Differential relationships between stress and disease activity for immunologically distinct subgroups of people with rheumatoid arthritis.

Immunologically distinct subgroups of patients with rheumatoid arthritis (RA)--those with the autoantibody rheumatoid factor (seropositive RA) and those without (seronegative RA)--were compared on a variety of clinical and self-report measures in a consecutive series of women with disease of 7 years' or less duration. The groups were comparable on clinical, pain, functional, and psychosocial variables. However, the seronegative RA group reported elevated levels of preonset negative life event stress. Postonset life event stress and disease activity were significantly correlated for the seronegative RA group, but not for the seropositive RA group. Results suggest that stress factors may be more important in the etiology and maintenance of seronegative RA and that the seronegative RA group may possibly derive particular benefit from psychological techniques to enhance stress management skills.