Biomedical subjects

A J Zautra

Publications and source records attributed to A J Zautra.

At least 19 recordsLinked to original sources

PubMed2001

Vulnerability to stress among women in chronic pain from fibromyalgia and osteoarthritis.

In two investigations, we studied vulnerability to the negative effects of stress among women in chronic pain from 2 types of musculoskeletal illnesses, fibromyalgia syndrome (FMS) and osteoarthritis (OA). In Study 1, there were 101 female participants 50 to 78 years old: 50 had FMS, 29 had OA knee pain and were scheduled for knee surgery, and 22 had OA but were not planning surgery. Cross-sectional analyses showed that the three groups were comparable on demographic variables, personality attributes, negative affect, active coping, and perceived social support. As expected, FMS and OA surgery women reported similar levels of bodily pain, and both groups scored higher than OA nonsurgery women. However, women with FMS reported poorer emotional and physical health, lower positive affect, a poorer quality social milieu, and more frequent use of avoidant coping with pain than did both groups of women with OA. Moreover, the perception and use of social support were closely tied to perceived social stress only among the FMS group. In Study 2, we experimentally manipulated negative mood and stress in 41 women 37 to 74 years old: 20 women had FMS, and 21 women had OA. Participantsfrom each group were randomly assigned to either a negative mood induction or a neutral mood (control) condition, and then all participants discussed a stressful interpersonal eventfor 30 min. Stress-related increases in pain were exacerbated by negative mood induction among women with FMS but not women with OA, and pain during stress was associated with decreases in positive affect in women with FMS but not women with OA. These findings suggest that among women with chronic pain, those with FMS may be particularly vulnerable to the negative effects of social stress. They have fewer positive affective resources, use less effective pain-coping strategies, and have more constrained social networks than their counterparts with OA, particularly those who experience similar levels ofpain. They also seem to experience more prolonged stress-related increases in pain under certain circumstances, all of which may contribute to a lowering of positive affect and increased stress reactivity over time.

Adaptation, Psychological↗

PubMed2000

Stressful events and information processing dispositions moderate the relationship between positive and negative affect: implications for pain patients.

Relationships between positive affect, negative affect, and pain were analyzed as a prospective function of stressful events in a sample of rheumatoid arthritis patients and as a cross-sectional function of an information processing disposition in persons with fibromyalgia. Positive affect and negative affect were statistically separate factors overall in both samples. In addition, negative affect and pain were related across all conditions. However, positive affect and negative affect were more negatively correlated during stressful periods and more negatively correlated for patients who processed information in a more simplistic fashion. Also, positive affect predicted pain during stressful times and did so for patients who processed information more simplistically as well. These data suggest positive affect and negative affect are unique factors whose interrelation and external correlates are not static.

Affect↗

PubMed2000

Stressful life events, psychological distress, coping, and parenting of divorced mothers: a longitudinal study.

This was a prospective longitudinal study of the relationships among life stress, psychological distress, coping, and parenting behaviors in a sample of divorced custodial mothers. First, the differential effects of major events and daily stressors on psychological distress and parenting were explored. Second, the mediational links among stress, distress, and 3 dimensions of parenting behaviors were studied. Third, 3 coping strategies were studied as moderators of the relationship between distress and parenting. The results showed that both major and small events had significant effects on parental distress, with the effects of daily negative events being greater than those of major events. Parental distress mediated the relationships between stressful life events and parental acceptance of their children's behaviors. Parental coping strategies moderated the relationship between mothers' psychological distress and mothers' discipline practice.

Adaptation, Psychological↗

PubMed2000

The role of stressful events in the relationship between positive and negative affects: evidence from field and experimental studies.

Three studies are presented that examine the effects of stress on the relationship between positive and negative affective states. In the first study, recently bereaved and disabled older adults were compared to matched control groups without these recent stressors. Negative affect was inversely correlated with positive affect to a significantly greater extent for the highly stressed groups compared with controls. In a second study, older adults were exposed to a laboratory stressor, and their positive and negative affective reactions recorded. Immediately following a speech stressor task, the inverse correlation between positive and negative affect was significantly greater than in pre- and postassessments of affects. The third study was an attempt to replicate and extend the findings from Study 2 with a mid-aged sample of women. The speech stressor had the same effects as in Study 2. A second stressor, which induced pain through immersion of an arm into cold water, had no effects on the correlation between affective states. Alternative explanations for these effects and the implications for cognitive interventions are discussed.

