CHAPTER 22:Stress and Resilience in Women

With Rheumatic Disease

Introduction

• Rheumatic disease refers to over 100 different types of illnesses affecting the joints, tissues that surround joints, and other connective tissue.

Introduction

• Rheumatoid Arthritis (RA)– 70% are middle-aged women.

• Systemic Lupus Erythematosus (SLE)– Occurs 10 times more frequently in females than

males.– Typically develops during young adulthood.

Reproductive Choices, Sexuality, and Social Roles

• Reproductive Choices– Timing– Medical treatments can compromise ability to

conceive.– Pregnancy may put women at risk for disease

flares.

Reproductive Choices, Sexuality, and Social Roles

• Sexuality– More gynecological problems– Lower sexual functioning– Poorer body image– Greater depression, pain, and fatigue

Reproductive Choices, Sexuality, and Social Roles

• Social Roles– Division of household responsibilities may need to

be shifted.– Acceptance and flexibility are key in adapting to

changing roles.• May influence mental health.

Differences Across Demographics and Culture

• Ethnicity and Socioeconomic Status– Role of acculturation

• Religion and Spirituality– Benefits of prayer– Coping

Stress and Resilience

• Stress has an impact on quality of life and can exacerbate disease activity.

• Interpersonal stress in particular is an important variable in the study of women with rheumatic disease.

Stress and Resilience

• Individual-Level Stress and Implications for Intervention– CBT– Psychoeducation– Emotional disclosure– Group counseling– Stress management– Biofeedback

Stress and Resilience

• Interpersonal-Level Stress and Implications for Intervention– Involving close others in psychosocial

interventions– Focus on communication, social support,

understanding of disease

Stress and Resilience

• Resilience– Growing body of research is revealing the complex

pathways through which positive affect influences physical health and even longevity.

Future Directions

• Focus on contextual variables, such as gender and culture

• Understanding the contribution of gender is critically important, but remains a challenge