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The Influence of Perceived Stress on the Onset of Arthritis in Women: Findings from the Australian Longitudinal Study on Women’s Health

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Psychosocial factors are considered as risk factors for some chronic diseases. A paucity of research exists surrounding the role of perceived stress in arthritis onset.

Purpose

Perceived stress as a risk factor for arthritis development was explored in an ageing cohort of Australian women.

Methods

This study focused on 12,202 women from the 1946–1951 cohort who completed the Australian Longitudinal Study on Women’s Health surveys in 2001, 2004 and 2007. Longitudinal associations were modelled, with and without a time lag.

Results

Findings from the multivariate time lag modelling, excluding women with persistent joint pain, revealed that perceived stress predicted the onset of arthritis, with women experiencing minimal and moderate/high stress levels having a 1.7 and 2.4 times greater odds of developing arthritis 3 years later, respectively (p’s < 0.001).

Conclusion

Chronically perceiving life as stressful is detrimental to future health. The findings provide support for perceived stress to be considered alongside other modifiable risk factors.

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References

  1. Access Economics. Painful Realities: The Economic Impact of Arthritis in Australia in 2007. Sydney: Arthritis Australia;2007.

  2. Badley EM, Kasman NM. The impact of arthritis on Canadian women. BMC Womens Health. 2004;4(Suppl 1):S18.

    Article  PubMed  Google Scholar 

  3. National Arthritis and Musculoskeletal Conditions Advisory Group. Evidence to Support the National Action Plan for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis: Opportunities to Improve Health-Related Quality of Life and Reduce the Burden of Disease and Disability. Canberra: Australian Government Department of Health and Ageing; 2004.

    Google Scholar 

  4. CDC. Prevalence and most common causes of disability among adults—United States, 2005. MMWR Morb Mortal Wkly Rep. 2009;58(16):421-426.

    Google Scholar 

  5. Parkinson L, Gibson R, Robinson I, Byles J. Older women and arthritis: Tracking impact over time. Australas J Ageing. 2010;29(4):155-160.

    Article  PubMed  Google Scholar 

  6. CDC. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2003–2005. MMWR Morb Mortal Wkly Rep. 2006;55(40):1089-1092.

    Google Scholar 

  7. Knox SA, Harrison CM, Britt HC, Henderson JV. Estimating prevalence of common chronic morbidities in Australia. Med J Aust. 2008;189(2):66-70.

    PubMed  Google Scholar 

  8. Helmick CG, Felson DT, Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum. 2008;58(1):15-25.

    Article  PubMed  Google Scholar 

  9. McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365(23):2205-2219.

    Article  PubMed  CAS  Google Scholar 

  10. Williams FM, Spector TD. Biomarkers in osteoarthritis. Arthritis Res Ther. 2008;10(1):101.

    Article  PubMed  Google Scholar 

  11. Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res. 2002;4(Suppl 3):S265-272.

    Article  PubMed  Google Scholar 

  12. MacGregor AJ, Li Q, Spector TD, Williams FM. The genetic influence on radiographic osteoarthritis is site specific at the hand, hip and knee. Rheumatol. 2009;48(3):277-280.

    Article  CAS  Google Scholar 

  13. Cooper C, Snow S, McAlindon TE, et al. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000;43(5):995-1000.

    Article  PubMed  CAS  Google Scholar 

  14. Felson DT, Lawrence RC, Dieppe PA, et al. Osteoarthritis: New insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000;133(8):635-646.

    Article  PubMed  CAS  Google Scholar 

  15. Symmons DP. Epidemiology of rheumatoid arthritis: Determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol. 2002;16(5):707-722.

    Article  PubMed  Google Scholar 

  16. Buckwalter JA, Lappin DR. The disproportionate impact of chronic arthralgia and arthritis among women. Clin Orthop Relat Res. 2000;372:159-168.

    Article  PubMed  Google Scholar 

  17. Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis Cartilage. 2005;13(9):769-781.

    Article  PubMed  Google Scholar 

  18. Lee DM, Weinblatt ME. Rheumatoid arthritis. Lancet. 2001;358(9285):903-911.

    Article  PubMed  CAS  Google Scholar 

  19. MacGregor AJ, Antoniades L, Matson M, Andrew T, Spector TD. The genetic contribution to radiographic hip osteoarthritis in women: Results of a classic twin study. Arthritis Rheum. 2000;43(11):2410-2416.

    Article  PubMed  CAS  Google Scholar 

  20. Silman AJ, MacGregor AJ, Thomson W, et al. Twin concordance rates for rheumatoid arthritis: Results from a nationwide study. Br J Rheumatol. 1993;32(10):903-907.

