Annals of Behavioral Medicine

, Volume 30, Issue 1, pp 44–53

Styles of emotion regulation and their associations with perceived health in patients with rheumatoid arthritis

  • Henriët van Middendorp
  • Rinie Geenen
  • Marjolijn J. Sorbi
  • Joop J. Hox
  • Ad J. J. M. Vingerhoets
  • Lorenz J. P. van Doornen
  • Johannes W. J. Bijlsma


Background: Patients with rheumatoid arthritis face the challenge of adjusting to adverse health consequences and accompanying emotions. Styles of emotion regulation may affect health.Purpose: The objective is to examine associations between styles of emotion regulation and perceived health, consisting of psychological well-being, social functioning, physical functioning, and disease activity.Methods: Principal component analysis was used to summarize styles of emotion regulation of 335 patients with rheumatoid arthritis. Relationships between emotion regulation and perceived health were examined with structural equation modeling.Results: Four styles of emotion regulation were identified: ambiguity, control, orientation, and expression. Ambiguity and control were mutually correlated, as were orientation and expression. Styles of emotion regulation were not uniquely related to perceived physical functioning and disease activity. Emotional ambiguity and orientation were related to poorer, whereas expression and control were related to more favorable psychological well-being and social functioning.Conclusions: Our cross-sectional study suggests that emotion regulation is not of direct importance for perceived somatic health of patients with rheumatoid arthritis, but it may be of importance for psychological well-being and social functioning, and perhaps through this route for somatic health. The more conscious and controlled aspects of control and expression are positively related to psychosocial health, and the more unconscious automatic aspects of ambiguity and orientation are negatively related. Changing emotion regulation will potentially affect psychosocial health. It would be worthwhile to verify this possibility in prospective research.


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Copyright information

© The Society of Behavioral Medicine 2005

Authors and Affiliations

  • Henriët van Middendorp
    • 1
  • Rinie Geenen
    • 1
  • Marjolijn J. Sorbi
    • 1
  • Joop J. Hox
    • 2
  • Ad J. J. M. Vingerhoets
    • 3
  • Lorenz J. P. van Doornen
    • 1
  • Johannes W. J. Bijlsma
    • 4
  1. 1.Department of Health PsychologyUtrecht UniversityUtrechtThe Netherlands
  2. 2.Department of Methodology and StatisticsUtrecht UniversityThe Netherlands
  3. 3.Department of Psychology and Health Tilburg UniversityCenter of Research on Psychology in Somatic disease (CoRPS)The Netherlands
  4. 4.Department of Rheumatology and Clinical ImmunologyUniversity Medical Center UtrechtThe Netherlands

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