Adult↗

PubMed1999

Field research on the relationship between stress and disease activity in rheumatoid arthritis.

We review empirical evidence from two field studies for the role of stressful life events in disease flare-ups among patients with rheumatoid arthritis (RA). RA patients were expected to be more vulnerable psychologically, and physiologically, to stressful events in their everyday lives than other arthritis patients without an autoimmune disease. Findings from two studies are reviewed both for their substantive contribution, but also to provide guidance on measurement issues in future field research of this kind. One study included 41 patients with RA, who were interviewed weekly and called to a clinic for blood work and joint examinations when their levels of interpersonal stress increased significantly. A second study used a similar design but included comparison samples of patients with osteoarthritis (OA) and healthy controls of similar age and the same gender as the RA sample. The findings provided support for the proposition that interpersonal stressors are predictive of increases in disease activity. Not all RA patients, however, showed these relationships, and there was evidence that some participants with OA who were depressed also showed higher disease activity following interpersonal stressors. Significant individual differences in the stress-disease relationship were uncovered that deserve greater attention in future studies. Important improvements in the assessment of stressful events and refinements in panel study design are also presented as guides to research on the role of stress in disease processes.

Adaptation, Psychological↗

PubMed1998

An examination of individual differences in the relationship between interpersonal stress and disease activity among women with rheumatoid arthritis.

OBJECTIVE: The effects of interpersonal stress on disease activity were examined for married women with rheumatoid arthritis (RA) who differ in the quality of their relationships with their spouses. METHODS: Measures of interpersonal events were collected weekly for 12 weeks and related to disease activity through a comparison of clinician ratings and immune markers taken at baseline and during a highly stressful week for 20 RA patients. Individual differences in marital relationship variables and illness characteristics were used to predict group differences in how stress affected disease activity. RESULTS: Significant elevations in total T cell activation (DR + CD3 cells), soluble interleukin-2 receptor (sIL-2R), and clinician's global ratings of disease activity were found during a week of significant interpersonal stress. However, women with better spousal relationships did not show increases in disease activity following an episode of interpersonal stress. In addition, patients taking low-dose prednisone showed greater reactivity to stress than patients not currently using glucocorticoid treatment. CONCLUSION: The results are consistent with the hypothesis that disease activity in RA increases following increases in interpersonal stress and that women with stronger marital relationships were less vulnerable to those stressors.

Adult↗

PubMed1997

Examination of changes in interpersonal stress as a factor in disease exacerbations among women with rheumatoid arthritis.

OBJECTIVE: This study examined the effects of change in interpersonal stress on disease activity among 41 women with rheumatoid arthritis (RA). METHODS: Measures of everyday stressful events and perceived stress were collected weekly for twelve weeks and related to disease activity in a series of pooled time-series regression analyses. RESULTS: Increases in the number of interpersonal stressors in the same week and one week prior were associated with increases in disease activity. Pain from joint tenderness also was significantly related to a decrease in stressful events one week later. A subgroup of 20 patients showed a significant increase in interpersonal stress from baseline during the course of the study. For this group, significant elevations in DR + CD3 cells, sIL-2R, clinician's rating of disease, and self-reports of joint tenderness were found during the week of increased interpersonal stress. CONCLUSIONS: Interpersonal stress appears to be associated with increases in disease activity among RA patients.

Adult↗

PubMed1997

Stressful life events' effects on rheumatoid arthritis disease activity.

