Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-04-30T13:22:29.765Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychological factors in symptom severity and quality of life in Raynaud’s phenomenon

Published online by Cambridge University Press:  29 January 2024

Dulcie Irving Open the ORCID record for Dulcie Irving [Opens in a new window]  and
Jo Daniels Open the ORCID record for Jo Daniels [Opens in a new window]
Dulcie Irving
Affiliation:
Department of Psychology, University of Bath, Bath, UK
Jo Daniels*
Affiliation:
Department of Psychology, University of Bath, Bath, UK
*
Corresponding author: Jo Daniels; Email: j.daniels@bath.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Despite emotional stress being recognised as a key trigger for Raynaud’s phenomenon episodes, research in the area is still in its infancy.

Aims:

This study investigated the role of psychological factors relating to symptom severity and quality of life, and differences between Raynaud’s types (primary and secondary) to further inform the development of intervention in this field.

Method:

A cross-sectional design was used. Two hundred and ten adults with Raynaud’s completed an online questionnaire measuring stress, anxiety, depression, anxiety sensitivity, beliefs about emotions, symptom severity and quality of life.

Results:

Primary and secondary Raynaud’s groups differed in anxiety (p < .004), symptom severity (p < .001) and quality of life (p < .001). Stepwise multiple regressions indicated anxiety and Raynaud’s type explained 23% variance in hand symptom severity (p < .001); anxiety, Raynaud’s type and anxiety sensitivity explained 29% variance in symptom severity (global impact, p < .001); depression, Raynaud’s type and anxiety sensitivity explained 32% variance in quality of life (p < .001).

Conclusions:

Results highlight the importance of psychological factors in Raynaud’s phenomenon, indicating possible targets for treatment. Interventions such as cognitive behavioural therapy, which target both physical and psychological wellbeing, bear some promise as an adjuvant therapy for this group.

