Cultural Syndromes and Age Moderate the Emotional Impact of Illness Intrusiveness in Rheumatoid Arthritis

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Objective:The authors investigated cultural syndromes (multidimensional vectors comprising culturally based attitudes, values, and beliefs) and age as moderators of the emotional impact of illness intrusiveness—illness-induced lifestyle disruptions— in rheumatoid arthritis (RA) and examined illness intrusiveness effects in total and separately for three life domains (relationships and personal development, intimacy, and instrumental).Research Method/Design:People with RA (n = 105) completed the Illness Intrusiveness Ratings, Individualism–Collectivism, and Center for Epidemiologic Studies—Depression scales in a one-on-one interview.Results:Controlling for disease and background characteristics, the association between illness intrusiveness (total score and the Relationships and Personal Development subscale) and distress was inverse when young adults with RA endorsed high horizontal individualism. Illness intrusiveness into intimacy was associated with increased distress, and this intensified when respondents endorsed high vertical individualism, horizontal collectivism, vertical collectivism, or low horizontal individualism. The negative emotional impact of illness intrusiveness into intimacy diminished with increasing age.Conclusion:Given an aging and increasingly pluralistic society, diversity can no longer be ignored in addressing the psychosocial impact of chronic, disabling disease.

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