A 53-year-old female rheumatoid arthritis (RA) patient endured 2 unexpected family deaths during a 12-week study investigating the prospective relationships between stressful small life events, negative affect, and disease activity. Her disease went into temporary remission the same week as the deaths. She was identified as a case study participant, and weekly data collection was extended to 1 year. Clinical exams verified a large decrease in disease status immediately after the major losses. In addition to major events, negative affect and small events were found to serve as independent arthritis symptom predictors within this patient. Major events were associated with decreased symptoms. Negative affect and small events related to symptom increases. Subsequent between-subjects analyses conducted on 25 participants from the parent project probed for generalizability. The substantive findings from the case study were supported: Major life events and small life events functioned as opposing predictors of RA disease states.

Arthritis, Rheumatoid↗

PubMed1996

Investigations of the ongoing stressful situations among those with chronic illness.

This paper examines methods of adaptation among those faced with stress from chronic health problems. Studies of disabled older adults and those with muscular-skeletal disorders are described with special emphasis on the role of everyday life events, and the threats to well-being imposed by chronic stressors. Attention is paid not only to psychological distress as outcome of a failure to adapt, but also to indices of psychological well-being which provide evidence of the benefits for those who cope successfully with chronic illness. The paper examines evidence for the proposition that everyday stressors can influence physiological processes linked to disease course. The implications of these findings for social interventions are discussed from community and health psychology perspectives.

Adaptation, Psychological↗

PubMed1996

Major life events and minor stressors: identifying mediational links in the stress process.

Whether the relationship between major life events and distress is mediated through minor stressors was examined in three stress groups: those who (a) experienced the death of a spouse, (b) divorced, or (c) were the parent of a child with asthma. Each of these major stress groups was compared with a control group. Path analyses conducted by aggregating the data cross major stress groups indicated that major life events exert both a direct influence on distress and an indirect influence through minor stressors. On the other hand, the nature of the mediational relation linking major life events with psychological distress through minor stressors was found to vary as a function of the major life stress situation under consideration. Methodological and theoretical implications for the study of stress processes are discussed.

Adaptation, Psychological↗

PubMed1996

Health downturns and predictors of suicidal ideation: an application of the Baumeister model.

Suicidal thoughts and attempts have been studied from a number of perspectives, but only recently has an attempt been made to incorporate many different psychological perspectives into one framework. Baumeister (1990) has integrated personality and social psychological perspectives into one sequential model, moving from instigating events to a final stage of suicidal thoughts. Employing a sample of older adult subjects undergoing the stresses of a recent health downturn, this study tested a four-stage model of suicidal ideation based on many of the components proposed by Baumeister. Structural equation modeling achieved a good fit to the data. Results are discussed in terms of the importance of including life events, particularly poor health, and cognitive variables such as confusions in thinking, in understanding suicidal ideation.

Aged↗

PubMed1995

Spouse encouragement of self-reliance and other-reliance in rheumatoid arthritis couples.

Studying and helping couples burdened with a major life stressor such as rheumatoid arthritis (RA) can be enhanced by employing well-understood conceptual and empirical frameworks, in our research person/environment fit (P x E) models. We measured P x E effects in a sample of 62 rheumatoid arthritis (RA) patients with locus of control beliefs, age, and the health status of the subjects as the Person variables and their spouses' control encouragement as the Environment variable. As predicted, externals were most sensitive to their spouses' behavior. Health status and age moderated the effects of the subjects' control beliefs and spouses' control efforts. Control encouragement showed positive benefits, but only for the younger and healthier subjects; it was related to increased psychological distress for externals in poorer health. Although many models of therapy suggest the benefits of increasing personal control, these data suggest the necessity of employing a more complex model integrating both person and social environment variables in understanding mental health.

Activities of Daily Living↗

PubMed1995

The examination of myofascial face pain and its relationship to psychological distress among women.

In this study, 110 female myofascial face pain patients were assessed monthly for 10 months on measures of pain, distress, and stressful life events. D. A. Kenny and A. J. Zautra's (1995) structural equation model for examining the separate trait, state, and error components of the variables was used to analyze the data. Both pain and distress had sizable trait variance, and the trait components were correlated. The 2 variables also showed sizable state variance, and the states of pain covaried with states of distress. A significant time-lagged relationship between the 2 variables was found: Increases in distress led to elevations in pain 1 month later. Stressful life events arising from major social roles were also associated with greater distress, but not pain. Illness events unrelated to the pain syndrome were associated with both pain and distress.