Keywords

AnxietyBeliefsDepressionQuality of lifeRaynaud’s phenomenonSymptoms
Type
Main
Information
Behavioural and Cognitive Psychotherapy , First View , pp. 1 - 14
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychological Association (2019). What’s the Difference Between Stress and Anxiety? Retrieved from: https://www.apa.org/topics/stress-anxiety-difference Google Scholar
Anyfanti, P., Triantafyllou, A., Panagopoulos, P., Triantafyllou, G., Pyrpasopoulou, A., Chatzimichailidou, S., Koletsos, N., Botis, I., Aslanidis, S., & Douma, S. (2016). Predictors of impaired quality of life in patients with rheumatic diseases. Clinical Rheumatology, 35, 1705–1711. https://doi.org/10.1007/s10067-015-3155-z CrossRefGoogle ScholarPubMed
Asmundson, G. J. G., Wright, K. D., & Hadjistavropoulos, H. D. (2000). Anxiety sensitivity and disabling chronic health conditions: state of the art and future directions. Scandinavian Journal of Behaviour Therapy, 29, 100–117. https://doi.org/10.1080/028457100300049719 Google Scholar
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176. https://doi.org/10.1037/1040-3590.10.2.176 CrossRefGoogle Scholar
Bernstein, M. T., Mackenzie, C. S., Sareen, J., Dufault, B., Hitchon, C., & El-Gabalawy, R. (2019). Examining the cross-sectional and longitudinal effects of anxiety sensitivity on indicators of disease severity among patients with inflammatory arthritis. Journal of Anxiety Disorders, 67, 102117. https://doi.org/10.1016/j.janxdis.2019.102117 CrossRefGoogle ScholarPubMed
Bowers, H., & Wroe, A. (2016). Beliefs about emotions mediate the relationship between emotional suppression and quality of life in irritable bowel syndrome. Journal of Mental Health, 25, 154–158. https://doi.org/10.3109/09638237.2015.1101414 CrossRefGoogle ScholarPubMed
Brooks, S. K., Chalder, T., & Rimes, K. A. (2017). Chronic fatigue syndrome: cognitive, behavioural and emotional processing vulnerability factors. Behavioural and Cognitive Psychotherapy, 45, 156–169. https://doi.org/10.1017/S1352465816000631 CrossRefGoogle ScholarPubMed
Brown, K. M., Middaugh, S. J., Haythornthwaite, J. A., & Bielory, L. (2001). The effects of stress, anxiety, and outdoor temperature on the frequency and severity of Raynaud’s attacks: the Raynaud’s Treatment Study. Journal of Behavioral Medicine, 24, 137–153. https://doi.org/10.1023/a:1010758530555 CrossRefGoogle ScholarPubMed
Camfield, L., & Skevington, S. M. (2008). On subjective well-being and quality of life. Journal of Health Psychology, 13, 764–775. https://doi.org/10.1177/1359105308093860 CrossRefGoogle ScholarPubMed
Choi, E., & Henkin, S. (2021). Raynaud’s phenomenon and related vasospastic disorders. Vascular Medicine, 26, 56–70. https://doi.org/10.1177/1358863X20983455 CrossRefGoogle ScholarPubMed
Crawford, J. R., & Henry, J. D. (2003). The Depression Anxiety Stress Scales (DASS): normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42, 111–131. https://doi.org/10.1348/014466503321903544 CrossRefGoogle Scholar
Daniels, J. (2021). ‘We have seen principles of CBT trickle down into the mainstream’. The Psychologist, 16 September 2021. https://www.bps.org.uk/psychologist/we-have-seen-principles-cbt-trickle-down-mainstream Google Scholar
Daniels, J., & Turner-Cobb, J. M. (2017). Adjuvant psychological therapy in long-term endocrine conditions. Clinical Endocrinology, 86, 772–777. https://doi.org/10.1111/cen.13341 CrossRefGoogle ScholarPubMed
Daniels, J., Pauling, J. D., & Eccleston, C. (2018). Behaviour change interventions for the management of Raynaud’s phenomenon: a systematic literature review. BMJ Open, 8, e024528. https://doi.org/10.1136/bmjopen-2018-024528 CrossRefGoogle ScholarPubMed
Daré, L. O., Bruand, P. E., Gérard, D., Marin, B., Lameyre, V., Boumédiène, F., & Preux, P. M. (2019). Co-morbidities of mental disorders and chronic physical diseases in developing and emerging countries: a meta-analysis. BMC Public Health, 19, 1–12. https://doi.org/10.1186/s12889-019-6623-6 Google ScholarPubMed