    Article  PubMed  CAS  Google Scholar 

  21. Felson DT, Zhang Y, Hannan MT, et al. Risk factors for incident radiographic knee osteoarthritis in the elderly: The Framingham Study. Arthritis Rheum. 1997;40(4):728-733.

    Article  PubMed  CAS  Google Scholar 

  22. Seavey WG, Kurata JH, Cohen RD. Risk factors for incident self-reported arthritis in a 20 year follow-up of the Alameda County Study Cohort. J Rheumatol. 2003;30(10):2103-2111.

    PubMed  Google Scholar 

  23. Wilder FV, Hall BJ, Barrett JP Jr, Lemrow NB. History of acute knee injury and osteoarthritis of the knee: A prospective epidemiological assessment. The Clearwater Osteoarthritis Study. Osteoarthritis Cartilage. 2002;10(8):611-616.

    Article  PubMed  CAS  Google Scholar 

  24. Maetzel A, Makela M, Hawker G, Bombardier C. Osteoarthritis of the hip and knee and mechanical occupational exposure—a systematic overview of the evidence. J Rheumatol. 1997;24(8):1599-1607.

    PubMed  CAS  Google Scholar 

  25. Felson DT, Hannan MT, Naimark A, et al. Occupational physical demands, knee bending, and knee osteoarthritis: Results from the Framingham Study. J Rheumatol. 1991;18(10):1587-1592.

    PubMed  CAS  Google Scholar 

  26. Costenbader KH, Feskanich D, Mandl LA, Karlson EW. Smoking intensity, duration, and cessation, and the risk of rheumatoid arthritis in women. Am J Med. 2006;119(6):503.e1-503.e9.

    Article  Google Scholar 

  27. Silman AJ, Newman J, MacGregor AJ. Cigarette smoking increases the risk of rheumatoid arthritis. Results from a nationwide study of disease-discordant twins. Arthritis Rheum. 1996;39(5):732-735.

    Article  PubMed  CAS  Google Scholar 

  28. Stolt P, Bengtsson C, Nordmark B, et al. Quantification of the influence of cigarette smoking on rheumatoid arthritis: Results from a population based case–control study, using incident cases. Ann Rheum Dis. 2003;62(9):835-841.

    Article  PubMed  CAS  Google Scholar 

  29. Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: A review of the epidemiology, risk and treatment evidence. Med J Aust. 2009;190(7 Suppl):S54-60.

    PubMed  Google Scholar 

  30. Kune S, Kune GA, Watson LF, Rahe RH. Recent life change and large bowel cancer. Data from the Melbourne Colorectal Cancer Study. J Clin Epidemiol. 1991;44(1):57-68.

    Article  PubMed  CAS  Google Scholar 

  31. Wulsin LR, Singal BM. Do depressive symptoms increase the risk for the onset of coronary disease? A systematic quantitative review. Psychosom Med. 2003;65(2):201-210.

    Article  PubMed  Google Scholar 

  32. Kopec JA, Sayre EC. Traumatic experiences in childhood and the risk of arthritis: A prospective cohort study. Can J Public Health. 2004;95(5):361-365.

    PubMed  Google Scholar 

  33. Fuller-Thomson E, Stefanyk M, Brennenstuhl S. The robust association between childhood physical abuse and osteoarthritis in adulthood: Findings from a representative community sample. Arthritis Rheum. 2009;61(11):1554-1562.

    Article  PubMed  Google Scholar 

  34. Von Korff M, Alonso J, Ormel J, et al. Childhood psychosocial stressors and adult onset arthritis: Broad spectrum risk factors and allostatic load. Pain. 2009;143(1–2):76-83.

    Article  Google Scholar 

  35. Lazarus RS, Folkman S. Transactional theory and research on emotions and coping. Eur J Pers. 1987;1(3):141-169.

    Article  Google Scholar 

  36. Evers AW, Kraaimaat FW, Geenen R, Jacobs JW, Bijlsma JW. Stress-vulnerability factors as long-term predictors of disease activity in early rheumatoid arthritis. J Psychosom Res. 2003;55(4):293-302.

    Article  PubMed  Google Scholar 

  37. Zautra AJ, Hoffman JM, Matt KS, et al. An examination of individual differences in the relationship between interpersonal stress and disease activity among women with rheumatoid arthritis. Arthritis Care Res. 1998;11(4):271-279.