Female↗

PubMed1995

Arthritis and perceptions of quality of life: an examination of positive and negative affect in rheumatoid arthritis patients.

The utility of measuring both positive and negative affective states for assessing rheumatoid arthritis (RA) patients was examined in 3 independent samples of male and female RA patients (Sample A: 179 women, 48 men; Sample B: 177 women, 24 men; Sample C: 134 women, 38 men). Confirmatory factor analyses of each sample indicated that positive and negative affect constituted separate, negatively correlated factors. The relations among disease variables, coping, and affects were consistent with a model in which coping mediates the relationship between disease variables and positive and negative affect. Patients with higher pain and limitation from RA had higher levels of maladaptive coping, and maladaptive coping was associated with lower positive affect and higher negative affect. Those RAs with higher activity limitation also reported less adaptive coping, which was associated with less positive affect.

Activities of Daily Living↗

PubMed1995

Psychological impact of illness downturns: a comparison of new and chronic conditions.

Older adults (N = 166) who had chronic arthritis, a chronic vision problem, new arthritis symptoms, or a new vision problem were compared with older adult controls on psychological distress and well-being. The psychological impact of new versus chronic illness stressors, and stressors associated with arthritis versus vision loss, were examined. The chronic arthritis group had the greatest psychological distress, the least well-being and the greatest self-reported pain. Results supported an additivity theory approach to chronic illness and not an anticipatory coping approach. Differences in level of pain accounted in part for elevations in distress but did not explain differences between groups in psychological well-being. Positive affect was found to be the indicator of well-being that best differentiated groups.

Adaptation, Psychological↗

PubMed1994

Interpersonal stress, depression, and disease activity in rheumatoid arthritis and osteoarthritis patients.

The relationships among interpersonal stressors, depression, coping inefficiency, hormones (prolactin, cortisol, and estradiol), and disease activity were examined. The sample comprised 33 women with rheumatoid arthritis (RAs; age 37-78) and 37 women with osteoarthritis (OAs; age 47-91), who served as controls. In a regression analysis, interpersonal conflict events accounted for more than twice as much variance in depression in RAs than in OAs. In the RA patients, the immune-stimulating hormones prolactin and estradiol were significantly positively correlated with interpersonal conflicts, depression, coping inefficacy, and clinician ratings of disease activity, suggesting that RAs are more reactive to interpersonal stressors than are OAs, both psychologically and physiologically.

Adaptation, Psychological↗

PubMed1992

Coping with arthritis. Current status and critique.

Our understanding of the complex role of coping in the psychological adjustment to arthritis has improved over the past decade. Studies have consistently demonstrated a relationship between certain coping strategies and psychological outcomes. However, unresolved problems in the methodology and theory concerning these studies cloud the picture, limiting the conclusions that can be drawn. There are general problems with the ways in which coping has been conceptualized and measured by researchers evaluating stress and coping, and there are problems more specific to the ways coping concepts and measures have been used to study patients with arthritis. A complete understanding of the relationship between coping and mental health in this population would have important theoretical and clinical implications. Such studies would serve as a model for investigations of stress and coping in patients with other illnesses, and would point to effective psychosocial interventions for improving the quality of life for this population.

Adaptation, Psychological↗

PubMed1991

Coping success and its relationship to psychological distress for older adults.

The role of coping success on psychosocial distress was investigated in 147 older adults who experienced a major health problem and 82 older adults who reported a major loss in the past 6 months. Home interviews provided data on satisfaction with coping efforts and negative changes associated with events. Significant predictors of coping success were identified and controlled for in subsequent analyses predicting mental health. Efficacy in coping with loss was associated with less psychological distress. Coping efficacy interacted with coping efforts in predicting distress for those with health downturns; efficacy in coping was associated with less distress only for those who were actively engaged in coping. Analyses of longitudinal data replicated the cross-sectional findings for coping with loss.

Activities of Daily Living↗