De Angelis, R., Salaffi, F., & Grassi, W. (2008). Health-related quality of life in primary Raynaud phenomenon. Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases, 14, 206–210. https://doi.org/10.1097/RHU.0b013e31817a2485 CrossRefGoogle ScholarPubMed
DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 2101–2107. https://doi.org/10.1001/archinte.160.14.2101 CrossRefGoogle ScholarPubMed
Edwards, C. M., Marshall, J. M., & Pugh, M. (1998). Lack of habituation of the pattern of cardiovascular response evoked by sound in subjects with primary Raynaud’s disease. Clinical Science, 95, 249–260. https://doi.org/10.1042/cs0950249 CrossRefGoogle ScholarPubMed
EuroQol (2017). EQ-5D. https://euroqol.org/eq-5d-instruments/eq-5d-3l-about/ Google Scholar
Evers, A. W. M., Zautra, A., & Thieme, K. (2011). Stress and resilience in rheumatic diseases: a review and glimpse into the future. Nature Reviews. Rheumatology, 7, 409–415. https://doi.org/10.1038/nrrheum.2011.80 CrossRefGoogle ScholarPubMed
Fabian, B., Csiki, Z., & Bugan, A. (2020). Alexithymia and emotion regulation in patients with Raynaud’s disease. Journal of Clinical Psychology, 76, 1696–1704. https://doi.org/10.1002/jclp.22947 CrossRefGoogle ScholarPubMed
Fábián, B., Fábián, A. K., Bugán, A., & Csiki, Z. (2019). Comparison of mental and physical health between patients with primary and secondary Raynaud’s phenomenon. Journal of Psychosomatic Research, 116, 6–9. https://doi.org/10.1016/j.jpsychores.2018.11.001 CrossRefGoogle ScholarPubMed
Fardoun, M. M., Nassif, J., Issa, K., Baydoun, E., & Eid, A. H. (2016). Raynaud’s phenomenon: a brief review of the underlying mechanisms. Frontiers in Pharmacology, 7. https://doi.org/10.3389/fphar.2016.00438 CrossRefGoogle Scholar
Field, A. (2013). Discovering Statistics Using IBM SPSS Statistics (5th edn). London: SAGE.Google Scholar
Freedman, R. R., & Ianni, P. (1983). Role of cold and emotional stress in Raynaud’s disease and scleroderma. British Medical Journal, 287, 1499–1502. https://doi.org/10.1136/bmj.287.6404.1499 CrossRefGoogle ScholarPubMed
Freedman, R. R., & Ianni, P. (1985). Effects of general and thematically relevant stressors in Raynaud’s disease. Journal of Psychosomatic Research, 29, 275–280. https://doi.org/10.1016/0022-3999(85)90054-6 CrossRefGoogle ScholarPubMed
Garner, R., Kumari, R., Lanyon, P., Doherty, M., & Zhang, W. (2015). Prevalence, risk factors and associations of primary Raynaud’s phenomenon: systematic review and meta-analysis of observational studies. BMJ Open, 5, e006389. https://doi.org/10.1136/bmjopen-2014-006389 CrossRefGoogle ScholarPubMed
Gigante, A., Villa, A., Pellicano, C., & Rosato, E. (2020). In systemic sclerosis patients the anxiety disorder and Raynaud’s phenomenon are increased during lock down period for COVID-19 pandemic. Internal and Emergency Medicine, 16, 1095–1096. https://doi.org/10.1007/s11739-020-02557-z CrossRefGoogle Scholar
Gosling, S. D., & Mason, W. (2015). Internet research in psychology. Annual Review of Psychology, 66, 877–902. https://doi.org/10.1146/annurev-psych-010814-015321 CrossRefGoogle ScholarPubMed
Geenen, R., & Dures, E. (2019). A biopsychosocial network model of fatigue in rheumatoid arthritis: a systematic review. Rheumatology, 58 (suppl 5), v10–v21. https://doi.org/10.1093/rheumatology/kez403 CrossRefGoogle ScholarPubMed
Harth, M., & Nielson, W. R. (2019). Pain and affective distress in arthritis: relationship to immunity and inflammation. Expert Review of Clinical Immunology, 15, 541–552. https://doi.org/10.1080/1744666X.2019.1573675 CrossRefGoogle ScholarPubMed
Horenstein, A., Potter, C. M., & Heimberg, R. G. (2018). How does anxiety sensitivity increase risk of chronic medical conditions? Clinical Psychology: Science and Practice, 25, e12248. https://doi.org/10.1111/cpsp.12248 Google Scholar
Hudson, M., Thombs, B. D., Steele, R., Watterson, R., Taillefer, S., Baron, M., & Canadian Scleroderma Research Group Investigators (2008). Clinical correlates of quality of life in systemic sclerosis measured with the World Health Organization Disability Assessment Schedule II. Arthritis and Rheumatism, 59, 279–284. https://doi.org/10.1002/art.23344 CrossRefGoogle ScholarPubMed