    Article  PubMed  CAS  Google Scholar 

  38. Rios R, Zautra AJ. Socioeconomic disparities in pain: The role of economic hardship and daily financial worry. Health Psychol. 2011;30(1):58-66.

    Article  PubMed  Google Scholar 

  39. Zautra AJ, Smith BW. Depression and reactivity to stress in older women with rheumatoid arthritis and osteoarthritis. Psychosom Med. 2001;63(4):687-696.

    PubMed  CAS  Google Scholar 

  40. Curtis R, Groarke A, Coughlan R, Gsel A. Psychological stress as a predictor of psychological adjustment and health status in patients with rheumatoid arthritis. Patient Educ Couns. 2005;59(2):192-198.

    Article  PubMed  Google Scholar 

  41. Treharne GJ, Lyons AC, Booth DA, Kitas GD. Psychological well-being across 1 year with rheumatoid arthritis: Coping resources as buffers of perceived stress. Brit J Health Psychol. 2007;12(Pt 3):323-345.

    Article  Google Scholar 

  42. Evers AW, Kraaimaat FW, Geenen R, Bijlsma JW. Determinants of psychological distress and its course in the first year after diagnosis in rheumatoid arthritis patients. J Behav Med. 1997;20(5):489-504.

    Article  PubMed  CAS  Google Scholar 

  43. Dekkers JC, Geenen R, Evers AW, Kraaimaat FW, Bijlsma JW, Godaert GL. Biopsychosocial mediators and moderators of stress–health relationships in patients with recently diagnosed rheumatoid arthritis. Arthritis Rheum. 2001;45(4):307-316.

    Article  PubMed  CAS  Google Scholar 

  44. Brown GK, Wallston KA, Nicassio PM. Social support and depression in rheumatoid arthritis: A one-year prospective study. J Appl Soc Psychol. 1989;19:1164-1181.

    Article  Google Scholar 

  45. Fitzpatrick R, Newman S, Archer R, Shipley M. Social support, disability and depression: A longitudinal study of rheumatoid arthritis. Soc Sci Med. 1991;33:605-611.

    Article  PubMed  CAS  Google Scholar 

  46. Affleck G, Tennen H, Urrows S, Higgins P. Person and contextual features of daily stress reactivity: Individual differences in relations of undesirable daily events with mood disturbance and chronic pain intensity. J Pers Soc Psychol. 1994;66(2):329-340.

    Article  PubMed  CAS  Google Scholar 

  47. Lee C, Dobson AJ, Brown WJ, et al. Cohort profile: The Australian Longitudinal Study on Women’s Health. Int J Epidemiol. 2005;34(5):987-991.

    Article  PubMed  Google Scholar 

  48. Brown WJ, Bryson L, Byles JE, et al. Women’s Health Australia: Recruitment for a national longitudinal cohort study. Women Health. 1998;28(1):23-40.

    PubMed  CAS  Google Scholar 

  49. Brown WJ, Bryson L, Byles JE, et al. Women’s Health Australia: Establishment of the Australian Longitudinal Study on Women’s Health. Women Health. 1996;5(5):467-472.

    Article  Google Scholar 

  50. Bombard JM, Powell KE, Martin LM, Helmick CG, Wilson WH. Validity and reliability of self-reported arthritis: Georgia senior centers, 2000–2001. Am J Prev Med. 2005;28(3):251-258.

    Article  PubMed  Google Scholar 

  51. Sacks JJ, Harrold LR, Helmick CG, Gurwitz JH, Emani S, Yood RA. Validation of a surveillance case definition for arthritis. J Rheumatol. 2005;32(2):340-347.

    PubMed  Google Scholar 

  52. CDC. Prevalence of doctor-diagnosed arthritis and possible arthritis—30 states, 2002. MMWR Morb Mortal Wkly Rep. 2004;53(18):383-386.

    Google Scholar 

  53. Women’s Health Australia. ALSWH data dictionary supplement. 2007; http://www.alswh.org.au/for-researchers/data/data-dictionary-supplement. Accessibility verified July 24, 2009.

  54. Strodl E, Kenardy J, Aroney C. Perceived stress as a predictor of the self-reported new diagnosis of symptomatic CHD in older women. Int J Behav Med. 2003;10(3):205-220.

    Article  PubMed  Google Scholar 

  55. Beatty LJ, Adams J, Sibbritt D, Wade TD. Evaluating the impact of cancer on complementary and alternative medicine use, distress and health related QoL among Australian women: A prospective longitudinal investigation. Complement Ther Med. 2012;20(1–2):61-69.

