1. CHAPTER 22: Stress and Resilience in Women With Rheumatic Disease

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

3. 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.

4. 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.

5. Reproductive Choices, Sexuality, and Social Roles Sexuality – More gynecological problems – Lower sexual functioning – Poorer body image – Greater depression, pain, and fatigue

6. 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.

7. Differences Across Demographics and Culture Ethnicity and Socioeconomic Status – Role of acculturation Religion and Spirituality – Benefits of prayer – Coping

8. 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.

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

10. Stress and Resilience Interpersonal-Level Stress and Implications for Intervention – Involving close others in psychosocial interventions – Focus on communication, social support, understanding of disease

11. Stress and Resilience Resilience – Growing body of research is revealing the complex pathways through which positive affect influences physical health and even longevity.

12. Future Directions Focus on contextual variables, such as gender and culture Understanding the contribution of gender is critically important, but remains a challenge