Hughes, M., Snapir, A., Wilkinson, J., Snapir, D., Wigley, F. M., & Herrick, A. L. (2015). Prediction and impact of attacks of Raynaud’s phenomenon, as judged by patient perception. Rheumatology, 54, 1443–1447. https://doi.org/10.1093/rheumatology/kev002 CrossRefGoogle ScholarPubMed
Jones, S. D., Steiner, A., Garrett, S. L., & Calin, A. (1996). The Bath Ankylosing Spondylitis Patient Global Score (BAS-G). British Journal of Rheumatology, 35, 66–71. https://doi.org/10.1093/rheumatology/35.1.66 CrossRefGoogle ScholarPubMed
Kallen, M. A., Mayes, M. D., Kriseman, Y. L., de Achaval, S. B., Cox, V. L., & Suarez-Almazor, M. E. (2010). The symptom burden index: development and initial findings from use with patients with systemic sclerosis. Journal of Rheumatology, 37, 1692–1698. https://doi.org/10.3899/jrheum.090504 CrossRefGoogle ScholarPubMed
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd edn). Sydney, NSW: University of New South Wales.Google Scholar
Marques, A., Santos, E., Nikiphorou, E., Bosworth, A., & Carmona, L. (2021). Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. RMD Open, 7, e001647. https://doi.org/10.1136/rmdopen-2021-001647 CrossRefGoogle ScholarPubMed
Marmura, M. J. (2018). Triggers, protectors, and predictors in episodic migraine. Current Pain and Headache Reports, 22, 81. https://doi.org/10.1007/s11916-018-0734-0 CrossRefGoogle ScholarPubMed
Mehta, S., Rice, D., Janzen, S., Pope, J. E., Harth, M., Shapiro, A. P., & Teasell, R. W. (2016). Mood, disability, and quality of life among a subgroup of rheumatoid arthritis individuals with experiential avoidance and anxiety sensitivity. Pain Research & Management, 2016, 7241856. https://doi.org/10.1155/2016/7241856 Google ScholarPubMed
Meier, F. M., Frommer, K. W., Dinser, R., Walker, U. A., Czirjak, L., Denton, C. P., Allanore, Y., Distler, O., Riemekasten, G., Valentini, G., Müller-Ladner, U. , & EUSTAR Co-authors (2012). Update on the profile of the EUSTAR cohort: an analysis of the EULAR Scleroderma Trials and Research group database. Annals of the Rheumatic Diseases, 71, 1355–1360. https://doi.org/10.1136/annrheumdis-2011-200742 CrossRefGoogle ScholarPubMed
Miaskowski, C., Blyth, F., Nicosia, F., Haan, M., Keefe, F., Smith, A., & Ritchie, C. (2020). A biopsychosocial model of chronic pain for older adults. Pain Medicine, 21, 1793–1805. https://doi.org/10.1093/pm/pnz329 CrossRefGoogle ScholarPubMed
Moseley, G. L., & Butler, D. S. (2015). Fifteen years of explaining pain: the past, present, and future. Journal of Pain, 16, 807–813. https://doi.org/10.1016/j.jpain.2015.05.005 CrossRefGoogle ScholarPubMed
Murphy, S. L., Lescoat, A., Alore, M., Hughes, M., Pauling, J. D., Sabbagh, M., & Khanna, D. (2021). How do patients define Raynaud’s phenomenon? Differences between primary and secondary disease. Clinical Rheumatology, 40, 1611–1616. https://doi.org/10.1007/s10067-021-05598-7 CrossRefGoogle ScholarPubMed
Newton, E. G., Thombs, B. D., & Groleau, D. (2012). The experience of emotional distress among women with scleroderma. Qualitative Health Research, 22, 1195–1206. https://doi.org/10.1177/1049732312449207 CrossRefGoogle ScholarPubMed
National Institute of Health Excellence (2020). Generalised Anxiety Disorder and Panic Disorder in Adults: Management. NICE. https://www.nice.org.uk/guidance/cg113/chapter/Recommendations Google Scholar
National Institute of Health Excellence (2022). Scenario: Management of Raynaud’s Phenomenon. NICE. https://cks.nice.org.uk/topics/raynauds-phenomenon/management/management/ Google Scholar
NHS England (2018). The Improving Access to Psychological Therapies (IAPT) Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms. https://www.england.nhs.uk/wp-content/uploads/2018/03/improving-access-to-psychological-therapies-long-term-conditions-pathway.pdf Google Scholar
Office for National Statistics (2018). Personal well-being in the UK. https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/methodologies/personalwellbeingintheukqmi Google Scholar
