotion regulation and health in rheumatoid arthritis.

Keywords: Emotions; Psychological adaptation; Alexithymia; Stress; Erythrocyte sedimentation rate; Interleukin-6; Noradrenaline; Cortisol; Psychoneuroimmunology; Rheumatoid arthritis.
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