Coping mediates the influence of personality on life satisfaction in patients with rheumatic diseases


A rheumatic disease can severely impair a person’s quality of life. The degree of impairment, however, is not closely related to objective indicators of disease severity. This study investigated the influence and the interplay of core psychological factors, i.e., personality and coping, on life satisfaction in patients with rheumatic diseases. Particularly, it was tested whether coping mediates the effects of personality on life satisfaction. In a cross-sectional design, 158 patients diagnosed with a rheumatic disease completed questionnaires assessing the Big 5 personality traits (BFI-10), several disease-related coping strategies (EFK) and life satisfaction (HSWBS). Data were analyzed using a complex multiple mediation analysis with the Big 5 personality traits as predictors, coping strategies as mediators and life satisfaction as outcome. All personality traits and seven of the nine coping strategies were associated with life satisfaction (rs > |0.16|, ps ≤ 0.05). The mediation analysis revealed that personality traits had no direct, but rather indirect effects on life satisfaction through coping. Neuroticism had a negative indirect effect on life satisfaction through less active problem solving and more depressive coping (indirect effects > −0.03, ps < 0.05). Extraversion, agreeableness, and conscientiousness had positive indirect effects on life satisfaction through more active problem solving, less depressive coping and/or a more active search for social support (indirect effects > 0.06, ps < 0.05). Personality and coping play a role in adjustment to rheumatic diseases. The interplay of these variables should be considered in psychological interventions for patients with rheumatic diseases.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Global Burden of Disease Study 2013 Collaborators (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386:743–800. doi:10.1016/s0140-6736(15)60692-4

    Article  PubMed Central  Google Scholar 

  2. 2.

    WHO Chronic Rheumatic Conditions, Fact Sheet, WHO, Geneva, available at:

  3. 3.

    Patten SB, Williams JV, Wang J (2006) Mental disorders in a population sample with musculoskeletal disorders. BMC Musculoskel Dis 7:37–46. doi:10.1186/1471-2474-7-37

    Article  Google Scholar 

  4. 4.

    Geenen R, Newman S, Bossema ER, Vriezekolk JE, Boelen PA (2012) Psychological interventions for patients with rheumatic diseases and anxiety or depression. Best Pract Res Cl Rh 26:305–319. doi:10.1016/j.berh.2012.05.004

    Article  Google Scholar 

  5. 5.

    Nyklíček I, Hoogwegt F, Westgeest T (2015) Psychological distress across twelve months in patients with rheumatoid arthritis: the role of disease activity, disability, and mindfulness. J Psychosom Res 78:162–167. doi:10.1016/j.jpsychores.2014.08.004

    Article  PubMed  Google Scholar 

  6. 6.

    Pollard LC, Choy EH, Gonzalez J, Khoshaba B, Scott DL (2006) Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology 45:885–889. doi:10.1093/rheumatology/kel021

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Stanton AL, Revenson TA, Tennen H (2007) Health psychology: psychological adjustment to chronic disease. Annu Rev Psychol 58:565–592. doi:10.1146/annurev.psych.58.110405.085615

    Article  PubMed  Google Scholar 

  8. 8.

    de Ridder D, Geenen R, Kuijer R, van Middendorp H (2008) Psychological adjustment to chronic disease. Lancet 372:246–255. doi:10.1016/s0140-6736(08)61078-8

    Article  PubMed  Google Scholar 

  9. 9.

    Bolger N, Zuckerman A (1995) A framework for studying personality in the stress process. J Pers Soc Psychol 69:890–902. doi:10.1037/0022-3514.69.5.890

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Benyon K, Hill S, Zadurian N, Mallen C (2010) Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review. Musculoskelet Care 8:224–236. doi:10.1002/msc.187

    Article  Google Scholar 

  11. 11.

    Ramjeet J, Smith J, Adams M (2008) The relationship between coping and psychological and physical adjustment in rheumatoid arthritis: a literature review. J Clin Nurs 17:418–428. doi:10.1111/j.1365-2702.2008.02579.x

    Article  PubMed  Google Scholar 

  12. 12.

    Vriezekolk JE, van Lankveld WGJM, Geenen R, van den Ende CHM (2011) Longitudinal association between coping and psychological distress in rheumatoid arthritis: a systematic review. Ann Rheum Dis 70:1243–1250. doi:10.1136/ard.2010.143271

    Article  PubMed  Google Scholar 

  13. 13.