Ouimet, A. J., Kane, L., & Tutino, J. S. (2016). Fear of anxiety or fear of emotions? Anxiety sensitivity is indirectly related to anxiety and depressive symptoms via emotion regulation. Cogent Psychology, 3, 1249132. https://doi.org/10.1080/23311908.2016.1249132 CrossRefGoogle Scholar
Parent, M. C. (2012). Handling item-level missing data: simpler is just as good. The Counseling Psychologist, 41, 568–600. https://doi.org/10.1177/0011000012445176 CrossRefGoogle Scholar
Pauling, J. D., Domsic, R. T., Saketkoo, L. A., Almeida, C., Withey, J., Jay, H., Frech, T. M., Ingegnoli, F., Dures, E., Robson, J., McHugh, N. J., Herrick, A. L., Matucci-Cerinic, M., Khanna, D., & Hewlett, S. (2018). Multinational qualitative research study exploring the patient experience of Raynaud’s phenomenon in systemic sclerosis. Arthritis Care & Research, 70, 1373–1384. https://doi.org/10.1002/acr.23475 CrossRefGoogle ScholarPubMed
Peterson, R. A., & Plehn, K. (1999). Measuring anxiety sensitivity. In Anxiety Sensitivity: Theory, Research, and Treatment of the Fear of Anxiety (pp. 61–81). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8. https://doi.org/10.1016/0005-7967(86)90143-9 CrossRefGoogle ScholarPubMed
Rettie, H., & Daniels, J. (2021). Coping and tolerance of uncertainty: predictors and mediators of mental health during the COVID-19 pandemic. American Psychologist, 76, 427. https://doi.org/10.1037/amp0000710 CrossRefGoogle ScholarPubMed
Rimes, K. A., & Chalder, T. (2010). The Beliefs about Emotions Scale: validity, reliability and sensitivity to change. Journal of Psychosomatic Research, 68, 285–292. https://doi.org/10.1016/j.jpsychores.2009.09.014 CrossRefGoogle ScholarPubMed
Ryan, S., & McGuire, B. (2016). Psychological predictors of pain severity, pain interference, depression, and anxiety in rheumatoid arthritis patients with chronic pain. British Journal of Health Psychology, 21, 336–350. https://doi.org/10.1111/bjhp.12171 CrossRefGoogle ScholarPubMed
Shapiro, S. C., & Wigley, F. M. (2017). Treating Raynaud phenomenon: beyond staying warm. Cleveland Clinic Journal of Medicine, 84, 797–804. https://doi.org/10.3949/ccjm.84a.17025 CrossRefGoogle ScholarPubMed
Sierakowska, M., Doroszkiewicz, H., Sierakowska, J., Olesińska, M., Grabowska-Jodkowska, A., Brzosko, M., Leszczyński, P., Pawlak-Buś, K., Batko, B., Wiland, P., Majdan, M., Bykowska-Sochacka, M., Romanowski, W., Zon-Giebel, A., Jeka, S., & Ndosi, M. (2019). Factors associated with quality of life in systemic sclerosis: a cross-sectional study. Quality of Life Research, 28, 3347–3354. https://doi.org/10.1007/s11136-019-02284-9 CrossRefGoogle ScholarPubMed
Smitherman, T. A., Davis, R. E., Walters, A. B., Young, J., & Houle, T. T. (2014). Anxiety sensitivity and headache: diagnostic differences, impact, and relations with perceived headache triggers. Cephalalgia, 35, 710–721. https://doi.org/10.1177/0333102414557840 CrossRefGoogle ScholarPubMed
Tinkler, L., & Hicks, S. (2011). Measuring subjective well-being. London: Office for National Statistics, 2011, 443–455. https://webarchive.nationalarchives.gov.uk/ukgwa/20160105160709/http://www.ons.gov.uk/ons/guide-method/user-guidance/well-being/wellbeing-knowledge-bank/understanding-wellbeing/measuring-subjective-well-being.pdf Google Scholar
Wan, S. W., He, H.-G., Mak, A., Lahiri, M., Luo, N., Cheung, P. P., & Wang, W. (2016). Health-related quality of life and its predictors among patients with rheumatoid arthritis. Applied Nursing Research, 30, 176–183. https://doi.org/10.1016/j.apnr.2015.07.004 CrossRefGoogle ScholarPubMed
Waltz, C. F., Strickland, O. L., & Lenz, E. R. (1991). Measurement in Nursing Research (2nd edn). New York: Springer Publishing Company.Google Scholar
Wanous, J. P., Reichers, A. E., & Hudy, M. J. (1997). Overall job satisfaction: how good are single-item measures? Journal of applied Psychology, 82, 247–252. https://doi.org/10.1037/0021-9010.82.2.247 CrossRefGoogle ScholarPubMed
Wroe, A. L., & Bowers, H. M. (2019). Beliefs about sharing illness experiences: development of a scale and relationship with symptoms of fibromyalgia. British Journal of Health Psychology, 24, 687–703. https://doi.org/10.1111/bjhp.12376 CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.