    Article  PubMed  CAS  Google Scholar 

  56. Bell S, Lee C. Development of the perceived stress questionnaire for young women. Psychol Health Med. 2002;7(2):189-201.

    Article  Google Scholar 

  57. Bell S, Lee C. Perceived stress revisited: The Women’s Health Australia project young cohort. Psychol Health Med. 2003;8(3):343-353.

    Article  Google Scholar 

  58. Norbeck JS. Modification of life event questionnaires for use with female respondents. Res Nurs Health. 1984;7(1):61-71.

    Article  PubMed  CAS  Google Scholar 

  59. Australian Bureau of Statistics. 1989–1990 National Health Survey Users Guide. Canberra: ABS; 1991.

    Google Scholar 

  60. Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705-714.

    Article  PubMed  CAS  Google Scholar 

  61. WHO Consultation on Obesity. Obesity: Report to WHO Consultation. Geneva: World Health Organization; 1999.

    Google Scholar 

  62. Armstrong T, Bauman A, Davies J. Physical Activity Patterns of Australian Adults: Results of the 1999 National Physical Activity Survey. Canberra: Australian Institute of Health and Welfare; 2000.

    Google Scholar 

  63. AIHW. National Health Data Dictionary. version 6.0. Standard questions on the use of tobacco among adults: Australian Institute of Health and Welfare;1997.

  64. Department of Primary Industries and Energy. Rural, Remote and Metropolitan Areas Classification: 1991 Census Edition. Canberra: Australian Government Publishing Service; 1994.

    Google Scholar 

  65. Brambilla DJ, McKinlay SM, Johannes CB. Defining the perimenopause for application in epidemiologic investigations. Am J Epidemiol. 1994;140(12):1091-1095.

    PubMed  CAS  Google Scholar 

  66. Twisk JR. Applied Longitudinal Data Analysis for Epidemiology. Cambridge: Cambridge University Press; 2003.

    Google Scholar 

  67. Chan KW, Felson DT, Yood RA, Walker AM. The lag time between onset of symptoms and diagnosis of rheumatoid arthritis. Arthritis Rheum. 1994;37(6):814-820.

    Article  PubMed  CAS  Google Scholar 

  68. Bedson J, Jordan K, Croft P. The prevalence and history of knee osteoarthritis in general practice: A case–control study. Fam Pract. 2005;22(1):103-108.

    Article  PubMed  Google Scholar 

  69. Kumar K, Daley E, Carruthers DM, et al. Delay in presentation to primary care physicians is the main reason why patients with rheumatoid arthritis are seen late by rheumatologists. Rheumatol. 2007;46(9):1438-1440.

    Article  CAS  Google Scholar 

  70. Cutolo M, Straub RH. Stress as a risk factor in the pathogenesis of rheumatoid arthritis. Neuroimmunomodulation. 2006;13(5–6):277-282.

    Article  PubMed  CAS  Google Scholar 

  71. Marques-Deak A, Cizza G, Sternberg E. Brain–immune interactions and disease susceptibility. Mol Psychiatry. 2005;10(3):239-250.

    Article  PubMed  CAS  Google Scholar 

  72. Kudielka BM, Kirschbaum C. Sex differences in HPA axis responses to stress: A review. Biol Psychol. 2005;69(1):113-132.

    Article  PubMed  Google Scholar 

  73. McEwen BS. Protection and damage from acute and chronic stress: Allostasis and allostatic overload and relevance to the pathophysiology of psychiatric disorders. Ann N Y Acad Sci. 2004;1032:1-7.

    Article  PubMed  Google Scholar 

  74. McEwen BS, Wingfield JC. What is in a name? Integrating homeostasis, allostasis and stress. Horm Behav. 2010;57(2):105-111.

    Article  PubMed  Google Scholar 

  75. McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171-179.

    Article  PubMed  CAS  Google Scholar 

  76. Perry BD, Azad I. Posttraumatic stress disorders in children and adolescents. Curr Opin Pediatr. 1999;11(4):310-316.

    Article  PubMed  CAS  Google Scholar 

  77. Perry BD, Pollard RH, Blakley TL, Baker WL, Vigilante D. Childhood trauma, the neurobiology of adaption and use-dependent development of the brain: How states become traits. Infant Ment Health J. 1995;16(4):271-291.

    Article  Google Scholar 

  78. Hawkley LC, Berntson GG, Engeland CG, Marucha PT, Masi CM, Cacioppo JT. Stress, aging and resilience: Can accrued wear and tear be slowed? Can Psychol. 2005;46(3):115-125.