    Benka J, Nagyova I, Rosenberger J, Macejova Z, Lazurova I, van der Klink J et al (2014) Is coping self-efficacy related to psychological distress in early and established rheumatoid arthritis patients? J Dev Phys Disabil 26:285–297. doi:10.1007/s10882-013-9364-y

    Google Scholar 

  14. 14.

    Persson LO, Sahlberg D (2002) The influence of negative illness cognitions and neuroticism on subjective symptoms and mood in rheumatoid arthritis. Ann Rheum Dis 61:1000–1006

    Article  PubMed  PubMed Central  Google Scholar 

  15. 15.

    Suurmeijer TPBM, van Sonderen FLP, Krol B, Doeglas DM, van den Heuvel WJA, Sanderman R (2005) The relationship between personality, supportive transactions and support satisfaction, and mental health of patients with early rheumatoid arthritis. Results from the Dutch part of the EURIDISS study. Soc Indic Res 73:179–197. doi:10.1007/s11205-004-0562-y

    Article  Google Scholar 

  16. 16.

    Steel P, Schmidt J, Shultz J (2008) Refining the relationship between personality and subjective well-being. Psychol Bull 134:138–161. doi:10.1037/0033-2909.134.1.138

    Article  PubMed  Google Scholar 

  17. 17.

    Hayes AF, Preacher KJ (2014) Statistical mediation analysis with a multicategorical independent variable. Br J Math Stat Psychol 67:451–470. doi:10.1111/bmsp.12028

    Article  PubMed  Google Scholar 

  18. 18.

    Rammstedt B, John OP (2007) Measuring personality in one minute or less: a 10-item short version of the Big Five Inventory in English and German. J Res Pers 41:203–212. doi:10.1016/j.jrp.2006.02.001

    Article  Google Scholar 

  19. 19.

    Franke GH, Mähner N, Reimer J, Spangemacher B, Esser J (2000) Erste Überprüfung des Essener Fragebogens zur Krankheitsverarbeitung (EFK) an sehbeeinträchtigten Patienten [First evaluation of the Essener Coping Questionnaire (EFK) in patients with visual impairment]. J Individ Differ 21:166–172

    Google Scholar 

  20. 20.

    Dalbert C (1992) Subjektives Wohlbefinden junger Erwachsener: theoretische und empirische Analysen der Struktur und Stabilität [Subjective well-being of young adults: theoretical and empirical analyses of structure and stability]. J Individ Differ 13:207–220

    Google Scholar 

  21. 21.

    Ferguson E, Patterson F (1998) The five factor model of personality: openness a distinct but related construct. Pers Indiv Differ 24:789–796. doi:10.1016/S0191-8869(97)00241-9

    Article  Google Scholar 

  22. 22.

    Vriezekolk JE, Geenen R, van den Ende CHM, Slot H, van Lankveld WGJM, van Helmond T (2012) Behavior change, acceptance, and coping flexibility in highly distressed patients with rheumatic diseases: feasibility of a cognitive-behavioral therapy in multimodal rehabilitation. Patient Educ Couns 87:171–177. doi:10.1016/j.pec.2011.09.001

    Article  PubMed  Google Scholar 

  23. 23.

    Knittle K, Maes S, de Gucht V (2010) Psychological interventions for rheumatoid arthritis: examining the role of self-regulation with a systematic review and meta-analysis of randomized controlled trials. Arthritis Care Res 62:1460–1472. doi:10.1002/acr.20251

    Article  Google Scholar 

  24. 24.

    Astin JA, Beckner W, Soeken K, Hochberg MC, Berman B (2002) Psychological interventions for rheumatoid arthritis: a meta-analysis of randomized controlled trials. Arthritis Care Res 47:291–302. doi:10.1002/art.10416

    Article  Google Scholar 

  25. 25.

    Shin SY, Kolanowski AM (2010) Best evidence of psychosocially focused nonpharmacologic therapies for symptom management in older adults with osteoarthritis. Pain Manag Nurs 11:234–244. doi:10.1016/j.pmn.2009.06.001

    Article  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Manja Vollmann.

Ethics declarations

Participation was voluntary and anonymous. The study was approved by the Ethical Committee of the Bremen State Chamber of Physicians.




No funding was received for this study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vollmann, M., Pukrop, J. & Salewski, C. Coping mediates the influence of personality on life satisfaction in patients with rheumatic diseases. Clin Rheumatol 35, 1093–1097 (2016).

Download citation


  • Big 5 personality traits
  • Coping
  • Life satisfaction
  • Mediation
  • Rheumatic diseases