    Article  Google Scholar 

  79. Epel ES, Blackburn EH, Lin J, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA. 2004;101(49):17312-17315.

    Article  PubMed  CAS  Google Scholar 

  80. Sibille KT, Langaee T, Burkley B, et al. Chronic pain, perceived stress, and cellular aging: An exploratory study. Mol Pain. 2012;8(1):12.

    Article  PubMed  Google Scholar 

  81. McEwen BS, Stellar E. Stress and the individual. Mechanisms leading to disease. Arch Intern Med. 1993;153(18):2093-2101.

    Article  PubMed  CAS  Google Scholar 

  82. Velasquez MT, Katz JD. Osteoarthritis: Another component of metabolic syndrome? Metab Syndr Relat Disord. 2010;8(4):295-305.

    Article  PubMed  Google Scholar 

  83. Schnurr PP, Green BL. Understanding relationships among trauma, posttraumatic stress disorder, and health outcomes. In: Schnurr PP, Green BL, eds. Physical Health Consequences of Exposure to Extreme Stress. Washington DC: American Psychological Association; 2004:150-159.

    Chapter  Google Scholar 

  84. Jood K, Redfors P, Rosengren A, Blomstrand C, Jern C. Self-perceived psychological stress and ischemic stroke: A case–control study. BMC Med. 2009;7:53.

    Article  PubMed  Google Scholar 

  85. Grimby-Ekman A, Andersson EM, Hagberg M. Analyzing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: A cohort study. BMC Musculoskelet Disord. 2009;10:73.

    Article  PubMed  Google Scholar 

  86. Smith BW, Papp ZZ, Montague EQ, Robinson AE, Cosper CJ. Traumatic events, perceived stress and health in women with fibromyalgia and healthy controls. Stress Health. 2010;26:83-93.

    Article  Google Scholar 

  87. McEwen BS. Stress, adaptation, and disease. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33-44.

    Article  PubMed  CAS  Google Scholar 

  88. Magin P, Sibbritt D, Bailey K. The relationship between psychiatric illness and skin disease. Arch Dermatol. 2009;145(8):896-902.

    Article  PubMed  Google Scholar 

  89. March LM, Schwarz JM, Carfrae BH, Bagge E. Clinical validation of self-reported osteoarthritis. Osteoarthritis Cartilage. 1998;6(2):87-93.

    Article  PubMed  CAS  Google Scholar 

  90. Bagge E, Bjelle A, Eden S, Svanborg A. Osteoarthritis in the elderly: Clinical and radiological findings in 79 and 85 year olds. Ann Rheum Dis. 1991;50(8):535-539.

    Article  PubMed  CAS  Google Scholar 

  91. Kean WF, Kean R, Buchanan WW. Osteoarthritis: Symptoms, signs and source of pain. Inflammopharmacology. 2004;12(1):3-31.

    Article  PubMed  CAS  Google Scholar 

  92. Bagge E, Bjelle A, Eden S, Svanborg A. A longitudinal study of the occurrence of joint complaints in elderly people. Age Ageing. 1992;21(3):160-167.

    Article  PubMed  CAS  Google Scholar 

  93. Wang J, Korczykowski M, Rao H, et al. Gender difference in neural response to psychological stress. Soc Cogn Affect Neurosci. 2007;2(3):227-239.

    Article  PubMed  Google Scholar 

  94. Jezova D, Jurankova E, Mosnarova A, Kriska M, Skultetyova I. Neuroendocrine response during stress with relation to gender differences. Acta Neurobiol Exp (Wars). 1996;56(3):779-785.

    CAS  Google Scholar 

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Acknowledgements

The research on which this paper is based was conducted as part of the Australian Longitudinal Study on Women’s Health, the University of Newcastle and the University of Queensland. We are grateful to the Australian Government Department of Health and Ageing for funding and to the women who provided the survey data.

Conflict of Interest Statement

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Priority Research Centre for Gender, Health and Ageing, Faculty of Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia

    Melissa L. Harris B.A., Deborah Loxton Ph.D, David W. Sibbritt Ph.D & Julie E. Byles Ph.D

  2. Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia

    David W. Sibbritt Ph.D

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  1. Melissa L. Harris B.A.
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  2. Deborah Loxton Ph.D
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Correspondence to Melissa L. Harris B.A..

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Harris, M.L., Loxton, D., Sibbritt, D.W. et al. The Influence of Perceived Stress on the Onset of Arthritis in Women: Findings from the Australian Longitudinal Study on Women’s Health. ann. behav. med. 46, 9–18 (2013). https://doi.org/10.1007/s12160-013-9478-6

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